Form990
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2018 , and ending 12-31-2018
BCheck if applicable:
CName of organization
Norton Hospitals Inc
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
Accounting 224 E Broadway 5th Floor
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Louisville, KY40202
D Employer identification number

61-0703799
E Telephone number

G Gross receipts $ 2,024,393,837
F Name and address of principal officer:
RUSSELL F COX
4967 US Highway 42 Suite 100
Louisville,KY40222
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.nortonhealthcare.com
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1969
M State of legal domicile: KY
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Norton Hospitals, Inc.'s purpose is to provide quality health care to all those to all those we serve, in a manner that responds to the needs of our communities and faith heritage.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 23
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 22
5 Total number of individuals employed in calendar year 2018 (Part V, line 2a) ...... 5 11,029
6 Total number of volunteers (estimate if necessary) ............. 6 1,394
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 5,927,294
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 12,474,603 12,610,334
9 Program service revenue (Part VIII, line 2g) ......... 1,860,586,773 2,006,718,274
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 13,850 0
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 14,130,179 4,170,365
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,887,205,405 2,023,498,973
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...   0
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 634,795,603 629,536,586
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 967,909,379 1,139,850,798
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,602,704,982 1,769,387,384
19 Revenue less expenses. Subtract line 18 from line 12....... 284,500,423 254,111,589
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,271,045,747 2,551,346,959
21 Total liabilities (Part X, line 26)............. 130,550,044 156,881,955
22 Net assets or fund balances. Subtract line 21 from line 20..... 2,140,495,703 2,394,465,004
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2018)
Form 990 (2018)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: Norton Hospitals, Inc.'s purpose is to provide quality health care to all those we serve, in a manner that responds to the needs of our communities and faith heritage.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,710,270,230 including grants of $   ) (Revenue $ 2,004,837,353 )
Norton Hospitals, Inc. (Hospitals) 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. Hospitals has a total of 1,837 licensed beds, Norton Hospital - 605 beds; Norton Children's Hospital - 300; Norton Audubon Hospital - 432 beds: Norton Women's and Children's Hospital - 373 beds; and Norton Brownsboro Hospital - 127 beds. These hospitals operate twenty-four (24) hours a day, seven (7) days a week. In 2018, Hospitals' facilities and diagnostic centers served 72,355 inpatients, 560,845 outpatients, and 249,388 emergency department visits. In addition, Hospitals' operating rooms cared for 20,947 inpatient surgical patients and 35,751 outpatient surgical patients. Additionally, 7,564 deliveries were performed at Hospitals' birthing centers. Under its charity care program, Hospitals provided free care to 13,284 patients, at a cost of $13.4 million. Also, Hospitals 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, 11,472 patients were provided care at discounted rates. Other contributions to the community were the unpaid cost of Medicaid services of $95.4 million and educational support of $43.3 million, primarily to the University of Louisville's School of Medicine. Also, community health improvement services totaled $10.1 million, and contributions to community groups were $3.2 million.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet1,710,270,230
Form 990 (2018)
Form 990 (2018)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III.................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III.............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII .................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
Form 990 (2018)
Form 990 (2018)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
288
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2018)
Form 990 (2018)
Page 5
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
11,029
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
Yes
 
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................
16
 
No
Form 990 (2018)
Form 990 (2018)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
23
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
22
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletHelena SchulzAccounting 224 E BROADWAY 5th Fl   Louisville,KY40202 (502) 629-8263
Form 990 (2018)
Form 990 (2018)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Russell F Cox
 
President & CEO/Trustee
 10.0
.................
40.0 		X   X       0 2,023,748 139,421
(2) Gary L Stewart
 
Chair
 1.0
.................
12.5 		X           0 1,600 0
(3) Edie Nixon
 
Vice Chair
 1.0
.................
7.5 		X           0 0 0
(4) Maria L Bouvette
 
Trustee (partial year)
 1.0
.................
2.5 		X           0 1,600 0
(5) Brendan Canavan
 
Trustee
 1.0
.................
2.5 		X           0 0 0
(6) Sue Davis EdD RN
 
Trustee
 1.0
.................
2.5 		X           0 1,600 0
(7) Marshall Farrer
 
Trustee
 1.0
.................
2.5 		X           0 0 0
(8) Lee K Garlove
 
Trustee
 1.0
.................
3.5 		X           0 3,200 0
(9) Maria Gerwing Hampton
 
Trustee
 1.0
.................
4.5 		X           0 0 0
(10) Craig D Grant
 
Trustee
 1.0
.................
2.5 		X           0 1,600 0
(11) Rick Guillaume
 
Chair Emeritus
 1.0
.................
3.5 		X           0 0 0
(12) Martha K Heyburn MD
 
Trustee
 1.0
.................
4.5 		X           0 0 0
(13) Rita Hudson Shourds EdD
 
Trustee
 1.0
.................
2.5 		X           0 0 0
(14) Richard R Ivey
 
Trustee
 1.0
.................
2.5 		X           0 1,600 0
(15) Ronald Lehocky MD
 
Trustee
 1.0
.................
4.5 		X           0 0 0
(16) Gail Lyttle
 
Trustee
 1.0
.................
2.5 		X           0 1,600 0
(17) Gregory E Mayes
 
Trustee
 1.0
.................
6.5 		X           0 1,600 0
Form 990 (2018)
Form 990 (2018)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Barry Pennybaker
 
Trustee
 1.0
.......................2.5 		X           0 0 0
(19) Erwin Roberts
 
Trustee
 1.0
.......................2.5 		X           0 0 0
(20) Donald H Robinson
 
Trustee
 1.0
.......................6.5 		X           0 0 0
(21) G Hunt Rounsavall Jr
 
Trustee
 1.0
.......................6.5 		X           0 1,600 0
(22) Rev William J Schultz
 
Trustee
 1.0
.......................4.5 		X           0 0 0
(23) James L Sublett MD
 
Trustee
 1.0
.......................2.5 		X           0 1,600 0
(24) Richard S Wolf MD
 
Chair Emeritus
 1.0
.......................2.5 		X           0 1,600 0
(25) Robert B Azar
 
Sr VP Chief Legal Officer/Secretary
 10.0
.......................40.0 		    X       0 1,953,813 127,178
(26) Michael W Gough
 
Exec VP and COO
 10.0
.......................40.0 		    X       0 1,331,576 214,821
(27) Adam Kempf
 
Sr VP, CFO/Treasurer
 10.0
.......................40.0 		    X       0 587,990 116,583
(28) Joseph Flynn DO
 
CAO NMG - Physician -in-Chief NCI
 50.0
.......................0 		      X     837,612 0 133,057
(29) Thomas Kmetz
 
Division President Women and Children Services (partial year)
 49.0
.......................1.0 		      X     798,197 0 151,365
(30) Matthew Ayers
 
Hospital CAO
 50.0
.......................0 		      X     474,712 0 88,594
(31) Charlotte Ipsan
 
Hospital CAO
 50.0
.......................0 		      X     457,744 0 95,044
(32) Jon Cooper
 
Hospital CAO
 50.0
.......................0 		      X     452,096 0 86,114
(33) Andrew Strausbaugh
 
Hospital CAO
 50.0
.......................0 		      X     402,773 0 83,767
(34) Aaron Spalding MD
 
Physician
 50.0
.......................0 		        X   1,253,443 0 53,004
(35) Don Stevens MD
 
Physician
 50.0
.......................0 		        X   1,189,870 0 52,722
(36) Yong Cha MD
 
Physician
 50.0
.......................0 		        X   1,162,191 0 52,516
(37) Shawn Glisson MD
 
Physician
 50.0
.......................0 		        X   1,049,438 0 40,108
(38) Michael Driscoll MD
 
Physician
 50.0
.......................0 		        X   937,961 0 46,657
(39) Mary Gruebbel
 
Former, VP Patient Care Svc/CNO
 0.0
.......................0 		          X 439,818 0 39,942
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 9,455,855 5,916,328 1,520,893
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet389
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Messer Construction Co

11001 Plantside Dr
LOUISVILLE,KY40299 		Construction 49,663,566
University of Louisville

323 E Chestnut St
Suite 312
Louisville,KY40202 		Residency Program 11,660,290
Harshaw Trane Service

12700 Plantside Dr
Louisville,KY40299 		Equipment and Repair 9,205,455
Morrison Management Specialist

400 Northridge Rd
Suite 600
Sandy Springs,GA75038 		Dietary Services 8,010,050
Northstar Anesthesia of KY II PLLC

6225 N State Hwy 161
Suite 200
Irving,TX75038 		Anesthesia Services 7,739,133
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet158
Form 990 (2018)
Form 990 (2018)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 12,610,334
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$  
h Total. Add lines 1a-1f.......MediumBullet 12,610,334
Program Service RevenueAmt Business Code
2a Net Patient Revenue 621110 2,005,444,300 1,999,779,307 5,664,993  
b Healthcare Education 611710 1,273,974 1,273,974    
c
d
e
f All other program service revenue. 0 0 0 0
g Total. Add lines 2a–2f ....MediumBullet 2,006,718,274
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet        
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   1,018,856
b Less: rental expenses   894,864
c Rental income or (loss) 0 123,992
d Net rental income or (loss)......MediumBullet 123,992     123,992
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss) 0 0
d Net gain or (loss).....MediumBullet        
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a Purchasing Co-Op Inc. 561499 2,472,357 2,210,056 262,301  
b Parking Income 812930 1,448,783 1,448,783    
c Retail Rx Sales 900099 90,461 90,461    
d All other revenue .... 34,772 34,772 0 0
e Total. Add lines 11a–11d ...... MediumBullet 4,046,373
12 Total revenue. See Instructions......MediumBullet 2,023,498,973 2,004,837,353 5,927,294 123,992
Form 990 (2018)
Form 990 (2018)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21    
2 Grants and other assistance to domestic individuals. See Part IV, line 22    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 2,314,392 2,314,392    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 295,670 295,670    
7 Other salaries and wages 503,559,223 503,559,223    
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 28,070,238 28,070,238    
9 Other employee benefits ....... 60,330,252 60,330,252    
10 Payroll taxes ........... 34,966,811 34,966,811    
11 Fees for services (non-employees):        
a Management ......        
b Legal .........        
c Accounting ...........        
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 144,623,673 144,623,673 0 0
12 Advertising and promotion ....        
13 Office expenses ....... 8,021,015 8,021,015    
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 21,573,620 21,573,620    
17 Travel ............ 786,199 786,199    
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 38,786,075 38,786,075    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 64,956,911 64,956,911    
23 Insurance ... 12,142,834 12,142,834    
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Medical Supplies 489,617,838 489,617,838    
b Allocated Support 262,976,664 203,859,510 59,117,154  
c Bad Debt 57,114,018 57,114,018    
d Provider Tax 20,129,732 20,129,732    
e All other expenses 19,122,219 19,122,219 0 0
25 Total functional expenses. Add lines 1 through 24e 1,769,387,384 1,710,270,230 59,117,154 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2018)
Form 990 (2018)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 8,830 1 8,900
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 227,871,524 4 210,952,565
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
  6 0
7 Notes and loans receivable, net ....   7  
8 Inventories for sale or use ........ 48,251,315 8 54,383,711
9 Prepaid expenses and deferred charges ...... 2,090,332 9 2,422,181
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,703,092,554
b Less: accumulated depreciation 10b 952,565,179 673,568,490 10c 750,527,375
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 ..... 0 12  
13 Investments—program-related. See Part IV, line 11 .. 0 13  
14 Intangible assets ............... 7,445,984 14 7,445,984
15 Other assets. See Part IV, line 11 ........... 1,311,809,272 15 1,525,606,243
16 Total assets. Add lines 1 through 15 (must equal line 34)... 2,271,045,747 16 2,551,346,959
Liabilities 17 Accounts payable and accrued expenses ..... 91,003,603 17 101,720,807
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..   22 0
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 39,546,441 25 55,161,148
26 Total liabilities. Add lines 17 through 25.. 130,550,044 26 156,881,955
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 2,133,569,992 27 2,383,303,240
28 Temporarily restricted net assets ........... 6,925,711 28 11,161,764
29 Permanently restricted net assets   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund ...   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 2,140,495,703 33 2,394,465,004
34 Total liabilities and net assets/fund balances ........ 2,271,045,747 34 2,551,346,959
Form 990 (2018)
Form 990 (2018)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
2,023,498,973
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,769,387,384
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
254,111,589
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
2,140,495,703
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-142,288
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
2,394,465,004
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2018)
Form 990 (2018)
Additional Data


Software ID: 18007697
Software Version: 2018v3.1
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
Norton Hospitals Inc
 
Employer identification number

61-0703799
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9

10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2018 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2018 		(iii)
Distributable
Amount for 2018
1 Distributable amount for 2018 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2018:
a From 2013.......  
b From 2014.......  
c From 2015.......  
d From 2016.......  
e From 2017.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2018 distributable amount  
i Carryover from 2013 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2018 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2018 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2018, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.		  
6 Remaining underdistributions for 2018. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.		  
7 Excess distributions carryover to 2019. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2014......  
b Excess from 2015.....  
c Excess from 2016.....  
d Excess from 2017.....  
e Excess from 2018.....  
Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Name of the organization
Norton Hospitals Inc
 
Employer identification number

61-0703799
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
Name of organization
Norton Hospitals Inc
  		Employer identification number
61-0703799
Part I
Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 3
Name of organization
Norton Hospitals Inc
  		Employer identification number

61-0703799
Part II
Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 4
Name of organization
Norton Hospitals Inc
  		Employer identification number

61-0703799
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data


Software ID: 18007697
Software Version: 2018v3.1
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Norton Hospitals Inc
 
Employer identification number

61-0703799
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2018

Schedule C (Form 990 or 990-EZ) 2018
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................    
c Total lobbying expenditures (add lines 1a and 1b) ...................................................................    
d Other exempt purpose expenditures ........................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2018


Schedule C (Form 990 or 990-EZ) 2018
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
73,732
j
Total. Add lines 1c through 1i ....................................................................................................
73,732
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Norton Hospitals, Inc. pays dues to the Kentucky Hospital Association. A portion of those dues in the amount of $73,732 was spent on lobbying.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Norton Hospitals, Inc. pays dues to the Kentucky Hospital Association. A portion of those dues in the amount of $73,732 was spent on lobbying.
Schedule C (Form 990 or 990EZ) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
Norton Hospitals Inc
 
Employer identification number

61-0703799
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 20,691,046 18,843,030 18,722,595 20,430,388 20,805,488
b Contributions ... 127,680 30,621 31,092 -86,737 -90,195
c Net investment earnings, gains, and losses -1,053,047 2,617,227 987,970 -772,654 489,431
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		884,587 799,832 898,627 848,402 774,336
f Administrative expenses ....          
g End of year balance ...... 18,881,092 20,691,046 18,843,030 18,722,595 20,430,388
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet98.13 %
c
Temporarily restricted endowment SchDMd Bullet1.87 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
No
(ii) related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   25,560,360 25,560,360
b Buildings ....   881,772,852 382,673,168 499,099,684
c Leasehold improvements        
d Equipment ....   686,570,286 562,032,271 124,538,015
e Other .....   109,189,056 7,859,740 101,329,316
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 750,527,375
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) RECEIVABLE FROM AFFILIATE 1,522,083,701
(2) INVESTMENT IN PREMIER PURCHASING PARTNERS LP 3,072,542
(3) MISCELLANEOUS RECEIVABLES 450,000
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 1,525,606,243
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
DUE TO THIRD PARTY PAYORS 47,377,675
PHYSICIAN GUARANTEE LIABILITY  
ASSET RETIREMENT OBLIGATION 7,783,473
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 55,161,148
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 2,024,995,645
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 9,103,736
e Add lines 2a through 2d ..................... 2e 9,103,736
3 Subtract line 2e from line 1.................. 3 2,015,891,909
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b 7,607,064
c Add lines 4a and 4b.................... 4c 7,607,064
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 2,023,498,973
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 1,778,491,120
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d 9,103,736
e Add lines 2a through 2d.................... 2e 9,103,736
3 Subtract line 2e from line 1................... 3 1,769,387,384
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b 0
c Add lines 4a and 4b..................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 1,769,387,384
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D, Part V, Line 4 Intended uses of endowment funds The Children's Hospital Foundation, Inc. and Norton Healthcare Foundation, Inc. utilize income generated from endowment funds to support various programs and services and capital projects for the benefit of Norton Hospitals, Inc.
Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 Rental Income - Internal - 8126436 Rental Expenses - Salary - 211755 Rental Expenses - Other - 683109 - Fees and Special Services - 82436
Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements CONTRIBUTIONS & GRANTS - 10558198 ASSETS RELEASED - PROGRAMS - -2831735 ASSETS RELEASED - FINANCIAL ASSISTANCE - -287774 ASSETS RELEASED - PP & E - -3076927 EQUIPMENT CONTRIBUTION RECEIVED - 3245302
Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 Rental Income - Internal - 8126436 Rental Expenses - Salary - 211755 Rental Expenses - Other - 683109 Fees and Special Services - 82436
Schedule D (Form 990) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
Norton Hospitals Inc
 
Employer identification number

61-0703799
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    13,424,931 839,208 12,585,723 0.74 %
b Medicaid (from Worksheet 3, column a) . . . . .     434,101,087 338,735,836 95,365,251 5.57 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     563,555 3,078,592 0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 448,089,573 342,653,636 107,950,974 6.30 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     12,407,227 2,273,084 10,134,143 0.59 %
f Health professions education (from Worksheet 5) . . .     47,902,601 4,618,925 43,283,676 2.53 %
g Subsidized health services (from Worksheet 6) . . . .     0 0 0 0 %
h Research (from Worksheet 7) .     2,965,304 0 2,965,304 0.17 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     3,165,092   3,165,092 0.18 %
j Total. Other Benefits . . 0 0 66,440,224 6,892,009 59,548,215 3.48 %
k Total. Add lines 7d and 7j . 0 0 514,529,797 349,545,645 167,499,189 9.78 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     0 0 0 0 %
2 Economic development     0 0 0 0 %
3 Community support     1,066,727 0 1,066,727 0.06 %
4 Environmental improvements     0 0 0 0 %
5 Leadership development and
training for community members		     0 0 0 0 %
6 Coalition building     0 0 0 0 %
7 Community health improvement advocacy     0 0 0 0 %
8 Workforce development     0 0 0 0 %
9 Other     0 0 0 0 %
10 Total 0 0 1,066,727 0 1,066,727 0.06 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
57,114,018
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
1,286,073
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
380,883,443
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
374,310,466
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
6,572,977
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?5Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Norton Hospital
200 E Chestnut St
Louisville,KY40202
http://www.nortonhealthcare.com/nortonhospital
100234 		X X   X     X     A
2 Norton Children's Hospital
231 E Chestnut St
Louisville,KY40202
http://www.nortonchildrens.com/
100234 		X X X X     X     A
3 Norton Women's and Children's Hospital
4001 Dutchmans Lane
Louisville,KY40207
http://www.nortonhealthcare.com/pages/nwch.aspx
100255 		X X   X     X     A
4 Norton Audubon Hospital
One Audubon Plaza Drive
Louisville,KY40217
http://www.nortonhealthcare.com/NortonAudubonHospital
100252 		X X   X     X     A
5 Norton Brownsboro Hospital
4950 Norton Healthcare Blvd
Louisville,KY40241
http://www.nortonhealthcare.com/nortonbrownsborohospital
100475 		X X         X     A
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 16
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): nortonhealthcare.com/about-us/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
www.nortonhealthcare.com/fap
b
www.nortonheatlhcare.com/fap
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 6
Part VFacility Information (continued)

Billing and Collections
A
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - ALL HOSPITALS. NORTON HOSPITALS, INC. OWNS AND OPERATES FIVE HOSPITALS LOCATED IN LOUISVILLE, JEFFERSON COUNTY, KENTUCKY. THE HOSPITALS ARE: - NORTON HOSPITAL - NORTON CHILDREN'S HOSPITAL - NORTON WOMEN'S AND CHILDREN'S HOSPITAL - NORTON AUDUBON HOSPITAL - NORTON BROWNSBORO HOSPITAL
Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - OTHER ORGANIZATIONS. THE LOUISVILLE AREA HOSPITALS COLLABORATED WITH LOUISVILLE METRO GOVERNMENT TO CONDUCT THE COMMUNITY WIDE HEALTH SURVEY AND FOCUS GROUPS.
Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - All Hospitals. Norton Healthcare, Inc. conducted a Community Health Needs Assessment (CHNA), using primary and secondary data, to ensure community benefit programs and resources are focused on significant health needs as perceived by the community at large, and aligned with Norton's mission, services and strategic priorities. Key findings for each identified health need were summarized and health needs were prioritized. Norton Executive Leadership and the Community Benefit Committee of the Board of Trustees identified areas where Norton can most effectively focus its resources to have significant impact and developed Implementation Strategies for 2017-2019, in conjunction with their strategic planning process. CHANGING MARKET DEMOGRAPHICS - Norton Hospitals, Inc. (Hospitals) serves A SMALL BUT GROWING IMMIGRANT POPULATION IN THE COMMUNITY. IN RESPONSE TO THIS, Hospitals HAS INITIATED EMPLOYEE RESOURCE GROUPS WITHIN THE ORGANIZATION TO ENHANCE ASSIMILATION WITH Hospitals AND THE COMMUNITY. FIVE GROUPS CURRENTLY EXIST FOR AFRICAN AMERICANS, WOMEN, VETERANS, LGBTQ INDIVIDUALS AND ALLIES, AND YOUNG PROFESSIONALS. EACH GROUP IS OPEN TO ANY EMPLOYEE WHO WANTS TO JOIN. IN 2018 Hospitals LAUNCHED A WOMEN'S LEADERSHIP ACADEMY AND MENTORING PROGRAM THROUGH THEIR WOMEN'S EMPLOYEE RESOURCE GROUP TO INVEST IN THE PROFESSIONAL DEVELOPMENT TO MAINTAIN HIGH LEVELS OF PERFORMANCE AS A HEALTH CARE PROVIDER. Hospitals HAS ENHANCED RECRUITING EFFORTS WITH A FOCUS ON INCLUSIVENESS AND ENSURING THAT THE WORKFORCE IS CONSISTENT WITH THE PATIENTS WE SERVE IN THE COMMUNITY AND REGION. Hospitals HAS INCORPORATED DIVERSITY AND INCLUSION TRAINING INTO THE ORIENTATION PROCESS FOR NEW HIRES, AS WELL AS UTILIZING PATIENT FAMILY ADVISORY COUNCILS TO IDENTIFY PROCESS AND SERVICE IMPROVEMENTS. Hospitals HAS ADDED FREE CLASSES AVAILABLE TO ALL EMPLOYEES SPECIFIC TO IMPROVING CARE FOR LGBTQ PATIENTS, MILITARY AND VETERAN POPULATIONS, LIMITED-ENGLISH PROFICIENT, AND OTHER CULTURAL COMPETENCY COURSES TO HELP PROVIDE THE BEST POSSIBLE CARE TO THOSE WE SERVE. EQUITABLE & INCLUSIVE CARE: Hospitals WAS NAMED A LEADER IN HEALTHCARE EQUALITY BY THE HUMAN RIGHTS CAMPAIGN IN 2017 AND 2018. THE HUMAN RIGHTS CAMPAIGN'S HEALTHCARE EQUALITY INDEX IS AN ANNUAL SURVEY THAT PROMOTES AND ENCOURAGES INCLUSIVE CARE FOR LGBTQ PEOPLE IN HEALTHCARE FACILITIES ACROSS THE UNITED STATES. TO HELP SUPPORT THE EFFORTS OF CREATING A SAFE, ACCESSIBLE CARE ENVIRONMENT FOR OUR PATIENTS, MEDICAL STAFF OR EMPLOYED PROVIDERS ARE ENCOURAGED TO REGISTER FOR ONLINE COURSES PROVIDED THROUGH OUR INTERNAL LEARNING WEBSITE. POVERTY LEVELS - Hospitals FACILITIES ACCEPT ALL PATIENTS, IRRESPECTIVE OF THEIR ABILITY TO PAY. Hospitals HAS A CAPITATION CONTRACT WITH PASSPORT FOR OUR COMMUNITY TO CARE FOR QUALIFIED MEDICAID PATIENTS. Hospitals ALSO HAS A generous CHARITY POLICY WITH REPRESENTATIVES WHO ASSIST THOSE PATIENTS AND FAMILIES AS NEEDED TO ENSURE ALL POTENTIAL RESOURCES ARE AVAILABLE TO THEM WHEN CARE IS PROVIDED. IN 2017, Hospitals LAUNCHED A COMMUNITY PROJECT CALLED UNITY JAM, FOCUSED ON PROVIDING FREE ACCESS TO HEALTHCARE SCREENING SERVICES AND HEALTHCARE EDUCATION FOR RESIDENTS OF POVERTY LADEN AREAS IN THE COMMUNITY. UNITY JAM CONTINUES TO BE AN ANNUAL EVENT IN THE COMMUNITY. REGISTRATIONS INCREASED FROM 267 HOUSEHOLDS IN 2017 TO 1,001 IN 2018. OVER 200 PEOPLE HAVE BEEN SCREENED THROUGH UNITY JAM OVER THE PAST TWO YEARS THIS EVENT HAS TAKEN PLACE. LANGUAGE - Hospitals HAS MANY EMPLOYEES THAT SPEAK SPANISH AND OTHER FOREIGN LANGUAGES. WE CONTRACT WITH A SERVICE TO PROVIDE TRANSLATIONAL SERVICES TO FACILITATE CARE DELIVERY. IN 2017 Hospitals' PREVENTION & WELLNESS TEAM BEGAN SPONSORING THE ANNUAL HISPANIC/LATINO HEALTH FAIR PROVIDING FREE HEALTHCARE AND HEALTH EDUCATION TO MORE THAN 400 PEOPLE. Hospitals HAS CONTINUED TO SPONSOR THIS IN 2018 AND 2019 PROVIDING A FOOD PANTRY, HEALTH EDUCATION, AND CAR SEAT INSTALLATION CHECKS. EDUCATION - Hospitals PROVIDES EXTENSIVE EDUCATIONAL OFFERINGS AND LEADERSHIP DEVELOPMENT PROGRAMS, AS WELL AS EDUCATIONAL ASSISTANCE, FOR ALL EMPLOYEES AT NO ADDITIONAL COST TO THE EMPLOYEE. THESE PROGRAMS ARE PROVIDED THROUGH THE NORTON UNIVERSITY AND Norton Healthcare INSTITUTE FOR NURSING. PROGRAMS ARE EVALUATED ANNUALLY TO DETERMINE GAPS AND FUTURE PROGRAM OPPORTUNITIES IN COLLABORATION WITH NORTON UNIVERSITY LEADERSHIP. IN 2017 Hospitals CREATED KENTUCKY FIRST NURSING APPRENTICESHIP PROGRAM IN RESPONSE TO A CHALLENGE FROM GOVERNOR MATT BEVIN TO ADDRESS TALENT SHORTAGES IN THE STATE THROUGH APPRENTICESHIP. THE PROGRAM PROVIDES PAID, HANDS-ON TRAINING FOR PROSPECTIVE NURSES FOR 12 TO 18 MONTHS WITH AN EXPERIENCED MENTOR IN THE Hospitals' SYSTEM. AT THE END OF THE PROGRAM NURSES ARE NOT REQUIRED TO WORK FOR Hospitals. BEGINNING IN FALL 2017 THROUGH SPRING 2019 232 NURSES HAVE GRADUATED THROUGH THIS PROGRAM. OVER 80,000 PAID STUDENT NURSE HOURS HAVE BEEN INVESTED THROUGH NORTON HEALTHCARE, Inc. (NHC) FOR THIS PROGRAM. TEEN BIRTHS - THE BIRTH RATE FOR TEENAGERS IN THE LOUISVILLE METRO AREA IS 32.4 BIRTHS PER 1,000 FEMALES AGED 15 TO 19 WHICH IS ABOVE THE NATIONAL AVERAGE OF 22.3 PER 1,000 FEMALES AGE 15-19. AS A LEADING PROVIDER FOR BIRTHING SERVICES IN THE COMMUNITY AND THE PREMIER PROVIDER OF PEDIATRIC SERVICES, CONTINUING TO PROMOTE HEALTH AWARENESS AS IT RELATES TO PREGNANCY PREVENTION ALTERNATIVES IS AN AREA OF RESPONSIBILITY FOR OUR ORGANIZATION. Hospitals HAS EXPANDED MATERNAL FETAL MEDICINE LOCATIONS, NOW UTILIZING TELEMEDICINE TOOLS TO BROADEN ACCESS. Hospitals ALSO CONTINUES TO EXPAND CLINICAL AFFILIATIONS WITH RURAL PROVIDERS. Hospitals CONTINUES TO SUPPORT EDUCATION AND AWARENESS OF PREGNANCY PREVENTION ALTERNATIVES FOR THE COMMUNITY, INCLUDING EDUCATIONAL OFFERINGS THROUGH THE MARSHALL WOMEN'S CENTER LOCATED ON OUR ST. MATTHEWS CAMPUS. PRENATAL CARE, LOW BIRTH WEIGHT AND INFANT MORTALITY - IN KENTUCKY, LOW BIRTH WEIGHT BABIES EXCEED THE NATIONAL AVERAGE AND INFANT MORTALITY RATES ARE SLIGHTLY HIGHER THAN THE NATIONAL AVERAGE. Hospitals IS COMMITTED TO ESTABLISHING A MATERNAL FETAL MEDICINE CENTER OF EXCELLENCE FOR THE STATE AND REGION TO ENSURE THE FEMALE POPULATION HAS ACCESS TO CLINICAL RESOURCES FOR THE BEST POSSIBLE CARE AND OUTCOME FOR THEIR BABY. PART OF THIS INITIATIVE INVOLVES EDUCATION ON PRENATAL CARE AND THE VALUE OF THESE EFFORTS TO REDUCE LOW BIRTH WEIGHT BABIES AND OTHER COMPLICATIONS. PRENATAL CLASS OFFERINGS ARE AVAILABLE AT MULTIPLE LOCATIONS IN THE COMMUNITY. ADDITIONALLY, Hospitals PROVIDES CLINICAL RESOURCES TO THE SHAWNEE CHRISTIAN COMMUNITY AND PARK DUVALLE COMMUNITIES TO FURTHER PROMOTE HEALTH AND WELLNESS. ACCESS TO CARE - Hospitals IS PROMOTING EDUCATION AND AWARENESS OF PRIMARY CARE OFFICE LOCATIONS IN THE COMMUNITY AS AN ALTERATIVE TO THE EMERGENCY DEPARTMENT. TO INCREASE ACCESS TO CARE, EMPLOYED PROVIDERS ARE EXPANDING OFFICE HOURS TO ENSURE WALK IN PATIENTS CAN BE SEEN. TO REDUCE WAIT TIMES FOR PRIMARY CARE PHYSICIAN APPOINTMENTS, Hospitals IS UTILIZING THE NORTON ACCESS CENTER TO MORE EFFICIENTLY NAVIGATE PATIENTS TO NEARBY PROVIDERS. NORTON ECARE IS A NEW SERVICE THAT PROVIDES REMOTE DELIVERY OF CARE THROUGH A VIRTUAL VISIT WITH A PROVIDER. Hospitals HAS A TEAM OF NURSE PRACTIONERS THAT ARE DEDICATED TO HELP WITH THE REMOTE DELIVERY OF HEALTH CARE SERVICES. Hospitals ECARE PROVIDERS ARE AVAILABLE SEVEN DAYS A WEEK THROUGH TWO SECURE ONLINE OPTIONS. NHC HAD OVER 4,000 ECARE VISITS IN 2018. IN 2018, WALGREENS AND Hospitals ANNOUNCED NHC WILL OPERATE AND PROVIDE ALL CLINICAL SERVICES AT EIGHT RETAIL HEALTH CLINICS LOCATED WITHIN WALGREENS STORES ACROSS THE GREATER LOUISVILLE AREA, INCLUDING THREE IN SOUTHERN INDIANA AND FIVE IN LOUISVILLE. NORTON PROMPT CARE AT WALGREENS OPERATES DAILY, INCLUDING EVENINGS AND WEEKENDS. THIS GIVES PATIENTS THE OPTION TO ACCESS A VARIETY OF HEALTH CARE SERVICES WITHOUT AN APPOINTMENT. Hospitals HAS SAME OR NEXT DAY APPOINTMENT AVAILABILITY WITHIN OB/GYN. PATIENT CALLS 629-4GYN AND AN APPOINTMENT IS SCHEDULED SAME OR NEXT DAY IN ALL OF OUR OB/GYNPRACTICES. ACCESS TO PEDIATRIC SPECIALISTS - Hospitals, IN PARTNERSHIP with the University OF Louisville (U of L), ANNOUNCED THE CREATION OF NORTON CHILDREN'S CANCER INSTITUTE TO PROVIDE IMPROVED ACCESS AND ADDITIONAL SERVICES TO CARE FOR CHILDREN FIGHTING CANCER AND BLOOD DISORDERS. THE PROGRAM IS EXPECTED TO INCREASE THE NUMBER OF CLINICAL TRIALS OFFERED TO PATIENTS AND GAIN EARLIER ACCESS TO NEW THERAPIES, DEVELOP GROUND-BREAKING RESEARCH AND TECHNOLOGIES, AS WELL AS RECRUIT ADDITIONAL HEMATOLOGY/ONCOLOGY SPECIALISTS AND MEDICAL STUDENTS.
Schedule H, Part V, Section B, Line 11 Facility A, 2 Facility A, 2 - All Hospitals. DIABETES - THE DIABETES PATIENT POPULATION CONTINUES TO GROW IN KENTUCKY AND MORTALITY RATES FOR THE STATE AND LOUISVILLE METRO CONTINUE TO EXCEED NATIONAL AVERAGES. Hospitals HAS A FOCUSED PROGRAM AT OUR CHILDREN'S HOSPITAL TO PROMOTE EDUCATION AND AWARENESS WHILE UTILIZING PROTOCOLS FOR EARLY DETECTION OF PATIENTS WITH DIABETES. ADDITIONALLY NHI'S CLINICAL EFFECTIVENESS TEAM UTILIZES BEST PRACTICE CLINICAL PROTOCOLS TO IDENTIFY DIABETES PATIENTS AND RECOMMEND THEM TO A SPECIALIST FOR ONGOING CARE MANAGEMENT TO IMPROVE PATIENT HEALTH. Hospitals IS WORKING TO INCREASE PARTICIPATION IN DIABETES MANAGEMENT PROGRAMS THROUGH INCREASED TESTING TO IMPROVE LEVELS OF DIAGNOSED PATIENTS. THE WENDY NOVAK DIABETES CENTER AT NORTON CHILDREN'S HOSPITAL (NCH) AND U OF L CURRENTLY CARE FOR MORE THAN 1,540 CHILDREN WITH TYPE 1 DIABETES. THE CENTER OFFERS PERSONALIZED DIABETES EDUCATION PROGRAMS FOR PATIENTS, FAMILIES AND COMMUNITY MEMBERS. THE WENDY NOVAK DIABETES CENTER AT NCH AND U OF L WAS RECENTLY RANKED BY U.S. NEWS & WORLD REPORT AS ONE OF THE TOP 50 BEST HOSPITALS FOR PEDIATRIC DIABETES & ENDOCRINOLOGY SERVICES IN THE UNITED STATES. DEDICATED OUTPATIENT DIABETES CARE IS PROVIDED THROUGH THE NEW NOVAK CENTER FOR CHILDREN'S HEALTH. OBESITY, NUTRITION & EXERCISE - OBESITY IS A SIGNIFICANT HEALTH ISSUE FOR THE LOUISVILLE AREA AS WELL AS THE STATE. KENTUCKY'S ADULT OBESITY RATE IS CURRENTLY AT 34.3%, UP FROM 30.4% IN 2012. ALMOST 33% OF JEFFERSON COUNTY ADULTS ARE OBESE. Hospitals FEELS A RESPONSIBILITY TO THE CHILDREN OF OUR COMMUNITY TO PROMOTE HEALTHY FOOD CHOICES AND RECREATIONAL ACTIVITIES AS THE STATE'S EXPERT IN PEDIATRIC SERVICES. AS PART OF OUR ONGOING PEDIATRIC SERVICES, WE CURRENTLY HAVE A dietary CLINIC AND PROVIDE NUTRITIONAL GUIDANCE FOR OUR PATIENTS AND FAMILIES. Hospitals HAS A BARIATRIC CENTER THAT PROVIDES EXERCISE AND NUTRITION PROGRAMS. BARIATRIC SURGICAL CANDIDATES PARTICIPATE IN AN EDUCATION PROGRAM PRIOR TO THE PROCEDURE TO ENSURE SUCCESS IN MAINTAINING A HEALTHY WEIGHT FOLLOWING THE PROCEDURE. Hospitals HAS ESTABLISHED A FOCUSED PREVENTION AND WELLNESS SERVICE LINE TO ENCOURAGE HEALTHY BEHAVIOR AND TAKE ADVANTAGE OF SCREENINGS AND OTHER PREVENTION ACTIVITIES TO FACILITATE EARLY DETECTION OF CHRONIC CONDITIONS AND RELATED RISK FACTORS. Hospitals WILL CONTINUE TO EXPAND OUR GEOGRAPHIC REACH FOR THESE PROGRAMS AS FEASIBLE. Hospitals HAS PARTNERED WITH THE YMCA OF GREATER LOUISVILLE TO CONTINUE TO ADDRESS CHILDHOOD OBESITY AND IMPROVE EMPLOYEE HEALTH. THROUGH A SPONSORSHIP WITH GONOODLE, Hospitals IS PROMOTING PHYSICAL ACTIVITY IN LOCAL SCHOOLS AND COMMUNITY SETTINGS TO HELP INCREASE THE PHYSICAL HEALTH OF CHILDREN IN THE COMMUNITY. FOOD INSECURITY: AS PART OF ALL WELLNESS VISITS, SELECT Hospitals PEDIATRIC PRACTICES SCREEN PATIENTS TO IDENTIFY FAMILIES facing HUNGER. PATIENTS WITH FOOD INSECURITIES ARE GIVEN ACCESS TO A FOOD PANTRY THAT STOCKS HEALTHY OPTIONS SUCH AS CEREALS LOW IN SUGAR, BROWN RICE, NUTS, SPICES, CANNED FRUIT IN NATURAL JUICES AND CANNED VEGETABLES WITH NO ADDED SALT. CANCER INCIDENCE & MORTALITY - THE KENTUCKY INCIDENCE AND MORTALITY RATES FOR ALL CANCERS ARE WELL ABOVE THE NATIONAL AVERAGE. Hospitals HAS A STRONG DEPTH AND BREADTH OF SUBSPECIALISTS IN THE AREA OF ONCOLOGIC CARE WITH NORTON CANCER INSTITUTE (NCI). WE OPERATE KENTUCKY'S ONLY ACCREDITED NETWORK CANCER CENTER AND UTILIZE EVIDENCE BASED CLINICAL PROTOCOLS AND PATHWAYS TO ENHANCE THE QUALITY OF LIFE AND SURVIVORSHIP OF OUR CANCER PATIENTS. IN 2018 Hospitals OPENED NCI: PROMPT CARE CLINIC SPECIFICALLY FOR CANCER PATIENTS WITH URGENT CARE NEEDS WITH THE GOAL OF KEEPING THEM health and well and thereby OUT OF THE HOSPITAL. IN ADDITION, Norton Cancer CENTER BROWNSBORO IS A NEW COMPREHENSIVE CANCER CARE CENTER DESIGNED TO MINIMIZE WAIT TIMES AND PROVIDE FOR ALL OF THE MULTI DISCIPLINARY NEEDS OF OUR CANCER PATIENTS IN ONE CONVENIENT LOCATION. LUNG CANCER - THE INCIDENCE RATES FOR LUNG CANCER IN KENTUCKY ARE AMONG THE HIGHEST IN THE NATION. THE SURVIVAL RATE UNFORTUNATELY LAGS NATIONAL AVERAGES SIGNIFICANTLY. Hospitals HAS IMPLEMENTED A LUNG CT SCREENING PROGRAM TO FACILITATE EARLY DETECTION. INCEPTED IN 2016 THE PROGRAM IS NOW PERFORMING OVER 2,000 SCREENINGS ANNUALLY. Hospitals ALSO OFFERS TOBACCO AND SMOKING CESSATION CLASSES. IN ADDITION, A MULTI-DISCIPLINARY PROGRAM HAS BEEN ESTABLISHED IN PARTNERSHIP WITH PULMONARY LEADERSHIP TO ADDRESS COMPREHENSIVE PATIENT NEEDS. NORTON CHILDREN'S PREVENTION & WELLNESS - Hospitals PROVIDES INJURY PREVENTION SERVICES INCLUDING CAR SEAT CHECKS, bike HELMET DISTRIBUTION, SAFE SLEEP EDUCATION AND SAFE KIDS COALITIONS. TO HELP REDUCE INJURIES PRESENTING TO THE EMERGENCY ROOM, Hospitals WORKS WITH EXTERNAL PARTNERS, INCLUDING JEFFERSON COUNTY PUBLIC SCHOOLS, TO PROVIDE EDUCATION AND ACCESS TO INJURY PREVENTION SERVICES. MENTAL HEALTH - Hospitals ADDRESSES MENTAL HEALTHCARE NEEDS USING A VARIETY OF MENTAL HEALTH SERVICES. AS OF NOVEMBER 2018 A PEDIATRIC PSYCHOLOGIST HAS BEEN INTEGRATED IN FIVE NORTON PEDIATRIC PRACTICES. ALL Hospitals PEDIATRIC PRACTICES ADMINISTER DEPRESSION SCREENINGS STARTING AT AGE 11. FOR OUR PATIENTS FIGHTING CANCER, NCI IS ONE OF FEW ONCOLOGY PROGRAMS NATIONWIDE OFFERING A ROBUST PROGRAM FOR MENTAL AND EMOTIONAL HEALTH NEEDS. BEHAVIORAL ONCOLOGISTS OFFER FULL DIAGNOSTIC ASSESSMENTS, TREATMENT AND ONGOING FOLLOW-UP CARE. THE NCI ALSO PROVIDES spiritual care, ART THERAPY, A NEW THERAPY DOG PROGRAM LAUNCHED IN 2018 AND MUSIC THERAPY TO EASE THE DISCOMFORT AND ANXIETY OFTEN ASSOCIATED WITH HOSPITALIZATION. Hospitals ALSO PROVIDES OUTPATIENT WOMEN'S MENTAL HEALTH SERVICES ON THE NORTON HEALTHCARE - ST. MATTHEWS CAMPUS. BREAST CANCER - Hospitals HAS MULTIPLE ACCESS POINTS FOR MAMMOGRAPHY SCREENINGS AND OTHER PREVENTION AND WELLNESS ACTIVITIES. Hospitals HAS IMPLEMENTED A BREAST HEALTH PROGRAM TO IMPROVE SERVICE OPTIONS FOR PATIENTS, TO STREAMLINE SCREENING ACTIVITIES AND PROVIDE A SINGLE ACCESS POINT TO EVALUATE CARE AND TREATMENT OPTIONS. PROSTATE CANCER - NCI PROVIDES PROSTATE SCREENINGS THROUGH VARIOUS VENUES, INCLUDING OUR MOBILE HEALTH UNIT IN needy AREAS, AS WELL AS OTHER ROUTINE HEALTH FAIRS WHERE SCREENINGS ARE OFFERED. Hospitals PROVIDES COMPREHENSIVE SERVICES, BEING THE FIRST IN THE COMMUNITY TO PROVIDE RADICAL PROSTATECTOMIES WITH THE DAVINCI ROBOT, PRESERVING TISSUE AND IMPROVING RECOVERY TIME. HEART DISEASE MORTALITY - Hospitals' CARDIOVASCULAR PROGRAM HAS SPECIFIC INITIATIVES TO EXPAND ADVANCED IMAGING TO IMPROVE DIAGNOSIS RATES. FURTHER, OUR CLINICAL PROGRAMS ARE FOCUSED AROUND QUALITY INITIATIVES AND CONTINUOUS ENHANCEMENT OF BEST PRACTICES AND PROTOCOLS. Hospitals CONTINUES TO STRIVE FOR CLINICAL PROGRAM EXCELLENCE THROUGH ATTAINMENT OF ADVANCED ACCREDITATION LEVELS WITH NATIONAL AUTHORITIES AND WILL CONTINUE ENHANCEMENT OF OUR WORKFORCE AND PROGRAMS TO MEET COMMUNITY NEEDS. Hospitals HAS IMPLEMENTED A HEART FAILURE CLINIC UTILIZING ARNP'S FOR MANAGEMENT OF HIGH RISK PATIENTS. Hospitals IS WORKING WITH FAITH PARTNERS TO CONDUCT HYPERTENSION WORKSHOPS TO ADDRESS EARLY IDENTIFICATION OF HYPERTENSION. Hospitals WILL CONTINUE TO INCREASE AWARENESS AND ENABLE EARLY DETECTION OF AT RISK PATIENTS THROUGH DEVELOPMENT OF SPECIFIC CLASSES PROMOTING AWARENESS OF HEART DISEASE SYMPTOMS. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) - AS A LEADING STATE FOR THE use OF TOBACCO AND WITH MULTIPLE INDUSTRIAL PROVIDERS IN THE COMMUNITY, KENTUCKY'S INCIDENCE RATES FOR COPD ARE EXCESSIVE. Hospitals HAS MULTIPLE PULMONOLOGISTS ON STAFF AND OFFERS A BROAD RANGE OF ACUTE CARE SERVICES AS WELL AS RESPIRATORY THERAPY AT ALL HOSPITALS AND AMBULATORY FACILITIES. Hospitals' PREVENTION AND WELLNESS TEAM CONTINUES TO EXPAND SCREENING EFFORTS TO IDENTIFY THESE CHRONIC PATIENTS. IN ADDITION, OUR CARE MANAGEMENT TEAM HAS ESTABLISHED AND WILL CONTINUE TO IMPROVE UPON BEST PRACTICE PROTOCOLS FOR EFFECTIVE MANAGEMENT OF COPD PATIENTS. SYSTEM WIDE ICU/TCU ADMISSION CRITERIA ARE UTILIZED AND A COMPREHENSIVE CARE MODEL ENCOMPASSING HOSPITALISTS, PULMONARY SPECIALISTS AND CRITICAL CARE NP'S IS IN DEVELOPMENT TO IMPROVE CARE AND OUTCOMES FOR PATIENTS.
Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - All Hospitals. Other eligibility criteria in addition to the criteria answered above would include as described in the Financial Assistance Policy: * The patient does not qualify for subsidized coverage of government assistance such as Disproportionate Share Hospital, Children's Health Insurance Program, Medicaid, Medicaid Managed Care Organization, or Hoosier Healthcare. * To be eligible for assistance for non-emergent Medically Necessary Care, a patient (or that patient's guarantor) mush be a resident of Kentucky, Indiana, Tennessee, Ohio, or Illinois. This residency requirement does not apply to emergency care.
Schedule H, Part V, Section B, Line 16 Facility A, 1 Facility A, 1 - ALL HOSPITALS. SEE RESPONSE TO PART VI, LINE 3; PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?0
Name and address Type of Facility (describe)
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Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
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Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Schedule H, Line 7, Input 7 STATE FILING OF COMMUNITY BENEFIT REPORT NOT REQUIRED AT THIS TIME.
Schedule H, Part I, Line 6b Community Benefit Report The annual community benefit initiative report is for all five hospitals in Norton Hospitals, Inc. (Hospitals) and is contained in the report prepared by Hosptals' parent corporation, Norton Healthcare, Inc.
Schedule H, Part VI, Line 5 Promotion of community health Norton Healthcare Inc. (NHC) is a not-for-profit corporation based in Louisville, Ky. In 2018, NHC, through its affiliate, Norton Hospitals Inc., had a total of 1,837 licensed beds: Norton Hospital (Norton) 605 beds; Norton Children's Hospital (NCH) - 300 beds; Norton Audubon Hospital (Audubon) - 432 beds; Norton Women's and Children's Hospital (NWCH) - 373 beds and Norton Brownsboro Hospital (NBH) - 127 beds. These five hospitals operate 24 hours a day, seven days a week. In 2018, NHC, through its affiliate, Community Medical Associates, Inc., had approximately 2.2 million patient encounters. NHC's hospitals, diagnostic centers and Norton Cancer Institute (NCI) served 72,355 inpatients, 560,845 outpatients, and 249,388 emergency room visits. In addition NHC hospitals' operating rooms cared for 20,947 inpatient surgical patients and 35,751 outpatient surgical patients. Additionally, 7,564 babies were delivered at NHC birthing centers. As part of our commitment to improving the health of our community, NHC provides funding for a wide array of life-saving and life-enhancing services that benefit the communities we serve. In 2018, under its charity care program, NHC provided free care to 13,284 patients, at a cost of $13.4 million. Also, NHC 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, 11,472 patients were provided care at discounted rates. Other contributions to the community were the unpaid cost of Medicaid services of $95.4 million and educational support of $43.3 million primarily to the University of Louisville's School of Medicine. Also community health improvement services totaled $10.1 million, and contributions to community groups were $3.2 million. As NHC representatives, our employees donated 53,607 hours of community benefit service, a benefit valued at more than $1.0 million. In addition, many employees self-reported personal volunteer activities. NHC provides programmatic support to the University of Louisville School of Medicine through funding and facilities. During the 2018 calendar year, 180 residents completed clinical rotations in 42 specialties at NHC facilities. Residency programs are part of the $43.3 million in educational support and clinical funding provided to the school. Contributions to the Community * NHC employees and physicians gave nearly $952,775 to the 2018-2019 Combined Giving Campaign to help support community organizations also committed to improving the health and well-being of community residents. Supported organizations include: the WHAS Crusade for Children, Metro United Way, Fund for the Arts, The Children's Hospital Foundation (CHF) and Norton Healthcare Foundation (NHF). * More than 140 NHC employees "Raised the Roof" on a Habitat for Humanity house on Broadleaf Drive in Louisville, Ky. This is the twelfth Habitat home NHC employees have built. * In 2018, more than 2,500 NHC employees donated time and funds to plan, purchase and deliver gifts, food and clothing for the Caring Tree program. The program assisted 438 employees and their 975 children/dependents by providing for their families at Christmas. * More than 38,000 pounds of usable surplus medical supplies valued at more than $623,000 and $40,000 in equipment were donated for use locally and around the world. Community Education and Workforce Development . As one of Kentucky's largest healthcare systems, NHC has established a culture of continual, lifelong learning through the departments of Workforce Development, Norton Institute for Nursing and Norton University. Workforce Development, encourages continuing education, improves job performance and provides financial assistance for designated educational programs related to the business operations of the organization. NHC encourages and supports employees and dependents career goals by providing financial assistance and scholarships as well as other advancement opportunities. Established in the early 2000's, the Office of Workforce Development has assisted more than 6,000 students (74 percent frontline) with tuition assistance. In 2018, Workforce Development financially supported 639 students with nearly $5.1 million in educational assistance programs. * Workforce Development Career Center served over 1,400 students. Each program participant worked directly with a Certified Career Management Coach, offering services in resume writing; career and educational exploration; financial assistance opportunities for educational pursuit; interviewing skills and mentoring. * Norton Scholars Accelerated Program, a student loan program, for employees and non-employees, provides educational funding to students interested in pursuing designated healthcare careers. It is an affiliation between NHC and over 100 colleges and universities nationally. This program has 2,736 graduates and 2,228 of these graduates have continued their careers with NHC. * In 2014, NHC was a National Fund for Workforce Solutions CareerSTAT Frontline Worker Champion. Since 2011, NHC, through Workforce Development, has been a partner with the city of Louisville through a summer job and internship program known as the Mayor Summers Work Program, to give young adults an opportunity to be employed in our healthcare environment during the summer months. In 2018, NHC evolved the Summer Works program into a strategic pipeline development program in conjunction with our public school system. Jefferson County Public Schools created an Academy model in which students have the opportunity to select focused education and industry recognized credentials in high school. NHC transformed the summer program and previous high school scholarships into a comprehensive three tiered academy apprentice program for healthcare academy students. The model is a three tiered apprentice model: Explorer, Summer Extern, and Apprentice. Beginning with a student's junior year, the student will explore career pathways in one of 4 key areas: Patient Care, Medical Office, Allied Health, and Pharmacy Technician. NHC primarily focused on Patient Care and Medical Office in 2018. Each phase offers a rigorous curriculum, business acumen, and professional development, as well as hands on learning opportunities in the career field of their choice. Thirty students participated in the 2018 pilot program. Retention was 100 percent over the first year. To date, NHC has transitioned over 20 of the 30 into full staff positions with the organization post completion of the program offering tuition assistance to continue their academic and career pursuits while working in the field of their choice. * The Student Nurse Apprenticeship program is a 12-to-18-month apprenticeship in which nursing students will work and engage in hands-on learning with an experienced mentor, in addition to becoming acclimated to NHC. Top area student nurses with good grades, good references and a desire to be the best will gain the skills and the confidence to deliver quality patient care. Norton University provides learning opportunities to enhance the professional, educational, and personal development of all employees. Norton University's Value Proposition states "Norton University nurtures learning and relationships to inspire change that leads to exceptional experiences for both patients and employees." In 2018, Norton University held 270,525 learning events, an average of 18 trainings per employee. In 2018, 136,697 web-based training courses and 51,829 instructor-led courses were completed by leaders and staff of all disciplines. * Elevating the First Line Employee, School at Work, College at Work, and Career Coaching programs expose entry-level staff to healthcare careers and help them obtain a higher level position, GED, or college degree. * Leadership development programs support the development of leaders (Nursing, Physician Practices, Physician, and System) across the continuum. * Organizational development activities that assist in creating a more effective and efficient workplace with highly engaged employees. * Of the 23 member Hospital board, 22 are independent community members who reside in the hospital's primary service area.
Schedule H, Part VI, Line 5 Promotion of community health Norton Faith and Health Ministries Norton Faith and Health Ministries (FHM) works with churches and faith communities to weave health and faith together, promoting the intentional integration of faith, healing, and wellness through the development of health ministries. FHM provides mentoring, educational resources, and networking opportunities to assist health ministry coordinators and faith community nurses minister to their churches. In 2018, the department mentored and served nearly 200 multi-denominational faith communities with active health ministry programs, and assisted others with health and wellness efforts. * FHM nurtured relationships with faith communities through participation in events held by the Episcopal Diocese of Kentucky, the Kentucky Conference of United Methodist Church, Central District Baptist Association, United Church of Christ Ministerium, Tri-Kentucky Presbytery, and others. * In order to advance congregational health ministries, faith community nursing and other health-related programs, FHM made 36,000 contacts by distributing 19 electronic newsletters. At 90 regional faith community events, people were provided health literacy education using educational tools loaned from FHM. At 214 events, 1,600 people were screened for blood pressure, blood glucose, body mass index and/or cholesterol, and often received counseling and referrals by faith community nurses. Six formal educational and networking events were held reaching 358 individuals. Norton Pastoral Care The Pastoral Care Department provides spiritual, religious, and emotional care and support for patients, families and staff throughout the system, 24 hours a day, 7 days a week. In 2018, chaplains made more than 35,000 patient contacts plus additional contacts with their families. The assistance included, but was not limited to: grief support and facilitation of decision making at deaths, end of life and goals of care conversations, education and enacting advance directives, religious rituals and literature, ethical dilemmas, comfort and conversation with patient who are lonely, afraid, conflicted, or struggling. Chaplains care for people regardless of their religious or spiritual background or beliefs to help them use and strengthen their spiritual, emotional, and relational resources in better cope and to thrive. A unique aspect of care provided by the Pastoral Care Department is the Bereavement Intervention Program. Through this program, the Bereavement Chaplain connects with all of the more than 100 families whose child died at NCH. That contact often begins at the time of death, and can include a funeral home visit, visit in the home, phone calls, letters, and a dinner and grief educational program that helps family and friends know better how to care for the parents. In addition to the visits to caring for patient and families, the chaplains provide care every day to the staff of the system through individual counseling, sharing prayers and other rituals, debriefing stressful events on units, comforting a department when a co-worker dies, and blessing newly-renovated units. Through teaching, committee involvement, ethics consults, and many other ways, chaplains are fully integrated into the life of the system. Norton Heart Care Norton Heart & Vascular Institute provides the region's most comprehensive screening, education and prevention program and is committed to educating our community about heart health and risk factor management. In 2018: * Norton Heart & Vascular Institute Resource Center offered several free class series to the community including: Circle of Hearts class series, a quarterly heart disease and prevention class that focuses on heart health education and other wellness issues of interest to women. Total attendees for the 2018 class series was 110. Tai Chi for Heart Health, a free class series offered several times a year designed for those with heart issues to help improve quality of life, psychological well-being, blood pressure, balance, flexibility, stress, and depression. Total attendees for 2018 was 24. Afib Education Workshops were offered three times in 2018 where patients facing an atrial fibrillation (A-fib) diagnosis could learn more about the latest in treatment and medication options, steps to lower risk of stroke, and how to live better with A-fib. Total attendees for 2018 was 120. Heart Failure Education Workshops were offered 6 times in 2018 to patients and their families to learn about ways to live a full life and reduce side effects while managing heart failure. Total attendees for 2018 was 81. * The Norton Heart & Vascular Institute is a 10 year active supporter of the American Heart Association's (AHA) Go Red for Women movement. As part of our support, Norton Prevention & Wellness participated in several community events hosted by the AHA and provided 491 free health screenings and education to those in attendance. In addition, a free breakout session was offered prior to the annual Go Red for Women luncheon, Heart Healthy Snacking the Blue Zone Way, to more than 45 attendees to provide education and resources to modify snack choices to promote a heart healthy lifestyle. * Norton Heart & Vascular Institute Resource Center cardiovascular nurse navigator attended 16 heart health community events, including health fairs, presentations and speaking engagements representing businesses, churches, women's groups and health care professionals. More than 1,347 participants attended the events. * Norton Heart & Vascular Institute offers the only WomenHeart Support group in Kentucky and is the only hospital system in Kentucky to be a WomenHeart National Hospital Alliance Member. Women Heart is the national coalition for women living with cardiovascular disease and is the only patient-centered program offering support and education for women living with cardiovascular disease. In 2018, Norton Heart & Vascular Institute supported the addition of one woman heart survivor to join our team of WomenHeart Champions for a total of 8. Each of these champions attend a training at the Mayo Clinic during the Women Heart Symposium to gain the skills necessary to provide support and education to our patients and to the women in our community living with cardiovascular disease. * The monthly WomenHeart Support Group is offered at the Marshall Women's Health and Education Center. It is led by the eight trained WomenHeart Champions and a designated cardiovascular nurse navigator from the Norton Heart & Vascular Institute Resource Center, who provide emotional support as well as education on healthy nutrition, exercise, and stress management. We offered 11 support group classes and 208 female heart patients attended in 2018. We also offered a one day WomenHeart Retreat at the Louisville Seminary and 17 female heart patients attended. * The Women Heart Champions provide support and education to women preparing to undergo cardiac surgeries or procedures and also to women who were in the recovery phase of their cardiac surgery or procedure. They visit women at all three of our Norton Cardiac Rehabilitation centers and provided support to 47 female heart patients in 2018. * The Women Heart Champions attended 11 community events, health fairs, and provide educational presentations to businesses, churches, women groups, and healthcare professionals, which had 1,332 participants. Norton Orthopedic Care Norton Orthopedic Institute earned The Joint Commission's Gold Seal of Approval for knee and hip replacement. This recognition confirms Norton Orthopedic Institute provides a consistently high level of quality care, expert training on best practices, a team approach to patient care, and a culture of excellence throughout NHC hospitals and doctors' offices. * Norton Orthopedic & Hand Center near the campus of NBH is a state-of-the-art facility with specialists of Norton Orthopedic Institute, Norton Sports Health and NHC to provide a multidisciplinary approach to innovative orthopedic care. The facility supports research, training, and education. It also offers patients subspecialized trained orthopedists, a Norton Immediate Care Center with a focus on orthopedics, rehabilitation services, advanced sports training, and primary care services with an emphasis on orthopedics.
Schedule H, Part VI, Line 5 Promotion of community health Women's Services * In 2018, Norton Women's Care birthing facilities at Norton and NWCH provided the care and medical services for 7,564 deliveries. * Free childbirth education classes are provided at Norton and NWCH. Norton Children's Prevention & Wellness * Child passenger safety technicians from NCH check car and booster seats and also provide car and booster seats at free checkup clinics statewide. In 2018, 115 car seats were given to families in need through the community events and hospital admissions. Additionally 46 special needs car seats were loaned to children with body cast and premature infants who would not fit in a conventional car seat. * NCH's Bike Rodeo Program taught 13,170 students from grades three through five throughout Kentucky through 122 bike safety "rodeos." * Following interactive classroom lessons on pedestrian safety, 350 elementary school students and teachers participated in "Safe Kids Walk This Way," a program led by NCH. The program is designed to reduce the number of pedestrian injuries. * NCH's "Just for Kids" Transport Team transports babies and children from across the region to NCH. In 2018, 2,111 transportation trips were completed. Transportation was provided by airplane, helicopter and specially equipped ambulances (mobile intensive care units). * More than 3,500 Kindergarten students, teachers, chaperones, and nursing students participated in the 35th annual Children & Hospitals Week event led by NCH. The program was held at Louisville Slugger Field and supported by a Kohl's Cares grant. Children & Hospitals Week, held each year in March, is designed to teach safe decisions and behaviors to help lessen the fear and anxiety children may have about coming to a hospital. Kentucky Poison Control Center * NCH is home to the Kentucky Poison Control Center. In 2018, the center received nearly 50,000 calls and made nearly 37,000 follow-up calls to concerned families from all 120 counties in Kentucky. The center provided treatment consultation and education about how to correctly handle exposures to poisons. In addition, the center distributed more than 20,000 prevention education resources to physicians' offices, health departments and schools and more than 1,000 packets of materials to individuals who called the toll-free Poison Help Line, (800) 222-1222, available 24 hours a day, 7 days a week. Norton Neuroscience Institute Founded in 2009, Norton Neuroscience Institute (NNI) is continuing its quest to be the regional and national leader in treatment, research and academic training for adult and pediatric neuroscience disciplines. NNI allows patients to be treated for neurological disorders without having to leave the region for care. Subspecialty neurosurgeons, neurologists, and other neurological-related specialists have joined the growing institute. These physicians and advanced level practitioners provide expertise in stroke care, epilepsy, Parkinson's disease, multiple sclerosis, ALS, brain tumors, headaches, concussions, spine care, and many other neurological conditions. * Kentucky is considered to be part of the stroke belt, a region of the US that sees a high number of incidents of stroke cases. As a result, NNI has committed to being a leader in stroke care. NBH is a designated Comprehensive Stroke Center while Norton, Audubon, and NWCH are all certified Primary Stroke Centers. * Neurosurgeons with NNI were the first in Kentucky to use minimally invasive surgery techniques to include robotic surgery, laser ablation and SEEG in the treatment of brain tumors and epilepsy for both pediatric and adult patients. * NNI offers treatment for all neurological disorders including aneurysm, brain tumor, epilepsy, multiple sclerosis, Parkinson's disease, and stroke care. The neurologists and neurosurgeons subspecialize and are fellowship trained. They all work together for the patient, providing multidisciplinary programs in areas of brain tumor, ALS, movement disorders, epilepsy and stroke). * Norton Spine Care offers advanced treatment options of spine conditions ranging from chiari malformation, degenerative disc diseases, scoliosis, spinal stenosis as well as tumors and infections of the spine. * Norton Spine Care which is comprised of Norton Leatherman Spine Center, NNI Spine Care and Norton Spine Specialists, is a multidisciplinary program that embraces a combined orthopedic and neurosurgical approach to spine care. The center's surgeons have pioneered many important breakthroughs in spinal treatment that are performed in the U.S. and around the world. In fact, patients from as far away as South America, Southeast Asia, and Europe have traveled to Louisville for treatment. * Patients served by NCH, the only free standing children's hospital in Kentucky, are fortunate to be cared for by three fellowship trained pediatric neurosurgeons. The neurosurgeons work in a multidisciplinary fashion with neurologist and additional neuro specialist including an embedded pediatric neuropsychologist. Prevention and Wellness * In 2018, the Norton Healthcare Prevention & Wellness staff provided preventive screenings involving the NHC Mobile Prevention Center in collaboration with various community partners. Almost 2,500 women received mammograms and/or wellness exams, including cervical cancer screening, aboard the Mobile Prevention Center. Of them, approximately 10 percent had not been screened in the past five years and 11% had never had a mammogram. Fourteen individuals were diagnosed and treated for pre-invasive and invasive breast cancer. Of the almost 200 Mobile Prevention Center events, over half of these locations were in underserved communities and over 70 percent of patients came from medically underserved areas. * Eligible patients received education on colon cancer screening, and if agreeable, were offered referral for colonoscopy or given an at home testing kit that they could mail to the lab, and receive their results. 96 people received at home kits, and 96 people were referred for colonoscopy. Prevention and Wellness implemented 446-WELL, a number that links eligible patients to colonoscopy or in home tests, eliminating barriers to care. * Staff also provided almost 10,000 cardiovascular screenings (blood pressure, BMI, glucose, and cholesterol) for approximately 3,700 participants in multiple locations throughout Jefferson and surrounding counties, including Southern Indiana, in collaboration with many community partners. Each participant received education on healthy lifestyle choices such as diet and exercise. Group education on various health and wellness information was provided to almost 5,000 participants in 2018. * Prevention and wellness conducted 20 Freedom from Smoking classes in 2018, including two that were offered in Spanish. Research * NHC guides one of the largest portfolios of clinical research of any community healthcare system in the United States. At any given point in time, more than 750 clinical studies are active or pending at NHC. These studies engage more than 300 NHC staff and significantly impact our patients and their families. * NHC invests in research to benefit our community/patients and to support clinical science by participating in the development of new clinical interventions (drugs/device/procedures) that will become generalizable to and shared with a wide number of patient populations and medical professionals. These new, innovative treatments expand the medical community's knowledge and potentially improve the quality of medical care now and in the future. * The Norton Healthcare Research Office partnered with Norton University to offer research education to all researchers in Metro Louisville and beyond. In 2018, education programs were offered, and attendees included staff from; NHC, KentuckyOne Health, University of Louisville Hospital, Floyd Memorial Hospital, Cincinnati Children's Hospital Medical Center, St. Vincent Health, University of Kentucky, University of Louisville and various community-based practices.
Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care Norton Hospitals, Inc. has a policy where we discount charges for all self pay patients with no insurance coverage regardless of income qualifications. Because of this policy, we responded "No" to line 3b in that we do not utilize federal poverty guidelines for providing discounted care.
Schedule H, Part I, Line 6a Community benefit report prepared by related organization Norton Healthcare, Inc.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 57114018
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The costing methodology used to calculate the community benefit expenses was to calculate the cost by hospital location (five separate locations under one Medicare provider number). The cost was determined based on a specific location cost to charge ratio. The cost to charge ratio was adjusted for bad debt expense and other costs. The cost used in the calculator was reduced by bad debt expense, provider taxes, Graduate Medical Education expenses, and other costs. The adjusted cost to charge ratio was then multiplied times the gross charges for qualified financial assistance charges, Medicaid, and the state Disproportionate Program (other means tested government program) to obtain the specific community benefit expense.
Schedule H, Part II Community Building Activities NORTON HOSPITALS INC. (Hospitals) supported over 400 community organizations with leadership support which included over 53,000 hours and over $1.0 million in salaries. Hospitals' representatives served on a variety of nonprofits and government agencies that helped improve access to health services, enhanced the health of the community, advanced medical and health care knowledge, and relieved or reduced the burden of government or community effort. Hospitals' purpose is to provide quality health care to all those we serve, in a manner that responds to the needs of our communities and honors our faith heritage. Our Community Benefit Initiative aligns with our mission to promote the health of the community through service on local boards, advisory councils and volunteering. Hospitals' employees represent Hospitals on many community board positions that help to enhance the community including the American Red Cross, Greater Louisville Inc. Board, The Kentucky Board of Nursing, Habitat for Humanity, Metro United Way, The American Heart Association, The Ronald McDonald House, and many more. Hospitals has a rich cultural history of providing community support and Hospitals employees are passionate about serving others and promoting the health of our community.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE BAD DEBT EXPENSE IS BASED ON THE NET ESTIMATED AMOUNT EXPECTED TO BE DUE FROM THE PATIENT/PAYOR. BAD DEBT EXPENSE FALLS INTO THREE CATEGORIES, TRUE SELF PAY, PATIENT RESPONSIBILITY AFTER INSURANCE, AND OTHER. -TRUE SELF PAY - FOR TRUE SELF PAY PATIENTS, THE SELF PAY DISCOUNT IS APPLIED TO THE ACCOUNT ASSUMING THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE. THE BAD DEBT EXPENSE WRITE-OFF IS THE DISCOUNTED AMOUNT LESS ANY PAYMENTS MADE BY THE PATIENT. -PATIENT RESPONSIBILITY AFTER INSURANCE - THE BAD DEBT EXPENSE WRITE-OFF FOR PATIENT'S RESPONSIBILITY AFTER INSURANCE IS BASED ON THE PATIENT'S LIABILITY PER THE EXPLANATION OF BENEFITS AND CONTRACT WITH THE INSURANCE COMPANY. THE BAD DEBT EXPENSE WRITE-OFF IS THE EXPECTED AMOUNT DUE LESS ANY PAYMENTS MADE BY THE PATIENT. -Other-The other category is for insurance amounts due from payors. Most expected payments not received from an insurance company after investigation into payment differences are written off to contractual allowance/denial category.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology The method used to determine the amount that reasonably could be attributable to patients who likely would qualify for financial assistance under our financial assistance policy is based on our outside eligibility vendor's experience with qualifying accounts as financial assistance. Medassist Firstsource, our outside vendor, screens all self-pay accounts and based on an initial screening, will classify the account as "probable financial assistance. If the accounts appear to meet Norton Hospital, Inc.'s (Hospitals) financial assistance program guidelines, these accounts are then required to submit the necessary documentation to ultimately be classified as a financial assistance account. Based on all accounts that are classified as "probable financial assistance" by Medassist Firstsource and their experience with getting accounts qualified as financial assistance, it is estimated that 55% of those accounts classified as probable financial assistance and which do not submit the required documentation would qualify as a Hospitals financial assistance account. The estimated cost of accounts that are estimated to qualify for our financial assistance programs is calculated based on gross charges for accounts for the year that are probable but do not submit the necessary documentation multiplied times our cost to charge ratio times the 55% estimated conversion factor.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITEOFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COST WAS BASED ON THE MEDICARE PRINCIPLES USED IN COMPLETING THE MEDICARE COST REPORT. ALL COST REPORTED CAME FROM THE MEDICARE COST REPORT. NORTON HOSPITALS, INC. (NHI) ACCEPTS ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS AND therefore OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. NHI BELIEVES THAT ANY MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY COMPENSATE HOSPITALS FOR THE COST OF PROVIDING HOSPITAL CARE TO MEDICARE BENEFICIARIES, AS MEDICARE ALLOWED COST IS LESS THAN ACTUAL COST.
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 Hospital's Inc. will not start collection efforts pending the patient submitting the necessary information to document meeting the financial assistance qualifications. If the patient submits the necessary documentation within a reasonable time period, then there will not be any collection efforts made to collect any amount from the patient. The patient will receive a statement/bill reflecting the amount due through the financial assistance application process pending the patient's financial assistance application, but there will be no collection efforts. Only after attempts are made to contact the patient to obtain the necessary documentation for completing the financial assistance application and the patient not responding, will collection efforts begin. There is ongoing effort throughout the collection process to screen for Medicaid eligibility, Disproportionate Share, and the need for providing financial assistance applications to patients. When a patient is approved for financial assistance, their account balance is written off.
Schedule H, Part V, Section B, Line 16a FAP website A - Norton Hospital: Line 16a URL: www.nortonhealthcare.com/fap;
Schedule H, Part V, Section B, Line 16b FAP Application website A - Norton Hospital: Line 16b URL: www.nortonheatlhcare.com/fap;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - Norton Hospital: Line 16c URL: www.nortonheatlhcare.com/fap;
Schedule H, Part VI, Line 2 Needs assessment NORTON HOSPITALS, INC. (Hospitals) 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 Hospitals IMPORTANT STATISTICS AND DATA TO USE IN EVALUATING COMMUNITY ACCESS TO HEALTH CARE SERVICES AND HEALTH CARE DISPARITIES. ADDITIONALLY, Hospitals ACCESSES DATA FROM ORGANIZATIONS SUCH AS THE CENTER FOR DISEASE CONTROL AND THE UNITED STATES CENSUS BUREAU TO ASSESS AREAS OF GREATEST ANTICIPATED POPULATION GROWTH AND LOW-INCOME AREAS - BOTH OF WHICH MAY BE IN GREATEST NEED FOR PREVENTION EDUCATION, FREE SCREENINGS AND ACCESS TO HEALTH CARE. Norton Healthcare, Inc. (NHC), the parent company of Hospitals, CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR ALL five HOSPITALS. THE CHNA DEFINED THE PATIENT SERVICE AREA BY PATIENT ORIGIN FOR INPATIENT STAYS. DEMOGRAPHIC, SOCIOECONOMIC, POPULATION, AND OTHER HEALTH RELATED INDICATORS 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. NHC BOARD OF TRUSTEES AS WELL AS THE LEADERSHIP OF NHC AND HOSPITAL CHIEF ADMINISTRATIVE OFFICERS HAVE APPROVED THE ASSESSMENT AND IMPLEMENTATION PLAN.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Signage is posted in all Norton Healthcare, Inc. (NHC) Hospital facilities, including the Admission area and emergency room, providing information on the ability to apply for financial assistance and to seek help in paying your bill. The signage is translated in five languages and all languages are contained on the same poster. The languages are: English, Spanish, Vietnamese, Croatian, and Arabic. At the time of registration, the patient access/registration department discusses with the patient the financial assistance/charity options, guidelines, and provides assistance as needed in filling out a financial assistance application and answering questions. The patient may also be referred to the NHC Eligibility Vendor for assistance at no cost to the patient/guarantor. Additional questions from the patient/guarantor can be facilitated through the NHC single billing office (SBO) area, Customer Service, and NHC Vendors. NHC has created a number of different options for the patient/guarantor to supply the information/application for financial assistance to NHC. Those various methods of delivery include: in person, by mail, by fax, on-line application submission via the website, and by specific email address. These various options are publicized and made known to the patient. In 2018 statements mailed to the guarantors by Norton Hospitals, Inc. (Hospitals) contained information to start the financial assistance application process. Hospitals employs an outside eligibility vendor, Medassist Firstsource. All Self-pay accounts for the facilities are placed for eligibility screening with Medassist Firstsource. They screen for NHC Financial Assistance, Medicaid, Medicaid Managed Care Organizations, Presumptive Eligibility, and DSH/KHCP. In addition, they may provide education and referral assistance to the appropriate county/state departments for food stamps, rent assistance, heating assistance, etc. The process of completing the application is often performed by Medassist FirstSource. They protect filing deadlines by submitting the appropriate forms to the State/County. They follow up to secure proof of income documents for Norton Financial Assistance and follow-up with a state caseworker as needed. Medassist Firstsource also makes outside field calls or home visits to the patients to secure the needed information for eligibility assistance if the patient is homebound. Additionally, Medassist Firstsource may provide assistance with patient transportation needs so that the patient can make their scheduled appointments with their caseworker. All of the services provided by Medassist Firstsource Eligibility are at no cost to the patient. Cost to Hospitals for these eligibility and enrollment services was in excess of $4,500,000 in 2018. Hospitals has a staff of over 11 full-time employees including a supervisor, that are dedicated to performing the following functions: processing, reviewing, and approving the hundreds of financial assistance applications received each week. Additionally, some of those employees make out-bound calls to solicit financial assistance information needed to process the patient's application. Financial assistance for Norton Financial Assistance is not limited to the self-pay population. Even patients with insurance coverage are encouraged to apply for assistance so their deductible, co-payments, and co-insurance amounts are covered under the various assistance programs. Financial Counselors/Social Workers at the facilities are educated and trained to assist with counseling patients to determine and explain our financial assistance programs. They continue to receive on-going education throughout the entire year regarding eligibility changes and additions for Norton Financial Assistance, Disproportionate Share Hospital/Kentucky Children's Health Insurance Program, Medicaid, Medicaid Managed Care Organizations, Presumptive Eligibility, etc. As the Foundation Office receives inquiries directed to their offices, they refer these individuals to Patient Financial Services to screen for possible Norton Financial Assistance or Children's Hospital Foundation Funding. If a child's account does not qualify for Norton Financial Assistance, then those not qualifying for children's applications are referred to management of Patient Financial Services for consideration for special funding through The Children's Hospital Foundation, Inc. as well as other programs. The charity application was provided on the back of the Single Business Office statement. Hospitals ensures that all patients were made aware of financial assistance regardless of where the patient's account may have been in the collection cycle. Even if the patient/guarantor had not previously availed themselves of the opportunity to apply for financial assistance and decided they will now cooperate, then allowed the patient/guarantor to apply and approved if they met the qualifications. Financial assistance notifications and applications were made available to the patient/guarantor via telephone, face to face meetings, website, mail, electronically, etc. Primary collection agencies chosen by Hospitals include with their initial placement letter an insert of copy of a financial assistance application for the guarantor to complete. Calls resulting from notification correspondence sent by the collection agencies may be routed to Spanish-speaking customer service representatives or patient/guarantors may also request an interpreter service to assist in facilitating information regarding financial assistance. Hospitals has translated the full financial assistance policy, Financial Assistance Applications and The Plain Language Summary into four languages: Spanish, Vietnamese, Arabic, and Croatian. Hospitals Customer Service Department routinely instructs and screens patients in the protocol regarding financial assistance through The Norton Financial Assistance Program. Since 2007, Hospitals has offered at the time of final billing all true hospital self-pay patients a significant discount off of total charges that were reflected on their monthly statements and the amount due. Contracted collection agencies are required to solicit financial assistance applications when the guarantor/patient indicates "cannot pay". The statements provided by Hospitals in 2018 included the link to the NHC website to allow the patient/guarantor to learn more about financial assistance. The statement contained the financial assistance application on the back of the statement so the guarantor could apply using the actual Hospitals statement and could then mail, fax, bring the application directly to the facilities, or email the form to Patient Financial Services. The statement included a phone number to call to learn more about the application process and discuss financial assistance options.
Schedule H, Part VI, Line 4 Community information PRIMARY SERVICE AREA NORTON HOSPITALS INC.'S (Hospitals) PRIMARY SERVICE AREA POPULATION IS OVER 1.5 MILLION AND EXPECTED TO INCREASE 3% BETWEEN 2019 AND 2024. IN 2016, THE PRIMARY SERVICE AREA INCREASED FROM A 7 COUNTY AREA TO AN AREA INCLUSIVE OF 16 COUNTIES, 5 OF WHICH ARE LOCATED ALONG THE OHIO RIVER BORDER IN KENTUCKY, 4 BORDER THE RIVER IN INDIANA, AND INCLUDES 5 ADDITIONAL KENTUCKY COUNTIES AND 2 ADDITIONAL INDIANA COUNTIES THAT DO NOT BORDER THE OHIO RIVER. 94% OF Hospitals' PATIENTS ARE DERIVED FROM THIS SERVICE AREA. APPROXIMATELY 30% OF THE POPULATION IS OVER 55 YEARS OLD; COMPARED TO 29% IN THE USA. THIS PORTION OF THE POPULATION TENDS TO USE ADDITIONAL HEALTHCARE SERVICES. THE PEDIATRIC POPULATION IN 2019 WAS ESTIMATED AT 343,703 AND IS EXPECTED TO INCREASE TO 345,251 WITHIN 5 YEARS AND REPRESENTS 23% OF THE POPULATION. THE NUMBER OF HOUSEHOLDS IN THE PRIMARY SERVICE AREA WAS ESTIMATED AT 608,808 IN 2019 AND IS EXPECTED TO INCREASE 2.9% BY 2024. CURRENTLY 11% OF THE ADULT POPULATION DOES NOT HAVE A HIGH SCHOOL DEGREE AND 19.5% OF THE HOUSEHOLD INCOME IS LESS THAN $25,000 A YEAR; THE AVERAGE HOUSEHOLD INCOME IS $79,656 COMPARED TO $89,646 FOR THE UNITED STATES. Hospitals TREATS 40% OF THE ADULT INPATIENT CASES IN THE COMMUNITY AND ITS PAYOR MIX IS 52% MEDICARE, 23% MEDICAID/PASSPORT AND 1% SELF PAY. THE LARGEST COUNTY IN THE SERVICE AREA IS JEFFERSON COUNTY AND ITS MAY 2019 PRELIMINARY NON-SEASONALLY ADJUSTED UNEMPLOYMENT RATE WAS 3.8% COMPARED TO 4% FOR KENTUCKY AND 3.4% FOR THE UNITED STATES. SECONDARY SERVICE AREA Hospitals' SECONDARY SERVICE AREA DECREASED FROM 26 COUNTIES TO 17 COUNTIES IN 2016 AS MANY COUNTIES ARE NOW INCLUDED IN THE PRIMARY SERVICE AREA. Hospitals' SECONDARY SERVICE AREA POPULATION WAS 428,109 IN 2019 AND IS EXPECTED TO INCREASE 3.1% BETWEEN 2019 AND 2024. THE SECONDARY SERVICE AREA SPREADS ACROSS 15 KENTUCKY COUNTIES AND 2 INDIANA COUNTIES. THE 55+ AGE COHORT REPRESENTS 29.2% OF THE SECONDARY SERVICE AREA POPULATION AND IS SLIGHTLY HIGHER THAN IN THE UNITED STATES. THE PEDIATRIC POPULATION IN 2019 WAS ESTIMATED AT 96,149 AND EXPECTED TO INCREASE TO 97,241 BY 2024. ALTHOUGH THE PEDIATRIC POPULATION IS EXPECTED TO REMAIN RELATIVELY FLAT (1% GROWTH), THERE IS A NEED FOR CHILDREN TO HAVE APPROPRIATE ACCESS TO CARE IN THE RURAL AREAS OF KENTUCKY. THE NUMBER OF HOUSEHOLDS IN THE SECONDARY SERVICE AREA WAS ESTIMATED AT 168,483 IN 2019 AND IS EXPECTED TO INCREASE 3.3% BY 2024. OVER 47,000 ADULTS IN THIS SERVICE AREA DO NOT HAVE A HIGH SCHOOL EDUCATION AND THE HOUSEHOLD INCOME IS UNDER $25,000 FOR 27.5% OF THE POPULATION. THE AVERAGE HOUSEHOLD INCOME IS $61,405, 13% LESS THAN KENTUCKY AND 23% LESS THAN THE PRIMARY SERVICE AREA AVERAGE HOUSEHOLD INCOME.
Schedule H, Part VI, Line 6 Affiliated health care system Norton Healthcare, Inc. (the controlling company) and its affiliates, including Norton Hospitals, Inc., Norton Properties, Inc., Community Medical Associates, Inc., The Children's Hospital Foundation, Inc., Norton Healthcare Foundation, Inc., and Norton Enterprises, Inc. operate in the Louisville, Kentucky metropolitan area and the operations of the affiliated healthcare system include 1,837 licensed beds, over 200 physician practice locations, and 14 Norton Immediate Care Center locations, and other ancillary health care services.
Schedule H (Form 990) 2018
Additional Data


Software ID: 18007697
Software Version: 2018v3.1
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
Norton Hospitals Inc
 
Employer identification number

61-0703799
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
 
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1Russell F Cox
 
President & CEO/Trustee 		(i)

(ii)		 0
-------------
1,092,389 		0
-------------
539,014 		0
-------------
392,345 		0
-------------
109,695 		0
-------------
29,726 		0
-------------
2,163,169 		0
-------------
38,500
2Robert B Azar
 
Sr VP Chief Legal Officer/Secretary 		(i)

(ii)		 0
-------------
468,944 		0
-------------
173,855 		0
-------------
1,311,015 		0
-------------
114,337 		0
-------------
12,841 		0
-------------
2,080,992 		0
-------------
958,590
3Michael W Gough
 
Exec VP and COO 		(i)

(ii)		 0
-------------
789,537 		0
-------------
310,970 		0
-------------
231,069 		0
-------------
192,261 		0
-------------
22,559 		0
-------------
1,546,397 		0
-------------
91,560
4Adam Kempf
 
Sr VP, CFO/Treasurer 		(i)

(ii)		 0
-------------
382,599 		0
-------------
119,735 		0
-------------
85,657 		0
-------------
91,525 		0
-------------
25,058 		0
-------------
704,573 		0
-------------
37,372
5Mary Gruebbel
 
Former, VP Patient Care Svc/CNO 		(i)

(ii)		 17,210
-------------
0 		83,371
-------------
0 		339,238
-------------
0 		31,783
-------------
0 		8,159
-------------
0 		479,760
-------------
0 		0
-------------
0
6Joseph Flynn DO
 
CAO NMG - Physician -in-Chief NCI 		(i)

(ii)		 582,056
-------------
0 		174,619
-------------
0 		80,937
-------------
0 		105,538
-------------
0 		27,518
-------------
0 		970,668
-------------
0 		61,200
-------------
0
7Thomas Kmetz
 
Division President Women and Children Services (partial year) 		(i)

(ii)		 48,569
-------------
0 		169,020
-------------
0 		580,608
-------------
0 		124,088
-------------
0 		27,277
-------------
0 		949,562
-------------
0 		540,735
-------------
0
8Matthew Ayers
 
Hospital CAO 		(i)

(ii)		 321,057
-------------
0 		92,001
-------------
0 		61,655
-------------
0 		66,048
-------------
0 		22,547
-------------
0 		563,307
-------------
0 		36,124
-------------
0
9Charlotte Ipsan
 
Hospital CAO 		(i)

(ii)		 292,537
-------------
0 		83,441
-------------
0 		81,767
-------------
0 		72,181
-------------
0 		22,863
-------------
0 		552,788
-------------
0 		35,596
-------------
0
10Jon Cooper
 
Hospital CAO 		(i)

(ii)		 290,874
-------------
0 		86,747
-------------
0 		74,475
-------------
0 		63,302
-------------
0 		22,812
-------------
0 		538,210
-------------
0 		0
-------------
0
11Andrew Strausbaugh
 
Hospital CAO 		(i)

(ii)		 282,092
-------------
0 		74,707
-------------
0 		45,974
-------------
0 		58,738
-------------
0 		25,030
-------------
0 		486,540
-------------
0 		0
-------------
0
12Aaron Spalding MD
 
Physician 		(i)

(ii)		 642,124
-------------
0 		540,914
-------------
0 		70,405
-------------
0 		17,358
-------------
0 		35,646
-------------
0 		1,306,447
-------------
0 		0
-------------
0
13Don Stevens MD
 
Physician 		(i)

(ii)		 821,899
-------------
0 		333,800
-------------
0 		34,171
-------------
0 		30,653
-------------
0 		22,069
-------------
0 		1,242,591
-------------
0 		0
-------------
0
14Yong Cha MD
 
Physician 		(i)

(ii)		 640,438
-------------
0 		500,773
-------------
0 		20,980
-------------
0 		13,750
-------------
0 		38,766
-------------
0 		1,214,707
-------------
0 		0
-------------
0
15Shawn Glisson MD
 
Physician 		(i)

(ii)		 913,912
-------------
0 		131,641
-------------
0 		3,885
-------------
0 		13,750
-------------
0 		26,358
-------------
0 		1,089,546
-------------
0 		0
-------------
0
16Michael Driscoll MD
 
Physician 		(i)

(ii)		 740,809
-------------
0 		194,132
-------------
0 		3,020
-------------
0 		13,750
-------------
0 		32,907
-------------
0 		984,618
-------------
0 		0
-------------
0
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part I, Line 1a Discretionary spending account DISCRETIONARY SPENDING ACCOUNTS ARE TREATED AS TAXABLE COMPENSATION. THE ORGANIZATION PROVIDES A DISCRETIONARY SPENDING ACCOUNT FOR ELIGIBLE NORTON HEALTHCARE, INC. (NHC) EXECUTIVES, EFFECTIVE OCTOBER 1, 2007. NHC PROVIDES BENEFITS TO ITS IDENTIFIED EXECUTIVE STAFF TO PROVIDE A TOTAL COMPENSATION PACKAGE THAT IS COMPETITIVE WITH THE MARKET AND WHICH CONFORMS TO THE PHILOSOPHY AND GUIDELINES SET OUT BY THE BOARD OF TRUSTEES, THROUGH THE EXECUTIVE COMPENSATION PHILOSOPHY AND PROGRAMS. THROUGH THE DISCRETIONARY SPENDING ACCOUNT POLICY, EXECUTIVES ARE FREE TO CHOOSE WHATEVER BENEFITS THEY FIND MOST USEFUL OR IMPORTANT TO THEM AND NHC DOES NOT REIMBURSE FOR THE COST OF THOSE BENEFITS, AS THEY ARE PART OF THE DISCRETIONARY SPENDING ACCOUNT. THE INTERESTED PERSONS LISTED BELOW RECEIVED THE BENEFIT OF A DISCRETIONARY SPENDING ACCOUNT IN 2018: Matthew Ayers - $10,000 Thomas Kmetz - $17,500 Charlotte Ipsan - $10,000 Jon Cooper - $10,000 Joseph Flynn - $10,000 Andrew Strausbaugh - $10,000
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation NORTON HEALTHCARE INC (NHC) EIN 61-1028725 IS THE PARENT ORGANIZATION FOR NORTON HOSPITALS, INC. AND THEREFORE ESTABLISHES COMPENSATION FOR THE CEO, OFFICERS AND KEY EMPLOYEES THROUGH ENGAGING WITH THE EXECUTIVE COMMITTEE OF NHC; AN INDEPENDENT COMPENSATION CONSULTANT; WRITTEN EMPLOYMENT AGREEMENTS; THIRD PARTY COMPENSATION SURVEYS AND APPROVAL BY THE EXECUTIVE COMMITTEE AND BOARD. SEE NARRATIVE IN SCHEDULE O, REFERENCING PART VI, LINE 15 WHICH FURTHER DESCRIBES THE PROCESS FOR DETERMINING COMPENSATION FOR THE ORGANIZATION.
Schedule J, Part I, Line 4a Severance or change-of-control payment Severance payment was received during 2018 by key employee: Thomas Kmetz in the amount of $471,267 other compensation included in Schedule J column B(iii) and former Key Employee: Mary Gruebbel in the amount of $272,999 other compensation included in Schedule J column B(iii)
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE FOLLOWING INTERESTED PERSONS PARTICIPATED IN OR RECEIVED PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS AS DESCRIBED IN IRC SECTION 457(F). THE INTERESTED PERSONS BELOW MAY HAVE PARTICIPATED IN ONE OR MORE OF THE FOLLOWING PLANS: THE EXECU-FLEX BENEFIT PLAN, THE EXECU-PLUS BENEFIT PLAN, DEFINED BENEFIT AND DEFINED CONTRIBUTION RESTORATION PLANS, AND THE PHYSICIAN DEFERRED PLAN. THE "PAY CREDIT" OULINED BELOW REPRESENTS A REASONABLE ESTIMATE OF THE ANNUAL INCREASE IN ACTUARIAL VALUE OF THE PLANS; AND THEREFORE, REPRESENTS THE ORGANIZATION'S CONTRIBUTION TO THE VALUE OF THE BENEFITS. NAME - PAY CREDIT Russell F. Cox - $83,271 Michael W. Gough - $166,273 Robert Azar - $95,263 Adam Kempf - $72,433 Matthew Ayers - $47,731 Jon Cooper - $44,179 Charlotte Ipsan - $47,723 Thomas Kmetz - $94,365 Joseph Flynn - $91,788 Andrew Strausbaugh - $39,900 Mary Gruebbel - $9,783 THE "PAYMENT RECEIVED" OUTLINED BELOW REPRESENTS CASH PAYMENTS THAT THE EMPLOYEE RECEIVED DURING 2018 AND CAN BE COMPRISED OF CURRENT AND OR PRIOR YEARS EMPLOYEE AND EMPLOYER CONTRIBUTIONS. NAME - PAYMENT RECEIVED Russell F. Cox - $195,580 Michael W. Gough - $108,176 Robert Azar - $1,267,600 Adam Kempf - $48,754 Matthew Ayers - $46,863 Jon Cooper - $41,776 Charlotte Ipsan - $40,830 Thomas Kmetz - $81,310 Joseph Flynn - $61,755 Andrew Strausbaugh - $32,696 Mary Gruebbel - $45,890
Schedule J, Part I, Line 7 Non-fixed payments In 2018, Norton Healthcare, Inc. (NHC) had in place a Variable Compensation Plan for Executives, eligibility under which extended to employees holding a full-time position as Senior Officer, Officer, System Director or other designated Director level position. Under the plan, a variable compensation pool amount is approved by the Board of Trustees. Each participant's performance is evaluated relative to the goals and objectives documented as part of the participant's plan; and an award is determined for the participant, based on achievement of the goals and objectives, subject to the funding of the variable compensation pool. At the end of each year, the Committee on Executive Compensation and Benefits determines an appropriate award for the NHC's President & Chief Executive Officer, and the President & Chief Executive Officer recommends appropriate awards for other senior executives to the Committee on Executive Compensation and Benefits for its review and approval.
Schedule J (Form 990) 2018
Additional Data


Software ID: 18007697
Software Version: 2018v3.1
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
Norton Hospitals Inc
 
Employer identification number

61-0703799
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2018
Schedule L (Form 990 or 990-EZ) 2018
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) JASON NACAZEL
  		FAMILY MEMBER OF RONALD LEHOCKY, TRUSTEE 83,368 COMPENSATION   No
(2) BARBARA KMETZ
  		FAMILY MEMBER OF THOMAS KMETZ, KEY EMPLOYEE 88,123 COMPENSATION   No
(3) SARAH A ROBINSON
  		FAMILY MEMBER OF DONALD H ROBINSON, TRUSTEE 54,746 COMPENSATION   No
(4) Lorraine Bouvette
  		Family member of Marie Bouvette, Trustee 69,433 COMPENSATION   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
Norton Hospitals Inc
 
Employer identification number

61-0703799
Return Reference Explanation
Form 990, Part V, Line 2a COMMON PAYING AGENT FOR EMPLOYEES NORTON HEALTHCARE, INC. (NHC) EIN 61-102875 IS THE COMMON PAYING AGENT FOR NORTON HOSPITALS, INC. (Hospitals) THEREFORE, ALL APPLICABLE IRS TAX COMPLIANCE FILINGS ARE REPORTED BY NHC ON BEHALF OF Hospitals. Hospitals HAS APPROXIMATELY 11,029 EMPLOYEES.
Form 990, Part V, Line 1a COMMON PAYING AGENT 1099S NORTON HEALTHCARE, INC. (NHC) EIN 61-1028725 IS THE COMMON PAYING AGENT FOR NORTON HOSPITALS, INC. (Hospitals) AND THEREFORE, ALL VENDORS, INCLUDING INDEPENDENT CONTRACTORS, ARE PAID AND REPORTED BY NHC ON BEHALF OF Hospitals. FOR PURPOSES OF PART V, LINE 1, THE NUMBER OF 1099S REPORTED AND FILED FOR 2018 BY NHC FOR Hospitals, WAS APPROXIMATELY 288. Hospitals HAS 158 INDEPENDENT CONTRACTORS EXCEEDING $100,000 FOR 2018.
Form 990, Part VI, Line 1a Delegate broad authority to a committee THE EXECUTIVE COMMITTEE SHALL POSSESS AND MAY EXERCISE ALL THE POWERS AND AUTHORITY OF THE BOARD OF TRUSTEES IN THE MANAGEMENT AND DIRECTION OF THE BUSINESS AND AFFAIRS OF THE CORPORATION. HOWEVER, THE EXECUTIVE COMMITTEE DOES NOT POSSESS THE AUTHORITY TO DO THE FOLLOWING: A) FILL VACANCIES ON THE BOARD; B) CHANGE THE MEMBERSHIP OF THE EXECUTIVE COMMITTEE; C) MAKE DECISIONS TO MERGE, LIQUIDATE, OR OTHERWISE MAKE DECISIONS OUTSIDE OF THE NORMAL COURSE OF BUSINESS, D) MAKE FINAL DETERMINATIONS OF LONG-TERM POLICY; E) HIRE OF FIRE THE CHIEF EXECUTIVE OFFICER; AND F) AMEND THE ARTICLES OF INCORPORATION OR BYLAWS.
Form 990, Part VI, Line 6 Classes of members or stockholders Norton Healthcare, Inc. EIN 61-1028725 is the sole member of Norton Hospitals, Inc.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The Board of Trustees of Norton Healthcare, Inc. appoints the Trustees of the organization.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders According to the Articles of Incorporation of the organization, Norton Healthcare, Inc. (NHC ) the sole member, possesses all of the rights granted to a member pursuant to law, including the right to elect Trustees or Directors and approve amendments to the Articles of Incorporation of the organization. NHC also possesses the right to require the organization to (I) provide contributions of funds of the organization to pay all to a portion of the principle of, interest on, and all other payments to become due and owing with respect to any and all indebtedness incurred by NHC, and (II) provide security for such indebtedness.
Form 990, Part VI, Line 11b Review of form 990 by governing body AT THE October 3, 2019 NORTON HEALTHCARE, INC. (NHC) FINANCE COMMITTEE MEETING AND AT THE OCTOBER 17, 2019 NHC BOARD OF TRUSTEES MEETING, THE 990S WERE DISCUSSED AND COMMITTEE MEMBERS AND TRUSTEES HAD AN OPPORTUNITY TO ASK QUESTIONS. COINCIDING WITH THE FINANCE COMMITTEE MEETING, ELECTRONIC COPIES OF THE 990S WERE MADE AVAILABLE TO ALL MEMBERS OF THE FINANCE COMMITTEE AND BOARD OF TRUSTEES THROUGH THE DIRECTORS PORTAL SITE, PRIOR TO THE FILING WITH THE IRS. NHC IS THE PARENT OF COMMUNITY MEDICAL ASSOCIATES, INC., NORTON HOSPITALS, INC., NORTON PROPERTIES, INC., NORTON HEALTHCARE FOUNDATION, INC., AND THE CHILDREN'S HOSPITAL FOUNDATION, INC.
Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY ANNUALLY DISTRIBUTING A QUESTIONNAIRE THAT REQUIRES OFFICERS, TRUSTEES, AND KEY EMPLOYEES TO DISCLOSE INTERESTS THAT MAY GIVE RISE TO CONFLICTS. IF A CONFLICT ARISES, THE POLICY PROVIDES PROCEDURES FOR ADDRESSING CONFLICTS TO ENSURE DECISIONS ARE MADE IN THE BEST INTERST OF THE ORGANIZATION.
Form 990, Part VI, Line 15a Process to establish compensation of top management official Please see explanation provided for Form 990, Part VI, Line 15b.
Form 990, Part VI, Line 15b Process to establish compensation of other employees The organization takes all necessary steps to ensure that compensation for all officers, directors and key employees is reasonable and appropriate for the services provided to the organization. The organization provides a total compensation package that is on par with compensation provided by similar organizations and which conforms to the policies and guidelines set out by the Board of Trustees. Norton Healthcare, Inc. (NHC) engages an outside independent compensation consultant, Integrated Healthcare Strategies (IHS), to provide comparability data for NHC's officers and key employees on total compensation for similar positions at health systems and hospital organizations similar in size, scope of services, and circumstances. In addition, the organization participates in third party surveys which provide aggregate, comparative compensation data for officers and key employees in similar positions at similar organizations. IHS consultants presented and discussed this comparability data in 2017 for the 2018 compensation review and met in 2018 for the 2019 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 NHC's variable compensation program and determined appropriate awards for performance relative to goals set for the year. After the Committee determined appropriate compensation and benefits for officers and key employees, the Board approved their total compensation.
Form 990, Part VI, Line 19 Required documents available to the public 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. (NHC) and affiliates (Norton Hospitals, Inc., Community Medical Associates, Inc., Norton Properties, Inc., Norton Healthcare Foundation, Inc., and The Children's Hospital Foundation, Inc.) encourages and facilitates board member attendance at educational programs and conferences on subjects relevant to NHC. NHC's travel policy for Board of Trustees provides that for each trustee that attends at least one out of town educational conference, a lump sum stipend will be paid to cover unreimbursed travel expense and other miscellaneous expenses associated with conference preparation, attendance or follow up. In compliance with IRS regulations, NHC provides a form 1099 to any trustee that receives a stipend. These amounts have been reported in Part VII or the form 990 as reportable compensation to the trustee receiving stipends in 2018.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Outside Lab Services - Total Revenue: 34772, Related or Exempt Function Revenue: 34772, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances AFFILIATE TRANSFER - -142288;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
Norton Hospitals Inc
 
Employer identification number

61-0703799
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)NORTON HEALTHCARE INC
ACCOUNTING 224 E BROADWAY 5TH FLOOR

LOUISVILLE,KY40202
61-1028725 		PROVIDE ADMINISTRATIVE AND SUPPORT SERVICES KY 501(c)(3) Type II NA
 
 
No
(2)COMMUNITY MEDICAL ASSOCIATES INC
ACCOUNTING 224 E BROADWAY 5TH FLOOR

LOUISVILLE,KY40202
61-1276316 		OPERATES A NETWORK OF PHYSICIAN PRACTICES KY 501(c)(3) 10 NORTON HEALTHCARE INC
 
 
No
(3)NORTON PROPERTIES INC
ACCOUNTING 224 E BROADWAY 5TH FLOOR

LOUISVILLE,KY40202
61-1028724 		MAINTAIN OFFICE AND PARKING FACILITIES KY 501(c)(3) Type I NORTON HEALTHCARE INC
 
 
No
(4)THE CHILDREN'S HOSPITAL FOUNDATION INC
ACCOUNTING 224 E BROADWAY 5TH FLOOR

LOUISVILLE,KY40202
61-6027530 		GENERATE FUNDS TO SUPPORT PROGRAMS AND SERVICES KY 501(c)(3) 7 NORTON HEALTHCARE INC
 
 
No
(5)NORTON HEALTHCARE FOUNDATION INC
ACCOUNTING 224 E BROADWAY 5TH FLOOR

LOUISVILLE,KY40202
31-0914919 		GENERATE FUNDS TO SUPPORT PROGRAMS AND SERVICES KY 501(c)(3) 7 NORTON HEALTHCAREINC
 
 
No




For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) NORTON ENTERPRISES INC

224 E BROADWAY 5TH FLOOR
LOUISVILLE,KY402022025
61-1054301 		PROVIDE NURSING AND PATHOLOGY SERVICES KY NA
  		C Corporation         No












Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2018

Additional Data


Software ID: 18007697
Software Version: 2018v3.1