2014-04-25T10:31:54-05:00 2013-06-30 990 2012-07-01 540566029 NORTON COMMUNITY HOSPITAL INC NORT 2766799600 100 15TH STREET NW NORTON VA 24273 STEPHEN SAWYER 2766799600 2014-04-25 false 2012 2015-11-30 17:44:51Z MARK LEONARD 100 15TH STREET NW NORTON VA 24273 64157865 false X WWW.MSHA.COM/NCH X 1949 VA PART I, LINE 1 ORGANIZATION'S MISSION: NORTON COMMUNITY HOSPITAL (NCH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH. 14 1 563 23 64272 44063 40281 46598 63092112 62231683 895140 1032218 560147 702525 64587680 64013024 127216 125100 0 35956826 35223910 0 0 26321606 27863770 62405648 63212780 2182032 800244 80140242 88215652 31004052 37707405 49136190 50508247 X PART I, LINE 1 ORGANIZATION'S MISSION: NORTON COMMUNITY HOSPITAL (NCH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH. false false 52772304 125100 62468971 NORTON COMMUNITY HOSPITAL (NCH) IS LOCATED IN THE HEART OF SOUTHWEST VIRGINIA AND THE APPALACHIAN MOUNTAINS. IT IS A NOT-FOR-PROFIT, 129-BED, ACUTE-CARE FACILITY, PROUDLY SERVING SOUTHWEST VIRGINIA AND SOUTHEASTERN KENTUCKY SINCE 1949. OUR MISSION IS TO BE A LEADER IN IMPROVING THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY, BY WORKING TOGETHER AS A TEAM DEDICATED TO EXCELLENCE. AS THE LARGEST HEALTHCARE FACILITY IN THE COALFIELD REGION, NCH PROVIDES A WIDE ARRAY OF SERVICES THROUGH HIGHLY TRAINED PHYSICIANS AND SUPPORT STAFF. NCH IS A MEMBER OF THE VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION AND IS ACCREDITED BY THE AMERICAN OSTEOPATHIC ASSOCIATION. NCH WAS THE FIRST AOA ACCREDITED TEACHING FACILITY IN THE STATE OF VIRGINIA. (CONT.'D ON SCHEDULE O) THE INTERNAL MEDICINE RESIDENTS OF THIS PROGRAM ROTATE THROUGH ALL AREAS OF MEDICINE, FROM HEALTH MAINTENANCE TO CRITICAL CARE. THE RESIDENTS ASSIST OUR PHYSICIANS IN PROVIDING QUALITY HANDS ON PATIENT CARE, THROUGH OBSERVATIONS, EDUCATION AND BY PARTICIPATING IN GRAND ROUNDS. IN ADDITION TO THESE SERVICES WITHIN THE HOSPITAL SETTING, THE RESIDENTS ARE ALSO EXPOSED TO TREATING PATIENTS IN AN OFFICE SETTING AT THE COMMUNITY CLINIC (RESIDENT CONTINUITY CLINIC)IN WISE, VIRGINIA. THE VIRGINIA HEALTH QUALITY CENTER (VHQC), A NONPROFIT HEALTH QUALITY CONSULTING COMPANY, SELECTED WINNERS IN SIX CATEGORIES FOR THEIR CONTRIBUTIONS TO IMPROVING HEALTH CARE FOR PATIENTS IN VIRGINIA. MOUNTAIN STATES HEALTH ALLIANCE'S VIRGINIA HOSPITALS, WHICH INCLUDE NORTON COMMUNITY HOSPITAL, EARNED THE HONOR FOR THEIR PATIENT-CENTERED CARE. THE WINNERS WERE ANNOUNCED DURING QUALITYSYNC, VHQC'S ANNUAL LEARNING EVENT, HELD IN RICHMOND, AND WERE SELECTED FROM NEARLY 30 NOMINATIONS. "MSHA'S VIRGINIA HOSPITALS DEVELOPED AN INNOVATIVE APPROACH TO BRINGING A PATIENT-CENTERED APPROACH TO ALL OF ITS FACILITIES", THE VHQC STATED IN A NEWS RELEASE. "BY ESTABLISHING 10 GUIDING PRINCIPLES AND INCORPORATING THEM INTO EACH HOSPITAL'S OPERATIONS, THIS ORGANIZATION HAS SIGNIFICANTLY IMPROVED PATIENT-PROVIDER RELATIONSHIPS, ENVIRONMENTS AND SERVICE DELIVERY". IN JANUARY 2013, NORTON COMMUNITY HOSPITAL OPENED A STATE-OF-THE-ART SURGICAL ADDITION. THIS CONSTRUCTION WAS INITIATED DUE TO THE DILAPIDATED APPEARANCE AND DISREPAIR OF THE OLD SURGERY SUITE. THE ADDITION ADDED NEW TECHNOLOGIES THAT ARE AVAILABLE IN TODAY'S MARKET TO IMPROVE NCH'S ABILITY TO PROVIDE THE BEST PROVISION OF SURGICAL SERVICES TO OUR PATIENTS. REPLACING OUR OLD ANTIQUATED SURGICAL SUITE ALSO PROVIDES AN INCENTIVE FOR RECRUITMENT OF SURGEONS TO OUR RURAL COMMUNITY. THE NEW ADDITION WAS DESIGNED WITH AN INPATIENT ENTRANCE FROM THE HOSPITAL AS WELL AS A PICK-UP/DROP-OFF AREA TO ACCOMMODATE OUR PATIENTS AND MEET THEIR REQUESTS FOR IMPROVING INCOMING/OUTGOING TRANSPORT. OUR NEW SURGERY SUITE ALLOWS OUR PATIENTS TO HAVE THE SAME TYPE OF CARE THAT THEY WOULD PREVIOUSLY HAVE HAD TO ENDURE EXCESSIVE TRAVEL FOR IN ORDER TO REACH A LARGE HOSPITAL. OUR NEW SURGERY SUITE IS ALSO BEING USED BY THE REMOTE AREA MEDICAL (RAM) PROGRAM. RAM PROVIDES FREE HEALTHCARE TO MANY CITIZENS FROM THE COUNTIES THAT ARE WITHIN OUR SERVICE AREA THAT DO NOT HAVE HEALTH INSURANCE. WE OFFER OUR SURGERY SUITE FREE OF CHARGE TO RAM FOR USE BY ORAL SURGEONS TO PERFORM PEDIATRIC DENTAL SURGERY. THE CHILDREN BENEFITING FROM THIS SERVICE WOULD NOT RECEIVE THIS CARE IF NOT FOR RAM AND THE USE OF OUR SURGERY SUITE. TO IMPROVE ACCESS TO PRIMARY CARE, NORTON COMMUNITY HOSPITAL, INC. OPERATES SEVERAL CLINICS: COMMUNITY PHYSICIANS-NORTON, COMMUNITY PHYSICIANS-COEBURN, COMMUNITY PHYSICIANS-WISE, COMMUNITY ORTHOPEDICS, NORWISE OB/GYN, COMMUNITY CLINIC - WISE (RESIDENT CONTINUITY CLINIC), OCCUMED HEALTH CENTER AND THE WISE PROFESSIONAL OFFICE BUILDING WHICH OFFERS PHYSICIAN OFFICE SPACE AND IS HOME TO OUR COMPREHENSIVE HOME HEALTH SERVICES. OUR MEDICAL STAFF CONSISTS OF OVER 130 PHYSICIANS AND SURGEONS WITH SPECIALTY TRAINING IN: FAMILY PRACTICE, INTERNAL MEDICINE, EAR-NOSE-THROAT, GENERAL SURGERY, UROLOGY, PEDIATRICS, EMERGENCY MEDICINE, GERIATRIC MEDICINE, CRITICAL CARE, CARDIOLOGY, PULMONOLOGY, RADIOLOGY, ONCOLOGY, NEUROLOGY, ORTHOPEDICS, GASTROENTEROLOGY, OPTHALMOLOGY, OBSTETRICS, GYNECOLOGY AND DENTISTRY. PROGRAMS AND SERVICES INCLUDE INTENSIVE CARE/CRITICAL CARE/ CORONARY CARE, 24-HOUR EMERGENCY ROOM SERVICES, PEDIATRIC CARE, LASER SURGERY, OUTPATIENT SURGERY, LITHOTRIPSY SERVICES, HOME HEALTH, HYPERBARIC MEDICINE, DIETARY/NUTRITION SUPPORT, PHARMACY, INPATIENT AND OUTPATIENT SURGICAL SERVICES, 12-BED INTENSIVE CARE UNIT, PASTORAL CARE, VOLUNTEER SERVICES, HELPING HANDS GIFT SHOP, COMMUNITY OUTREACH AND EDUCATION PROGRAMS, SCREENING SERVICES, AND UVA TELEMEDICINE AND PAIN MANAGEMENT. OUR RADIOLOGICAL SERVICES INCLUDE ANGIOGRAPHY, MAMMOGRAPHY, ULTRASOUND, STEREOTACTIC BREAST BIOPSY, NUCLEAR MEDICINE, PET SCANS, IN-HOUSE MAGNETIC RESONANCE IMAGING UNIT (MRI), AND CT SCANNER. IN 2012 OUR RADIOLOGY DEPARTMENT RECEIVED ACCREDITATION FOR ITS PET SERVICES THROUGH THE AMERICAN COLLEGE OF RADIOLOGY. THIS LATEST ACR ACCREDITATION IS ONE OF SEVERAL THE RADIOLOGY DEPARTMENT HAS RECEIVED OVER THE LAST YEAR. THE OTHERS INCLUDE NUCLEAR MEDICINE, MAMMOGRAPHY AND MRI, WITH MRI STAFF OBTAINING THEIR CERTIFICATION THIS YEAR AS WELL. THE FAMILY BIRTHING CENTER HAS SIX (6) SEMI-PRIVATE GYNECOLOGICAL SUITES AND SEVEN (7) LDRP (LABOR, DELIVERY, RECOVERY, AND POSTPARTUM) SUITES THAT OFFER COMFORT, CARE, AND COMPASSION THAT IS UNPARALLELED IN THE REGION. WE OFFER PREPARED CHILDBIRTH, PARENTING, SIBLING AND SAFE-SITTER CLASSES, INCLUDING EDUCATION ON BREASTFEEDING AND WOMEN'S HEALTH. THE CENTER ALSO OFFERS A SPECIAL AREA FOR CESAREAN SECTIONS AND ROUTINE GYNECOLOGICAL PROCEDURES. OUR CARDIOPULMONARY SERVICES DEPARTMENT PROVIDES AN EXTENSIVE LINE OF CARDIAC, PULMONARY AND NEURO-DIAGNOSTIC SERVICES. THEY ALSO PROVIDE A COMPREHENSIVE SLEEP MEDICINE PROGRAM AS WELL AS AN APPROVED SITE FOR THE DEPARTMENT OF LABOR'S FEDERAL BLACK LUNG PROGRAM. THE REGIONAL REHAB CENTER OFFERS OCCUPATIONAL THERAPY, PHYSICAL THERAPY, SPEECH THERAPY, PULMONARY REHAB, ANODYNE THERAPY, CARDIAC REHABILITATION, CARDIOPULMONARY REHAB, SMOKING CESSATION CLASSES AND FIT-ONE, A COMMUNITY WELLNESS PROGRAM. OUR THREE YEAR, CARF ACCREDITED (COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES), 11-BED INPATIENT REHABILITATION UNIT PROVIDES A RESPONSIVE, CARING ENVIRONMENT THAT ENHANCES RECOVERY AND SPEEDS THE RETURN TO NORMAL LIFE FOR PATIENTS SUFFERING FROM STROKE, PARKINSON'S DISEASE, POLYNEUROPATHY, BRAIN INJURY AND HIP FRACTURES. THE INCIDENCE OF DIABETES IS ON THE RISE IN THE UNITED STATES WITH AN ALARMING NUMBER OF UNDIAGNOSED DIABETIC AND PRE-DIABETIC PATIENTS THAT ACTUALLY EXCEED THE NUMBER OF PATIENTS THAT HAVE BEEN DIAGNOSED WITH DIABETES. THE VIRGINIA DEPARTMENT OF HEALTH REPORTS THAT DIABETES IS THE 6TH LEADING CAUSE OF DEATH IN OUR STATE. IN ADDITION, THE SOUTHWEST VIRGINIA AND THE APPALACHIAN REGION EXCEEDS THE NATIONAL DIABETES PREVALENCE RATE. BEGINNING THIS FISCAL YEAR, NCH BEGAN TO PURSUE A DIABETES EDUCATION PROGRAM FOR OUR REGION. A SATELLITE PROGRAM WAS ESTABLISHED AT NORTON THROUGH THE JOHNSTON MEMORIAL HOSPITAL (JMH) PROGRAM. JMH IS AN AFFILIATE OF NCH LOCATED IN ABINGDON, VIRGINIA. NCH APPLIED FOR A CERTIFICATE OF RECOGNITION FROM THE AMERICAN DIABETES ASSOCIATION AND RECEIVED THE CERTIFICATION A FEW MONTHS FOLLOWING THE CLOSE OF THIS FISCAL YEAR. PRIOR TO THIS RECOGNITION, MANY PATIENTS HAD TO TRAVEL AT LEAST 1 TO 2 HOURS TO ACCESS THIS TYPE OF CARE. ALSO, MEDICARE PATIENTS CAN NOW RECEIVE 2 HOURS OF ONE-ON-ONE EDUCATION AND PARTICIPATE IN 8 HOURS OF GROUP EDUCATION IN THEIR FIRST YEAR OF PROGRAM PARTICIPATION SO THE ESTABLISHMENT OF THE DIABETES PROGRAM IN NORTON IS OF GREAT BENEFIT TO OUR MEDICARE-AGE RESIDENTS. WE ARE EXCITED THAT THIS SERVICE IS NOW AVAILABLE TO THE SOUTHWEST VIRGINIA REGION AND THE POSITIVE IMPACT THE NEW DIABETES PROGRAM WILL HAVE ON THE HEALTH OF OUR COMMUNITY MEMBERS. THE DIABETES CARE CENTER STAFF EDUCATE CLIENTS ABOUT DIABETES SELF-MANAGEMENT TECHNIQUES AND THEY HELP TAILOR A PLAN TO THE INDIVIDUAL TO FIT EACH PERSON'S SCHEDULE. TRAINING INCLUDES INFORMATION ABOUT MEDICATIONS, EATING HABITS, EXERCISE, AND BLOOD GLUCOSE MONITORING. NORTON COMMUNITY HOSPITAL HAS ENABLED BUSINESSES TO LOWER THEIR MEDICAL CARE COSTS THROUGH OUR COMPREHENSIVE OCCUPATIONAL MEDICINE PROGRAM AT OCCUMED HEALTH CENTER. OCCUMED OFFERS NURSING CASE MANAGEMENT, WORK-RELATED INJURY TREATMENT AND FOLLOW-UP, PRE-EMPLOYMENT PHYSICALS, DRUG SCREENINGS, VACCINATIONS, WORK-SITE SAFETY ANALYSIS, GENERAL HEALTH SCREENINGS, OSHA REGULATION COMPLIANCE ASSISTANCE, AND INDUSTRIAL REHABILITATION. COMMUNITY HOME CARE OFFERS DURABLE MEDICAL EQUIPMENT SUCH AS LIFT CHAIRS, MOTORIZED SCOOTERS, LIMB BRACES, DIABETIC SUPPLIES, TURBANS, AND A PRIVATE FITTING ROOM FOR MASTECTOMY FITTINGS. THE WANDA WAMPLER CENTER FOR WOMEN'S HEALTH HOUSES OUR COMPREHENSIVE WOMEN'S HEALTH SERVICES. THE CENTER OFFERS STEREOTACTIC BREAST BIOPSY, BONE DENSITOMETRY, AND DIGITAL MA 52772304 true true false true false false false false false false true true false true true true false true false false false false false false true false true true true false true false false false false false true true false false false false false true true true true false false true 150 0 true 563 true true true false false false false false false false false false X 14 1 false false false false true true true true true false true true true true true true true true true true false VA X ROWENA BLACK 2764391011 100 15TH STREET NW NORTON VA 24273 MARVIN EICHORN 2.00 58.00 X 0 620102 39538 ANN FLEMING 2.00 58.00 X 0 426280 66282 MATTHEW CUSANO MD 40.00 X 360158 0 43912 ALLEN MULLINS MD 40.00 X 299401 0 43542 JOHN DOYLE 10.00 40.00 X 0 229038 34966 ROBERT LEONARD 2.00 0.50 X 21054 0 0 CHARLES WARD 2.00 X 19497 0 0 BUFORD STURGILL 2.00 0.50 X 18117 0 0 JAMES MANICURE 2.00 0.50 X 16419 0 0 JOHN WRIGHT 2.00 0.50 X 15636 0 0 WILLIE PRICE-HARRIS 2.00 X 7279 0 0 BILL WAMPLER 2.00 X 7071 0 0 HARRY DOTSON 2.00 X 427 0 0 SANDRA BROOKS MD 2.00 6.00 X 0 0 0 MARK LEONARD 49.00 6.00 X 0 238735 42885 STEPHEN SAWYER 49.00 6.00 X 0 132632 20060 DAVID NAUSS MD 40.00 X 617122 0 41807 ISAM ZIBDEH MD 40.00 X 457421 0 31276 LATISHA HILTON MD 40.00 X 291584 0 10139 CHARLES BEGLEY MD 40.00 X 279149 0 40668 JODY BENTLEY MD 40.00 X 274161 0 43348 2684496 1646787 458423 33 false true false WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 PHYSICIAN FEES 1750907 LOCUMTENESCOM LLC PO BOX 405547 ATLANTA GA 303845547 PHYSICIAN FEES 342710 HANCOCK DANIEL JOHNSON & NAGLR PC PO BOX 72050 RICHMOND VA 232552050 LEGAL SERVICES 189136 DR TAMY E PERNG DO 224 CLINTON AVENUE E BIG STONE GAP VA 24219 PHYSICIAN FEES 139172 SHARED HEALTH SERVICES INC 207 E MAIN STREET STE 1E JOHNSON CITY TN 37604 MEDICAL SERV. 130316 6 16755 28644 1199 46598 PATIENT REVENUE 622110 59464414 59464414 WELLNESS PROGRAMS 622110 2716156 2716156 P/S INCOME FROM K-1 UBS 561000 34825 34825 LABORATORY 622110 16288 16288 62231683 832143 832143 451399 130365 321034 321034 47984 273050 145813 54262 145813 54262 200075 200075 17031 14476 2555 2555 CAFETERIA & VENDING 900099 141648 141648 MANAGEMENT FEES 900099 107338 107338 INSURANCE SETTLEMENT 900099 97984 97984 31966 31966 378936 64013024 62215395 64272 1686759 X 125100 125100 1382743 833897 548846 26505443 23163548 3341895 1076171 953095 123076 4574800 4468675 106125 1684753 1640687 44066 39122 39122 288404 4319 284085 90663 90663 64064 64064 6628912 5378290 1250622 206094 162163 43931 791128 699677 91451 389064 384225 4839 1149917 1044345 105572 242992 225130 17862 64914 64914 260268 260268 4074727 3033902 1040825 13020 13020 MEDICAL SUPPLIES 7500884 7456426 44458 MANAGEMENT FEES 4332196 1593942 2738254 REPAIRS & MAINTENANCE 1173839 1103873 69966 ALL OTHER 553562 436096 117466 63212780 52772304 10440476 0 663638 3076642 7795842 7771480 824224 793831 1197907 1119384 513243 875310 82961182 40597940 34740567 42363242 16622502 18029491 17782319 14186272 80140242 88215652 11745948 7930105 11663856 21238380 1919 7592329 8538920 31004052 37707405 X 49051085 50421089 85105 87158 49136190 50508247 80140242 88215652 X 800244 571813 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 2199 false false false 2199 false SCHEDULE C, PART II-B, LINE 1 PORTION OF DUES PAID TO VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION THAT ARE ATTRIBUTABLE TO DIRECT LOBBYING. 2111034 2111034 37582018 16098418 21483600 282116 161286 120830 40040644 24085447 15955197 2945370 252789 2692581 42363242 INVESTMENTS - OTHER 18029491 18029491 UNDER BOND INDENTURE AGREEMENTS 14064102 OTHER ASSETS 122170 14186272 RETIREE BENEFITS PAYABLE 7813149 RESERVE FOR PROF LIABILITIES 450645 DUE TO AFFILIATES 275126 8538920 X LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X "THE HOSPITAL IS CLASSIFIED AS AN ORGANIZATION EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS SUCH, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR THE HOSPITAL. COMMUNITY HOME CARE (CHC) IS A TAXABLE ENTITY AND ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC 740, INCOME TAXES (NOTE K). AT JUNE 30, 2013 TAX RETURNS FOR FISCAL YEARS 2010 THROUGH 2012 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE HOSPITAL HAS NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2013 AND 2012. AS SUCH, NO INTEREST OR PENALTIES WERE RECOGNIZED IN THE STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS RELATED TO UNRECOGNIZED TAX BENEFITS". BOOK SALES 17031 17031 14476 17031 17031 14476 14476 2555 PART II LINE 9 PERCENTAGE OF SALES PAID TO BOOK COMPANY true true true X true X true true true false true true 844094 844094 0.01340 14421429 8530165 5891264 0.09320 15265523 8530165 6735358 0.10660 98241 98241 0.00160 1809149 1162815 646334 0.01020 2227037 1373197 853840 0.01350 100100 100100 0.00160 4234527 2536012 1698515 0.02690 19500050 11066177 8433873 0.13340 24999 24999 0.00040 24999 24999 0.00040 true 7801594 5539132 15313712 14993006 320706 true true 1 1 NORTON COMMUNITY HOSPITAL

100 15TH STREET NW NORTON VA 24273

X X X X NORTON COMMUNITY HOSPITAL 1 true X X X X X X X 11 true true true X X X X X X X X false false true true 200.0 true 400.0 true X X X X X true true X X X X X true false true X false false RELATED ORGANIZATION INFORMATION PART I LINE 6A MOUNTAIN STATES HEALTH ALLIANCE PREPARED AND MADE PUBLIC A COMMUNITY BENEFIT REPORT TO INCLUDE INFORMATION FOR ALL OF THE HOSPITALS WITHIN THE HEALTH SYSTEMINCLUDING NCH COSTING METHODOLOGY EXPLANATION PART I LINE 7 A COST TO CHARGE RATIO WAS USED TO CALCULATE LINE 7 EXCEPT FOR LINE 7G UTILIZING THE SCHEDULE H APPLICABLE WORKSHEETS INCLUDING WORKSHEET 2 A RATIO OF PATIENT CARE COST TO GROSS PATIENT CHARGES LINE 7G USED DIRECT COSTS OF A SPECIFIC PROGRAM WE SUBTRACTED LINE 7G COLUMNC EXPENSE FROM WORKSHEET 2 LINE 4 SO THAT SUBSIDIZED HEALTH SERVICES COMMUNITY BENEFIT EXPENSE WOULD NOT BE DUPLICATED BAD DEBT EXPENSE EXPLANATION PART III LINE 4 OUR VICE PRESIDENT OF PATIENT FINANCIAL SERVICES ESTIMATES THAT 71 OF TOTAL BAD DEBT EXPENSE WAS ASSUMED ATTRIBUTABLE TO PATIENTS LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE WE HAVE MANY INSTANCES DURING THE YEAR OF PATIENTS WITH LARGE ACCOUNT BALANCES AND NO HEALTH INSURANCE COVERAGE THAT WE ARE SURE WOULD QUALIFY FOR CHARITY CARE ALTHOUGH HOSPITAL TEAM MEMBERS ENCOURAGE THESE INDIVIDUALS TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION MANY WILL NOT DO SO EVEN WHEN THESE INDIVIDUALS ARE TOLD WE FEEL SURE THEY DO QUALIFY FOR FULL OR PARTIAL ASSISTANCE THEY STILL REFUSE TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION REGARDING LINE 3 IT IS IMPLAUSIBLE TO DETERMINE THE AMOUNT OF NCHS BAD DEBT ASSOCIATED WITH THOSE PATIENTS WHO MAY HAVE MET THE CRITERIA SET FORTH IN OUR FINANCIAL ASSISTANCE POLICY WITHOUT HAVING A COMPLETED FINANCIAL ASSESSMENT WE ARE UNABLE TO DETERMINE OUR PATIENTS FINANCIAL CIRCUMSTANCES UNLESS A COMPLETED FINANCIAL ASSESSMENT FORM IS VOLUNTARILY PROVIDED TO US WE CAN ASSERT THAT MORE THAN 97 OF OUR PATIENTS WHO HAVE PROVIDED COMPLETED FINANCIAL ASSESSMENT FORMS HAVE BEEN APPROVED FOR AT LEAST PARTIAL FINANCIAL ASSISTANCE FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRDPARTY COVERAGE THE ALLIANCE ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS IF NECESSARY FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLE ACCOUNTS FOR WHICH THE THIRDPARTY PAYER HAS NOT PAID OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL THE ALLIANCE RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS REPORT THE AMOUNT OF ESTIMATED UNCOLLECTIBLE SELFPAY AND EXPLAIN THAT UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE ESTIMATED RESERVES ARE BASED UPON PRIOR COLLECTION HISTORY FOR GROUPS OF RECEIVABLES KNOWN COLLECTION RISKS AND OTHER ENVIRONMENTAL FACTORS INCLUDING THE AGE OF THE RECEIVABLES MEDICARE EXPLANATION PART III LINE 8 MEDICARE ALLOWABLE COSTS WERE REPORTED USING NCHS FILED MEDICARE COST REPORT CR THE CR USES A COST TO CHARGE RATIO BASED ON A STEPDOWN ALLOCATION METHODOLOGY IN CARING FOR THE PATIENT THERE ARE SEVERAL SERVICES THAT ARE CONSIDERED NONALLOWABLE SUCH AS TRANSPORTATION OF A PATIENT COMFORT ITEMS TO INCLUDE A TELEVISION MAGAZINES OR A TELEPHONE ADDITIONAL NONALLOWABLE COSTS INCLUDE THE RECRUITMENT OF PHYSICIANS PHYSICIAN GUARANTEES AND A PORTION OF THE BAD DEBT 12 ASSOCIATED WITH THE CARE OF THE PATIENT COLLECTION PRACTICES EXPLANATION PART III LINE 9B NCH PROVIDES A PATIENT FRIENDLY BILLING FLOW CHART ON ITS WEBSITE THAT GUIDES A PATIENT THROUGH THE PROCESS BEGINNING WITH ADMISSION AND ENDING WITH THE PATIENTS ACCOUNT BEING SUCCESSFULLY RESOLVED NCH FOLLOWS A STRONG COLLECTION PROGRAM THAT COMMUNICATES FINANCIAL RESPONSIBILITY TO THE PATIENT COLLECTION PRACTICES APPLY TO ALL PATIENTS CHARITY AND NONCHARITY CARE IN ROUTINE CIRCUMSTANCES WHEN IT IS DETERMINED THAT A PATIENT HAS NOT RESPONDED TO REQUESTS FOR PAYMENT AND HAS NOT PROVIDED INFORMATION TO ASCERTAIN ABILITY TO PAY AN ACCOUNT CAN BE REFERRED TO AN OUTSIDE COLLECTION AGENCY FOR COLLECTION ASSISTANCE NCH ENSURES THAT OUTSIDE COLLECTION AGENCIES FOLLOW HOSPITAL BILLING AND COLLECTION GUIDELINES ONCE A DELINQUENT PATIENT ACCOUNT HAS BEEN SUBMITTED TO AN OUTSIDE AGENCY IT CAN BE ADJUSTED TO CHARITY IF THE DETERMINATION IS LATER MADE THAT THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE ALL REQUESTS FOR FINANCIAL ASSISTANCE MUST BE ACCOMPANIED BY A COMPLETED FINANCIAL ASSESSMENT FORM AND SUPPORTING DOCUMENTATION NEEDS ASSESSMENT PART VI PART VI LINE 2 MSHA INCLUDED AMERICAS HEALTH RANKINGS AHR IN ITS ASSESSMENT IN ORDER TO BETTER DEFINE THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES TENNESSEE RANKS 42ND AND VIRGINIA RANSD 26TH HOWEVER IT SHOULD BE NOTED THAT SOUTHWEST VIRGINIA WHERE MSHA FACILITIES ARE LOCATED CLOSELY RESEMBLES THE HEALTH RANKINGS FOR TENNESSEE AMERICAS HEALTH RANKINGS ARE BASED ON A SERIES OF MEASURES INCLUDING SEVERAL HEALTH OUTCOMES AND HEALTH FACTORS A SURVEY WAS GIVEN TO 67 INDIVIDUALS REPRESENTING THE NINE COUNTIES IN WHICH MSHA OWNS A FACILITY THESE INDIVIDUALS INCLUDED PHYSICIANS PUBLIC HEALTH LEADERS NONPROFIT DIRECTORS SCHOOL NURSES AND OFFICIALS AND BUSINESS LEADERS A SURVEY WAS GIVEN TO EACH INDIVIDUAL SEEKING FEEDBACK REGARDING AVAILABLE RESOURCES IN EACH AREA THE HEALTH STATUS HEALTH PRIORITIES AND SUGGESTIONS FOR IMPROVEMENT THE MAJORITY OF RESPONSES SUGGESTED FOCUSING ON EDUCATION IN ORDER TO PROMOTE HEALTHY HABITS OTHER RESPONSES INCLUDED MAKE PHYSICAL EDUCATION A REQUIREMENT AS PART OF SCHOOL CURRICULUM IMPROVE NATURAL TRAILS AND WALKWAYS INCREASE COMMUNITY SUPPORT FOR SMOKEFREE AREAS PARTNER WITH LOCAL FARMERS MARKETS SHARE HEALTH INFORMATION BETWEEN PHARMACIES NETWORK WITH SMALL BUSINESSES AND NONPROFITS IN ORDER TO AVOID DUPLICATING RESOURCES AND PROVIDE EARLY SCREENINGS FOR THE UNINSURED OR UNDERINSURED OVERALL THE COMMUNITY MEMBERS GAVE MSHAS CORE SERVICE AREA A HEALTH STATUS RANKING OF 424 OUT OF 10 1 BEING THE LOWEST 10 BEING THE HIGHEST ALSO ALL 67 PARTICIPANTS AGREED THAT OBESITY CANCER HEART DISEASE AND DIABETES WERE THE TOP HEALTH PRIORITIES IN EACH COUNTY AHR REPORTS THAT TENNESSEE AND VIRGINIA BOTH SAW AN INCREASE IN DIABETES AND OBESITY WITHIN THE PAST TEN YEARS TENNESSEE ALSO RANKS 44TH FOR CARDIOVASCULAR DISEASE 45TH FOR CANCER DEATHS AND 46TH FOR DIABETES VIRGINIA OVERALL HAS A BETTER RANKING IN THESE THREE CATEGORIES BUT AS STATED EARLIER SOUTHWEST VIRGINIA CLOSELY RESEMBLES TENNESSEE SINCE COMPLETIN OF THE CHNA AND ITS IMPLEMENTATION PLAN MSHA HAS PARTNERED WITH SCHOOLS NONPROFIT AGENCIES AND OTHERS ON VARIOUS INITIATIVES TO ADDRESS HEALTHISSUES CHILDHOOD OBESITY IN PARTICULAR PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI PART VI LINE 3 NCH PROVIDES COMMUNICATION OF FINANCIAL ASSISTANCE ON ITS WEBSITE AND ON POSTERS LOCATED IN PROMINENT AREAS OF THE HOSPITAL SUCH AS ADMITTING AND THE EMERGENCY DEPARTMENT PRINTED EDUCATIONAL MATERIALS INCLUDING FINANCIAL ASSISTANCE CONTACT INFORMATION ARE ALSO PROVIDED IN EACH PATIENTS PAPERWORK POSTERS AND REFERENCE MATERIALS ARE WRITTEN IN BOTH ENGLISH AND SPANISH ADMITTING STAFF ARE TRAINED TO EDUCATE PATIENTS ON NCHS FINANCIAL ASSISTANCE POLICY NCH ALSO HAS FINANCIAL COUNSELORS TO PROVIDE FURTHER INFORMATION AND ASSISTANCE TO NCH PATIENTS REGARDING NCHS FINANCIAL ASSISTANCE POLICY THESE COUNSELORS ALSO HELP UNINSURED PATIENTS DETERMINE SOURCES OF PAYMENT FOR MEDICAL BILLS AND HELP PATIENTS DETERMINE ELIGIBILITY FOR PROGRAMS SUCH AS MEDICAID IN ADDITION NCH CONTRACTS WITH THE COMPANY FIRSTSOURCE SOLUTIONS USA TO WORK WITH SELFPAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES FIRSTSOURCE SOLUTIONS DETERMINES A PATIENTS ELIGIBILITY IN MEDICAL COVERAGE OPTIONS AND ASSISTS WITH THEIR ENROLLMENT NCH BEARS THE COST FOR THE FIRSTSOURCE SOLUTIONS PROGRAM COMMUNITY INFORMATION PART VI PART VI LINE 4 NCH IS LOCATED IN NORTON WISE COUNTY WHICH IS IN RURAL SOUTHWEST VIRGINIA BOTH NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA SWVA ARE LOCATED WITHIN THE APPALACHIAN MOUNTAINS SPECIFICALLY THE BLUE RIDGE MOUNTAIN REGION AND TENNESSEE VALLEY SWVA IS CONSIDERED RURAL AND MUCH DIFFERENT THAN THE REST OF THE STATE SWVA HAS BEEN AND REMAINS A MAJOR COAL MINING REGION WISE COUNTY HAS A HIGH RATE OF INDIVIDUALS WHO ARE UNINSURED THE POPULATION OF WISE COUNTY IS JUST OVER 41450 AND THE CITY OF NORTON HAS A POPULATION OF 3713 THE LATEST CENSUS BUREAU DATA ESTIMATES THE MEDIAN AGE RESIDENTS OF WISE COUNTY IS 39 WHICH IS OLDER THAN THE MEDIAN AGE OF 375 IN VIRGINIA THE BUREAU ESTIMATES WISE COUNTY MEDIAN HOUSEHOLD INCOME AT 35120 COMPARED TO 61741 FOR THE STATE OF VIRGINIA 28 OF WISE COUNTYS CHILDREN LIVE IN POVERTY COMPARED TO 16 STATEWIDE HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI PART VI LINE 5 NORTON COMMUNITY HOSPITAL IS DEDICATED TO OPERATING EFFICIENTLY SO THAT WASTE IS MINIMIZED NCHS LEADERSHIP REMAINS MINDFUL OF MANAGING THE HOSPITALS LIMITED RESOURCES SO THAT ADEQUATE FACILITIES AND EQUIPMENT ARE AVAILABLE FOR THE CARE OF OUR PATIENTS VARIOUS CHECKS AND BALANCES ARE ESTABLISHED TO ENSURE THAT EXPENDITURES FOR OPERATING EXPENSES AND CAPITAL COSTS ARE REASONABLE AND NECESSARY THE MAJORITY OF NCHS GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATIONS PRIMARY SERVICE AREA ONLY THREE DIRECTORS MARVIN EICHORN ANN FLEMING AND JOHN DOYLE EMPLOYEES OF MSHA LIVE OUTSIDE THE AREA PHYSICIANS THAT REQUEST PRIVILEGES WHO ARE QUALIFIED AND CREDENTIALED ARE EXTENDED PRIVILEGES BY NCH AFFILIATED HEALTH CARE INFORMATION PART VI PART VI LINE 6 NCH IS A 129BED ACUTECARE FACILITY OPERATED UNDER THE DIRECTION OF A 13MEMBER BOARD OF DIRECTORS PRIMARILY COMPRISED OF LOCAL COMMUNITY RESIDENTS NCH IS ACCREDITED BY THE AMERICAN OSTEOPATHIC ASSOCIATION NCH IS MAJORITY OWNED BY MOUNTAIN STATES HEALTH ALLIANCE MSHA BASED IN JOHNSON CITY TENNESSEE MSHA IS INTEGRATED BOTH VERTICALLY AND HORIZONTALLY AND IS THE LARGEST REGIONAL HEALTHCARE SYSTEM WITH 13 HOSPITALS MSHA PROVIDES CARE TO PEOPLE IN 29 COUNTIES IN TENNESSEE VIRGINIA KENTUCKY AND NORTH CAROLINA NCH SERVES AS THE COUNTYS PRIMARY HEALTH SERVICE PROVIDER PATIENTS BENEFIT FROM NCHS AFFILIATION WITH A HEALTHCARE SYSTEM WHERE THEY CAN BE EFFICIENTLY MOVED ALONG AN INTEGRATED COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES PATIENTS CAN BE MOVED TO THE SYSTEMS FLAGSHIP FACILITY JOHNSON CITY MEDICAL CENTER WHICH IS A TERTIARY CARE FACILITY PROVIDING ADVANCED TREATMENT OPTIONS LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED PART VI VIRGINIA NORTON COMMUNITY HOSPITAL LINE NUMBER 1 PART V LINE 3 PART V LINE 3 MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING NCH LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES 16 COUNTIES EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS NURSES NONPROFIT DIRECTORS COMMUNITY DEVELOPERS FAITH BASED LEADERS PUBLIC OFFICIALS AND SCHOOL REPRESENTATIVES EACH GROUP RANGED IN ATTENDANCE FROM 6 TO 21 INDIVIDUALS PARTICIPANTS WERE GIVEN SURVEYS TO DETERMINE A COUNTYS HEALTH STATUS RATING AVAILABLE RESOURCES TOP HEALTH PRIORITIES AND SUGGESTIONS FOR IMPROVEMENT OPEN DISCUSSION FOLLOWED THE COLLECTED INFORMATION WAS THEN PAIRED WITH STATISTICAL DATA IN ORDER TO PRIORITIZE HEALTH NEEDS THE SPECIFIC NEEDS FOR EACH COUNTY WERE INCLUDED IN THE APPROPRIATE FACILITY IMPLEMENTATION PLAN NORTON COMMUNITY HOSPITAL LINE NUMBER 1 PART V LINE 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES DICKENSON COMMUNITY HOSPITAL AND NORTON COMMUNITY HOSPITAL ALSO HAD ONE COMMUNITY GROUP SURVEYED THESE TWO COUNTIES SERVE SIMILAR COMMUNITIES AND HAVE SIMILAR HEALTH RANKINGS ACCORDING TO AMERICAS HEALTH RANKINGS EVEN THOUGH ONLY TWO COMMUNITY GROUPS SERVED ON BEHALF OF THE FOUR HOSPITALS LISTED STATISTICAL DATA WAS COLLECTED FOR EACH INDIVIDUALLY NCHS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE JOHNSON CITY MEDICAL CENTER FRANKLIN WOODS COMMUNITY HOSPITAL INDIAN PATH MEDICAL CENTER SYCAMORE SHOALS HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL LINE NUMBER 1 PART V LINE 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH HOSPITALS BOARD APPROVED THE IMPLEMENTATION PLAN DURING THE MONTHS OF MAY AND JUNE 2012 MSHA ANNUALLY TRACKS PROGRESS OF IMPLEMENTATION STRATEGIES FOR EACH HOSPITAL DUE TO LACK OF RESOURCES SOME OF MSHA FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED NORTON COMMUNITY HOSPITAL LINE NUMBER 1 PART V LINE 14G PART V LINE 14G THE MOUNTAIN STATES HEALTH ALLIANCE FINANCIAL ASSISTANCE POLICY HAS BEEN APPROVED BY ITS BOARD OF DIRECTORS AND APPLIES TO ALL MSHA HOSPITALS DURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISE THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY NORTON COMMUNITY HOSPITAL LINE NUMBER 1 PART V LINE 20D PART V LINE 20D UNINSURED PATIENTS RECEIVE A 62 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT true ST MARY'S HEALTH WAGON 119 NUMBER 10 STREET CLINCHO VA 24226 043739083 501C3 100000 INDIGENT SUPPORT UNIVERSITY OF VIRGINIA AT WISE ONE COLLEGE AVE WISE VA 24293 541638774 501C3 25000 EDUCATION 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES SCHEDULE I, PAGE 1, PART I, LINE 2 GRANTS ARE APPROVED BY THE BOARD OF DIRECTORS. FUNDING MAY BE PROVIDED TO LOCAL 501(C)(3)ORGANIZATIONS WHOSE FOCUS IS ON HEALTH AND EDUCATION. false true false false false false false false false MARVIN EICHORN 447614 94466 78022 15000 24538 659640 ANN FLEMING 351697 51836 22747 48425 17857 492562 MATTHEW CUSANO MD 300688 58703 767 8492 35420 404070 ALLEN MULLINS MD 260090 17183 22128 9265 34277 342943 JOHN DOYLE 189318 25716 14004 12188 22778 264004 MARK LEONARD 199011 34371 5353 18453 24432 281620 STEPHEN SAWYER 128321 1500 2811 4003 16057 152692 DAVID NAUSS MD 493698 123424 10214 31593 658929 ISAM ZIBDEH MD 435652 21769 8452 22824 488697 LATISHA HILTON MD 180262 87228 24094 8677 1462 301723 CHARLES BEGLEY MD 201755 76122 1272 8583 32085 319817 JODY BENTLEY MD 237346 36063 752 7508 35840 317509 RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION SCHEDULE J, PAGE 1, PART I, LINE 3 NCH'S CEO'S SALARY AND BENEFITS ARE SUBJECT TO THE MOUNTAIN STATES HEALTH ALLIANCE (MSHA) COMPENSATION COMMITTEE PROCESS, WHEREBY THE MSHA CEO RECOMMENDS THE SALARY AND IT IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE, BASED UPON MARKET DATA, MADE AVAILABLE BY THIRD PARTY CONSULTANTS. THE COMPENSATION COMMITTEE HAS FINAL APPROVAL OF MSHA'S CEO RECOMMENDATIONS FOR PAY AND BENEFITS FOR THE NCH CEO. WE USE AN OUTSIDE, INDEPENDENT CONSULTING FIRM TO PROVIDE CONSULTATION ON EXECUTIVE PAY AS WELL AS OUR EXECUTIVE PAY AT RISK PLAN. SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 ANN FLEMING 0 35,925 0 MARK LEONARD 0 10,264 0 OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III PART I, LINE 4B ANN FLEMING AND MARK LEONARD PARTICIPATED IN A 457(F) RETIREMENT PLAN PROVIDED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA). THE 457(F)PLAN IS A NONQUALIFIED TAX-DEFERRED COMPENSATION PLAN AVAILABLE TO A SELECT GROUP OF KEY EXECUTIVES FOR THE INTENT OF SUPPORTING RETENTION AND TO OFFER A COMPETITIVE TOTAL RETIREMENT PROGRAM. ACCOUNT BALANCES HAVE A "SUBSTANTIAL RISK OF FORFEITURE". IN ADDITION TO CREDITOR RISK, SUBSTANTIAL RISK OF FORFEITURE IS CREATED THROUGH DEFAULT RISK IF THE PARTICIPANT'S EMPLOYMENT WITH MSHA IS TERMINATED PRIOR TO AGE 65. HOWEVER, THE 457(F) PLAN CONTAINS A NON-COMPETE PROVISION THAT PROVIDES THE ACCOUNT BALANCE TO BE PAID IN A LUMP SUM AFTER THE EXECUTIVE SATISFIES THE TWO-YEAR NON-COMPETE PERIOD. THIS PROVISION APPLIES TO EMPLOYER CONTRIBUTIONS IF THE EXECUTIVE HAS PROVIDED ELIGIBLE SERVICE FOR SIX OR MORE YEARS. (ELIGIBLE SERVICE IS OFFICER SERVICE THAT PERMITTED THE EXECUTIVE TO PARTICIPATE IN THE PLAN.) THE EXECUTIVE WILL RECEIVE THE ENTIRE ACCOUNT BALANCE IF HE/SHE BECOMES DISABLED, DIES OR IF THE EXECUTIVE TERMINATES FOR "GOOD REASON" OR IS INVOLUNTARILY TERMINATED WITHOUT "GOOD CAUSE" WITHIN A 24 MONTH PERIOD AFTER A CHANGE-OF-CONTROL OCCCURS. DISTRIBUTIONS FROM THIS PLAN ARE SUBJECT TO FEDERAL, STATE, AND LOCAL TAXES ON THE ENTIRE ACCOUNT BALANCE UPON DISTRIBUTION. JAMIE FLEMING FAMILY MEMBER 35134 FAMILY MBR OF BD MBR false MARK LEONARD CEO OF NCH 7200 RENT PROP. FROM NCH false ADDITIONAL INFORMATION SCHEDULE L PART V BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS 1A NAME OF PERSON JAMIE FLEMING 1B RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION FAMILY MEMBER OF JAMES MANICURE NORTON COMMUNITY HOSPITAL NCHBOARD MEMBER 1D DESCRIPTION OF TRANSACTION JAMES MANICURE BOARD MEMBER OF NCH IS A FAMILY MEMBER OF JAMIE FLEMING AN EMPLOYEE OF NCH 2A NAME OF PERSON MARK LEONARD 2B RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION MARK LEONARD IS THE CEO OF NCH 2D DESCRIPTION OF TRANSACTION MARK LEONARD RENTED PROPERTY FROM NCH FOR PART OF FY13 THE RENTAL RATE WAS DETERMINED AT FAIR MARKET VALUE MR LEONARD MOVED OUT OF THE PROPERTY DURING FY13 ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION PART I, LINE 1 ORGANIZATION'S MISSION: NORTON COMMUNITY HOSPITAL (NCH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH. FIRST ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4A THE INTERNAL MEDICINE RESIDENTS OF THIS PROGRAM ROTATE THROUGH ALL AREAS OF MEDICINE, FROM HEALTH MAINTENANCE TO CRITICAL CARE. THE RESIDENTS ASSIST OUR PHYSICIANS IN PROVIDING QUALITY HANDS ON PATIENT CARE, THROUGH OBSERVATIONS, EDUCATION AND BY PARTICIPATING IN GRAND ROUNDS. IN ADDITION TO THESE SERVICES WITHIN THE HOSPITAL SETTING, THE RESIDENTS ARE ALSO EXPOSED TO TREATING PATIENTS IN AN OFFICE SETTING AT THE COMMUNITY CLINIC (RESIDENT CONTINUITY CLINIC)IN WISE, VIRGINIA. THE VIRGINIA HEALTH QUALITY CENTER (VHQC), A NONPROFIT HEALTH QUALITY CONSULTING COMPANY, SELECTED WINNERS IN SIX CATEGORIES FOR THEIR CONTRIBUTIONS TO IMPROVING HEALTH CARE FOR PATIENTS IN VIRGINIA. MOUNTAIN STATES HEALTH ALLIANCE'S VIRGINIA HOSPITALS, WHICH INCLUDE NORTON COMMUNITY HOSPITAL, EARNED THE HONOR FOR THEIR PATIENT-CENTERED CARE. THE WINNERS WERE ANNOUNCED DURING QUALITYSYNC, VHQC'S ANNUAL LEARNING EVENT, HELD IN RICHMOND, AND WERE SELECTED FROM NEARLY 30 NOMINATIONS. "MSHA'S VIRGINIA HOSPITALS DEVELOPED AN INNOVATIVE APPROACH TO BRINGING A PATIENT-CENTERED APPROACH TO ALL OF ITS FACILITIES", THE VHQC STATED IN A NEWS RELEASE. "BY ESTABLISHING 10 GUIDING PRINCIPLES AND INCORPORATING THEM INTO EACH HOSPITAL'S OPERATIONS, THIS ORGANIZATION HAS SIGNIFICANTLY IMPROVED PATIENT-PROVIDER RELATIONSHIPS, ENVIRONMENTS AND SERVICE DELIVERY". IN JANUARY 2013, NORTON COMMUNITY HOSPITAL OPENED A STATE-OF-THE-ART SURGICAL ADDITION. THIS CONSTRUCTION WAS INITIATED DUE TO THE DILAPIDATED APPEARANCE AND DISREPAIR OF THE OLD SURGERY SUITE. THE ADDITION ADDED NEW TECHNOLOGIES THAT ARE AVAILABLE IN TODAY'S MARKET TO IMPROVE NCH'S ABILITY TO PROVIDE THE BEST PROVISION OF SURGICAL SERVICES TO OUR PATIENTS. REPLACING OUR OLD ANTIQUATED SURGICAL SUITE ALSO PROVIDES AN INCENTIVE FOR RECRUITMENT OF SURGEONS TO OUR RURAL COMMUNITY. THE NEW ADDITION WAS DESIGNED WITH AN INPATIENT ENTRANCE FROM THE HOSPITAL AS WELL AS A PICK-UP/DROP-OFF AREA TO ACCOMMODATE OUR PATIENTS AND MEET THEIR REQUESTS FOR IMPROVING INCOMING/OUTGOING TRANSPORT. OUR NEW SURGERY SUITE ALLOWS OUR PATIENTS TO HAVE THE SAME TYPE OF CARE THAT THEY WOULD PREVIOUSLY HAVE HAD TO ENDURE EXCESSIVE TRAVEL FOR IN ORDER TO REACH A LARGE HOSPITAL. OUR NEW SURGERY SUITE IS ALSO BEING USED BY THE REMOTE AREA MEDICAL (RAM) PROGRAM. RAM PROVIDES FREE HEALTHCARE TO MANY CITIZENS FROM THE COUNTIES THAT ARE WITHIN OUR SERVICE AREA THAT DO NOT HAVE HEALTH INSURANCE. WE OFFER OUR SURGERY SUITE FREE OF CHARGE TO RAM FOR USE BY ORAL SURGEONS TO PERFORM PEDIATRIC DENTAL SURGERY. THE CHILDREN BENEFITING FROM THIS SERVICE WOULD NOT RECEIVE THIS CARE IF NOT FOR RAM AND THE USE OF OUR SURGERY SUITE. TO IMPROVE ACCESS TO PRIMARY CARE, NORTON COMMUNITY HOSPITAL, INC. OPERATES SEVERAL CLINICS: COMMUNITY PHYSICIANS-NORTON, COMMUNITY PHYSICIANS-COEBURN, COMMUNITY PHYSICIANS-WISE, COMMUNITY ORTHOPEDICS, NORWISE OB/GYN, COMMUNITY CLINIC - WISE (RESIDENT CONTINUITY CLINIC), OCCUMED HEALTH CENTER AND THE WISE PROFESSIONAL OFFICE BUILDING WHICH OFFERS PHYSICIAN OFFICE SPACE AND IS HOME TO OUR COMPREHENSIVE HOME HEALTH SERVICES. OUR MEDICAL STAFF CONSISTS OF OVER 130 PHYSICIANS AND SURGEONS WITH SPECIALTY TRAINING IN: FAMILY PRACTICE, INTERNAL MEDICINE, EAR-NOSE-THROAT, GENERAL SURGERY, UROLOGY, PEDIATRICS, EMERGENCY MEDICINE, GERIATRIC MEDICINE, CRITICAL CARE, CARDIOLOGY, PULMONOLOGY, RADIOLOGY, ONCOLOGY, NEUROLOGY, ORTHOPEDICS, GASTROENTEROLOGY, OPTHALMOLOGY, OBSTETRICS, GYNECOLOGY AND DENTISTRY. PROGRAMS AND SERVICES INCLUDE INTENSIVE CARE/CRITICAL CARE/ CORONARY CARE, 24-HOUR EMERGENCY ROOM SERVICES, PEDIATRIC CARE, LASER SURGERY, OUTPATIENT SURGERY, LITHOTRIPSY SERVICES, HOME HEALTH, HYPERBARIC MEDICINE, DIETARY/NUTRITION SUPPORT, PHARMACY, INPATIENT AND OUTPATIENT SURGICAL SERVICES, 12-BED INTENSIVE CARE UNIT, PASTORAL CARE, VOLUNTEER SERVICES, HELPING HANDS GIFT SHOP, COMMUNITY OUTREACH AND EDUCATION PROGRAMS, SCREENING SERVICES, AND UVA TELEMEDICINE AND PAIN MANAGEMENT. OUR RADIOLOGICAL SERVICES INCLUDE ANGIOGRAPHY, MAMMOGRAPHY, ULTRASOUND, STEREOTACTIC BREAST BIOPSY, NUCLEAR MEDICINE, PET SCANS, IN-HOUSE MAGNETIC RESONANCE IMAGING UNIT (MRI), AND CT SCANNER. IN 2012 OUR RADIOLOGY DEPARTMENT RECEIVED ACCREDITATION FOR ITS PET SERVICES THROUGH THE AMERICAN COLLEGE OF RADIOLOGY. THIS LATEST ACR ACCREDITATION IS ONE OF SEVERAL THE RADIOLOGY DEPARTMENT HAS RECEIVED OVER THE LAST YEAR. THE OTHERS INCLUDE NUCLEAR MEDICINE, MAMMOGRAPHY AND MRI, WITH MRI STAFF OBTAINING THEIR CERTIFICATION THIS YEAR AS WELL. THE FAMILY BIRTHING CENTER HAS SIX (6) SEMI-PRIVATE GYNECOLOGICAL SUITES AND SEVEN (7) LDRP (LABOR, DELIVERY, RECOVERY, AND POSTPARTUM) SUITES THAT OFFER COMFORT, CARE, AND COMPASSION THAT IS UNPARALLELED IN THE REGION. WE OFFER PREPARED CHILDBIRTH, PARENTING, SIBLING AND SAFE-SITTER CLASSES, INCLUDING EDUCATION ON BREASTFEEDING AND WOMEN'S HEALTH. THE CENTER ALSO OFFERS A SPECIAL AREA FOR CESAREAN SECTIONS AND ROUTINE GYNECOLOGICAL PROCEDURES. OUR CARDIOPULMONARY SERVICES DEPARTMENT PROVIDES AN EXTENSIVE LINE OF CARDIAC, PULMONARY AND NEURO-DIAGNOSTIC SERVICES. THEY ALSO PROVIDE A COMPREHENSIVE SLEEP MEDICINE PROGRAM AS WELL AS AN APPROVED SITE FOR THE DEPARTMENT OF LABOR'S FEDERAL BLACK LUNG PROGRAM. THE REGIONAL REHAB CENTER OFFERS OCCUPATIONAL THERAPY, PHYSICAL THERAPY, SPEECH THERAPY, PULMONARY REHAB, ANODYNE THERAPY, CARDIAC REHABILITATION, CARDIOPULMONARY REHAB, SMOKING CESSATION CLASSES AND FIT-ONE, A COMMUNITY WELLNESS PROGRAM. OUR THREE YEAR, CARF ACCREDITED (COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES), 11-BED INPATIENT REHABILITATION UNIT PROVIDES A RESPONSIVE, CARING ENVIRONMENT THAT ENHANCES RECOVERY AND SPEEDS THE RETURN TO NORMAL LIFE FOR PATIENTS SUFFERING FROM STROKE, PARKINSON'S DISEASE, POLYNEUROPATHY, BRAIN INJURY AND HIP FRACTURES. THE INCIDENCE OF DIABETES IS ON THE RISE IN THE UNITED STATES WITH AN ALARMING NUMBER OF UNDIAGNOSED DIABETIC AND PRE-DIABETIC PATIENTS THAT ACTUALLY EXCEED THE NUMBER OF PATIENTS THAT HAVE BEEN DIAGNOSED WITH DIABETES. THE VIRGINIA DEPARTMENT OF HEALTH REPORTS THAT DIABETES IS THE 6TH LEADING CAUSE OF DEATH IN OUR STATE. IN ADDITION, THE SOUTHWEST VIRGINIA AND THE APPALACHIAN REGION EXCEEDS THE NATIONAL DIABETES PREVALENCE RATE. BEGINNING THIS FISCAL YEAR, NCH BEGAN TO PURSUE A DIABETES EDUCATION PROGRAM FOR OUR REGION. A SATELLITE PROGRAM WAS ESTABLISHED AT NORTON THROUGH THE JOHNSTON MEMORIAL HOSPITAL (JMH) PROGRAM. JMH IS AN AFFILIATE OF NCH LOCATED IN ABINGDON, VIRGINIA. NCH APPLIED FOR A CERTIFICATE OF RECOGNITION FROM THE AMERICAN DIABETES ASSOCIATION AND RECEIVED THE CERTIFICATION A FEW MONTHS FOLLOWING THE CLOSE OF THIS FISCAL YEAR. PRIOR TO THIS RECOGNITION, MANY PATIENTS HAD TO TRAVEL AT LEAST 1 TO 2 HOURS TO ACCESS THIS TYPE OF CARE. ALSO, MEDICARE PATIENTS CAN NOW RECEIVE 2 HOURS OF ONE-ON-ONE EDUCATION AND PARTICIPATE IN 8 HOURS OF GROUP EDUCATION IN THEIR FIRST YEAR OF PROGRAM PARTICIPATION SO THE ESTABLISHMENT OF THE DIABETES PROGRAM IN NORTON IS OF GREAT BENEFIT TO OUR MEDICARE-AGE RESIDENTS. WE ARE EXCITED THAT THIS SERVICE IS NOW AVAILABLE TO THE SOUTHWEST VIRGINIA REGION AND THE POSITIVE IMPACT THE NEW DIABETES PROGRAM WILL HAVE ON THE HEALTH OF OUR COMMUNITY MEMBERS. THE DIABETES CARE CENTER STAFF EDUCATE CLIENTS ABOUT DIABETES SELF-MANAGEMENT TECHNIQUES AND THEY HELP TAILOR A PLAN TO THE INDIVIDUAL TO FIT EACH PERSON'S SCHEDULE. TRAINING INCLUDES INFORMATION ABOUT MEDICATIONS, EATING HABITS, EXERCISE, AND BLOOD GLUCOSE MONITORING. NORTON COMMUNITY HOSPITAL HAS ENABLED BUSINESSES TO LOWER THEIR MEDICAL CARE COSTS THROUGH OUR COMPREHENSIVE OCCUPATIONAL MEDICINE PROGRAM AT OCCUMED HEALTH CENTER. OCCUMED OFFERS NURSING CASE MANAGEMENT, WORK-RELATED INJURY TREATMENT AND FOLLOW-UP, PRE-EMPLOYMENT PHYSICALS, DRUG SCREENINGS, VACCINATIONS, WORK-SITE SAFETY ANALYSIS, GENERAL HEALTH SCREENINGS, OSHA REGULATION COMPLIANCE ASSISTANCE, AND INDUSTRIAL REHABILITATION. COMMUNITY HOME CARE OFFERS DURABLE MEDICAL EQUIPMENT SUCH AS LIFT CHAIRS, MOTORIZED SCOOTERS, LIMB BRACES, DIABETIC SUPPLIES, TURBANS, AND A PRIVATE FITTING ROOM FOR MASTECTOMY FITTINGS. THE WANDA WAMPLER CENTER FOR WOMEN'S HEALTH HOUSES OUR COMPREHENSIVE WOMEN'S HEALTH SERVICES. THE CENTER OFFERS STEREOTACTIC BREAST BIOPSY, BONE DENSITOMETRY, AND DIGITAL MAMMOGRAPHY. NCH'S INPATIENT REHABILITATION UNIT IS ONE OF THE BEST IN THE NATION. FOR THE EIGHTH STRAIGHT YEAR, THE NCH INPATIENT REHAB UNIT HAS BEEN RANKED IN THE TOP 10 PERCENT NATIONALLY AMONG QUALIFYING INPATIENT REHABILITATION FACILITIES, ACCORDING TO THE UNIFORM DATA SYSTEM FOR MEDICAL REHABILITATION. FOR 2013, NCH WAS AT THE 96TH PERCENTILE OUT OF 774 INPATIENT REHAB FACILITIES THAT QUALIFIED TO BE RANKED IN THE INPATIENT REHAB FACILITY DATABASE. THE RANKINGS WERE DETERMINED BY USING UNIFORM DATA SYSTEM'S PROGRAM EVALUATION MODEL, WHICH RANKS NEARLY THREE-QUARTERS OF ALL INPATIENT REHAB FACILITIES IN THE COUNTRY. NCH IS PROUD TO BE RECOGNIZED AGAIN FOR DELIVERY OF QUALITY PATIENT CARE THAT IS EFFECTIVE, EFFICIENT, TIMELY AND PATIENT-CENTERED. NOR CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 MOUNTAIN STATES HEALTH ALLIANCE IS THE 50.1% MEMBER OF NORTON COMMUNITY HOSPITAL, INC. COMMUNITY HEALTHCARE FOUNDATION, INC. IS THE 49.9% MEMBER OF NORTON COMMUNITY HOSPITAL, INC. ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A THERE ARE TWO CLASSES OF MEMBERS AND EACH CLASS IS ENTITLED TO ELECT A SPECIFIED NUMBER OF DIRECTORS TO THE BOARD. THE MOUNTAIN STATES HEALTH ALLIANCE(MSHA)CLASS IS ELECTED BY THE MSHA BOARD OF DIRECTORS AND THE NORTON COMMUNITY HOSPITAL CLASS IS ELECTED BY THE COMMUNITY HEALTHCARE FOUNDATION BOARD OF DIRECTORS. NEITHER SIDE CAN VETO AN APPOINTMENT. DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE BOARD ARE, PURSUANT TO CHARTER AND VIRGINIA STATUTE, SUBJECT TO APPROVAL OF THE MEMBERS. THESE DECISIONS INCLUDE: DISSOLUTION OF THE CORPORATION; MERGER OF THE CORPORATION; NON-ORDINARY COURSE OF BUSINESS SALE OF ASSETS; ETC. NO ORDINARY, DAY TO DAY DECISIONS ARE SUBJECT TO MEMBER APPROVAL. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE CFO REVIEWED THE FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS AND THE RETURN WAS MADE AVAILABLE TO EACH BOARD MEMBER IN AN ELECTRONIC FORMAT PRIOR TO THE REVIEW. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY, THE CORPORATE AUDIT AND COMPLIANCE DEPARTMENT OF MSHA FORWARDS THE CONFLICT OF INTEREST POLICY AND DISCLOSURE FORM TO ALL MSHA MANAGEMENT TEAM MEMBERS AND BOARD MEMBERS. EMPLOYEES AND BOARD MEMBERS MUST NOTE ANY CONFLICTS OR ATTEST THEY HAVE "NONE", AND RETURN THE FORM TO THE AUDIT AND COMPLIANCE DEPARTMENT. ANY NOTED DISCLOSURES ARE FORWARDED TO THE APPROPRIATE MANAGEMENT OR BOARD PERSONNEL TO EVALUATE AND UTILIZE WHEN A TRANSACTION INVOLVING A CONFLICTED PERSON ARISES. ADDITIONALLY, PERSONNEL WHO HAVE A CONFLICT ARISE BETWEEN THE ANNUAL DISTRIBUTION OF THE POLICY AND FORMS ARE REQUIRED TO DISCLOSE THE CONFLICT AND WOULD BE DISCIPLINED IN ANY INSTANCE WHERE THEY HAVE NOT DISCLOSED AND ENGAGED IN A CONFLICTED TRANSACTION. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE CEO'S COMPENSATION AND BENEFITS ARE SUBJECT TO THE EXECUTIVE COMPENSATION POLICY OF MOUNTAIN STATES HEALTH ALLIANCE (MSHA). THE POLICY WAS ESTABLISHED BY MSHA'S BOARD OF DIRECTORS AND IS ALLIGNED WITH THE MSHA MISSION, VISION, AND VALUES, SUPPORTING THE ACHIEVEMENT OF THE HEALTH SYSTEM'S STRATEGIC PLANS AND ANNUAL GOALS AND OBJECTIVES. THE POLICY ENSURES THAT MSHA'S EXECUTIVE COMPENSATION IS COMPLIANT WITH THE LEGAL, REGULATORY, AND STATUTORY ENVIRONMENT AFFECTING COMPENSATION. MSHA'S PRESIDENT AND CEO MAKES RECOMMENDATIONS TO THE EXECUTIVE COMMITTEE OF THE MSHA BOARD FOR ALL ELEMENTS OF COMPENSATION FOR THE SENIOR MANAGEMENT TEAM, INCLUDING NORTON COMMUNITY HOSPITAL'S AND DICKENSON COMMUNITY HOSPITAL'S CEO, MARK LEONARD. THE BOARD OF DIRECTORS MONITORS THE PERFORMANCE OF THE SENIOR MANAGEMENT TEAM ON AN ONGOING BASIS, BUT AT LEAST ANNUALLY. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B SIMILAR TO THE CEO'S COMPENSATION, THE CFO RECEIVES COMPENSATION AND BENEFITS THAT COMPLY WITH MSHA'S SALARY POLICY. HIS PAY IS SET AT A MARKET PERCENTILE SPECIFIC TO HIS POSITION. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM. FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM, AND THEY ARE MADE AVAILABLE TO THOSE PARTIES WHO OWN INDEBTEDNESS OF THE COMPANY ON A QUARTERLY BASIS. OTHER FEES FOR SERVICES FORM 990, PART IX, LINE 11G HOSPITAL BASED PROVIDERS 5,378,290 0 0 LINEN & ENVIRONMENTAL SERV. 0 1,250,622 0 OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 9 RECLASSIFICATION OF GRANT ASSETS 2,053 ELIMINATION OF INTERCOMPANY REC/PAY 145,040 NET UNREALIZED GAINS ON INVESTMENTS 782,696 PENSION & POST LIABILITY ADJUSTMENT -339,272 PARTNERSHIP DIVIDEND INCOME NOT ON BOOKS -34,480 PARTNERSHIP INTEREST INCOME NOT ON BOOKS -345 PARTNERSHIP PORTFOLIO FEES NOT ON BOOKS 16,121 TOTAL TO FORM 990, PART XI, LINE 5 571,813 NORTON COMMUNITY PHYSICIAN SVCS LLC 96 15TH ST NW NORTON VA 24273 260868690 MED. SERV. 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