TY 2022 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) Russell F Cox President & CEO/Trustee	10.0 ................. 40.0	X	X	4,778,102	181,103
(2) Barry Pennybaker Trustee	1.0 ................. 2.5	X		2,000	0
(3) Brendan Canavan Trustee (partial year)	1.0 ................. 2.5	X		0	0
(4) Craig D Grant Trustee	1.0 ................. 4.5	X		2,000	0
(5) David Craig Trustee	1.0 ................. 3.5	X		2,000	0
(6) Donald H Robinson Trustee	1.0 ................. 5.5	X		0	0
(7) Edie Nixon Chair	1.0 ................. 14.5	X		2,000	0
(8) Erwin Roberts Trustee	1.0 ................. 2.5	X		2,000	0
(9) G Hunt Rounsavall Sr Trustee	1.0 ................. 5.5	X		2,000	0
(10) Gail Lyttle Trustee	1.0 ................. 2.5	X		2,000	0
(11) Gary L Stewart Vice-Chair (partial yr)	1.0 ................. 6.5	X		2,000	0
(12) Gregory E Mayes Trustee	1.0 ................. 6.5	X		2,000	0
(13) James L Sublett MD Trustee	1.0 ................. 2.5	X		2,000	0
(14) Judge Denise Clayton Trustee	1.0 ................. 2.5	X		2,000	0
(15) Lee K Garlove Trustee	1.0 ................. 3.5	X		2,000	0
(16) Maria Hampton Trustee	1.0 ................. 3.5	X		2,000	0
(17) Maria L Bouvette Trustee	1.0 ................. 2.5	X		2,000	0

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Martha K Heyburn MD Trustee	1.0 .......................2.5	X				0	2,000	0
(19) Rev William J Schultz Trustee	1.0 .......................4.5	X				0	2,000	0
(20) Richard R Ivey Trustee	1.0 .......................2.5	X				0	2,000	0
(21) Richard S Wolf MD Chair Emeritus	1.0 .......................2.5	X				0	2,000	0
(22) Rick Guillaume Chair Emeritus (partial year)	1.0 .......................2.5	X				0	0	0
(23) Rita Hudson Shourds EdD Trustee	1.0 .......................2.5	X				0	0	0
(24) Ronald Lehocky MD Trustee	1.0 .......................4.5	X				0	2,000	0
(25) Sue Davis EdD RN Trustee	1.0 .......................2.5	X				0	2,000	0
(26) Adam Kempf Sr VP, CFO/Treasurer	10.0 .......................41.0		X			0	1,039,507	178,515
(27) Michael W Gough Exec VP and COO	10.0 .......................40.0		X			0	1,834,089	133,598
(28) Robert B Azar Sr VP Chief Legal Officer/Secretary	10.0 .......................41.0		X			0	1,116,031	90,244
(29) Andrew Strausbaugh Hospital CAO	50.0 .......................0			X		499,691	0	552,632
(30) Charlotte Ipsan Hospital CAO	29.0 .......................21.0			X		395,341	198,638	126,651
(31) Emmett Ramser Hospital CAO	49.0 .......................1.0			X		535,504	0	118,697
(32) Joseph Flynn DO CAO NMG - Physician -in-Chief NCI	50.0 .......................0			X		957,323	0	153,513
(33) Karen Donahue Division VP Finance	50.0 .......................0			X		489,592	0	69,933
(34) Matthew Ayers Hospital CAO	50.0 .......................0			X		582,984	0	105,848
(35) Aaron Spalding MD Physician	50.0 .......................0				X	1,770,254	0	78,433
(36) Don Stevens MD Physician	50.0 .......................0				X	1,331,996	0	60,328
(37) Joseph Maly MD Physician	50.0 .......................0				X	1,395,625	0	64,291
(38) Muneeb Choudry MD Physician	50.0 .......................0				X	1,379,763	0	56,784
(39) Shawn Glisson MD Physician	50.0 .......................0				X	1,473,156	0	56,738

(A) Name and business address	(B) Description of services	(C) Compensation
Messer Construction Co 11001 Plantside Dr LOUISVILLE,KY40299	Construction	18,271,538
Northstar Anesthesia of KY II PLLC 6225 N State Hwy 161 Suite 200 Irving,TX75038	Anesthesia Services	15,187,027
Medical Solutions LLC P O Box 310737 Des Moines,IA503310737	Contact Labor	8,742,544
Morrison Management Specialist 400 Northridge Rd Suite 600 Sandy Springs,GA30350	Food Service	8,354,027
Pediatric Anesthesia Assoc 2600 Meidinger Tower Louisville,KY40202	Anesthesia Services	7,313,801
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 138

- TIN:

SCHEDULE A
(Form 990)

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.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2022

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 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

Public support percentage for 2022 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

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) 2022

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)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 on 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.)..

First 5 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

Public support percentage for 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2022

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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.

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.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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.

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.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c 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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

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.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on 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.

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

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) 2022

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

By reason of the relationship described in line 2 above, 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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

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.

Did the activities described on line 2a, above 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

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?If "Yes" or "No", provide details in Part VI.

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.

Schedule A (Form 990) 2022

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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 0.015 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 0.035	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2022

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2022 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

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) 2022

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Name of the organization

Norton Hospitals Inc

Employer identification number

61-0703799

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization Norton Hospitals Inc

Part I Contributors	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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

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) (2022)

Schedule B (Form 990) (2022)

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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2022)

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- TIN:

SCHEDULE C
(Form 990)

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 Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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.

Cat. No. 50084S

Schedule C (Form 990) 2021

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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) 2018	(b) 2019	(c) 2020	(d) 2021	(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) 2021

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)

Yes|No

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

54,003

Total. Add lines 1c through 1i ....................................................................................................

54,003

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

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 $54,003 was spent by the Kentucky Hospital Association on lobbying.

Schedule C (Form 990) 2021

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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 instructions and the latest information.

OMB No. 1545-0047

2021

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ....	30,615,700	27,056,341	24,411,014	18,881,092	20,691,046
b	Contributions ...	162,657	488,087	898,799	2,971,598	127,680
c	Net investment earnings, gains, and losses	-3,095,470	4,112,120	2,852,846	3,518,035	-1,053,047
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	1,140,989	1,040,848	1,106,318	959,711	884,587
f	Administrative expenses ....
g	End of year balance ......	26,541,898	30,615,700	27,056,341	24,411,014	18,881,092

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100 %

Term endowment SchDMd Bullet

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

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 ....	1,239,127,663	546,669,514	692,458,149
c	Leasehold improvements
d	Equipment ....	861,419,768	707,053,478	154,366,290
e	Other .....	67,925,518	9,680,966	58,244,552
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				930,629,351

Schedule D (Form 990) 2021

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.)

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.)

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				2,308,549,632
(2)MISCELLANEOUS RECEIVABLES				622,153
(3)RIGHT OF USE ASSETS				8,921,762
(4)DUE FROM THIRD PARTY PAYORS				22,527,768
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				2,340,621,315

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
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	18,431,598
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) 2021

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	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
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
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
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

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
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
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
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
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

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, services and capital projects for the benefit of Norton Hospitals, Inc.

Schedule D (Form 990) 2021

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2022

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

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other 30000 %

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: . . . . . . . .

200% 250% 300% 350% 400% Other %

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.

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"? . . . . . . . . . . . . .

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

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) . . .			15,526,985	342,821	15,184,164	0.64 %
b	Medicaid (from Worksheet 3, column a) . . . . .			620,236,264	680,915,407	0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .			247,549	0	247,549	0.01 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	636,010,798	681,258,228	15,431,713	0.65 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			14,259,074	2,380,695	11,878,379	0.50 %
f	Health professions education (from Worksheet 5) . . .			89,867,423	12,362,385	77,505,038	3.25 %
g	Subsidized health services (from Worksheet 6) . . . .			0	0	0	0 %
h	Research (from Worksheet 7) .			8,797,874	0	8,797,874	0.37 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			8,569,737	0	8,569,737	0.36 %
j	Total. Other Benefits . .	0	0	121,494,108	14,743,080	106,751,028	4.47 %
k	Total. Add lines 7d and 7j .	0	0	757,504,906	696,001,308	122,182,741	5.12 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

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	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing			0	0	0 %
2	Economic development			0	0	0 %
3	Community support			1,006,032	1,006,032	0.04 %
4	Environmental improvements			0	0	0 %
5	Leadership development and training for community members			0	0	0 %
6	Coalition building			0	0	0 %
7	Community health improvement advocacy			1,226,120	1,226,120	0.05 %
8	Workforce development			0	0	0 %
9	Other			0	0	0 %
10	Total	0	0	2,232,152	2,232,152	0.09 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

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. ......

1,347,480

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

Enter total revenue received from Medicare (including DSH and IME).....

373,007,981

Enter Medicare allowable costs of care relating to payments on line 5.....

448,924,832

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-75,916,851

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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) 2022

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)							Facility reporting group
1	Norton Hospital 200 E Chestnut St Louisville,KY40202 https://nortonhealthcare.com/location/hospitals/norton-hospital/ 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 https://nortonhealthcare.com/location/hospitals/norton-womens-and-childrens-hospital/ 100255	X	X		X	X	A
4	Norton Audubon Hospital One Audubon Plaza Drive Louisville,KY40217 https://nortonhealthcare.com/location/hospitals/norton-audubon-hospital/ 100252	X	X		X	X	A
5	Norton Brownsboro Hospital 4950 Norton Healthcare Blvd Louisville,KY40241 https://nortonhealthcare.com/location/hospitals/norton-brownsboro-hospital/ 100475	X	X			X	A

Schedule H (Form 990) 2022

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

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

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 .................

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..................................

Yes

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. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): https://nortonhealthcare.com/about-us/community-health-needs-assessment/

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): https://nortonhealthcare.com/about-us/community-health-needs-assessment/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 300.0%
and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.NORTONHEALTHCARE.COM/FAP

The FAP application form was widely available on a website (list url):

WWW.NORTONHEALTHCARE.COM/FAP

A plain language summary of the FAP was widely available on a website (list url):
WWW.NORTONHEALTHCARE.COM/FAP

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
Name of hospital facility or letter of facility reporting group

Yes

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?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2022

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

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2022

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, 20a, 20b, 20c, 20d, 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 5 Facility A, 1	Facility A, 1 - ALL HOSPITALS. NORTON HEALTHCARE, INC. (NHC) CONDUCTED A COMMUNITYWIDE SURVEY TO OBTAIN FEEDBACK FROM THE GENERAL PUBLIC REGARDING HEALTH NEEDS AND PERCEPTIONS. THE COMMUNITY SURVEY WAS MADE AVAILABLE IN MULTIPLE LANGUAGES, INCLUDING ENGLISH, SPANISH, FRENCH, ARABIC, CHINESE, NEPALI, RUSSIAN, SOMANI, AND VIETNAMESE, THROUGH ONLINE AND PAPER SURVEYING METHODS. THERE WERE 5,185 SURVEYS COLLECTED. SURVEYS THAT FELL OUTSIDE OF JEFFERSON COUNTY OR WERE MISSING THE ZIP CODE, AGE, GENDER, RACE AND EDUCATIONAL ATTAINMENT DEMOGRAPHIC INFORMATION WERE EXCLUDED FROM THE RESULTS. THIS LEFT 2,794 SURVEYS THAT WERE WEIGHTED BASED ON AGE, GENDER, RACE AND EDUCATIONAL ATTAINMENT IN ORDER TO MAKE THE SURVEY RESULTS MORE REPRESENTATIVE OF THE JEFFERSON COUNTY POPULATION AS A WHOLE. IN ADDITION, NHC OBTAINED INPUT FROM 54 VARIOUS COMMUNITY STAKEHOLDERS, INCLUDING 25 NORTON-EMPLOYED PHYSICIANS, 20 COMMUNITY LEADERS IN JEFFERSON COUNTY AND NINE LEADERS FROM AREAS SURROUNDING JEFFERSON COUNTY THROUGH FACE-TO-FACE VIRTUAL MEETINGS. COMMUNITY LEADERS REPRESENT AREAS OF PUBLIC HEALTH, MAJOR EMPLOYERS, PUBLIC SCHOOLS, SOCIAL SERVICES ORGANIZATIONS AND COMMUNITY HEALTH DEPARTMENTS. SHAWNEE CHRISTIAN HEALTH CENTER, JEFFERSON COUNTY PUBLIC SCHOOLS, URBAN LEAGUE OF LOUISVILLE, FORD MOTOR COMPANY, MOLO VILLAGE CDC, EVOLVE502, YMCA OF GREATER LOUISVILLE, CENTERSTONE, METRO UNITED WAY, BELLEWOOD & BROOKLAWN, FAMILY HEALTH CENTERS, HOSPARUS, CENTER FOR WOMEN & FAMILIES, PARK DUVALLE COMMUNITY HEALTH CENTER, BULLITT COUNTY PUBLIC SCHOOLS, AMERICANA COMMUNITY CENTER, LINCOLN TRAIL DISTRICT HEALTH DEPARTMENT, FOUNDATION FOR A HEALTHY KENTUCKY, OLDHAM COUNTY HEALTH DEPARTMENT, KENTUCKY YOUTH ADVOCATES, CLARK COUNTY HEALTH DEPARTMENT, LOUISVILLE METRO OFFICE FOR GLOBALIZATION, BULLITT COUNTY HEALTH DEPARTMENT, LOUISVILLE METRO DEPARTMENT OF PUBLIC HEALTH AND WELLNESS , AND NORTH CENTRAL HEALTH DISTRICT REPRESENTATIVES WERE ALL INCLUDED AS PART OF THE PROCESS TO INTERVIEW PEOPLE WHO REPRESENT THE COMMUNITY. THESE INTERVIEWS FOCUSED ON COVID-19, THE BLACK LIVES MATTER MOVEMENT AND GUN SAFETY, AS WELL AS THE FOLLOWING FOUR KEY AREAS: PRESSING PROBLEMS IN HEALTH CARE, BARRIERS TO HEALTH CARE, HEALTH CARE ENGAGEMENT AND GLOBAL OR UNIVERSAL ISSUES INVOLVING HEALTH CARE. TO ENSURE THE MEDICALLY UNDERSERVED WERE REPRESENTED IN THIS COMMUNITY HEALTH NEEDS ASSESMENT, MEDIAN HOUSEHOLD INCOMES IN NEIGHBORHOODS THROUGHOUT JEFFERSON COUNTY WERE COMPARED TO IDENTIFY NEIGHBORHOODS WITH A LOWER MEDIAN INCOME.
Schedule H, Part V, Section B, Line 6a Facility A, 1	Facility A, 1 - ALL HOSPITALS. NORTON HOSPITALS, INC. OWNS AND OPERATES FIVE HOSPITALS LOCATED IN LOUISVILLE, JEFFERSON COUNTY, KENTUCKY. THE HOSPITALS ARE: - NORTON HOSPITAL - NORTON CHILDREN'S HOSPITAL - NORTON WOMEN'S AND CHILDREN'S HOSPITAL - NORTON AUDUBON HOSPITAL - NORTON BROWNSBORO HOSPITAL
Schedule H, Part V, Section B, Line 6b Facility A, 1	Facility A, 1 - OTHER ORGANIZATIONS. Norton Healthcare, Inc. (NHC) collaborated with a variety of partners ranging from other local health systems to the Jefferson County Public School system and other community organizations. NHC conducted a community wide survey to obtain feedback from the general public regarding health needs and perceptions. The community survey was made available in multiple languages, including English, Spanish, French, Arabic, Chinese, Nepali, Russian, Somali, and Vietnamese, through online and paper surveying methods. After the conclusion of the survey, a few specific under-represented populations in the survey results were found. To ensure that the opinions and perspectives of these groups were adequately represented, NHC utilized IQS, an independent research organization, to assist with the collection of the surveys to target under-represented populations. Community input also was obtained through key stakeholder interviews of 54 community leaders and health care providers. To ensure the medically underserved were represented in this CHNA, interviews were conducted with representatives from Louisville Metro Department of Public Health and Wellness, Jefferson County Public Schools and health care organizations serving neighborhoods where median household incomes are very low, as well as agencies providing services related to mental health, domestic violence and recent immigration to the United States.
Schedule H, Part V, Section B, Line 11 Facility A, 1	Facility A, 1 - All Hospitals. SUBSTANCE USE THE KENTUCKY POISON CONTROL CENTER OF NORTON CHILDREN'S HOSPITAL (NCH) PROVIDES A 24/7 SUPPORT HOTLINE FOR HEALTH CARE PROVIDERS, PATIENTS AND FIRST RESPONDERS ON OPIOID-RELATED ISSUES. THE KENTUCKY OPIOID ASSISTANCE & RESOURCE HOTLINE - (800) 854-6813 - IS STAFFED BY TOXICOLOGY-CERTIFIED NURSES AND PHARMACISTS. FOR THE COMMUNITY, THE HOTLINE OFFERS ADVICE ON SAFE MEDICATION DISPOSAL, WHERE TO GET NALOXONE AND HOW TO USE IT. STAFF ALSO CAN DIRECTLY CONNECT USERS AND THEIR FAMILIES TO OPERATION UNITE FOR SUBSTANCE USE DISORDER TREATMENT AND ASSIST DISPLACED PATIENTS OF PAIN CLINICS THAT SUDDENLY CLOSE. THE NORTON MATERNAL OPIATE AND SUBSTANCE TREATMENT (MOST) PROGRAM WAS CREATED TO HELP PREGNANT WOMEN BREAK THE CYCLE OF ADDICTION. THE MOST PROGRAM OFFERS KNOWLEDGEABLE, SUPPORTIVE STAFF MEMBERS WHO ARE SKILLED IN CARING FOR PREGNANT WOMEN WITH SUBSTANCE USE DISORDERS AND FOR THEIR BABIES. IN 2022, 90 WOMEN WERE ENROLLED IN THE PROGRAM. IN 2018 NORTON HEALTHCARE, INC. (NHC) CREATED AN OPIOID STEWARDSHIP PROGRAM TO DEVELOP PROTOCOLS FOR OPIOID USE AND DISPOSAL IN BOTH THE HOSPITAL AND AMBULATORY SETTING, AND TO PROMOTE ALTERNATIVE PAIN MANAGEMENT METHODS TO REDUCE THE NUMBER OF OPIOIDS IN THE COMMUNITY. THE PROGRAM FOCUSES ON CHANGING PRESCRIPTION PRACTICES BASED ON RECOMMENDATIONS MADE BY THE JOINT COMMISSION, A HEALTH CARE ACCREDITATION ORGANIZATION. NHC PREVENTION & WELLNESS OFFERS A COMPREHENSIVE TOBACCO CESSATION PROGRAM TO HELP THOSE IN THE COMMUNITY STRUGGLING WITH TOBACCO ADDICTION. CLASSES MEET FOR EIGHT 60- TO 90-MINUTE SESSIONS OVER SEVEN WEEKS. CLASSES FOLLOW THE AMERICAN LUNG ASSOCIATION FREEDOM FROM SMOKING PROGRAM, PROVEN TO BE EFFECTIVE FOR MILLIONS OF SMOKERS. NCH'S PREVENTION & WELLNESS HOSTS A FREE PROGRAM CREATED BY THE AMERICAN LUNG ASSOCIATION, N-O-T (NOT ON TOBACCO) WHICH IS AN EVIDENCE-BASED PROGRAM DESIGNED SPECIFICALLY FOR TEENS TO HELP THEM QUIT USING TOBACCO PRODUCTS, INCLUDING VAPES, CIGARETTES AND OTHER FORMS OF TOBACCO. APPROXIMATELY 90% OF TEENS WHO PARTICIPATED IN A N-O-T PROGRAM EITHER QUIT OR CUT BACK ON THEIR USE OF TOBACCO PRODUCTS. GROUP SESSIONS MEET ONCE WEEKLY TO DISCUSS THE IMPORTANCE OF HAVING GOOD HEALTH, LEARN TOOLS TO PREPARE FOR TOUGH MOMENTS AND SUPPORT EACH OTHER ON THEIR JOURNEY TO QUITTING. THIS IS A VOLUNTARY PROGRAM FOR TEENS AGES 14 TO 19. THE COMPREHENSIVE LUNG CENTER AT NORTON CANCER INSTITUTE (NCI) IS THE FIRST AND ONLY HEALTH SYSTEM IN KENTUCKY TO BECOME A GO2 FOUNDATION FOR LUNG CANCER CENTER OF EXCELELNCE IN BOTH CARE CONITUUM AND SCREENINGS. THE COMPREHENSIVE LUNG CENTER ALLOWS PATIENTS TO SEE AN ONCOLOGIST, SURGEON, RADIATION ONCOLOGIST, COUNSELOR, NUTRITIONIST AND OTHER MEMBERS OF THE CARE TEAM ALL IN ONE VISIT. NHC HAS ESTABLISHED A NO SMOKING POLICY ON ALL CAMPUSES TO ELIMINATE EXPOSURE TO TOBACCO SMOKE FOR OUR PATIENTS AND FAMILIES. NORTON HOSPITALS INC. (NHI) HAS MULTIPLE PULMONOLOGISTS ON STAFF AND OFFERS A BROAD RANGE OF ACUTE CARE SERVICES AS WELL AS RESPIRATORY THERAPY AT ALL NHI AND AMBULATORY FACILITIES. OBESITY WEIGHT-LOSS SEMINARS - EITHER ONLINE OR IN-PERSON - ARE FREE AT NORTON WEIGHT MANAGEMENT SERVICES TO GIVE INFORMATION ABOUT BARIATRIC SURGERY OR MEDICALLY GUIDED WEIGHT LOSS. THE BARIATRIC SURGERY SEMINAR IS LED BY A BOARD-CERTIFIED BARIATRIC SURGEON. IN 2019 THE LOUISVILLE URBAN LEAGUE AND NHC ANNOUNCED NHC'S SUPPORT OF THE WEST END MULTI-USE SPORTS AND LEARNING COMPLEX. NHC CONTRIBUTED $5 MILLION TO THE PROJECT THROUGH A $3 MILLION GRANT AND AN ADDITIONAL CHALLENGE GRANT OF $2 MILLION IN MATCHING FUNDS. THE FACILITY IS NAMED THE NORTON SPORTS HEALTH ATHLETICS & LEARNING COMPLEX AND OFFICIALLY OPENED IN FEBRUARY 2021. NHC OPENED A COMPREHENSIVE SPORTS PERFORMANCE AND HEALTH AND WELLNESS FACILITY IN 2022. THE NEW NORTON SPORTS HEALTH PERFORMANCE & WELLNESS CENTER OFFERS STATE-OF-THE-ART TECHNOLOGY AND TRAINING FOR ELITE AND HIGH SCHOOL ATHLETES, AS WELL AS PROGRAMMING AND WORKOUT SPACE FOR CASUAL EXERCISERS AND THOSE NEW TO FITNESS. THE 40,000-SQUARE-FOOT CENTER IS MORE THAN DOUBLE THE SIZE OF THE FORMER LOCATION AND REPRESENTS MORE THAN A $1 MILLION INVESTMENT. THE NEW LOCATION ALSO WILL OFFER A MORE TRADITIONAL GYM WITH CARDIO EQUIPMENT, WEIGHT MACHINES AND CLASSES FOR THE GENERAL PUBLIC. SENIORS WILL HAVE ACCESS TO THE FACILITY THROUGH THEIR MEDICARE SILVERSNEAKERS MEMBERSHIPS. THERE ALSO WILL BE PROGRAMMING FOR HIGH SCHOOL ATHLETES, INCLUDING TEAM TRAINING, STRENGTH AND CONDITIONING. POOR NUTRITION NCH'S PREVENTION & WELLNESS SPONSORS THE CHOPCHOP FAMILY COOKING MAGAZINE FOR AGES 5-12 AND THEIR FAMILIES. ADULTS WHO ARE JUST LEARNING TO COOK ARE ALSO WELCOME TO JOIN. ENDORSED BY THE AMERICAN ACADEMY OF PEDIATRICS, CHOPCHOP: THE FUN COOKING MAGAZINE FOR FAMILIES, IS A NONPROFIT QUARTERLY FOOD MAGAZINE. PUBLISHED BY CHOPCHOP KIDS, INC, A 501(C)(3), CHOPCHOP'S MISSION IS TO INSPIRE AND TEACH CHILDREN AND FAMILIES TO COOK AND EAT REAL FOOD TOGETHER. CHOPCHOP BELIEVES COOKING AND EATING TOGETHER IS A VITAL COMPONENT IN RESOLVING THE WIDESPREAD PROBLEMS OF OBESITY, HUNGER, AND POOR NUTRITION. NCH'S PREVENTION & WELLNESS HOSTS SKILL-BUILDING WORKSHOPS TO SUPPORT FAMILIES WITH TEENS IN THEIR JOURNEY TOWARD HEALTHY LIVING. THE SIX-WEEK WORKSHOP SERIES FOCUSES ON GOAL-SETTING FOR HEALTHY HABITS, HEALTHY MEAL PLANNING AND PREP, FUN WAYS TO STAY ACTIVE, INCLUDING FREE PASSES TO THE YMCA, AND TOOLS TO POSITIVELY REDUCE STRESS. NHI CONTINUES TO OFFER FREE HEALTH SCREENINGS AND EDUCATION TO THE COMMUNITY THROUGH USE OF OUR MOBILE PREVENTION UNIT, AS WELL AS THROUGH VARIOUS COMMUNITY EVENTS AND HEALTH FAIRS. IN 2022, THERE WERE ALMOST 400 FREE SCREENING EVENTS PERFORMED IN THE COMMUNITY. THE NHC MOBILE PREVENTION CENTER CONNECTS PEOPLE TO WELLNESS AT MULTIPLE STOPS EVERY WEEK. MANY OF THE SCREENINGS ARE PROVIDED AT LOW COST OR NO COST, AND OTHERS TYPICALLY ARE COVERED BY INSURANCE. NCI OFFERS ONCOLOGY NUTRITION COUNSELING FOR CANCER PATIENTS AT SEVEN CAMPUSES. LICENSED, REGISTERED DIETITIANS ARE AVAILABLE FOR COMPLIMENTARY, ONE-ON-ONE COUNSELING, IN PERSON OR BY TELEPHONE. NUTRITION SPECIALISTS HAVE EXPERTISE TO OFFER NUTRITION GUIDANCE BEFORE, DURING AND AFTER CANCER TREATMENT, WITH INTERVENTIONS DESIGNED TO OPTIMIZE QUALITY OF LIFE WHILE A PATIENT EXPERIENCES A CANCER DIAGNOSIS. MENTAL HEALTH NHI IMPLEMENTED THE COLUMBIA-SUICIDE SEVERITY RATING SCALE IN APRIL 2019. THIS IS A QUESTIONNAIRE WHICH IS USED TO ASSESS SUICIDE RISKS FOR PATIENTS AT ALL ACCESS POINTS, INCLUDING THE EMERGENCY ROOM AND AMBULATORY SETTING. THE TOOL IS USED TO ASSESS PATIENT RISK AND ENSURE REFERRAL TO APPROPRIATE RESOURCES FOR TREATMENT. FROM 2020 TO 2022 THE NUMBER OF SUICIDE SCREENINGS COMPLETED AT NORTON HEALTHCARE INCREASED BY 12%. HEALTH EDUCATORS FROM NCH'S PREVENTION & WELLNESS TEAM PARTNER WITH LOCAL MIDDLE/HIGH SCHOOLS TO OFFER PEER-TO-PEER EDUCATION AND AWARENESS ABOUT MENTAL HEALTH CONCERNS. WORKSHOPS ARE OFFERED IN SCHOOL HEALTH AND PHYSICAL EDUCATION CLASSROOMS, AT AFTER-SCHOOL EVENTS AND THROUGH SUMMER PROGRAMS. WORKSHOPS PROVIDE PEER EDUCATION TO SUPPORT YOUNG PEOPLE IN DEVELOPING POSITIVE GROUP NORMS AND MAKING HEALTHY DECISIONS. THIS SERIES TEACHES STUDENTS HOW TO REDUCE STRESS AND EMPOWERS STUDENTS TO BECOME VOICES IN THEIR SCHOOLS AND TO ENCOURAGE HEALTHY BEHAVIORS AND DECISION-MAKING. NCH OFFERS INPATIENT PSYCHIATRIC CARE FOR CHILDREN AGES 2 TO 17 THROUGH THE ACKERLY CHILD PSYCHIATRIC UNIT. THEIR MISSION IS TO HELP CHILDREN AND FAMILIES REACH THEIR FULLEST POTENTIAL IN A NURTURING AND SAFE ENVIRONMENT. THEY ARE EQUIPPED TO SERVE PATIENTS WITH DEVELOPMENTAL DISABILITIES AND AUTISM, AND ALSO EXTEND CARE REGARDLESS OF A FAMILY'S BACKGROUND OR ABILITY TO PAY. IN THE AMBULATORY SETTING, NORTON CHILDREN'S MEDICAL GROUP PSYCHIATRY & PSYCHOLOGY OFFERS CHILD AND ADOLESCENT PSYCHIATRY SERVICES. IN 2019, NHI ESTABLISHED THE NORTON BEHAVIORAL HEALTH PRACTICE, WITH THE GOAL OF PROVIDING CLINICALLY INTEGRATED FAMILY AND PATIENT-CENTERED MENTAL HEALTH CARE. THE PRACTICE OFFERS TELEMEDICINE VISITS IN PRIMARY CARE LOCATIONS TO IMPROVE ACCESS AND HELP OVERCOME THE STIGMA OFTEN ASSOCIATED WITH MENTAL HEALTH FACILITIES. THE PRACTICE CARED FOR OVER 10,000 UNIQUE PATIENTS IN 2022. NORTON WOMEN'S MENTAL HEALTH SERVICES PROVIDES OUTPATIENT WOMEN'S MENTAL HEALTH SERVICES ON THE NORTON - ST. MATTHEWS CAMPUS. THEY ARE COMMITTED TO PROVIDING QUALITY MENTAL HEALTH CARE TO WOMEN ACROSS THEIR LIFESPAN.
Schedule H, Part V, Section B, Line 11 Facility A, 2	Facility A, 2 - All Hospitals. THE NCI BEHAVIORAL ONCOLOGY PROGRAM IS STAFFED BY A TEAM TRAINED AND EQUIPPED TO CARE FOR THE EMOTIONAL AND MENTAL HEALTH NEEDS OF PATIENTS AND THEIR FAMILIES. NCI IS ONE OF FEW ONCOLOGY PROGRAMS NATIONWIDE OFFERING A ROBUST PROGRAM FOR MENTAL AND EMOTIONAL HEALTH NEEDS. NORTON CHILDREN'S BEHAVIORAL & MENTAL HEALTH, AFFILIATED WITH THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE, PROVIDES OUTPATIENT AND INPATIENT MENTAL HEALTH CARE FOR CHILDREN AGES 2 TO 21. PATIENTS AND THEIR FAMILIES HAVE ACCESS TO CHILD PSYCHIATRIC AND PSYCHOLOGICAL EVALUATION AND TREATMENTS. SERVICES INCLUDE MEDICATION THERAPY AND A BROAD RANGE OF INDIVIDUAL, GROUP AND FAMILY THERAPIES. A SOCIAL WORKER IS ON CALL TO ASSIST WITH ADDRESSING BARRIERS TO CARE. HEALTH LITERACY AS OF NOVEMBER 2022, A COMMUNITY HEALTH WORKER PROGRAM WAS ESTABLISHED AT THE INSTITUTE FOR HEALTH EQUITY, A PART OF NHC. THESE EIGHT COMMUNITY HEALTH WORKERS BUILD RELATIONSHIPS WITH PATIENTS TO REMOVE BARRIERS TO CARE AND ADDRESS SOCIAL DETERMINANTS OF HEALTH. THE TEAM IS TRAINED TO HELP DEVELOP PERSONALIZED ROAD MAPS TO HEALTHIER LIVES, TAKING INTO ACCOUNT THE UNIQUE NEEDS AND CULTURAL SENSITIVITIES OF UNDERSERVED POPULATIONS. EACH COMMUNITY HEALTH WORKER SPECIALIZES IN SERVING A UNIQUE PATIENT POPULATION SUCH AS THE HISPANIC, AFRICAN AMERICAN AND REFUGEE COMMUNITIES. COLLECTIVELY, THE TEAM SPEAKS 10 LANGUAGES AND DIALECTS. WHILE SPECIALIZING IN SPECIFIC COMMUNITIES, THE HEALTH WORKERS ARE CROSS-TRAINED TO PROVIDE SUPPORT TO ANY PATIENT OR FAMILY. HAVING A DESIGNATED AREA OF EXPERTISE ALLOWS FOR DEDICATED ATTENTION TO THE DISTINCTIVE SOCIAL DETERMINANTS OF HEALTH IMPACTING A PARTICULAR COMMUNITY. FOR ONE PATIENT, A COMMUNITY HEALTH WORKER MAY BE A CONNECTION TO A LOCAL FOOD PANTRY. FOR ANOTHER, THE WORKER MAY HELP TO ARRANGE RELIABLE TRANSPORTATION TO APPOINTMENTS. SOME PATIENTS NEED COACHING ON ACCESSING COMMUNITY RESOURCES. OTHERS MAY NOT FULLY UNDERSTAND THE BENEFITS OF ESTABLISHING A RELATIONSHIP WITH A PRIMARY CARE PROVIDER. HEALTH DISPARITIES NORTON WOMEN'S CARE LAUNCHED A NEW DOULA PROGRAM IN 2021 THAT AIMS TO IMPROVE THE LONG-TERM HEALTH OF NEW MOTHERS IN UNDERSERVED AREAS OF THE COMMUNITY. NHC HAS DEVELOPED THE COMMUNITY-BASED DOULA PROGRAM TO HELP WOMEN WITH STATISTICALLY POOR MATERNAL OUTCOMES IN LOUISVILLE HAVE ACCESS TO A DOULA AND THE BENEFITS ONE OFFERS. THE PROGRAM PROVIDES ELIGIBLE PREGNANT PATIENTS WITH A DOULA AT NO COST TO THEM. WHILE DOULAS ARE WELCOME IN MANY BIRTHING HOSPITALS, THIS IS THE FIRST PROGRAM IN KENTUCKY THAT EMPLOYS DOULAS AS PART OF THE CARE TEAM. THIS NEW PROGRAM INCLUDES SEVERAL HOME VISITS THROUGHOUT THE PATIENT'S PREGNANCY AND THE PERIOD AFTER DELIVERY. ELIGIBLE PATIENTS MUST LIVE IN THE CALIFORNIA, PORTLAND OR RUSSELL NEIGHBORHOOD, AND RECEIVE ADDITIONAL PRENATAL CARE THROUGH NORTON OB/GYN ASSOCIATES AND NORTON WOMEN'S SPECIALISTS DOWNTOWN PRACTICES, WITH BABIES DELIVERED AT NORTON HOSPITAL. INITIALLY, THE PROGRAM EMPLOYED THREE DOULAS. PROVIDERS AT NORTON WOMEN'S SPECIALISTS AND NORTON OB/GYN ASSOCIATES CAN REFER PATIENTS TO THE COMMUNITY-BASED DOULA PROGRAM. NHC ANNOUNCED CHANGES TO ITS FINANCIAL ASSISTANCE PROGRAM. THE CHANGES ARE INTENDED TO INCREASE ACCESS TO HEALTH CARE BY ALLEVIATING FINANCIAL STRESS THAT OFTEN SERVES AS A BARRIER AND PREVENTS INDIVIDUALS FROM SEEKING CARE. PREVIOUSLY, FAMILIES WERE ELIGIBLE FOR NHC'S FINANCIAL ASSISTANCE PROGRAM IF THEIR HOUSEHOLD INCOME WAS EQUAL TO OR LESS THAN 300% OF THE FEDERAL POVERTY GUIDELINES. WITH THESE CHANGES, THAT INCOME LEVEL HAS INCREASED TO 350% OF THE FEDERAL POVERTY GUIDELINES. FOR EXAMPLE, A FAMILY OF FOUR WITH A COMBINED HOUSEHOLD INCOME OF UP TO $105,000 NOW COULD BE ELIGIBLE FOR FINANCIAL ASSISTANCE. ADDITIONALLY, INDIVIDUALS CAN NOW APPLY IN ADVANCE TO PARTICIPATE IN THE EXPANDED FINANCIAL ASSISTANCE PROGRAM. BY COMPLETING THE QUALIFICATION PROCESS AHEAD OF TIME, IT WILL REMOVE THE BARRIER THAT SOME EXPERIENCE WHEN ASKED TO DISCUSS FINANCIAL STATUS MATTERS AT THE POINT OF CARE. PREVIOUSLY, FAMILIES WOULD COMPLETE AN APPLICATION AFTER RECEIVING TREATMENT, INCLUDING AFTER AN EMERGENCY OR SERIOUS MEDICAL CONDITION. NOW THIS CAN BE DONE BEFORE THERE IS A CRISIS OR NEED FOR MEDICAL TREATMENT. COMMUNITY MEMBERS CAN APPLY AT ANY TIME ONLINE OR CAN REQUEST A PAPER COPY OF THE APPLICATION, WHICH IS AVAILABLE IN SEVERAL LANGUAGES. ONCE APPROVED, THE APPLICATION WILL BE VALID FOR ONE YEAR. THOSE TAKING PART IN THE PROGRAM CAN RE-APPLY EVERY YEAR. NHI, IN PARTNERSHIP WITH THE UNITED WAY, IS PARTICIPATING IN THE UNITED COMMUNITY INITIATIVE. UNITED COMMUNITY SEEKS TO LINK HEALTH CARE SERVICES AND SOCIAL SERVICES VIA A DATABASE PLATFORM CALLED UNITE US. BETWEEN 2021 AND 2022 NHI INCREASED UNITED COMMUNITY REFFERED CASES BY 567%. NHI CAN REFER PATIENTS WITH SOCIOECONOMIC NEEDS TO APPROPRIATE RESOURCES USING THIS DATABASE PLATFORM. THE DATABASE IS INTEGRATED INTO THE PATIENT'S ELECTRONIC MEDICAL RECORD SO THAT PROVIDERS CAN SEE PATIENT REFERRALS TO SOCIAL SERVICES AS WELL AS THE OUTCOME OF THOSE REFERRALS. NHI HAS ESTABLISHED A SOCIAL SERVICES ASSESSMENT TOOL TO STREAMLINE THE SCREENING AND DOCUMENTATION OF SOCIAL NEEDS FOR PATIENTS. THE ASSESSMENT IS INTEGRATED IN THE ELECTRONIC MEDICAL RECORD AND UTILIZED BY SOCIAL WORKERS TO IDENTIFY AND DOCUMENT SOCIAL NEEDS AND TO REFER PATIENTS TO APPROPRIATE SOCIAL SERVICES RESOURCES USING THE UNITE US DATABASE PLATFORM. TRUST THE KEY TO ENSURING HEALTH EQUITY IS INCREASING ACCESS TO CARE IN LOUISVILLE'S UNDERSERVED AREAS. NHC EXPANDED ACCESS IN UNDERSERVED AREAS THROUGH THE OPENING OF A NEW PRIMARY CARE PRACTICE IN THE WEST END, INCLUDING A COVID-19 TESTING AND VACCINATION CENTER AT THAT LOCATION. NHC ALSO PURCHASED A SECOND MOBILE UNIT, MAKING IT EASIER FOR THE COMMUNITY TO ACCESS PREVENTIVE SERVICES SUCH AS MAMMOGRAMS, WELL-WOMAN EXAMS AND COLON CANCER SCREENINGS. ADDITIONAL SITE OPENINGS ARE PLANNED IN WEST AND SOUTH LOUISVILLE TO FURTHER EXPAND ACCESS TO CARE. GOODWILL INDUSTRIES OF KENTUCKY AND NHC BROKE GROUND IN 2022 ON THE NHC GOODWILL OPPORTUNITY CAMPUS AT 28TH STREET AND BROADWAY. THE CAMPUS WILL INCLUDE A 120,000 SQUARE-FOOT OPPORTUNITY CENTER AND THE FIRST HOSPITAL IN THE MOST UNDERSERVED PART OF THE COMMUNITY. TOGETHER, BOTH ORGANIZATIONS ARE INVESTING MORE THAN $100 MILLION TO TRANSFORM A 20-ACRE BROWNFIELD SITE IN THE PARKLAND NEIGHBORHOOD INTO AN "OPPORTUNITY CAMPUS" THAT WILL HOUSE GOODWILL'S HEADQUARTERS OPERATION, A FULL-SERVICE HOSPITAL AND A COLLECTION OF LOCAL SOCIAL-SERVICE AGENCIES THAT WILL WORK TOGETHER TO SERVE AN ESTIMATED 50,000 PEOPLE EVERY YEAR. WEST LOUISVILLE IS A NINE-NEIGHBORHOOD COMMUNITY WHERE THE MEDIAN HOUSEHOLD INCOME IS $21,000. THE AREA HAS ENDURED YEARS OF DISINVESTMENT THAT HAS LEFT MANY OF ITS 65,000 RESIDENTS WITH LIMITED EMPLOYMENT AND SELF-SUFFICIENCY RESOURCES. ACCORDING TO THE MOST RECENT LOUISVILLE METRO HEALTH EQUITY REPORT, RESIDENTS IN WEST LOUISVILLE HAVE SOME OF THE HIGHEST RATES OF DEATH CONNECTED TO HEART DISEASE, CANCER AND STROKE. NHC'S NEW HOSPITAL AIMS TO TRULY CHANGE HEALTH OUTCOMES AND PROVIDE ACCESS FOR ALL RESIDENTS. IN NOVEMBER 2022 RUSSELL F. COX, PRESIDENT AND CEO OF NHC, PRESENTED THE RESULTS OF A COMMUNITY SURVEY IN WHICH MORE THAN 4,500 PEOPLE SHARED THEIR IDEAS ABOUT THE FEATURES AND SERVICES THEY WANTED IN THE NEW NORTON WEST LOUISVILLE HOSPITAL. FEEDBACK FROM THE PUBLIC IS BEING INCORPORATED INTO PLANS FOR THE HOSPITAL, WHICH INCLUDES LANDSCAPED ROOFTOPS, A CENTRALIZED AREA FOR PATIENT CHECK-IN, A RETAIL PHARMACY AND A COMMUNITY ROOM. SURVEY RESPONDENTS LISTED THE IMPORTANCE OF ACCESS TO WOMEN'S HEALTH SERVICES, MENTAL HEALTH SERVICES, CARDIOLOGY, ORTHOPEDICS AND PRIMARY CARE FOR ADULTS AND CHILDREN. IT ALSO WILL HAVE A 24-HOUR EMERGENCY DEPARTMENT, INPATIENT CARE, OPERATING ROOMS AND IMAGING TECHNOLOGY. ALL OF THESE AND ADDITIONAL SERVICES WILL BE AVAILABLE AT NORTON WEST LOUISVILLE HOSPITAL WHEN IT OPENS IN 2024.
Schedule H, Part V, Section B, Line 11 Facility A, 3	Facility A, 3 - ALL HOSPITALS. IN 2020 NHC CREATED THE INSTITUTE FOR HEALTH EQUITY AS ONE OF FIVE INITIATIVES TO ADDRESS INEQUALITIES WITHIN THE COMMUNITY. THE PRIMARY FOCUS OF THE INSTITUTE IS TO IDENTIFY AND REMOVE OBSTACLES THAT PREVENT PEOPLE IN UNDERSERVED AREAS FROM RECEIVING THE HEALTH CARE THEY DESERVE, AS WELL AS TO ELIMINATE DISPARITIES IN CARE. IN 2021 THE INSTITUTE MOVED INTO THE VILLAGE @ WEST JEFFERSON, AN OFFICE BUILDING AT THE SOUTHEAST CORNER OF 12TH AND JEFFERSON STREETS, IN THE RUSSELL NEIGHBORHOOD OF LOUISVILLE. NHC IS POSITIONING THE INSTITUTE FOR HEALTH EQUITY TO SERVE AS A CENTRAL HUB FOR COMMUNITY-BASED ORGANIZATIONS AND RESOURCES TO COME TOGETHER TO ADDRESS FACTORS THAT CONTRIBUTE TO HEALTH DISPARITIES, INCLUDING HOUSING, HEALTHY FOOD OPTIONS, TRANSPORTATION AND CHILD CARE. THE 3,751-SQUARE-FOOT SPACE WAS BUILT TO ACCOMMODATE STAFF MEMBERS, COMMUNITY MEETING SPACE, CONSULTATION ROOMS FOR SOCIAL WORK AND MENTAL HEALTH CONSULTATIONS, AND A TELEHEALTH ROOM WHERE PATIENTS CAN HAVE ONE-ON-ONE APPOINTMENTS WITH MEDICAL PROVIDERS THROUGH VIDEOCONFERENCING TECHNOLOGY. THE SPACE ALSO HAS EDUCATIONAL RESOURCES FOR HEALTH AND WELL-BEING. LANGUAGE NORTON COMMUNITY MEDICAL ASSOCIATES - LA CLINICA PRESTON, NHC'S FIRST 100% BILINGUAL PRACTICE, OPENED IN 2021 IN OKOLONA WITH STAFF AND PROVIDERS WHO UNDERSTAND THE UNIQUE CONCERNS OF LOUISVILLE'S LATINX COMMUNITY AND FAMILIES. THOUGH TRANSLATION SERVICES HAVE ALWAYS BEEN AVAILABLE AT NHC FACILITIES, AN OFFICE EQUIPPED WITH TRUSTED EMPLOYEES WHO BRIDGE LANGUAGE AND CULTURE GAPS IS A WAY TO IMPROVE CARE FOR THE GROWING LATINX COMMUNITY. THERE ARE RADIATION ROOMS AT LA CLINICA PRESTON, AS WELL AS COMPLETE SAMPLE TESTING PRIVACY. IN THE HALLWAYS, SPANISH IS DISPLAYED FIRST ON EVERY LABEL. THE ULTIMATE GOAL IS TO IMPROVE HEALTH OUTCOMES. NHC HISPANIC HEALTH FAIR IS HOSTED BY NORTON PREVENTION & WELLNESS TO PROVIDE HEALTH SCREENINGS AND RESOURCES. THE HISPANIC HEALTH FAIR IS LOCATED AT ST. RITA CATHOLIC CHURCH AND PROVIDES FREE HEALTH SCREENINGS, EDUCATIONAL AND COMMUNITY RESOURCES, AND FAMILY FRIENDLY ACTIVITIES FOR THE HISPANIC/LATINX COMMUNITY. NHC ALSO HOSTED A FOOD AND DIAPER DRIVE AS PART OF THE HEALTH FAIR IN 2023. NHC'S COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDED A PRIORITIZATION PROCESS TO RANK IDENTIFIED NEEDS AND ISSUES BASED ON PERCEPTION OF THE COMMUNITY, SECONDARY RESEARCH AND HOW THE ISSUES ALIGN WITH NHC'S MISSION, VISION, VALUES AND STRATEGIC PRIORITIES. IDENTIFIED NEEDS WERE CATEGORIZED INTO FOUR CATEGORIES: HEALTH CONDITIONS, ACCESS TO CARE, BEHAVIORAL CONDITIONS AND SOCIOECONOMIC/DEMOGRAPHIC NEEDS. NHC EXECUTIVE LEADERSHIP AND THE COMMUNITY BENEFIT COMMITTEE OF THE BOARD OF TRUSTEES IDENTIFIED AREAS IN THE BEHAVIORAL AND SOCIOECONOMIC CATEGORIES WHERE NHC CAN MOST EFFECTIVELY FOCUS ITS RESOURCES TO HAVE SIGNIFICANT IMPACT. THOSE AREAS OF FOCUS ARE: SUBSTANCE USE, OBESITY, MENTAL HEALTH, POOR NUTRITION, HEALTH DISPARITIES, HEALTH LITERACY, LANGUAGE BARRIERS AND TRUST IN THE HEALTH CARE SYSTEM. NEEDS THAT WERE IDENTIFIED BUT ARE CURRENTLY NOT AN AREA OF FOCUS FOR NHC ARE HOME CRIME AND SAFETY CONCERNS, HOUSING INSECURITY, AND POVERTY LEVELS. THESE FALL OUTSIDE OF THE CURRENT CORE COMPETENCIES OF THE ORGANIZATION AND THEREFORE ARE NOT ADDRESSED DIRECTLY IN OUR COMMUNITY HEALTH NEEDS IMPLEMENTATION STRATEGIES. NHC HAS A DESIRE TO CONTINUE PROVIDING CLINICAL PROGRAMS AND SERVICES TO MEET COMMUNITY NEEDS WHILE ALSO PURSUING CONTINUOUS IMPROVEMENT IN EXISTING AND FUTURE PROGRAMS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY WE SERVE.
Schedule H, Part V, Section B, Line 13 Facility A, 1	Facility A, 1 - All Hospitals. Other eligibility criteria in addition to the criteria answered above would include as described in the Financial Assistance Policy: * The patient does not qualify for subsidized coverage of government assistance such as Disproportionate Share Hospital, Children's Health Insurance Program, Medicaid, Medicaid Managed Care Organization, or Hoosier Healthcare. * To be eligible for assistance for non-emergent Medically Necessary Care, a patient (or that patient's guarantor) must be a resident of Kentucky, Indiana, Tennessee, Ohio, or Illinois. This residency requirement does not apply to emergency care.
Schedule H, Part V, Section B, Line 16 Facility A, 1	Facility A, 1 - ALL HOSPITALS. See response to Part VI, Line 3; Patient education of eligibility for assistance.

Schedule H (Form 990) 2022

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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)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2022

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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 by Commonwealth of Kentucky.
Schedule H, Part I, Line 6b Community Benefit Report	The annual community benefit initiative report is for all five hospitals in Norton Hospitals, Inc.'s (NHI) and is contained in the report prepared by NHI's parent corporation, Norton Healthcare, Inc.
Schedule H, Part VI, Line 5 Promotion of community health pt 1	In 2022, Norton Hospitals, Inc. (NHI) had a total of 1,907 licensed beds: Norton Audubon Hospital (Audubon), 432 beds; Norton Brownsboro Hospital (NBH), 197 beds; Norton Children's Hospital (NCH), 300 beds; Norton Hospital (Norton), 605 beds; and Norton Women's & Children's Hospital (NWCH), 373 beds. These five hospitals operate 24 hours a day, seven days a week. NHI extends medical privileges to all physicians in the community who meet the credentialing qualifications necessary for appointment to its medical staff by specialty. In 2022, NHI's hospitals, diagnostic centers and Norton Cancer Institute (NCI) served 65,959 inpatients and 659,044 outpatients, and saw 254,632 emergency room visits. In addition, NHI's operating rooms cared for 16,402 inpatient surgical patients and 38,876 outpatient surgical patients. Additionally, 8,356 babies were delivered at NHI birthing facilities at Norton and NWCH. As part of our commitment to improving the health of our community, NHI provides funding for a wide array of lifesaving and life-enhancing services that benefit the communities we serve. In 2022, under its charity care program, NHI provided free care to 6,574 patients, at a cost of $15.4 million. Also, NHC grants a discount from billed charges to any patients who have no access to private health insurance or do not qualify for government assistance or charity care. Under this program, 6,183 patients were provided care at discounted rates. Another contribution to the community was educational support of $77.5 million, primarily to the University of Louisville (UofL) School of Medicine. Community health improvement services totaled $27.1 million and contributions to community groups were $2.2 million. Norton Healthcare, Inc. (NHC) employees donated more than 220,000 hours of community service, a benefit valued at more than $1.6 million in salaries. In addition, many employees self-reported personal volunteer activities. NHC provides programmatic support to the UofL School of Medicine through funding and facilities. During the 2022 calendar year, 211 residents completed clinical rotations in 50 specialties at NHC facilities. NHC applies surplus funds to improvements in facilities and equipment, patient care, medical training, education, and research. Residency programs are part of the $77.5 million in educational support and clinical funding provided to the medical school. NHC's Board of Trustees includes representatives from the community and largest employers in the region that live and work in the NHI's primary service area. Members are neither employees of nor independent contractors with the organization, nor family members thereof. Contributions to the community * NHC employees and physicians gave nearly $837,000 in the 2022-2023 Combined Giving Campaign to help support nonprofit organizations that also are committed to improving the health and well-being of community residents. Supported organizations include WHAS Crusade for Children, Metro United Way, Fund for the Arts, and our own Children's Hospital Foundation (CHF) and Norton Healthcare Foundation (NHF). * In 2022, 75 employees helped "raise the roof" on NHC's 17th Habitat for Humanity home at 517 Iowa Ave., Louisville, Kentucky. * In 2022, an estimated 1,404 NHC employees donated time and funds to plan, purchase and deliver gifts, food and clothing for the Caring Tree program. The program assisted 625 employees and their 1,367 children by providing for their families at Christmas. * NHC donated 210 syringe pumps to Smiths Medical in 2022. Smiths Medical is a leading global manufacturer of specialty medical devices that provides innovative and lifesaving solutions for the world's healthcare markets. The company specializes in infusion therapy, vascular access, and vital care. * The Institute for Health Equity (IHE), a Part of NHC, was formed in 2020 to address health and racial inequities in our community. The institute's main office, located at The Village @ West Jefferson in the Russell neighborhood of West Louisville, provides community meeting spaces for mental health services, support for chronic disease management, and access to prevention and wellness resources. NHC's community medical directors, all practicing physicians, are rooted within the institute to provide services and health education in communities and neighborhoods with the largest needs. The IHE also serves as a resource for physicians and other caregivers by strengthening knowledge of social drivers of health inequity, and advocating for policy changes to improve social determinants of health for underserved populations. * The planned construction of Norton West Louisville Hospital was announced on Feb. 23, 2022, by NHC, Goodwill Industries of Kentucky and Kentucky Gov. Andy Beshear. Opening in mid-2024, this new hospital will offer comprehensive services, including adult and pediatric primary care physician offices, emergency room services, inpatient services and outpatient functions. Imaging services, including X-rays and CT scans, will be available, along with specialty services such as women's health, cardiology, neurology and endocrinology. This hospital, the first to be built in West Louisville in more than 150 years, will be unlike any other medical facility in that community and will create approximately 100 new jobs. The new hospital is part of the Norton Healthcare Goodwill Opportunity Campus, a $100 million investment in West Louisville that will bring a collection of life-enhancing programs and services to one of Kentucky's most underserved communities. The groundbreaking ceremony for the campus took place on June 28, 2022. More information is available at WestLouisvilleHospital.org.
Schedule H, Part VI, Line 5 Promotion of community health pt 2	Community education and workforce development As one of Kentucky's largest health care systems, NHC has established a culture of continual, lifelong learning. Opportunities are available through our Human Resources Department's Workforce Development (WD) team and our Norton Healthcare Institute for Education & Development (IED). WD encourages continuing education, offers programs to improve job performance and provides financial assistance for educational programs aimed toward key areas of workforce need within the organization. NHC encourages and supports the career goals of employees and their dependents by providing tuition assistance and scholarships, as well as other advancement opportunities. Established in the early 2000s, WD has assisted more than 6,000 students with tuition assistance. In 2022, WD financially supported nearly 850 students with over $5.4 million in educational assistance programs. * In 2022, WD provided nearly 1,160 career coaching sessions to employees and students. Each program participant worked directly with a career management coach. Coaches offer services in resume writing, career and education exploration, financial assistance opportunities and interviewing skills. * The accelerated Norton Healthcare Scholars Program, a student loan program for employees and nonemployees, provides educational funding to students interested in pursuing health care-related degrees in key areas of workforce need. It is an affiliation between NHC and over 100 colleges and universities nationally. Since 2014, this program has assisted more than 1,000 graduates continue their careers with NHC. * In 2018, NHC was one of the founding partners in Jefferson County Public Schools' (JCPS) Academies of Louisville - a strategic pipeline development program established in conjunction with the local public school system. JCPS created an academy model in which students have the opportunity to select career-focused education and earn industry-recognized credentials while in high school. NHC transformed its summer program and previous high school scholarship offerings into a comprehensive internship program for students on the health care academy track. The program hires high school seniors who are enrolled in a health care academy pathway to participate in career exploration in identified health care areas. Beginning in their sophomore year, JCPS' health care academy students explore career pathways in one of four key areas: patient care, medical office, allied health and pharmacy technician. Each phase offers a rigorous curriculum, training in business acumen and professional development, and hands-on learning opportunities in the students' chosen career fields. The goal is to transition graduating students into staff positions within our organization after completion of the program. Tuition assistance is offered for these new employees to continue their academic and career pursuits while working at NHC in the field of their choice. * In 2019, NHC announced a strategic partnership program with UPS and its Metropolitan College program. NHC-UPS Health Care Career Tracks provides a two-plus-two method, splitting a four-year bachelor's degree into two parts. Typically, the first two years are spent working with UPS in a general or preclinical designation, and then the student begins their clinical program in the remaining two years. This transition allows students to explore employment with NHC, as well as become a NHC Scholar. This program helps to support career readiness in a health care-related field. The combined tuition assistance offers students a debt-free way to get a college education while working with two of the leading companies in the region. * Established in 2017, the Student Nurse Apprenticeship Program is a 12- to 18-month apprentice model lead by Norton Healthcare Center for Nursing Practice (CNP), a part of IED. Student nurses in the program engage in hands-on learning with an experienced nurse while living the mission of NHC. * In 2019, NHC launched two new apprenticeship programs. The Surgical Technologist Apprenticeship Program and the Respiratory Therapy Apprenticeship Program allow students to work and learn with tuition assistance as they grow their careers with NHC. Development of the Medical Assistant Training Program launched in 2020 with a goal of offering internal training programs to produce quality, prepared medical assistants to introduce into the NHC workforce. Several apprenticeship cohorts run throughout each year. * In 2022, CNP, created the Student Healthcare Assistant employment opportunity. College students enrolled in a health care discipline have the opportunity to learn about providing direct patient care while enrolled in their academic program, with emphasis on schedule flexibility and clinical experience. IED provides learning opportunities to enhance the professional, educational and personal development of all employees. It consists of seven centers: the Center for Academic Affairs, Center for Allied Health, Center for Continuing Medical, Nursing & Provider Education, Center for eLearning & Clinical Documentation Support, Center for Nursing Practice, Center for Professional Growth, and Center for System Nursing & Ancillary Education. The Center for Professional Growth provides learning and growth opportunities that meet the needs of NHC employees. Three types of leadership development courses are offered to address the needs of new, aspiring and current leaders: * N the Know: This is our orientation program for new leaders. Newly hired leaders and those promoted into leadership positions are automatically enrolled. The program consists of four required courses and six elective courses. * Learning the Norton Way: This six-week program is focused on preparing employees for leadership. Employees who wish to attend are required to obtain approval from their leaders. * Leading the Norton Way: This program is for current NHC leaders. It is a six-week program focused on best practices for effective leadership. * Additional leadership development is provided through quarterly NHC leadership conferences. * Staff development programs include general enrichment courses and personal and professional development opportunities that honor NHC's commitment to lifelong learning. A variety of online and instructor-led courses focus on learning topics such as communication, diversity, interpersonal relationship-building, accountability and proficiency in Microsoft Office tools. * NHC uses a comprehensive learning management system to provide a variety of online programs that enable staff in any specialty as well as other employees to expand their knowledge and skills. These programs were designed to meet the needs of NHC, as well as our community, and to ensure the highest quality of patient care.
Schedule H, Part VI, Line 5 Promotion of community health pt 3	Norton Faith & Health Ministries Norton Faith & Health Ministries partners with faith communities to weave together health and wellness promotion with the intentional care of the spirit. The department provides mentoring, educational resources and networking opportunities to assist health ministry coordinators and faith community nurses in ministering to their members. In 2022, the department engaged in 69 events with faith partners, including, but not limited to: * Partnering with a network of 183 faith communities to promote whole-person health and wellness, provide health educational tools and health screenings, and one-on-one health ministry mentoring. * Conferences, including, post COVID, restarting the annual faith leaders conferences which in 2022 was, "Resources for Faith Leaders: Ministering in a Divided World" * Sponsoring health ministry networking programs on emergency preparedness, aging gracefully, sharing health ministry best practices, and health care event planning. * Partnering with the Kentucky Heart Disease and Stroke Prevention Task Force to provide cardiovascular assessments, risk-reduction information and education on the blood pressure awareness program The department continued to serve as a trusted source for health and wellness information by coordinating subject matter experts and speakers for a variety of health topics. It also distributed electronic correspondence to a network of health ministries, a bimonthly newsletter to 1,400 subscribers, and multiple issues of the "Health Ministries Connection" newsletter to faith communities, NHC employees and more. Pastoral Care Department Organizational activity and patient volumes returned to normal in 2022. Learning from the pandemic, an increased use of technology and virtual communication helped bring comfort and hope to staff, patients and families 24 hours a day, 7 days a week, across the five hospitals in Louisville and many outpatient areas that make up NHC. Leadership consistently called on chaplains to be a resource for employees who were experiencing stress and burnout post-pandemic. Chaplain referrals and employee resources were regularly highlighted in leadership communications, alongside efforts to increase support for staff in outpatient and medical practice areas. Chaplains provided care in nearly 30,000 documented patient encounters, in addition to serving thousands of family members. Some of the many reasons chaplains became involved in the care of patients and families included: * Grief support and facilitation of decision-making at the time of death * Family support for pediatric trauma patients * Conversations about end-of-life decisions and goals of care * Education about and enacting advance directives * Offering religious rituals and literature * Discussing ethical dilemmas * Providing comfort and conversation with patients who were lonely, afraid, conflicted, struggling or celebrating good news Chaplains care for people, regardless of their religious or spiritual backgrounds and beliefs, helping them use and strengthen their spiritual, emotional and relational resources to better cope and to thrive. Through formal and informal staff support efforts, teaching, committee involvement, ethics consultations and many other ways, chaplains are fully integrated into the life of the NHC system. Norton Heart & Vascular Institute Norton Heart & Vascular Institute (NHVI), a part of NHC, is the Louisville area's leading cardiovascular disease prevention and treatment program. Each year, NHVI provides diagnostic, medical, interventional and surgical care for thousands of patients from Kentucky and Southern Indiana. A team of specialists treats patients at NHC's four adult-service hospitals in Louisville and numerous diagnostic outpatient and specialty centers throughout Greater Louisville. Each facility is accredited through the American College of Cardiology's Accreditation Services, which ensures the highest-quality standards for diagnostic services. All four of NHC's adult acute-care hospitals in Louisville are accredited by the American College of Cardiology's Accreditation Services as Chest Pain Centers, with the highest accreditation level possible for facilities able to treat heart attacks. Three of these facilities - Audubon, NBH and Norton - serve as American Heart Association award-winning regional percutaneous coronary intervention receiving centers and participate in the state's first regional STEMI program, providing 24/7 care for patients from throughout Kentucky and Southern Indiana who experience the most severe type of heart attack. NHVI offers a nationally recognized advanced heart failure and recovery program, with expertise in the management of end-stage heart failure, mechanical circulatory support implantation and support of patients who require heart transplantation. The NHVI Heart Rhythm Center provides state-of-the-art monitoring and a comprehensive suite of treatment options for all types of heart arrhythmias. NHVI opened a Women's Heart Program office staffed by a fellowship-trained cardiologist who specializes in and studies women's heart care. Our experienced team of cardiothoracic and vascular surgeons provides surgical capabilities that include ventricular assist device implantation, minimally invasive treatments for atrial fibrillation, cardiac valve repair and replacement, and repair of life-threatening vascular conditions. Vascular surgeons treat the spectrum of arterial and venous disease with endovascular and open surgical procedures, including balloon angioplasty and stenting, carotid endarterectomy, endovascular abdominal and thoracic aortic aneurysm repair with stent grafts, minimally invasive transcarotid artery revascularization, and radiofrequency and laser ablation. Norton Orthopedic Institute Norton Orthopedic Institute (NOI) provides advanced orthopedic care for all bones and joints, and for people of all ages. NOI is made up of board-certified physicians - many of whom are fellowship trained - who work together with therapists, physical rehabilitation specialists, primary care physicians, neurologists, certified athletic trainers and other care providers to offer a full range of multidisciplinary orthopedic services. These specialists practice a team approach in the diagnosis, treatment and rehabilitation of bone and joint conditions and injuries. NOI's hip and knee replacement program has been certified as an Orthopaedic Center of Excellence by DNV Healthcare, as meeting guidelines of the American Academy of Orthopaedic Surgeons and the American Association of Hip and Knee Surgeons. With locations throughout Greater Louisville, including Southern Indiana, NOI offers several specialty centers focused on providing expertise in general orthopedics, joint replacement, injuries, trauma, pediatrics, oncology, spinal conditions and sports health.
Schedule H, Part VI, Line 5 Promotion of community health pt 4	Norton Women's Care Norton Women's Care (NWC) offers a complete range of services with an emphasis on caring for the whole woman - mind, body and spirit. Services focus on the health and wellness of women at all stages of life - adolescence, pregnancy, motherhood, midlife and beyond. More women choose NWC at Norton and NWCH to deliver their babies than any other facility in the region. In 2022, NWC birthing facilities at Norton and NWCH provided care and medical services for 8,356 deliveries. NWC was recognized as High Performing in Adult Maternity Care (Uncomplicated Pregnancy) by U.S. News & World Report. Specialty services include full gynecologic care; pelvic health program; obstetrics, including high-risk pregnancy care; newborn care with access to Level III and IV neonatal intensive care units; cancer prevention and treatment, including a comprehensive breast health program; a dedicated women's heart and vascular care, education and support program; a bone health program addressing osteoporosis, rheumatology and prevention of other orthopedic diseases; and Norton Women's Mental Health Services for evaluation and treatment of issues including depression, premenstrual dysphoric disorder, infertility and menopause. NWC also offers a variety of educational wellness programs through the Marshall Women's Health & Education Center- St. Matthews campus. Instructors continue to teach at the Healthy Equity Institute, Norton and NWCH. In 2022, classes were expanded to reach more of the community and two new sites were added for prenatal classes, including Americana, which offers Spanish classes, and Elizabeth Catholic Charities. Marshall Women's Health & Education Center also participated in multiple health fairs throughout the community in 2022. Norton Children's Prevention & Wellness Norton Children's Prevention & Wellness is supported by CHF, which raises funds exclusively for the not-for-profit NCH and its sister facilities. Through donations, volunteerism and community support, the foundation is able to provide funding for equipment, new technologies, clinical research, child advocacy and health education for patients, families, medical staff and the community. * Child passenger safety technicians check car and booster seats and also provide car and booster seats at free checkup clinics statewide. In 2022, 626 virtual and in-person car seat checks were completed. Additionally, 110 new child passenger safety technicians were certified on how to properly install car seats. * More than 10,000 third and fourth graders across Kentucky learned about bicycle safety through the NCH Bike Safety Rodeo in 2022. * The Safety City program welcomed over 3,900 second-grade students to learn about bike and pedestrian safety. * In a virtual program, more than 4,800 kindergarten students participated in the 39th annual Children and Hospitals Week event. Children and Hospitals Week is designed to teach safe decisions and behaviors to help lessen the fear and anxiety children may have about coming to a hospital. This superhero-themed virtual option provides teachers with resources to administer the course, and students graduate as a "healthy superhero" at the conclusion of the class. * NCH's Food Pantries served over 20,000 individuals with food insecurity needs, a more than 20% increase compared to 2021. * Norton Children's Prevention & Wellness provided 16,000 toothbrush packs to community members and distributed over 2,300 fluoride treatments to dental practices. * Virtual classes continued in 2022, serving over 750 individuals with prevention and wellness programming. Events included cooking workshops, child safety classes and safe grandparenting classes. * The "Just for Kids" Transport Team transports babies and children from across the region to NCH. Transportation is provided helicopter and five specially equipped ambulances known as mobile intensive care units. In 2022, 2,985 transportation trips were completed. Kentucky Poison Control Center of NCH NCH is home to the Kentucky Poison Control Center. In 2022, the center received more than 40,000 calls and provided continued assistance through more than 42,000 follow-up calls to concerned families in all 120 counties in Kentucky, as well as to physicians and other health care providers from every health care facility in the state. The center provided treatment consultation and education about how to correctly handle exposures to poisons. In addition, the center distributed more than 35,000 prevention education resources to physicians' offices, health departments and schools, and almost 1,000 packets of materials to individuals who called the poison hotline at (800) 222-1222, which is available 24 hours a day, 7 days a week. The staff of the poison control center also answer the Kentucky HIV and Kentucky Opioid Assistance and Resource hotlines. Norton Neuroscience Institute Established in early 2009, Norton Neuroscience Institute (NNI) is the region's leading provider of neurological care. The multidisciplinary comprehensive program has more than 110 subspecialty fellowship-trained neurosurgeons, neurologists, neuropsychologists and advanced practice providers. These specialists are trained to provide patients and their families with advanced treatment for complex neurological disorders, including ALS; aneurysms; brain tumors; epilepsy; headache and concussion; memory and dementia disorders, movement disorders, including Parkinson's disease; multiple sclerosis; pediatric neurosurgery; spinal injuries and disorders; stroke; and more. Patients also have access to Cressman Neurological Rehabilitation, which offers advanced technology and specialized services in one location. NNI provides leadership for a system of stroke care, including at NBH, designated as a Comprehensive Stroke Center by DNV Healthcare Inc., representing the highest level of stroke care. In addition, The Joint Commission has certified Audubon and Norton as Primary Stroke Centers, and NWCH as an Acute Stroke Ready Hospital. NNI is a leader in the region for providing innovative surgery technology, such as NeuroPace, NeuroBlate and ROSA (a robotic surgical assistant) and cutting-edge treatment for brain tumors, including TruBeam and Optune therapies. As part of the comprehensive care provided by NNI, patients and their families have access to support resources to manage their diagnoses through two NNI Resource Centers. The resource centers offer dedicated patient navigators, support groups, exercise programs and extensive educational resources.
Schedule H, Part VI, Line 5 Promotion of Community Health pt5	Norton Prevention & Wellness Norton Prevention & Wellness (NPW) supported by the NHF, which raises funds exclusively for NHC's adult-services hospitals and services. * In 2022, NPW staff provided preventive screenings aboard the NPW Mobile Prevention Center in collaboration with various community partners. Over 1,541 women received mammograms and/or wellness exams, including cervical cancer screenings, aboard the mobile unit. Of those, approximately 13% had not been screened in the past five years and 11.3% had never had a mammogram. Of the 169 Mobile Prevention Center events, over half took place in underserved communities and over 60% of patients came from medically underserved areas. * Education on cardiovascular health, effects of smoking, prostate health, breast health and women's health, colon health and more was provided to 1,372 community members at various events, such as health fairs and presentations. If eligible and interested, participants were offered referrals for a colonoscopy or given an at-home testing kit that they could mail to the lab and later receive their results. Colonoscopy referrals were made for 143 people and 52 people received at-home testing kits. To help eliminate barriers to care, NPW implemented a dedicated phone number, (502) 446-WELL, that links eligible patients to colonoscopy scheduling or requesting in-home tests. * In collaboration with many community partners, staff provided 1,804 health screenings (blood pressure, body mass index, glucose and cholesterol levels) for 952 participants in multiple locations throughout Jefferson County and surrounding counties, including in Southern Indiana. Each participant received education on healthy lifestyle choices, such as diet and exercise. Group education on various health and wellness topics was provided throughout the year. * NPW conducted 11 American Lung Association Freedom from Smoking classes in 2022. Nearly half of the attendees reported being tobacco free. * In 2022, the Get Healthy Walking Club increased by 2000 members and reached over 8,000 total members. Members have free access to walk at the Louisville Zoo each day from March through October, from 8 to 9:30 a.m. Norton Healthcare Research Office NHC guides one of the largest portfolios of clinical research of any community health care system in the United States. At any time, more than 750 clinical studies are active or pending at NHC. These studies engage more than 400 NHC staff and significantly impact our patients and their families. Areas of clinical research focus include pediatrics, oncology, cardiology, orthopedics and spine, infectious diseases, neurology, neurosurgery and pulmonology. NHC invests significantly in clinical research to benefit our community and patients, and to support clinical science by participating in the development of new clinical interventions (drugs, devices, procedures) that will become generalized and shared with a wide number of patient populations and medical professionals. These new, innovative treatments expand the medical community's knowledge and potentially improve the quality of medical care now and in the future. In 2022, NHC started building its research capacity and infrastructure to address health disparity issues in our community and region. This research stream will be coordinated through the IHE. NCI NCI's mission is to blend comprehensive treatment and services with compassion, hope and healing for patients and their families. Through a multidisciplinary approach, its team of specialists offers patients the latest in treatments and technology focused on cancer prevention, diagnosis, care and survivorship across a broad range of specialties that include behavioral oncology, gynecologic oncology, hematology, medical oncology, neuro-oncology, oncologic dermatology, orthopedic oncology and radiation oncology. NCI offers state-of-the-art medicbural, surgical and radiation therapies, including minimally invasive robotic surgery, stereotactic radiosurgery (Novalis Tx and TrueBeam STx) and advanced brachytherapy. Patients have access to groundbreaking research through its participation in dozens of innovative NCI and industry-sponsored clinical trials. Extensive educational, physical and emotional support services, including support groups, seminars, art and music therapy, massage therapy, yoga and nutritional counseling are available through five NCI Resource Centers. NCI is designated by the American College of Surgeons Commission on Cancer as the only accredited Integrated Network Cancer Program in Kentucky. More information is available at NortonCancerInstitute.com.
Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care	Norton Hospitals, Inc. has a policy where we discount charges for all self-pay patients with no insurance coverage regardless of income qualifications. Because of this policy, we responded "No" to line 3b in that we do not utilize federal poverty guidelines for providing discounted care.
Schedule H, Part I, Line 6a Community benefit report prepared by related organization	Norton Healthcare, Inc.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	The costing methodology used to calculate the community benefit expenses was to calculate the cost by hospital location (five separate locations under one Medicare provider number). The cost was determined based on a specific location cost to charge ratio. The cost used in the calculator was reduced by provider taxes, Graduate Medical Education expenses, and other costs. The adjusted cost to charge ratio was then multiplied times the gross charges for qualified financial assistance charges, Medicaid, and the state Disproportionate Program (other means tested government program) to obtain the specific community benefit expense. Cost of Health Improvement and Community Benefit Programs, Health Education, Research Programs, some Subsidized Health Services, and Donations are stated at actual cost. The cost of these items are tracked throughout the general ledger process and through other accounting software.
Schedule H, Part II Community Building Activities	NORTON HOSPITALS, INC. (NHI) SUPPORTED OVER 300 COMMUNITY ORGANIZATIONS WITH LEADERSHIP SUPPORT WHICH INCLUDED OVER 220,000 HOURS AND OVER $1.6 MILLION IN SALARIES. NHI REPRESENTATIVES SERVED ON A VARIETY OF NONPROFITS AND GOVERNMENT AGENCIES THAT HELPED IMPROVE ACCESS TO HEALTH SERVICES, ENHANCED THE HEALTH OF THE COMMUNITY, ADVANCED MEDICAL AND HEALTH CARE KNOWLEDGE, AND RELIEVED OR REDUCED THE BURDEN OF GOVERNMENT OR COMMUNITY EFFORT. NHI'S PURPOSE IS TO PROVIDE QUALITY HEALTH CARE TO ALL THOSE WE SERVE, IN A MANNER THAT RESPONDS TO THE NEEDS OF OUR COMMUNITIES AND HONORS OUR FAITH HERITAGE. OUR COMMUNITY BENEFIT INITIATIVE ALIGNS WITH OUR MISSION TO PROMOTE THE HEALTH OF THE COMMUNITY THROUGH SERVICE ON LOCAL BOARDS, ADVISORY COUNCILS AND VOLUNTEERING. NHI EMPLOYEES REPRESENT NHI ON MANY COMMUNITY BOARD POSITIONS THAT HELP TO ENHANCE THE COMMUNITY INCLUDING THE AMERICAN RED CROSS, GREATER LOUISVILLE INC. BOARD, THE CENTER FOR WOMEN AND FAMILIES, HABITAT FOR HUMANITY, UNITED WAY OF KENTUCKY, THE AMERICAN HEART ASSOCIATION, THE RONALD MCDONALD HOUSE, AND MANY MORE. NHI HAS A RICH CULTURAL HISTORY OF PROVIDING COMMUNITY SUPPORT AND NHI EMPLOYEES ARE PASSIONATE ABOUT SERVING OTHERS AND PROMOTING THE HEALTH OF OUR COMMUNITY.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	FOR FINANCIAL STATEMENT PURPOSES, NORTON HEALTHCARE HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. THE AMOUNT REPORTED ON PART III, LINE 3 IS THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER NORTON HOSPITAL'S FINANCIAL ASSISTANCE POLICY ON A GROSS BASIS.
Schedule H, Part 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 vendor's experience with qualifying accounts as financial assistance. Medassist Firstsource, our outside vendor, screens all self-pay accounts and based on an initial screening, will classify the account as probable financial assistance. If the accounts appear to meet Norton Hospitals, Inc.'s (NHI) financial assistance program guidelines, these accounts are then required to submit the necessary documentation to ultimately be classified as a financial assistance account. Based on all accounts that are classified as probable financial assistance by Medassist Firstsource and their experience with getting accounts qualified as financial assistance, it is estimated that 55% of those accounts classified as probable financial assistance and which do not submit the required documentation would qualify as a NHI financial assistance account. The estimated cost of accounts that are estimated to qualify for our financial assistance programs is calculated based on gross charges for accounts for the year that are probable but do not submit the necessary documentation multiplied times our cost to charge ratio times the 55% estimated conversion factor.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	In accordance with accounting guidance, bad debt is no longer an expense, but is included as a reduction in net patient service revenue. The following paragraph per the audited financial statements (page 19, second paragraph) discusses the handling of patient deductible and coinsurance not paid by patients; Generally, patients who are covered by third-party payors are responsible for patient responsibility balances, including deductibles and coinsurance, which vary in amount. The Corporation estimates the transaction price for patients with deductibles and coinsurance based on historical experience and current market conditions. The initial estimate of the transaction price is determined by reducing the standard charge by any explicit price concessions, discounts, and /or implicit price concessions. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to net patient service revenue in the period of change.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	The costing methodology used to determine the Medicare allowable cost was based on the Medicare principles used in completing the Medicare cost report. All cost reported came from the Medicare cost report. Norton Hospitals, Inc. (NHI) accepts all Medicare patients with the knowledge that there may be shortfalls and operates to promote the Health of the community. NHI believes that any Medicare shortfall should be treated as a Community Benefit because Medicare does not typically fully compensate NHI for the cost of providing hospital care to Medicare beneficiaries.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	After the patient's initial screening for financial assistance, if it is believed that the patient qualifies for financial assistance; Norton Hospitals Inc. will not start collection efforts pending the patient submitting the necessary information to document meeting the financial assistance qualifications. If the patient submits the necessary documentation within a reasonable time period, then there will not be any collection efforts made to collect any amount from the patient. The patient may receive a statement/bill reflecting the amount due through the financial assistance application process pending the patient's financial assistance application, but there will be no collection efforts. Only after an attempt is made to contact the patient to obtain the necessary documentation for completing the financial assistance application and the patient not responding will collection efforts begin. There is ongoing effort throughout the collection process to screen for Medicaid eligibility, Disproportionate Share Hospital, and the need for providing financial assistance applications to patients. When a patient is approved for financial assistance, their account balance is written off.
Schedule H, Part V, Section B, Line 16a FAP website	A - Norton Hospital: Line 16a URL: WWW.NORTONHEALTHCARE.COM/FAP;
Schedule H, Part V, Section B, Line 16b FAP Application website	A - Norton Hospital: Line 16b URL: WWW.NORTONHEALTHCARE.COM/FAP;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	A - Norton Hospital: Line 16c URL: WWW.NORTONHEALTHCARE.COM/FAP;
Schedule H, Part VI, Line 2 Needs assessment	NEEDS ASSESSMENT NORTON HOSPITALS, INC (NHI) REGULARLY AND CONSISTENTLY EVALUATES WORKFORCE AND COMMUNITY HEALTH CARE NEEDS THROUGH PARTNERSHIPS WITH LOCAL HEALTH DEPARTMENTS, EMERGENCY MEDICAL SERVICES, LOCAL AND STATE UNIVERSITIES, KENTUCKIANA WORKS, AND THE WORKFORCE INVESTMENT BOARD FOR THE SEVEN COUNTY REGION SURROUNDING LOUISVILLE. PARTNERSHIPS WITH THESE ORGANIZATIONS, ALONG WITH NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS SUCH AS THE AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION AND OTHERS, ALSO PROVIDE NHI IMPORTANT STATISTICS AND DATA TO USE IN EVALUATING COMMUNITY ACCESS TO HEALTH CARE SERVICES AND HEALTH CARE DISPARITIES. ADDITIONALLY, NHI ACCESSES DATA FROM ORGANIZATIONS SUCH AS THE CENTER FOR DISEASE CONTROL AND THE UNITED STATES CENSUS BUREAU TO ASSESS AREAS OF GREATEST ANTICIPATED POPULATION GROWTH AND LOW-INCOME AREAS, BOTH OF WHICH MAY BE IN GREATEST NEED FOR PREVENTION EDUCATION, FREE SCREENINGS AND ACCESS TO HEALTH CARE. NORTON HEALTHCARE, INC. (NHC), THE PARENT COMPANY of NHI, CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR ALL FIVE HOSPITALS. THE CHNA DEFINED THE PATIENT SERVICE AREA BY PATIENT ORIGIN FOR INPATIENT STAYS, DEMOGRAPHIC, SOCIOECONOMIC, POPULATION, AND OTHER HEALTH RELATED INDICATORS UTILIZED TO PROVIDE INFORMATION ON THE HEALTH STATUS OF THE COMMUNITY. COMMUNITY INPUT WAS PROVIDED THROUGH PROVIDER AND COMMUNITY INTERVIEWS, TARGETED FOCUS GROUPS AND A COMMUNITY HEALTH SURVEY. HEALTH NEEDS WERE PRIORITIZED AND ADDRESSED BASED ON HEALTH STATUS FINDINGS AND COMMUNITY INPUT. THE CHNA IS A COMPONENT OF THE ORGANIZATIONS STRATEGIC PLANNING PROCESS AS RESOURCES ARE NECESSARY TO IMPLEMENT STRATEGIES OUTLINED FOR PRIORITIES IDENTIFIED. THE NHC BOARD OF TRUSTEES AS WELL AS THE LEADERSHIP OF NHC AND HOSPITAL CHIEF ADMINSTRATIVE OFFICERS HAVE APPROVED THE ASSESSMENT AND IMPLEMENTATION PLAN.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Signage is posted in all Norton Healthcare, Inc. (NHC) hospital facilities, including the admission area and emergency room, providing information on the ability to apply for financial assistance and to seek help in paying your bill. The signage is translated in five languages and all languages are contained on the same poster. The languages are: English, Spanish, Vietnamese, Croatian, and Arabic. At the time of registration, the Patient Access/Registration department discusses with the patient the financial assistance/charity options, guidelines, and provides assistance as needed in filling out a financial assistance application and answering questions. The patient may also be referred to the NHC eligibility vendor for assistance at no cost to the patient/guarantor. Additional questions from the patient/guarantor can be facilitated through the NHC Single Billing Office (SBO) area, Customer Service, and NHC vendors. NHC has created a number of different options for the patient/guarantor to supply the information/application for financial assistance to NHC. Those various methods of delivery include: in person, by mail, by fax, on-line application submission via the website, and by specific email address. These various options are publicized and made known to the patient. In 2022 statements mailed to the guarantors by Norton Hospitals, Inc. (NHI) contained information to start the financial assistance application process. NHI employs an outside eligibility vendor, Medassist Firstsource. All self-pay accounts for the facilities are placed for eligibility screening with Medassist Firstsource. They screen for NHC financial assistance, Medicaid, Medicaid Managed Care organizations, presumptive eligibility, and Disproportionate Share Hospital/Kentucky Children's Health Insurance Program (DSH/KCHIP). In addition, they may provide education and referral assistance to the appropriate county/state departments for food stamps, rent assistance, heating assistance, etc. The process of completing the application is often performed by Medassist Firstsource. They protect filing deadlines by submitting the appropriate forms to the state/county. They follow up to secure proof of income documents for Norton financial assistance and follow up with a state caseworker as needed. Medassist Firstsource also makes outside field calls or home visits to the patients to secure the needed information for eligibility assistance if the patient is homebound. Additionally, Medassist Firstsource may provide assistance with patient transportation needs so that the patient can make their scheduled appointments with their caseworker. All of the services provided by Medassist Firstsource eligibility are at no cost to the patient. Cost to the hospitals for these eligibility and enrollment services was in excess of $6,300,000 in 2022. NHI has a staff of 10 full-time employees including a supervisor that are dedicated to performing the following functions: processing, reviewing, and approving the hundreds of financial assistance applications received each week. Additionally, some of those employees make out-bound calls to solicit financial assistance information needed to process the patient's application. Financial assistance for Norton financial assistance is not limited to the self-pay population. Even patients with insurance coverage are encouraged to apply for assistance so their deductible, co-payments, and co-insurance amounts are covered under the various assistance programs. Financial counselors/social workers at the facilities are educated and trained to assist with counseling patients to determine and explain our financial assistance programs. They continue to receive on-going education throughout the entire year regarding eligibility changes and additions for Norton financial assistance, DSH/KCHIP, Medicaid, Medicaid Managed Care organization, presumptive eligibility, etc. As the foundation office receives inquiries directed to their office, they refer these individuals to Patient Financial Services (PFS) to screen for possible Norton financial assistance or The Children's Hospital Foundation, Inc. (CHF) funding. If a child's account does not qualify for Norton financial assistance, that account is referred to management of PFS for consideration for special funding through CHF as well as other programs. The charity application was provided on the back of the SBO statement. NHI ensures that all patients were made aware of financial assistance regardless of where the patient's account may have been in the collection cycle. Even if the patient/guarantor had not previously availed themselves of the opportunity to apply for financial assistance and decided they will now cooperate, then allowed the patient/guarantor to apply and approved if they met the qualifications. Financial assistance notifications and applications were made available to the patient/guarantor via telephone, face to face meetings, website, mail, electronically, etc. Primary collection agencies chosen by NHI include with their initial placement letter an insert of a copy of a financial assistance application for the guarantor to complete. Calls resulting from notification correspondence sent by the collection agencies may be routed to Spanish-speaking Customer Service representatives or patient/guarantors may also request an interpreter service to assist in facilitating information regarding financial assistance. NHI has translated the full financial assistance policy, financial assistance applications, billing and collection policy and the plain language summary into five languages: English, Spanish, Vietnamese, Croatian, and Arabic. NHI's Customer Service department routinely instructs and screens patients in the protocol regarding financial assistance through the Norton financial assistance program. Since 2007, NHI has offered at the time of final billing all true hospital self-pay patients a significant discount off of the total charges that were reflected on their monthly statements and the amount due. Contracted collection agencies are required to solicit financial assistance applications when the patient/guarantor indicates "cannot pay." The statement provided by NHI in 2022 included the link to the NHC website to allow the patient/guarantor to learn more about financial assistance. The statement contained the financial assistance application on the back of the statement so the guarantor could apply using the actual NHI statement and could then mail, fax, bring the application directly to the facilities, or email the form to PFS. The statement included a phone number to call to learn more about the application process and discuss financial assistance options.
Schedule H, Part VI, Line 4 Community information	PRIMARY SERVICE AREA NORTON HOSPITALS INC.'S (NHI) PRIMARY SERVICE AREA POPULATION IS OVER 1.5 MILLION AND EXPECTED TO INCREASE 3% BETWEEN 2023 AND 2028. IN 2016, THE PRIMARY SERVICE AREA INCREASED FROM A 7 COUNTY AREA TO AN AREA INCLUSIVE OF 16 COUNTIES, 5 OF WHICH ARE LOCATED ALONG THE OHIO RIVER BORDER IN KENTUCKY, 4 BORDER THE RIVER IN INDIANA, AND INCLUDES 5 ADDITIONAL KENTUCKY COUNTIES AND 2 ADDITIONAL INDIANA COUNTIES THAT DO NOT BORDER THE OHIO RIVER. 94% OF NHI'S PATIENTS ARE DERIVED FROM THIS SERVICE AREA. APPROXIMATELY 31% OF THE POPULATION IS OVER 55 YEARS OLD; COMPARED TO 34% IN THE USA. THIS PORTION OF THE POPULATION TENDS TO USE ADDITIONAL HEALTHCARE SERVICES. THE PEDIATRIC POPULATION IN 2023 WAS ESTIMATED AT 341,204 AND IS EXPECTED TO DECREASE TO 338,974 WITHIN 5 YEARS AND REPRESENTS 23% OF THE POPULATION. THE NUMBER OF HOUSEHOLDS IN THE PRIMARY SERVICE AREA WAS ESTIMATED AT 625,651 IN 2023 AND IS EXPECTED TO INCREASE 2% BY 2028. CURRENTLY 10% OF THE ADULT POPULATION DOES NOT HAVE A HIGH SCHOOL DEGREE AND 16% HAVE A HOUSEHOLD INCOME THAT IS LESS THAN $25,000 A YEAR; THE MEDIAN HOUSEHOLD INCOME IS $67,708 COMPARED TO $70,784 FOR THE UNITED STATES. NHI TREATS 41.8% OF THE ADULT INPATIENT CASES IN THE COMMUNITY AND ITS PAYOR MIX IS 47% MEDICARE, 24% MEDICAID/PASSPORT AND 1% SELF PAY. THE LARGEST COUNTY IN THE SERVICE AREA IS JEFFERSON COUNTY AND ITS MAY 2023 PRELIMINARY NON-SEASONALLY ADJUSTED UNEMPLOYMENT RATE WAS 3.6% COMPARED TO 3.8% FOR KENTUCKY AND 3.5% FOR THE UNITED STATES. NHI'S PRIMARY SERVICE AREA HAS ADEQUATE ACCESS TO HOSPITAL CARE, WITH OVER 3,200 INPATIENT SHORT-TERM ACUTE CARE BEDS IN JEFFERSON COUNTY ALONE, 1,712 (53.6%) OF WHICH ARE PART OF THE NORTON HEALTHCARE SYSTEM. REVIEW OF OCCUPANCY RATES FOR EACH HOSPITAL INDICATES THAT THE INPATIENT NEED IS CURRENTLY BEING MET. THROUGH A CERTIFICATE OF NEED (CON) PROCESS, KENTUCKY HAS A STATE HEALTH PLAN THAT REGULATES HEALTH SERVICES PROVIDED. THE CON PROCESS ESTABLISHES CRITERIA BASED ON COMMUNITY NEED IN AN ATTEMPT TO ENSURE THAT UNNECESSARY DUPLICATION OF SERVICES DOES NOT OCCUR. IN JEFFERSON COUNTY 9.4% OF THE COMMUNITY IS BELOW THE FEDERAL POVERTY GUIDELINES AS COMPARED TO 12.1% OF THE POPULATION BELOW THE FEDERAL POVERTY LINE IN KENTUCKY. POVERTY IS A KEY DRIVER OF HEALTH STATUS AND CREATES BARRIERS TO ACCESS, INCLUDING HEALTH SERVICES, HEALTHY FOOD CHOICES AND OTHER FACTORS THAT CONTRIBUTE TO POOR HEALTH. CERTAIN SEGMENTS OF THE COMMUNITIES SERVED BY NHI HAVE EXTREME POVERTY. THE CENTRAL AND WEST SEGMENTS OF JEFFERSON COUNTY HAVE POVERTY RATES TWICE THAT OF KENTUCKY AND NATIONAL RATES. RESIDENTS OF JEFFERSON COUNTY, KENTUCKY, ACCOUNT FOR APPROXIMATELY 64% OF NHI'S INPATIENT DISCHARGES AND 69.6% OF NHI'S INPATIENT AND OUTPATIENT CASES COMBINED. ALMOST 70% OF NHI'S PATIENTS ARE FROM JEFFERSON COUNTY, WHICH IS KENTUKCKY'S HEAVIEST POPULATED URBAN AREA. NHI'S PRIMARY SERVICE AREA'S POPULATION IS 68% URBAN, 31% URBAN, AND 1% RURAL. FOUR AREAS WITHIN JEFFERSON COUNTY HAVE BEEN DESIGNATED AS MEDICALLY UNDERSERVED AREAS BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA). THE HRSA IS THE PRIMARY FEDERAL AGENCY FOR IMPROVING HEALTH CARE FOR PEOPLE WHO ARE ECONOMICALLY AND MEDICALLY VULNERABLE. IT WORKS WITH STATE PARTNERS TO DETERMINE AREAS WITH TOO FEW PRIMARY CARE, DENTAL AND MENTAL HEALTH PROVIDERS AND SERVICES. THERE ARE LIMITED FEDERAL RESOURCES, SO THE DESIGNATION HELPS TO PRIORITIZE AND FOCUS RESOURCES TO AREAS WITH THIS DESIGNATION. SECONDARY SERVICE AREA NHI's SECONDARY SERVICE AREA DECREASED FROM 26 COUNTIES TO 17 COUNTIES IN 2016 AS MANY COUNTIES ARE NOW INCLUDED IN THE PRIMARY SERVICE AREA. NHI's SECONDARY SERVICE AREA POPULATION WAS 439,555 IN 2023 AND IS EXPECTED TO INCREASE 3% BETWEEN 2023 AND 2028. THE SECONDARY SERVICE AREA SPREADS ACROSS 15 KENTUCKY COUNTIES AND 2 INDIANA COUNTIES. THE 55+ AGE COHORT REPRESENTS 31% OF THE SECONDARY SERVICE AREA POPULATION AND IS BELOW THE 55+ PERCENTAGE IN THE UNITED STATES. THE PEDIATRIC POPULATION IN 2023 WAS ESTIMATED AT 99,754 AND EXPECTED TO INCREASE TO 101,058 BY 2028. 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 172,776 IN 2023 AND IS EXPECTED TO INCREASE 2.9% BY 2028. ALMOST 45,000 ADULTS IN THIS SERVICE AREA DO NOT HAVE A HIGH SCHOOL EDUCATION AND THE AVERAGE HOUSEHOLD INCOME IS UNDER $25,000 FOR 22% OF THE POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $51,364, 5% GREATER THAN KENTUCKY AND 24% LESS THAN THE PRIMARY SERVICE AREA AVERAGE HOUSEHOLD INCOME. NHI'S SECONDARY SERVICE AREA'S POPULATION IS 73% SUBURBAN, 20% URBAN, AND 7% RURAL.
Schedule H, Part VI, Line 6 Affiliated health care system	Norton Healthcare, Inc. (the controlling company) (NHC) and its affiliates, including Norton Hospitals, Inc., Norton Properties, Inc., Community Medical Associates, Inc., The Children's Hospital Foundation, Inc., Norton Healthcare Foundation, Inc., and Norton Enterprises, Inc. operate in the Louisville, Kentucky metropolitan area and the operations of the affiliated healthcare system include 1,907 licensed beds, over 300 physician practice locations, and 18 Norton Immediate Care Center locations, and other ancillary health care services. Norton Healthcare - Indiana, Inc. is an affiliate of NHC and operates Norton - King's Daughters' Hospital in Madison IN, which has 86 licensed beds and 8 physician practice and other ancillary health care service locations.

Schedule H (Form 990) 2022

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- TIN:

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

2022

Open to Public Inspection

Name of the organization

Norton Hospitals Inc

Employer identification number

61-0703799

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .....

Yes

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 on Line 1a? ....

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

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 ............

Yes

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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2022

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, 1099-MISC compensation, and/or 1099-NEC			(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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Russell F Cox President & CEO/Trustee	(i) (ii)	0 ------------- 1,381,929	0 ------------- 850,949	0 ------------- 2,545,224	0 ------------- 144,894	0 ------------- 36,209	0 ------------- 4,959,205	0 ------------- 1,456,526
2Robert B Azar Sr VP Chief Legal Officer/Secretary	(i) (ii)	0 ------------- 577,778	0 ------------- 257,754	0 ------------- 280,499	0 ------------- 74,695	0 ------------- 15,549	0 ------------- 1,206,275	0 ------------- 165,378
3Michael W Gough Exec VP and COO	(i) (ii)	0 ------------- 1,006,097	0 ------------- 501,896	0 ------------- 326,096	0 ------------- 101,573	0 ------------- 32,025	0 ------------- 1,967,687	0 ------------- 31,939
4Adam Kempf Sr VP, CFO/Treasurer	(i) (ii)	0 ------------- 617,611	0 ------------- 278,616	0 ------------- 143,280	0 ------------- 144,879	0 ------------- 33,636	0 ------------- 1,218,022	0 ------------- 78,012
5Matthew Ayers Hospital CAO	(i) (ii)	357,956 ------------- 0	142,821 ------------- 0	82,207 ------------- 0	75,945 ------------- 0	29,903 ------------- 0	688,832 ------------- 0	42,848 ------------- 0
6Karen Donahue Division VP Finance	(i) (ii)	274,097 ------------- 0	75,417 ------------- 0	140,078 ------------- 0	40,809 ------------- 0	29,124 ------------- 0	559,525 ------------- 0	0 ------------- 0
7Joseph Flynn DO CAO NMG - Physician -in-Chief NCI	(i) (ii)	619,886 ------------- 0	243,818 ------------- 0	93,619 ------------- 0	118,933 ------------- 0	34,580 ------------- 0	1,110,836 ------------- 0	73,144 ------------- 0
8Charlotte Ipsan Hospital CAO	(i) (ii)	182,409 ------------- 183,608	133,786 ------------- 0	79,146 ------------- 15,030	8,338 ------------- 87,392	17,752 ------------- 13,169	421,431 ------------- 299,199	40,136 ------------- 0
9Emmett Ramser Hospital CAO	(i) (ii)	342,982 ------------- 0	124,625 ------------- 0	67,897 ------------- 0	85,695 ------------- 0	33,002 ------------- 0	654,201 ------------- 0	37,388 ------------- 0
10Andrew Strausbaugh Hospital CAO	(i) (ii)	298,105 ------------- 0	124,326 ------------- 0	77,260 ------------- 0	520,221 ------------- 0	32,411 ------------- 0	1,052,323 ------------- 0	37,296 ------------- 0
11Muneeb Choudry MD Physician	(i) (ii)	354,795 ------------- 0	982,502 ------------- 0	42,466 ------------- 0	19,485 ------------- 0	37,299 ------------- 0	1,436,547 ------------- 0	0 ------------- 0
12Shawn Glisson MD Physician	(i) (ii)	887,606 ------------- 0	564,253 ------------- 0	21,297 ------------- 0	17,336 ------------- 0	39,402 ------------- 0	1,529,894 ------------- 0	0 ------------- 0
13Joseph Maly MD Physician	(i) (ii)	845,868 ------------- 0	546,164 ------------- 0	3,593 ------------- 0	12,924 ------------- 0	51,367 ------------- 0	1,459,916 ------------- 0	0 ------------- 0
14Aaron Spalding MD Physician	(i) (ii)	987,455 ------------- 0	636,673 ------------- 0	146,126 ------------- 0	18,695 ------------- 0	59,738 ------------- 0	1,848,687 ------------- 0	0 ------------- 0
15Don Stevens MD Physician	(i) (ii)	615,539 ------------- 0	651,321 ------------- 0	65,136 ------------- 0	32,779 ------------- 0	27,549 ------------- 0	1,392,324 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2022

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 2022: Matthew Ayers - $10,000 Charlotte Ipsan - $5,768 Joseph Flynn - $10,000 Andrew Strausbaugh - $9,616 Emmett Ramser - $10,000 Karen Donahue - $10,000
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	NORTON HEALTHCARE INC (NHC) EIN 61-1028725 IS THE PARENT ORGANIZATION FOR NORTON HOSPITALS, INC. AND THEREFORE ESTABLISHES COMPENSATION FOR THE CEO, OFFICERS AND KEY EMPLOYEES THROUGH ENGAGING WITH THE EXECUTIVE COMMITTEE OF NHC; AN INDEPENDENT COMPENSATION CONSULTANT; REVIEW OF OTHER ORGANIZATION'S FORM 990; WRITTEN EMPLOYMENT AGREEMENTS; THIRD PARTY COMPENSATION SURVEYS AND APPROVAL BY THE EXECUTIVE COMMITTEE AND BOARD. SEE NARRATIVE IN SCHEDULE O, REFERENCING PART VI, LINE 15 WHICH FURTHER DESCRIBES THE PROCESS FOR DETERMINING COMPENSATION FOR THE ORGANIZATION.
Schedule J, Part I, Line 4a Severance or change-of-control payment	Severance payment was received during 2022 by Key Employee, Andrew Strausbaugh in the amount of $9,850. Other compensation included in Schedule J Column B(iii)
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	THE FOLLOWING INTERESTED PERSONS PARTICIPATED IN OR RECEIVED PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS AS DESCRIBED IN IRC SECTION 457(F). THE INTERESTED PERSONS BELOW MAY HAVE PARTICIPATED IN ONE OR MORE OF THE FOLLOWING PLANS: THE EXECU-PLUS BENEFIT PLAN, DEFINED BENEFIT AND DEFINED CONTRIBUTION RESTORATION PLANS, AND THE PHYSICIAN DEFERRED PLAN. THE "PAY CREDIT" OUTLINED BELOW REPRESENTS A REASONABLE ESTIMATE OF THE ANNUAL INCREASE IN ACTUARIAL VALUE OF THE PLANS; AND THEREFORE, REPRESENTS THE ORGANIZATION'S CONTRIBUTION TO THE VALUE OF THE BENEFITS. NAME - PAY CREDIT Russell F. Cox - $117,699 Michael W. Gough - $74,682 Robert Azar - $54,258 Adam Kempf - $125,316 Matthew Ayers - $56,854 Charlotte Ipsan - $69,414 Joseph Flynn - $103,683 Andrew Strausbaugh - $37,141 Emmett Ramser - $56,407 Karen Donahue - $22,509 THE "PAYMENT RECEIVED" OUTLINED BELOW REPRESENTS CASH PAYMENTS THAT THE EMPLOYEE RECEIVED DURING 2022 AND CAN BE COMPRISED OF CURRENT AND OR PRIOR YEARS EMPLOYEE AND EMPLOYER CONTRIBUTIONS. NAME - PAYMENT RECEIVED Russell F. Cox - $2,156,367 Michael W. Gough - $178,379 Robert Azar - $228,616 Adam Kempf - $115,476 Matthew Ayers - $61,094 Charlotte Ipsan - $48,416 Joseph Flynn - $73,175 Andrew Strausbaugh - $53,498 Emmett Ramser - $52,672 Karen Donahue - $100,764
Schedule J, Part I, Line 7 Non-fixed payments	In 2022, 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) 2022

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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 section 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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

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) 2021

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) JASON NACHAZEL	FAMILY MEMBER OF RONALD LEHOCKY, TRUSTEE	93,019	COMPENSATION		No
(2) SARAH A ROBINSON	FAMILY MEMBER OF DONALD H ROBINSON, TRUSTEE	89,551	COMPENSATION		No
(3) Lorraine Bouvette	Family member of Maria Bouvette, Trustee	74,653	COMPENSATION		No
(4) Laura Hortert	FAMILY MEMBER OF EMMETT RAMSER, KEY EMPLOYEE	47,720	COMPENSATION		No
(5) Emrie Ipsan	Family member of Charlotte Ipsan, Key Employee	21,767	Compensation		No
(6) Emma Kempf	Family member of Adam Kempf, Officer	22,833	Compensation		No
(7) Megan Knights	Family member of Emmett Ramser, Key Employee	79,044	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) 2021

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

Norton Hospitals Inc

Employer identification number

61-0703799

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......	X		48,060	Market value
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Donated Meals/Gift Cards )	X	5	221,722	Market value
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2022)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
Schedule M, Part I Explanations of reporting method for number of contributions	Clothing and household goods - Number of contributions Other - Donated Meals/Gift Cards Number of contributions

Schedule M (Form 990) (2022)

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- TIN:

SCHEDULE O
(Form 990)

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

2021

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. (NHI) THEREFORE, ALL APPLICABLE IRS TAX COMPLIANCE FILINGS ARE REPORTED BY NHC ON BEHALF OF NHI. NHI HAS APPROXIMATELY 12,780 EMPLOYEES.
Form 990, Part V, Line 1a COMMON PAYING AGENT 1099S	NORTON HEALTHCARE, INC. (NHC) EIN 61-1028725 IS THE COMMON PAYING AGENT FOR NORTON HOSPITALS, INC. (NHI) AND THEREFORE, ALL VENDORS, INCLUDING INDEPENDENT CONTRACTORS, ARE PAID AND REPORTED BY NHC ON BEHALF OF NHI. FOR PURPOSES OF PART V, LINE 1, THE NUMBER OF 1099S REPORTED AND FILED FOR 2022 BY NHC FOR NHI, WAS APPROXIMATELY 260. NHI HAS 138 INDEPENDENT CONTRACTORS EXCEEDING $100,000 FOR 2022.
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 2 Family/business relationships amongst interested persons	Russell F. Cox, Michael W. Gough, Robert B. Azar (Officers, Norton Enterprise, Inc.) - Business relationship
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 5, 2023 NORTON HEALTHCARE, INC. (NHC) FINANCE COMMITTEE MEETING AND AT THE OCTOBER 26, 2023 NHC BOARD OF TRUSTEES MEETING, THE 990S WERE DISCUSSED AND COMMITTEE MEMBERS AND TRUSTEES HAD AN OPPORTUNITY TO ASK QUESTIONS. COINCIDING WITH THE FINANCE COMMITTEE MEETING, ELECTRONIC COPIES OF THE 990S WERE MADE AVAILABLE TO ALL MEMBERS OF THE FINANCE COMMITTEE AND BOARD OF TRUSTEES THROUGH THE DIRECTORS PORTAL SITE, PRIOR TO THE FILING WITH THE IRS. NHC IS THE PARENT OF COMMUNITY MEDICAL ASSOCIATES, INC., NORTON HOSPITALS, INC., NORTON PROPERTIES, INC., NORTON HEALTHCARE FOUNDATION, INC., THE CHILDREN'S HOSPITAL FOUNDATION, INC., Norton King's Daughters' Health, Inc., and Norton Healthcare-Indiana, Inc.
Form 990, Part VI, Line 12c Conflict of interest policy	THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY ANNUALLY DISTRIBUTING A QUESTIONNAIRE THAT REQUIRES OFFICERS, TRUSTEES, AND KEY EMPLOYEES TO DISCLOSE INTERESTS THAT MAY GIVE RISE TO CONFLICTS. IF A CONFLICT ARISES, THE POLICY PROVIDES PROCEDURES FOR ADDRESSING CONFLICTS TO ENSURE DECISIONS ARE MADE IN THE BEST INTERST OF THE ORGANIZATION.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	The top management official is paid by a related organization. Please see explanation provided for Form 990, Part VI, Line 15b.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	The organization takes all necessary steps to ensure that compensation for all officers, directors and key employees is reasonable and appropriate for the services provided to the organization. The organization provides a total compensation package that is on par with compensation provided by similar organizations and which conforms to the policies and guidelines set out by the Board of Trustees. Norton Healthcare, Inc. (NHC) engages an outside independent compensation consultant, Gallagher, to provide comparability data, including review of other health systems and hospital organizations that have filed Form 990s, for NHC's officers and key employees on total compensation for similar positions at health systems and hospital organizations similar in size, scope of services, and circumstances. In addition, the organization participates in third party surveys which provide aggregate, comparative compensation data for officers and key employees in similar positions at similar organizations. Gallagher consultants presented and discussed this comparability data in 2021 for the 2022 compensation review and met in 2022 for the 2023 compensation review with the Executive Committee of the Board of Trustees (Board). The Committee reviewed the executive compensation and benefits program, determined total compensation for the CEO, and approved compensation for other officers and key employees. The Committee reviewed NHC's variable compensation program and determined appropriate awards for performance relative to goals set for the year. After the Committee determined appropriate compensation and benefits for officers and key employees, the Board approved their total compensation.
Form 990, Part VI, Line 19 Required documents available to the public	CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE HERE: HTTPS://NORTONHEALTHCARE.COM/ABOUT-US/FINANCIAL-INFORMATION/. GOVERNING DOCUMENTS, AND CONFLICTS OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC.
Form 990, Part VII, Section A, Line 1a, Column (E) Board Member Stipend Payments	Norton Healthcare, Inc. (NHC) and affiliates (Norton Hospitals, Inc., Community Medical Associates, Inc., Norton Properties, Inc., Norton Healthcare Foundation, Inc., and Norton King's Daughters' Health, 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 2022.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Misc. Income - Total Revenue: 3074831, Related or Exempt Function Revenue: 3074831, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	Contract labor - Total Expense: 97408900, Program Service Expense: 97408900, Management and General Expenses: , Fundraising Expenses: ; Professional fees - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: , Fundraising Expenses: ; Fees & special services - Total Expense: 57496087, Program Service Expense: 57496087, Management and General Expenses: , Fundraising Expenses: ; Lab services - Total Expense: 24015646, Program Service Expense: 24015646, Management and General Expenses: , Fundraising Expenses: ; Other - Total Expense: 11715497, Program Service Expense: 11715497, Management and General Expenses: , Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	AFFILIATE TRANSFER - -848135;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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?
(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	Yes	No
(1)NORTON HEALTHCARE INC ACCOUNTING 224 E BROADWAY 5TH FLOO 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 FLOO 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 FLOO 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 FLOO 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 FLOO LOUISVILLE,KY40202 31-0914919	GENERATE FUNDS TO SUPPORT PROGRAMS AND SERVICES	KY	501(c)(3)	7	NORTON HEALTHCAREINC		No
(6)NORTON HEALTHCARE - INDIANA INC ACCOUNTING 224 E BROADWAY 5TH FLOOR LOUISVILLE,KY40202 85-0513259	OPERATE HOSPITAL AND OTHER HEALTHCARE FACILITIES	IN	501(c)(3)	10	Norton Healthcare Inc		No
(7)NORTON KING'S DAUGHTERS' HEALTH INC ACCOUNTING 224 E BROADWAY 5TH FLOOR LOUISVILLE,KY40202 35-0895832	PROVIDE HOSPITAL SERVICES	IN	501(c)(3)	3	NORTON HEALTHCARE - Indiana INC		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2021

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	(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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

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?
(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	Yes	No
(1) NORTON ENTERPRISES INC 224 E BROADWAY 5TH FLOOR LOUISVILLE,KY402022025 61-1054301	Invests in partnerships that provide medical services.	KY	Norton Healthcare Inc	C Corporation					No

Schedule R (Form 990) 2021

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

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) 2021

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

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) 2021

Additional Data

Software ID:	22016089
Software Version:	2022v5.0

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 we serve, in a manner that responds to the needs of our communities and faith heritage.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	22
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	21
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	12,780
6	Total number of volunteers (estimate if necessary) .............	6	289
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	47,917,001	29,041,708
9	Program service revenue (Part VIII, line 2g) .........	2,479,713,857	2,590,071,928
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	34,081	0
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,458,015	8,591,574
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	2,534,122,954	2,627,705,210
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)	770,870,455	865,820,465
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,406,250,969	1,521,078,749
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,177,121,424	2,386,899,214
19	Revenue less expenses. Subtract line 18 from line 12.......	357,001,530	240,805,996
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	3,488,220,444	3,620,090,960
21	Total liabilities (Part X, line 26).............	274,473,788	166,386,443
22	Net assets or fund balances. Subtract line 21 from line 20.....	3,213,746,656	3,453,704,517

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 2,337,465,574 including grants of $ ) (Revenue $ 2,597,422,359 )
	Norton Hospitals, Inc. (NHI) was formed to: I) provide on a nonprofit basis, hospital or health care facilities and services for the care and treatment of ill and injured persons and those who otherwise require medical care and related services of the kind customarily furnished most effectively by hospitals or health care facilities; II) conduct educational activities related to rendering care to the sick and injured; III) promote and conduct scientific research related to the care of the sick and injured. NHI has a total of 1,907 licensed beds, Norton Hospital - 605 beds; Norton Children's Hospital - 300 beds; Norton Audubon Hospital - 432 beds; Norton Women's and Children's Hospital - 373 beds; and Norton Brownsboro Hospital - 197 beds. These hospitals operate twenty-four (24) hours a day, seven (7) days a week. In 2022, NHI's hospitals and diagnostic centers served 65,959 inpatients, 659,044 outpatients, 254,632 emergency department visits, and 33,332 observation cases. In addition, NHI's operating rooms cared for 16,402 inpatient surgical patients and 38,876 outpatient surgical patients. Additionally, 8,356 deliveries were performed at NHI birthing centers. As part of our commitment to improving the health of our community, NHI provides funding for a wide array of lifesaving and life-enhancing services that benefit the communities we serve. In 2022, under its charity care program, Norton Healthcare provided free care to 6,574 patients, at a cost of $15.4 million. Also, Norton Healthcare grants a discount from billed charges to any patients who have no access to private health insurance or do not qualify for government assistance or charity care. Under this program, 6,183 patients were provided care at discounted rates. Another contribution to the community was educational support of $77.5 million, primarily to the University of Louisville (UofL) School of Medicine. Community health improvement services totaled $27.1 million and contributions to community groups were $2.2 million. Norton Healthcare provides programmatic support to the UofL School of Medicine through funding and facilities. During the 2022 calendar year, 211 residents completed clinical rotations in 50 specialties at Norton Healthcare facilities. Residency programs are part of the $77.5 million in educational support and clinical funding provided to the medical school.

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 expenses2,337,465,574

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	10,811,229	9,006,367	2,027,308

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	7,471,116
e	Government grants (contributions)		1e	21,570,592

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g	269,782

h Total. Add lines 1a-1f.......		29,041,708

		Business Code
2a	Net Patient Revenue	621110	2,589,779,491	2,589,779,491
b	Healthcare Education	624190	292,437	292,437
c
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		2,590,071,928

3 Investment income (including dividends, interest, and othersimilar amounts) ......
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		1,086,920	6a
b	Less: rental expenses		1,414,062	6b
c	Rental income or (loss)	0	-327,142	6c
d	Net rental income or (loss).......			-327,142			-327,142
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)	0	0	7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	PURCHASING CO-OP INC		561499	3,601,272	3,601,272
b	PARKING INCOME		812930	1,568,285			1,568,285
c	AFFILIATION AGREEMENT		621990	674,328	674,328
d	All other revenue ....			3,074,831	3,074,831	0	0
e	Total. Add lines 11a–11d ......			8,918,716
12	Total revenue. See instructions.....			2,627,705,210	2,597,422,359	0	1,241,143

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, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	3,099,288	3,099,288
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	428,587	428,587
7	Other salaries and wages........	699,496,632	699,496,632
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	34,953,262	34,953,262
9	Other employee benefits .......	78,992,203	78,992,203
10	Payroll taxes ...........	48,850,493	48,850,493
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)	303,393,308	303,393,308	0	0
12	Advertising and promotion ....
13	Office expenses .......	12,772,580	12,772,580
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	26,729,195	26,729,195
17	Travel ............	1,072,381	1,072,381
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	41,315,610	41,315,610
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	92,097,222	92,097,222
23	Insurance ...	11,508,868	11,508,868
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	643,718,842	643,718,842
b	Allocated Support	308,960,251	259,526,611	49,433,640
c	Provider Tax/HRIP Expenses	54,454,280	54,454,280
d	Repairs & Maintenance	19,752,313	19,752,313
e	All other expenses	5,303,899	5,303,899	0	0
25	Total functional expenses. Add lines 1 through 24e	2,386,899,214	2,337,465,574	49,433,640	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			11,339	1	8,300
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			262,209,653	4	269,416,878
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			69,170,691	8	68,934,055
9	Prepaid expenses and deferred charges ......			3,454,993	9	3,035,077
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	2,194,033,309
b	Less: accumulated depreciation	10b	1,263,403,958	950,056,514	10c	930,629,351
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 ...........			2,195,871,270	15	2,340,621,315
16	Total assets. Add lines 1 through 15 (must equal line 33)...			3,488,220,444	16	3,620,090,960

17	Accounts payable and accrued expenses .....	242,492,154	17	147,954,845
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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	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	31,981,634	25	18,431,598
26	Total liabilities. Add lines 17 through 25..	274,473,788	26	166,386,443

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	3,209,220,477	27	3,451,498,916
28	Net assets with donor restrictions ...........	4,526,179	28	2,205,601
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	3,213,746,656	32	3,453,704,517
33	Total liabilities and net assets/fund balances ........	3,488,220,444	33	3,620,090,960