2024-11-12T07:15:47+00:00 2023-12-31 350921680 CROWE LLP 9600 Brownsboro Road Suite 400 Louisville KY 402413902 990 2023-01-01 850513259 NORTON HEALTHCARE-INDIANA INC NORT 5026293409 ACCOUNTING 224 E BROADWAY 5th FL LOUISVILLE KY 40202 Adam Kempf CFO 5026298263 2024-11-12 true Kim Scifres P01316095 5023263996 2024-11-12 2023 2024-10-15 13:58:12Z Russell Cox 4967 US Highway 42 Suite 100 Louisville KY 40222 48965742 false X WWW.NORTONHEALTHCARE.COM X 2020 KY Norton Healthcare-Indiana, Inc.'s purpose is to provide quality health care to all those we serve, in a manner that responds to the needs of our communities and honors our faith heritage. 17 16 1282 30 0 0 0 48396386 0 569356 0 48965742 0 0 25667997 0 0 28999610 54667607 0 -5701865 0 113664669 0 119366534 0 -5701865 X Norton Healthcare-Indiana, Inc.'s purpose is to provide quality health care to all those we serve, in a manner that responds to the needs of our communities and honors our faith heritage. true true 54482114 48850160 Norton Healthcare-Indiana, Inc. (NHC-IN) was formed to: I) provide on a tax-exempt 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 and 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; operate programs for the prevention of health care services. NHC-IN has a total of 261 licensed beds, Norton Clark Hospital, LLC - 236 beds and Norton Scott Hospital, LLC - 25 beds. These hospitals operate twenty-four (24) hours a day, seven (7) days a week. From September 29, 2023 (acquisition date) through December 31, 2023, NHC-IN's hospitals served 2,039 inpatients, 21,697 outpatients, 11,704 emergency department visits, and 1,023 observation cases. In addition, NHC-IN's operating rooms cared for 491 inpatient surgical patients and 1,795 outpatient surgical patients. Additionally, 251 deliveries were performed at NHC-IN. 54482114 true false false true false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false true true true false false false true 195 0 true 1282 true false false false false false false false false false false false false X 17 16 true false false false true true true true true false false true true true true true true true true false X Helena Schulz 5026298263 Accounting 224 E BROADWAY 5TH FL LOUISVILLE KY 402022025 Russell F Cox President & CEO/Trustee 1.0 49.0 X X 0 3068539 417106 Barry Pennybaker Trustee 1.0 3.5 X 0 2000 0 Craig D Grant Vice Chair 1.0 4.5 X 0 2000 0 Donald H Robinson Trustee 1.0 6.5 X 0 0 0 Edie Nixon Chair 1.0 15.5 X 0 2000 0 G Hunt Rounsavall Sr Trustee 1.0 6.5 X 0 0 0 Gail Lyttle Trustee (PARTIAL YEAR) 1.0 3.5 X 0 2000 0 Gary L Stewart Trustee 1.0 6.5 X 0 2000 0 Gregory E Mayes Trustee 1.0 5.5 X 0 2000 0 James L Sublett MD Trustee 1.0 3.5 X 0 2000 0 Joe Craig Trustee 1.0 4.5 X 0 2000 0 Judge Denise Clayton Trustee 1.0 3.5 X 0 2000 0 Lee K Garlove Trustee 1.0 3.5 X 0 2000 0 Maria Hampton Trustee 1.0 3.5 X 0 2000 0 Maria L Bouvette Trustee 1.0 3.5 X 0 2000 0 Martha K Heyburn MD Trustee (PARTIAL YEAR) 1.0 3.5 X 0 2000 0 Richard R Ivey Trustee 1.0 3.5 X 0 2000 0 Ronald Lehocky MD Trustee 1.0 5.5 X 0 2000 0 Sue Davis EdD RN Trustee 1.0 5.5 X 0 2000 0 Adam Kempf Sr VP, CFO/Treasurer 1.0 49.0 X 0 1141705 223063 Michael W Gough Exec VP and COO 1.0 49.0 X 0 1823008 288832 Robert B Azar Sr VP Chief Legal Officer/Secretary 1.0 49.0 X 0 1021584 169876 0 7086836 1098877 0 false true false Teksystems Inc PO Box 198568 Atlanta GA 303848568 Temporary Staffing 249687 The CSI Companies Inc PO Box 890841 Charlotte NC 282890841 Temporary Staffing 154980 2 0 Net Patient Revenue 621110 48396386 48396386 0 0 0 0 48396386 209342 0 209342 0 209342 209342 0 0 Miscellaneous Revenue 900099 244160 244160 Cafeteria Income 722310 115582 115582 Purchase Discounts 621999 272 272 0 0 0 0 360014 48965742 48850160 0 115582 X 22889222 22889222 205757 205757 1008702 1008702 1564316 1564316 9755417 9755417 0 0 625988 625988 1521156 1521156 38905 38905 28387 28387 1510502 1510502 92834 92834 Medical supplies 7926153 7926153 Provider tax expense 3652819 3652819 Repairs and maintenance 2151695 2151695 Allocated support 1236622 1051129 185493 459132 459132 0 0 54667607 54482114 185493 0 7953364 35292681 0 0 4546821 1869085 50226614 1312933 48913681 0 0 2483131 0 12605906 0 113664669 11510578 0 0 107855956 0 119366534 X -5701865 0 -5701865 0 113664669 -5701865 0 X false true X true false X false false false false false false false false true 3150 3150 Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Norton Healthcare-Indiana, Inc. pays dues to the Indiana Hospital Association and to the American Hospital Association. A portion of these dues in the amount of $3,150 was spent by the Indiana Hospital Association and the American Hospital Association on lobbying. 3447787 3447787 28704818 452102 28252716 17250309 850409 16399900 823700 10422 813278 48913681 Right of Use Assets 12149594 Cost report receivable 413044 Other receivables 43268 12605906 Payable to Affiliate 95801305 Lease liabilities 12054651 107855956 true true X true X 350 false false false false 1282762 0 1282762 0.0235 11279225 8933841 2345384 0.0429 0 0.0 0 0 12561987 8933841 3628146 0.0664 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 0 0 12561987 8933841 3628146 0.0664 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 0 0 18904742 22841935 -3937193 X true true 2 2 Norton Clark Hospital 1220 Missouri Ave Jeffersonville IN 47130 HTTPS://Nortonhealthcare.com/location/norton-clark-hospital/ 24-005009-1 X X X A 1 Norton Scott Hospital 1451 N Gardner St Scottsburg IN 47170 HTTPS://Nortonhealthcare.com/location/norton-scott-hospital/ 23-004788-1 X X X A A 2 false true false false true X 350.0 X X X X X true true X X X true X www.nortonhealthcare.com/fap X www.nortonhealthcare.com/fap X www.nortonhealthcare.com/fap X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 2 Norton Healthcare, Inc. (NHC) acquired Norton Clark Hospital (Clark) and Norton Scott Hospital (Scott) effective 9/29/2023. Clark and Scott were purchased from Lifepoint Health, which is a for-profit health system. Thus, Clark and Scott have transitioned to not-for-profit hospitals, consistent with all other NHC entities. Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - All Hospitals. Other eligibility criteria in addition to the criteria answered above would include as described in the financial assistance policy. *The patient does not qualify for subsidized coverage of government assistance such as Disproportionate Share Hospital, Children's Health Insurance Program, Medicaid, Medicaid Managed Care Organization, or Hoosier Healthcare. *To be eligible for assistance for non-emergent medically necessary care, a patient (or that patient's guarantor) mush be a resident of Kentucky, Indiana, Tennessee, Ohio, or Illinois. This residency requirement does not apply to emergency care. Schedule H, Part V, Section B, Line 16 Facility A, 1 Facility A, 1 - All Hospitals. See response to Part VI, Line 3: Patient Education of Eligibility for Assistance. 4 Norton Community Medical Associates - Endocrinology 130 Hunter Station Way Suite 101 Sellersburg IN 47172 Other Health Care Facility - Physician's Office Norton Community Medical Associates - Scottsburg 1461 N Gardner St Scottsburg IN 47170 Other Health Care Facility - Physician's Office Norton Rural Health Clinic 1465 N Gardner St Scottsburg IN 47170 Other Health Care Facility - Rural Health Clinic Norton Community Medical Associates - Jeffersonville Commons 2021 Mercy Way Suite 102 Jeffersonville IN 47130 Other Health Care Facility - Physician's Office Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care Norton Healthcare-Indiana, 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 7 Costing Methodology used to calculate financial assistance IF COSTS COULD BE DIRECTLY IDENTIFIED TO A PARTICULAR LINE, THAN THOSE DIRECT COSTS WERE UTILIZED. IF COSTS COULD NOT BE DIRECTLY IDENTIFIED, THEN A COST-TO-CHARGE RATIO WAS UTILIZED. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount In accordance with accounting guidance, bad debt is not presented as an expense, but is included as a reduction in net patient service revenue. 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 audited trial balance for the period of Norton Healthcare, Inc.'s ownership (9/29/2023-12/31/2023). Norton Healthcare-Indiana, Inc. (NHC-IN) accepts all Medicare patients with the knowledge that there may be shortfalls and operates to promote the Health of the community. NHC-IN believes that any Medicare shortfall should be treated as a Community Benefit because Medicare does not typically fully compensate NHC-IN 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 Healthcare-Indiana, 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 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 Clark Hospital: Line 16a URL: www.nortonhealthcare.com/fap; Schedule H, Part V, Section B, Line 16b FAP Application website A - Norton Clark Hospital: Line 16b URL: www.nortonhealthcare.com/fap; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - Norton Clark Hospital: Line 16c URL: www.nortonhealthcare.com/fap; Schedule H, Part VI, Line 2 Needs assessment NORTON HEALTHCARE, INC. (NHC), THE PARENT COMPANY OF NORTON HEALTHCARE-INDIANA, INC. BEGAN CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE TWO INDIANA AREA HOSPITALS SHORTLY AFTER THEY WERE AQUIRED IN LATE 2023 TO BE PUBLISHED IN 2025. 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 HAS BEEN PROVIDED THROUGH PROVIDER AND COMMUNITY INTERVIEWS AND A COMMUNITY HEALTH SURVEY. HEALTH NEEDS WILL BE PRIORITIZED AND ADDRESSED BASED ON HEALTH STATUS FINDINGS AND COMMUNITY INPUT IN EARLY 2025. THE CHNA IS A COMPONENT OF THE ORGANIZATIONS STRATEGIC PLANNING PROCESS AS RESOURCES ARE NECESSARY TO IMPLEMENT STRATEGIES OUTLINED FOR PRIORITIES IDENTIFIED. THE LEADERSHIP OF NHC AND HOSPITAL CHIEF ADMINSTRATIVE OFFICER WILL APPROVE THE ASSESSMENT AND IMPLEMENTATION PLAN ONCE IT IS COMPLETED. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Signage is posted in all Norton Healthcare-Indiana, Inc. (NHC-IN) 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. Additional questions from the patient/guarantor can be facilitated through the Norton Healthcare, Inc. (NHC) Billing Office and Customer Service. 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. Norton Clark Hospital (Clark) and Norton Scott (Scott) Hospital utilize internal staff to screen all uninsured patients for NHC financial assistance, Medicaid, Medicaid Managed Care organizations, presumptive eligibility 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 internal staff. They protect filing deadlines by submitting the appropriate forms to the state/county. They follow up with a state caseworker as needed. NHC has staff that is dedicated to performing the following functions: processing, reviewing, and approving financial assistance applications received. Additionally, some of those employees make out-bound calls to solicit financial assistance information needed to process the patient's application. Financial assistance for NHC 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 NHC financial assistance, Medicaid, Medicaid Managed Care organization, presumptive eligibility, etc. Charity information was provided on the front of the billing statement. NHC 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, NHC then allowed the patient/guarantor to apply and be 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 NHC 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. NHC's Customer Service department routinely instructs and screens patients in the protocol regarding financial assistance through the NHC financial assistance program. NHC 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 Clark and Scott statement provided in 2023 included the link to the website to allow the patient/guarantor to learn more about financial assistance and information on how to apply. Schedule H, Part VI, Line 4 Community information PRIMARY SERVICE AREA NORTON HEALTHCARE-INDIANA, INC'S (NHC-IN) PRIMARY SERVICE AREA POPULATION IS OVER 239,000 AND EXPECTED TO INCREASE 4% BETWEEN 2024 AND 2029. THE PRIMARY SERVICE AREA INCLUDES AN AREA INCLUSIVE OF 3 COUNTIES, 2 OF WHICH ARE LOCATED ALONG THE OHIO RIVER BORDER IN INDIANA AND 1 ADDITIONAL INDIANA COUNTY THAT DOES NOT BORDER THE OHIO RIVER. APPROXIMATELY 33% OF THE POPULATION IS OVER 55 YEARS OLD; COMPARED TO 30% IN THE USA. THIS PORTION OF THE POPULATION TENDS TO USE ADDITIONAL HEALTHCARE SERVICES. THE PEDIATRIC POPULATION IN 2024 WAS ESTIMATED AT 52,477 AND IS EXPECTED TO DECREASE TO 52,444 WITHIN 5 YEARS AND REPRESENTS 21% OF THE POPULATION. THE NUMBER OF HOUSEHOLDS IN THE PRIMARY SERVICE AREA WAS ESTIMATED AT 96,361 IN 2024 AND IS EXPECTED TO INCREASE 4% BY 2029. THE UNEMPLOYMENT RATE IS APPROXIMATELY 4.3%. 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 $69,170 COMPARED TO $74,580 FOR THE UNITED STATES. NHC-IN'S PRIMARY SERVICE AREA'S POPULATION IS 69% URBAN AND 31% RURAL. THE SCOTT SERVICE AREA WITHIN SCOTT COUNTY HAS 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 NHC-IN'S SECONDARY SERVICE AREA INCLUDES 3 COUNTIES. NHC-IN'S SECONDARY SERVICE AREA POPULATION WAS 95,236 IN 2024 AND IS EXPECTED TO INCREASE 1% BETWEEN 2024 AND 2029. THE SECONDARY SERVICE AREA SPREADS ACROSS 3 KENTUCKY COUNTIES. THE 55+ AGE COHORT REPRESENTS 34% OF THE SECONDARY SERVICE AREA POPULATION AND IS ABOVE THE 30% 55+ PERCENTAGE IN THE UNITED STATES. THE PEDIATRIC POPULATION IN 2024 WAS ESTIMATED AT 20,548 AND EXPECTED TO DECREASE TO 20,127 BY 2029. ALTHOUGH THE PEDIATRIC POPULATION IS EXPECTED TO REMAIN RELATIVELY FLAT (LESS THAN 1% GROWTH), THERE IS A NEED FOR CHILDREN TO HAVE APPROPRIATE ACCESS TO CARE IN THE RURAL AREAS OF KENTUCKY. THE NUMBER OF HOUSEHOLDS IN THE SECONDARY SERVICE AREA WAS ESTIMATED AT 37,510 IN 2024 AND IS EXPECTED TO INCREASE 1.7% BY 2029. OVER 7,000 ADULTS IN THIS SERVICE AREA DO NOT HAVE A HIGH SCHOOL EDUCATION AND THE AVERAGE HOUSEHOLD INCOME IS UNDER $25,000 FOR 16% OF THE POPULATION. THE UNEMPLOYMENT RATE IS APPROXIMATELY 4%. THE MEDIAN HOUSEHOLD INCOME IS $67,091, 3% LESS THAN THE PRIMARY SERVICE AREA AVERAGE HOUSEHOLD INCOME. NHC-IN'S SECONDARY SERVICE AREA'S POPULATION IS 29% URBAN AND 71% RURAL. Schedule H, Part VI, Line 5 Promotion of community health Norton Healthcare Inc. (NHC) is a not-for-profit corporation serving adult and pediatric patients from throughout Greater Louisville, Southern Indiana, the Commonwealth of Kentucky and beyond. The not-for-profit hospital and health care system has five Louisville-based hospitals, three hospitals in Southern Indiana and one under construction in West Louisville that is scheduled to open in late 2024. In 2023, NHC further expanded into Indiana with two additional hospitals through a wholly-owned affiliate, Norton Healthcare-Indiana, Inc. (NHC-IN): Norton Clark Hospital (Clark) in Jeffersonville and Norton Scott Hospital (Scott) in Scottsburg. Clark is a 236-bed acute care facility located on a 22-acre campus that also includes two medical office buildings and an outpatient surgery center. Scott is a 25-bed critical access hospital with a 24-hour physician-staffed emergency department and a comprehensive list of inpatient and outpatient services. NHC-IN extends medical privileges to all physicians in the community who meet the credentialing qualifications necessary for appointment to its medical staff by specialty. On September 29, 2023, NHC acquired Clark and Scott. From September 29, 2023 through the end of 2023, Norton Healthcare Indiana's hospitals served 2,039 inpatients and 21,697 outpatients, and saw 11,704 emergency room visits. In addition, NHC-INs' operating rooms cared for 491 inpatient surgical patients and 1,795 outpatient surgical patients. Additionally, 251 babies were delivered at Clark. NHC Board of Trustees includes representatives from the community and largest employers in the region that live and work in the NHC-IN's primary service area. Members are neither employees of nor independent contractors with the organization, nor family members thereof. 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 (NKDH) in Madison IN, Norton Clark Hospital (Clark) in Jeffersonville, IN, and Norton Scott Hospital (Scott) in Scottsburg, IN. NKDH has 86 licensed beds and 8 physician practices and other ancillary health care service locations. Clark has 236 licensed beds and includes two medical office buildings and an outpatient surgery center. Scott is a 25 bed critical access hospital. false true false false false false false true false Russell F Cox President & CEO/Trustee 0 1548059 0 816092 0 704388 0 378897 0 38209 0 3485645 0 117699 Michael W Gough Exec VP and COO 0 1046012 0 510862 0 266134 0 260502 0 28330 0 2111840 0 0 Robert B Azar Sr VP Chief Legal Officer/Secretary 0 630680 0 266833 0 124071 0 150278 0 19598 0 1191460 0 0 Adam Kempf Sr VP, CFO/Treasurer 0 755209 0 281470 0 105026 0 175860 0 47203 0 1364768 0 63188 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 HEALTHCARE FOUNDATION, 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 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 - $345,765 Michael W. Gough - $228,527 Robert Azar - $127,409 Adam Kempf - $153,943 THE "PAYMENT RECEIVED" OUTLINED BELOW REPRESENTS CASH PAYMENTS THAT THE EMPLOYEE RECEIVED DURING 2023 AND CAN BE COMPRISED OF Current and or PRIOR YEARS EMPLOYEE AND EMPLOYER CONTRIBUTIONS. NAME - PAYMENT RECEIVED Russell F. Cox - $283,857 Michael W. Gough - $114,222 Robert Azar - $68,880 Adam Kempf - $63,188 Schedule J, Part I, Line 7 Non-fixed payments In 2023, 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. Form 990, Part III, Line 2 New program services On September 29, 2023 Norton Healthcare-Indiana, Inc. acquired the ownership interests of Clark Memorial Hospital, Clark Memorial Hospital other health care facilities, Scott Memorial Hospital, and Scott Memorial Hospital other health care facilities. Form 990, Part III, Line 3 Significant changes in program services On September 29, 2023 Norton Healthcare-Indiana, Inc. acquired the ownership interests of Clark Memorial Hospital, Clark Memorial Hospital other health care facilities, Scott Memorial Hospital, and Scott Memorial Hospital other health care facilities. 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 or 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, Robert B. Azar, Adam D. Kempf, and Michael W. Gough (Officers, Norton Enterprises, Inc.) - Business Relationship - 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 Healthcare - Indiana, Inc. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The Board of Trustees of Norton Healthcare, Inc. appoints the trustees of the organization. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders According to the Articles of Incorporation of the organization, Norton Healthcare, Inc. (NHC), the sole member, possesses all of the rights granted to a member pursuant to law, including the right to elect trustees or directors and approve amendments to the Articles of Incorporation of the organization. NHC also possesses the right to require the organization to (I) provide contributions of funds of the organization to pay all to a portion of the principle of, interest on, and all other payments to become due and owing with respect to any and all indebtedness incurred by NHC, and (II) provide security for such indebtedness. Form 990, Part VI, Line 11b Review of form 990 by governing body At the October 3, 2024 Norton Healthcare, Inc. (NHC) Finance Committee meeting and at the October 17, 2024 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 interest 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 the 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 and similar organizations. Gallagher consultants presented and discussed this comparability data in 2022 for the 2023 compensation review and met in 2023 for the 2024 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., The Children's Hospital Foundation, Inc., Norton King's Daughters' Health, Inc., and Norton Healthcare-Indiana, 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 on the Form 990 as reportable compensation to the Trustee receiving stipends in 2023. Form 990, Part IX, Line 11g Other Fees Contract labor - Total Expense: 1695242, Program Service Expense: 1695242, Management and General Expenses: , Fundraising Expenses: ; Professional fees - Total Expense: 2795782, Program Service Expense: 2795782, Management and General Expenses: , Fundraising Expenses: ; Fees and special services - Total Expense: 5264393, Program Service Expense: 5264393, Management and General Expenses: , Fundraising Expenses: ; Norton Clark Hospital LLC Accounting 224 E Broadway 5th Floor Louisville KY 40202 474000401 Provide hospital services IN 40107510 97104669 The Regional Health Network of Kentucky and Southern Indiana LLC Norton Clark Physician Practices LLC Accounting 2224 E Broadway 5th Floor Louisville KY 40202 611764853 Provide physician services IN 5227991 6707344 The Regional Health Network of Kentucky and Southern Indiana LLC Norton Scott Hospital LLC Accounting 224 E Broadway 5th Floor Louisville KY 40202 461113518 Provide hospital services IN 4944088 9176140 The Regional Health Network of Kentucky and Southern Indiana LLC Norton Scott Physician Practices LLC Accounting 224 E Broadway 5th Floor Louisville KY 40202 371705734 Provide physician services IN 170658 153330 The Regional Health Network of Kentucky and Southern Indiana LLC The Regional Health Network of Kentucky and Southern Indiana LLC Accounting 224 E Broadway 5th Floor Louisville KY 40202 800835692 Provide hospital and physician practice services IN 0 0 Norton Healthcare-Indiana Inc Norton Healthcare Inc Accounting 224 E Broadway 5th Floo Louisville KY 40202 611028725 Provide administrative and support services KY 501(c)(3) Type II NA false Norton Hospitals Inc Accounting 224 E Broadway 5th Floo Louisville KY 40202 610703799 Provide Hospital Services KY 501(c)(3) 3 Norton Healthcare Inc false Community Medical Associates Inc Accounting 224 E Broadway 5th Floo Louisville KY 40202 611276316 Operates a network of physician practices KY 501(c)(3) 10 Norton Healthcare Inc false Norton Properties Inc Accounting 224 E Broadway 5th Floo Louisville KY 40202 611028724 Maintain Office and Parking Facilities KY 501(c)(3) Type I Norton Healthcare Inc false The Children's Hospital Foundation Inc Accounting 224 E Broadway 5th Floo Louisville KY 40202 616027530 Generate funds to support programs and services KY 501(c)(3) 7 Norton Healthcare Inc false Norton Healthcare Foundation Inc Accounting 224 E Broadway 5th Floo Louisville KY 40202 310914919 Generate funds to support programs and services KY 501(c)(3) 7 Norton Healthcare Inc false Norton King's Daughters' Health Inc Accounting 224 E Broadway 5th Floo Louisville KY 40202 350895832 Provide Hospital Services IN 501(c)(3) 3 Norton Healthcare-Indiana Inc true Norton Enterprises Inc Accounting 224 E Broadway 5th Floo Louisville KY 40202 611054301 Invests in Partnerships that Provide Medical Services KY Norton Healthcare Inc C Corporation false false false false false false false false false false false false false false false true false false true true