2013-05-06T07:33:45-05:00 2012-06-30 990 2011-07-01 540566029 NORTON COMMUNITY HOSPITAL INC NORT 2766799600 100 15TH STREET NW NORTON VA 24273 STEPHEN SAWYER 2766799600 2013-05-01 2011 2016-03-07 17:11:31Z MARK LEONARD 100 15TH STREET NW NORTON VA 24273 64737350 false X WWW.MSHA.COM/NCH X 1949 VA PART I, LINE 1 THE MISSION OF NORTON COMMUNITY HOSPITAL (NCH) IS TO BE A LEADER IN IMPROVING THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY. WORKING TOGETHER AS A TEAM DEDICATED TO EXCELLENCE, WE ENDEAVOR TO: - PROVIDE A CONTINUUM OF HIGH QUALITY AND COST EFFECTIVE MEDICAL CARE FOCUSING ON THE NEEDS OF OUR PATIENTS AND THEIR FAMILIES. - CONTINUOUSLY IMPROVE HEALTH CARE IN OUR COMMUNITY THROUGH NEW PROGRAMS, SERVICES, AND TECHNOLOGIES. - FOCUS ON WELLNESS AND PREVENTION THROUGH COMMUNITY EDUCATION AND HEALTH AWARENESS PROGRAMS. - SERVE AS A CENTER FOR THE TRAINING OF AREA HEALTHCARE PROFESSIONALS. - FORGE HEALTH CARE ALLIANCES WITH OUR COMMUNITY IN ORDER TO CONTRIBUTE TO ITS GROWTH AND DEVELOPMENT. 13 4 605 28 77462 37876 6082 40281 60925539 63092112 2500603 895140 617298 560147 64049522 64587680 133970 127216 0 36539760 35956826 0 903 26191266 26321606 62864996 62405648 1184526 2182032 76345300 80140242 25223522 31004052 51121778 49136190 X PART I, LINE 1 THE MISSION OF NORTON COMMUNITY HOSPITAL (NCH) IS TO BE A LEADER IN IMPROVING THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY. WORKING TOGETHER AS A TEAM DEDICATED TO EXCELLENCE, WE ENDEAVOR TO: - PROVIDE A CONTINUUM OF HIGH QUALITY AND COST EFFECTIVE MEDICAL CARE FOCUSING ON THE NEEDS OF OUR PATIENTS AND THEIR FAMILIES. - CONTINUOUSLY IMPROVE HEALTH CARE IN OUR COMMUNITY THROUGH NEW PROGRAMS, SERVICES, AND TECHNOLOGIES. - FOCUS ON WELLNESS AND PREVENTION THROUGH COMMUNITY EDUCATION AND HEALTH AWARENESS PROGRAMS. - SERVE AS A CENTER FOR THE TRAINING OF AREA HEALTHCARE PROFESSIONALS. - FORGE HEALTH CARE ALLIANCES WITH OUR COMMUNITY IN ORDER TO CONTRIBUTE TO ITS GROWTH AND DEVELOPMENT. false false 54271115 127216 63275389 NORTON COMMUNITY HOSPITAL (NCH) IS LOCATED IN THE HEART OF SOUTHWEST VIRGINIA AND THE APPALACHIAN MOUNTAINS. IT IS A NOT-FOR-PROFIT, 129-BED, ACUTE-CARE FACILITY, PROUDLY SERVING SOUTHWEST VIRGINIA AND SOUTHEASTERN KENTUCKY SINCE 1949. OUR MISSION IS TO BE A LEADER IN IMPROVING THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY, BY WORKING TOGETHER AS A TEAM DEDICATED TO EXCELLENCE. AS THE LARGEST HEALTHCARE FACILITY IN THE COALFIELD REGION, NCH PROVIDES A WIDE ARRAY OF SERVICES THROUGH HIGHLY TRAINED PHYSICIANS AND SUPPORT STAFF. NCH IS A MEMBER OF THE VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION AND IS ACCREDITED BY THE AMERICAN OSTEOPATHIC ASSOCIATION. NCH WAS THE FIRST AOA ACCREDITED TEACHING FACILITY IN THE STATE OF VIRGINIA. (CONT.'D ON SCHEDULE O) THE INTERNAL MEDICINE RESIDENTS OF THIS PROGRAM ROTATE THROUGH ALL AREAS OF MEDICINE, FROM HEALTH MAINTENANCE TO CRITICAL CARE. THE RESIDENTS ASSIST OUR PHYSICIANS IN PROVIDING QUALITY HANDS ON PATIENT CARE, THROUGH OBSERVATIONS, EDUCATION AND BY PARTICIPATING IN GRAND ROUNDS. IN ADDITION TO THESE SERVICES WITHIN THE HOSPITAL SETTING, THE RESIDENTS ARE ALSO EXPOSED TO TREATING PATIENTS IN AN OFFICE SETTING AT THE COMMUNITY CLINIC (RESIDENT CONTINUITY CLINIC)IN WISE, VIRGINIA. TO IMPROVE ACCESS TO PRIMARY CARE, NORTON COMMUNITY HOSPITAL, INC. OPERATES SEVERAL CLINICS: COMMUNITY PHYSICIANS-NORTON, COMMUNITY PHYSICIANS-COEBURN, COMMUNITY PHYSICIANS-WISE, COMMUNITY ORTHOPEDICS, NORWISE OB/GYN, COMMUNITY CLINIC-WISE (RESIDENT CONTINUITY CLINIC), OCCUMED HEALTH CENTER AND THE WISE PROFESSIONAL OFFICE BUILDING WHICH OFFERS PHYSICIAN OFFICE SPACE AND IS HOME TO OUR COMPREHENSIVE HOME HEALTH SERVICES. OUR MEDICAL STAFF CONSISTS OF OVER 130 PHYSICIANS AND SURGEONS WITH SPECIALTY TRAINING IN: FAMILY PRACTICE, INTERNAL MEDICINE, EAR-NOSE-THROAT, GENERAL SURGERY, UROLOGY, PEDIATRICS, EMERGENCY MEDICINE, GERIATRIC MEDICINE, CRITICAL CARE, CARDIOLOGY, PULMONOLOGY, RADIOLOGY, ONCOLOGY, NEUROLOGY, ORTHOPEDICS, GASTROENTEROLOGY, OPTHALMOLOGY, OBSTETRICS, GYNECOLOGY AND DENTISTRY. PROGRAMS AND SERVICES INCLUDE INTENSIVE CARE/CRITICAL CARE/CORONARY CARE, 24-HOUR EMERGENCY ROOM SERVICES, PEDIATRIC CARE, LASER SURGERY, OUTPATIENT SURGERY, LITHOTRIPSY SERVICES, HOME HEALTH, HYPERBARIC MEDICINE, DIETARY/NUTRITION SUPPORT, PHARMACY, INPATIENT AND OUTPATIENT SURGICAL SERVICES, 12-BED INTENSIVE CARE UNIT, PASTORAL CARE, VOLUNTEER SERVICES, HELPING HANDS GIFT SHOP, COMMUNITY OUTREACH AND EDUCATION PROGRAMS, SCREENING SERVICES, AND UVA TELEMEDICINE AND PAIN MANAGEMENT. OUR RADIOLOGICAL SERVICES INCLUDE ANGIOGRAPHY, MAMMOGRAPHY, ULTRASOUND, STEREOTACTIC BREAST BIOPSY, NUCLEAR MEDICINE, PET SCANS, IN-HOUSE MAGNETIC RESONANCE IMAGING UNIT (MRI), AND CT SCANNER. IN 2012 OUR RADIOLOGY DEPARTMENT RECEIVED ACCREDITATION FOR ITS PET SERVICES THROUGH THE AMERICAN COLLEGE OF RADIOLOGY. THIS LATEST ACR ACCREDITATION IS ONE OF SEVERAL THE RADIOLOGY DEPARTMENT HAS RECEIVED OVER THE LAST YEAR. THE OTHERS INCLUDE NUCLEAR MEDICINE, MAMMOGRAPHY AND MRI, WITH MRI STAFF OBTAINING THEIR CERTIFICATION THIS YEAR AS WELL. THE FAMILY BIRTHING CENTER HAS SIX (6)SEMI-PRIVATE GYNECOLOGICAL SUITES AND SEVEN (7) LABOR, DELIVERY, RECOVERY, AND POSTPARTUM SUITES THAT OFFER COMFORT, CARE, AND COMPASSION THAT IS UNPARALLELED IN THE REGION. WE OFFER PREPARED CHILDBIRTH, PARENTING, SIBLING AND SAFE-SITTER CLASSES, INCLUDING EDUCATION ON BREASTFEEDING AND WOMEN'S HEALTH. THE CENTER ALSO OFFERS A SPECIAL AREA FOR CESAREAN SECTIONS AND ROUTINE GYNECOLOGICAL PROCEDURES. OUR CARDIOPULMONARY SERVICES DEPARTMENT PROVIDES AN EXTENSIVE LINE OF CARDIAC, PULMONARY AND NEURO-DIAGNOSTIC SERVICES. THEY ALSO PROVIDE A COMPREHENSIVE SLEEP MEDICINE PROGRAM AS WELL AS AN APPROVED SITE FOR THE DEPARTMENT OF LABOR'S FEDERAL BLACK LUNG PROGRAM. THE REGIONAL REHAB CENTER OFFERS OCCUPATIONAL THERAPY, PHYSICAL THERAPY, SPEECH THERAPY, PULMONARY REHAB, ANODYNE THERAPY, CARDIAC REHABILITATION, CARDIOPULMONARY REHAB, SMOKING CESSATION CLASSES AND FIT-ONE, A COMMUNITY WELLNESS PROGRAM. OUR THREE-YEAR, CARF ACCREDITED (COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES), 11-BED INPATIENT REHABILITATION UNIT PROVIDES A RESPONSIVE, CARING ENVIRONMENT THAT ENHANCES RECOVERY AND SPEEDS THE RETURN TO NORMAL LIFE FOR PATIENTS SUFFERING FROM STROKE, PARKINSON'S DISEASE, POLYNEUROPATHY, BRAIN INJURY AND HIP FRACTURES. NORTON COMMUNITY HOSPITAL HAS ENABLED BUSINESSES TO LOWER THEIR MEDICAL CARE COSTS THROUGH OUR COMPREHENSIVE OCCUPATIONAL MEDICINE PROGRAM AT OCCUMED HEALTH CENTER. OCCUMED OFFERS NURSING CASE MANAGEMENT, WORK-RELATED INJURY TREATMENT AND FOLLOW-UP, PRE-EMPLOYMENT PHYSICALS, DRUG SCREENINGS, VACCINATIONS, WORK-SITE SAFETY ANALYSIS, GENERAL HEALTH SCREENINGS, OSHA REGULATION COMPLIANCE ASSISTANCE, AND INDUSTRIAL REHABILITATION. COMMUNITY HOME CARE OFFERS DURABLE MEDICAL EQUIPMENT SUCH AS LIFT CHAIRS, MOTORIZED SCOOTERS, LIMB BRACES, DIABETIC SUPPLIES, TURBANS, AND A PRIVATE FITTING ROOM FOR MASTECTOMY FITTINGS. THE WANDA WAMPLER CENTER FOR WOMEN'S HEALTH HOUSES OUR COMPREHENSIVE WOMEN'S HEALTH SERVICES. THE CENTER OFFERS STEREOTACTIC BREAST BIOPSY, BONE DENSITOMETRY, AND DIGITAL MAMMOGRAPHY. NORTON COMMUNITY HOSPITAL IS ALSO AN APROVED TRAINING CENTER FOR THE AMERICAN HEART ASSOCIATION (AHA). WE PROVIDE AHA HEARTSAVER PROGRAMS TO THE COMMUNITY AS WELL AS BASIC AND ADVANCED LIFE SUPPORT COURSES TO MEMBERS OF THE MEDICAL COMMUNITY. NCH HAS PARTNERED WITH THE COMPANY FIRSTSOURCE SOLUTIONS USA TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY12, FIRSTSOURCE REPRESENTATIVES WERE AVAILABLE AT NCH TO ASSIST PATIENTS. THE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID OR TENNCARE) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. DURING FY12, 543 PATIENTS WERE APPROVED FOR COVERAGE. ONCE A PERSON IS APPROVED FOR MEDICAID OR TENNCARE THROUGH THE PROGRAM OFFERED THROUGH NCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. FIRSTSOURCE IS COMPENSATED BY NCH. DURING FY12, NCH'S COST FOR THIS PROGRAM WAS 119,512. 54271115 true true false true false false false false false false true true false true true true false true false false false false false false true false true true true false true false false false false false true true false false false false false true true true true false false true 145 0 true 605 true true true false false false false false false false false false X 13 4 false false false false true true true true true false true true true true true true true true true true false VA X STEPHEN SAWYER 2764391011 100 15TH STREET NW NORTON VA 24273 MARVIN EICHORN 2.00 X 0 672484 35543 ANN FLEMING 2.00 X 0 501320 66728 EMORY ALLEN MULLINS 2.00 X 273005 0 29165 JOHN DOYLE 2.00 X 0 241176 36759 ROBERT LEONARD 2.00 X 18750 0 0 CHARLES WARD 2.00 X 18750 0 0 JAMES MANICURE 2.00 X 14242 0 0 BUFORD STURGILL 2.00 X 14242 0 0 JOHN WRIGHT 2.00 X 14242 0 0 WILLIE PRICE-HARRIS 2.00 X 6585 0 0 BILL WAMPLER 2.00 X 6585 0 0 HARRY DOTSON 2.00 X 0 0 0 SANDRA BROOKS MD 2.00 X 0 0 0 MARK LEONARD 55.00 X 0 246967 37083 STEPHEN SAWYER 55.00 X 0 129098 15141 ISAM ZIBDEH MD 40.00 X 428328 0 25690 DAVID NAUSS MD 40.00 X 410224 0 34356 MATTHEW CUSANO MD 40.00 X 388439 0 32267 GAYLE VEST MD 40.00 X 285695 0 31562 BERNIE SERGENT MD 40.00 X 281234 0 24880 2160321 1791045 369174 32 false true false WEATHERBY LOCUMS INC P O BOX 972633 DALLAS TX 753972633 PHYSICIAN SVCS 1044531 BALL CONSTRUCTION CO 1675 PARK AVE NW NORTON VA 24273 CONSTRUCTION 658157 PETERSON ASSOCIATES INC 2115 REXFORD RD STE 500 CHARLOTTE NC 28211 ARCHITECTS 388721 INTERNETWORK ENGINEERING P O BOX 636604 CINCINNATI OH 452636604 NETWORK ENG. 346851 CROTHALL LAUNDRY SERVICES INC 13028 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 LINEN SVCS 276451 18 1346 38600 335 40281 PATIENT REVENUE 621500 62935467 62935467 GAIN ON PENSION ADJUSTMENT 900099 518509 518509 WELLNESS PROGRAMS 621990 171880 171880 LABORATORY 621500 53418 53418 LOSS ON L-T DEBT RETIREMENT 900099 -587162 -587162 63092112 744250 744250 381240 121841 259399 259399 24044 235355 123801 27089 123801 27089 150890 150890 32740 27829 4911 4911 CAFETERIA & VENDING 722210 136604 136604 MANAGEMENT FEES 561000 81169 81169 OTHER 621400 78064 78064 295837 64587680 63197927 77462 1272010 127216 127216 777498 396600 380898 27686613 24629599 3057014 959930 850750 109180 4788842 4660332 127757 753 1743943 1694438 49505 22754 22754 294322 47080 247242 153182 153182 56236 56236 5851596 4876923 974673 340076 274388 65688 1079411 965011 114250 150 562934 550945 11989 997342 952186 45156 319021 301136 17885 22607 22599 8 153967 153967 2937660 2075398 862262 187967 505107 -317140 MEDICAL SUPPLIES 8097126 8043812 53314 MANAGEMENT FEES 3666204 1907437 1758767 REPAIRS & MAINTENANCE 1049197 978798 70399 ALL OTHER 530004 411360 118644 62405648 54271115 8133630 903 1017164 663638 6472714 7795842 1099598 824224 1300500 1197907 804090 513243 71322888 36582321 27310289 34740567 16275360 16622502 22065585 17782319 76345300 80140242 13183759 11745948 146255 11876127 11663856 17381 1919 7592329 25223522 31004052 X 51032560 49051085 85105 89218 51121778 49136190 76345300 80140242 X 2182032 -4167620 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false true 3354 false false false 3354 false false false false false SCHEDULE C, PART II-B, LINE 1 PORTION OF DUES PAID TO VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION THAT ARE ATTRIBUTABLE TO DIRECT LOBBYING. false false false false false false false false false false 2111034 2111034 30374343 14950053 15424290 632887 357563 275324 29712647 21274705 8437942 8491977 8491977 34740567 INVESTMENTS - OTHER 16622502 16622502 UNDER BOND INDENTURE AGREEMENTS 17597248 OTHER ASSETS 185071 17782319 RETIREE BENEFITS PAYABLE 4187011 LT-DEFINED PENSION PAYABLE 2154410 RESERVE FOR PROF LIABILITIES 767743 DUE TO AFFILIATES 483165 7592329 LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X "THE HOSPITAL IS CLASSIFIED AS AN ORGANIZATION EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3)OF THE INTERNAL REVENUE CODE. AS SUCH, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR THE HOSPITAL. AT JUNE 30, 2012, TAX RETURNS FOR FISCAL YEARS 2009 THROUGH 2011 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2012 AND 2011. AS SUCH, NO INTEREST OR PENALTIES WERE RECOGNIZED IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS RELATED TO UNRECOGNIZED TAX BENEFITS." BOOK SALE 32740 32740 27829 32740 32740 27829 27829 4911 true true true X true X true true true false false 956190 956190 0.01530 11215038 9092767 2122271 0.03400 12171228 9092767 3078461 0.04930 130057 130057 0.00210 1909888 1069531 840357 0.01350 1864930 1864930 0.02990 100645 100645 0.00160 4005520 1069531 2935989 0.04700 16176748 10162298 6014450 0.09640 26571 26571 0.00040 26571 26571 0.00040 true 1778788 1423030 16651849 16334814 317035 X true true 1 1 NORTON COMMUNITY HOSPITAL

100 15TH STREET NW NORTON VA 24273

X X X X NORTON COMMUNITY HOSPITAL 1 true X X X X X X X 11 true true true X X X X X X X X false true true 200.0 true 400.0 true X X X X true true X X X X X true false X X X X true X false false RELATED ORGANIZATION INFORMATION PART I LINE 6A MOUNTAIN STATES HEALTH ALLIANCE HAS HISTORICALLY PREPARED AND MADE PUBLIC A COMMUNITY BENEFIT REPORT TO INCLUDE INFORMATION FOR ALL OF THE HOSPITALS WITHIN THE HEALTH SYSTEM DURING FY12 WE DID NOT ISSUE A COMMUNITY BENEFIT REPORT HOWEVER WE INTEND TO PREPARE A COMMUNITY BENEFIT REPORT DURING FY13 COSTING METHODOLOGY EXPLANATION PART I LINE 7 A COST TO CHARGE RATIO WAS USED TO CALCULATE LINE 7 UTILIZING THE SCHEDULE H APPLICABLE WORKSHEETS INCLUDING WORKSHEET 2 A RATIO OF PATIENT CARE COST TO CHARGES BAD DEBT EXPENSE EXPLANATION PART III LINE 4 THE CALCULATED COST TO CHARGE RATIO WORKSHEET 2 WAS APPLIED TO BAD DEBT CONTRA REVENUE AND PROVISION FOR BAD DEBT IN DETERMINING LINE 2 OUR VICE PRESIDENT OF PATIENT FINANCIAL SERVICES AND OUR CFO ESTIMATE THAT 80 OF TOTAL BAD DEBT EXPENSE WAS ASSUMED ATTRIBUTABLE TO PATIENTS LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE WE HAVE MANY INSTANCES DURING THE YEAR OF PATIENTS WITH LARGE ACCOUNT BALANCES AND NO HEALTH INSURANCE COVERAGE THAT WE ARE SURE WOULD QUALIFY FOR CHARITY CARE ALTHOUGH HOSPITAL TEAM MEMBERS ENCOURAGE THESE INDIVIDUALS TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION MANY WILL NOT DO SO EVEN WHEN THESE INDIVIDUALS ARE TOLD WE FEEL SURE THEY DO QUALIFY FOR FULL OR PARTIAL ASSISTANCE THEY STILL REFUSE TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION REGARDING LINE 3 IT IS IMPLAUSIBLE TO DETERMINE THE AMOUNT OF NCHS BAD DEBT ASSOCIATED WITH THOSE PATIENTS WHO MAY HAVE MET THE CRITERIA SET FORTH IN OUR FINANCIAL ASSISTANCE POLICY WITHOUT HAVING A COMPLETED FINANCIAL ASSESSMENT WE ARE UNABLE TO DETERMINE OUR PATIENTS FINANCIAL CIRCUMSTANCES UNLESS A COMPLETED FINANCIAL ASSESSMENT FORM IS VOLUNTARILY PROVIDED TO US WE CAN ASSERT THAT MORE THAN 90 OF OUR PATIENTS WHO HAVE PROVIDED COMPLETED FINANCIAL ASSESSMENT FORMS HAVE BEEN APPROVED FOR AT LEAST PARTIAL FINANCIAL ASSISTANCE FOOTNOTE DISCLOSURE FROM NCHS FY12 AUDITED FINANCIAL STATEMENT READS NEW ACCOUNTING PRONOUNCEMENTS IN JULY 2011 THE FASB ISSUED ASU 201107 PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE PROVISION FOR BAD DEBTS AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH CARE ENTITIES THE ASU REQUIRES THE CHANGE OF PRESENTATION OF THE ESTIMATED PROVISION FOR BAD DEBTS IN THE CONSOLIDATED STATEMENTS OF OPERATIONS FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE NET OF CONTRACTUAL DEDUCTIONS AND DISCOUNTS ALONG WITH ADDITIONAL DISCLOSURES ABOUT THE POLICIES FOR RECOGNIZING REVENUE AND ASSESSING BAD DEBTS AND QUALITATIVE INFORMATION ABOUT CHANGES IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS THE HOSPITAL RETROACTIVELY ADOPTED ASU 201107 IN FISCAL YEAR 2012 MANAGEMENT BELIEVES THE ADOPTION OF ASU 201107 DID NOT HAVE A MATERIAL IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENT REPORT THE AMOUNT OF ESTIMATED UNCOLLECTIBLE SELFPAY AND EXPLAIN THAT UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE ESTIMATED RESERVES ARE BASED UPON PRIOR COLLECTION HISTORY FOR GROUPS OF RECEIVABLES KNOWN COLLECTION RISKS AND OTHER ENVIRONMENTAL FACTORS INCLUDING THE AGE OF THE RECEIVABLES MEDICARE EXPLANATION PART III LINE 8 MEDICARE ALLOWABLE COSTS WERE REPORTED USING NCHS FILED MEDICARE COST REPORT CR THE CR USES A COST TO CHARGE RATIO BASED ON A STEPDOWN ALLOCATION METHODOLOGY IN CARING FOR THE PATIENT THERE ARE SEVERAL SERVICES THAT ARE CONSIDERED NONALLOWABLE SUCH AS TRANSPORTATION OF A PATIENT COMFORT ITEMS TO INCLUDE A TELEVISION MAGAZINES OR A TELEPHONE ADDITIONAL NONALLOWABLE COSTS INCLUDE THE RECRUITMENT OF PHYSICIANS PHYSICIAN GUARANTEES AND A PORTION OF THE BAD DEBT 30 ASSOCIATED WITH THE CARE OF THE PATIENT COLLECTION PRACTICES EXPLANATION PART III LINE 9B NCH PROVIDES A PATIENT FRIENDLY BILLING FLOW CHART ON ITS WEBSITE THAT GUIDES A PATIENT THROUGH THE PROCESS BEGINNING WITH ADMISSION AND ENDING WITH THE PATIENTS ACCOUNT BEING SUCCESSFULLY RESOLVED NCH FOLLOWS A STRONG COLLECTION PROGRAM THAT COMMUNICATES FINANCIAL RESPONSIBILITY TO THE PATIENT COLLECTION PRACTICES APPLY TO ALL PATIENTS CHARITY AND NONCHARITY CARE IN ROUTINE CIRCUMSTANCES WHEN IT IS DETERMINED THAT A PATIENT HAS NOT RESPONDED TO REQUESTS FOR PAYMENT AND HAS NOT PROVIDED INFORMATION TO ASCERTAIN ABILITY TO PAY AN ACCOUNT CAN BE REFERRED TO AN OUTSIDE COLLECTION AGENCY FOR COLLECTION ASSISTANCE NCH ENSURES THAT OUTSIDE COLLECTION AGENCIES FOLLOW HOSPITAL BILLING AND COLLECTION GUIDELINES ONCE A DELINQUENT PATIENT ACCOUNT HAS BEEN SUBMITTED TO AN OUTSIDE AGENCY IT CAN BE RETRACTED IF IT IS LATER DETERMINED THAT THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE ALL REQUESTS FOR FINANCIAL ASSISTANCE MUST BE ACCOMPANIED BY A COMPLETED FINANCIAL ASSESSMENT FORM AND SUPPORTING DOCUMENTATION NEEDS ASSESSMENT PART VI PART VI LINE 2 MSHA INCLUDED AMERICAS HEALTH RANKINGS AHR IN ITS ASSESSMENT IN ORDER TO BETTER DEFINE THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES TENNESSEE RANKED 39TH AND VIRGINIA RANKED 20TH HOWEVER IT SHOULD BE NOTED THAT SOUTHWEST VIRGINIA WHERE MSHA FACILITIES ARE LOCATED CLOSELY RESEMBLES THE HEALTH RANKINGS FOR TENNESSEE AMERICAS HEALTH RANKINGS ARE BASED ON A SERIES OF MEASURES INCLUDING SEVERAL HEALTH OUTCOMES AND HEALTH FACTORS A SURVEY WAS GIVEN TO 67 INDIVIDUALS REPRESENTING THE NINE COUNTIES IN WHICH MSHA OWNS A FACILITY THESE INDIVIDUALS INCLUDED PHYSICIANS PUBLIC HEALTH LEADERS NONPROFIT DIRECTORS SCHOOL NURSES AND OFFICIALS AND BUSINESS LEADERS A SURVEY WAS GIVEN TO EACH INDIVIDUAL SEEKING FEEDBACK REGARDING AVAILABLE RESOURCES IN EACH AREA THE HEALTH STATUS HEALTH PRIORITIES AND SUGGESTIONS FOR IMPROVEMENT THE MAJORITY OF RESPONSES SUGGESTED FOCUSING ON EDUCATION IN ORDER TO PROMOTE HEALTHY HABITS OTHER RESPONSES INCLUDED MAKE PHYSICAL EDUCATION A REQUIREMENT AS PART OF SCHOOL CURRICULUM IMPROVE NATURAL TRAILS AND WALKWAYS INCREASE COMMUNITY SUPPORT FOR SMOKEFREE AREAS PARTNER WITH LOCAL FARMERS MARKETS SHARE HEALTH INFORMATION BETWEEN PHARMACIES NETWORK WITH SMALL BUSINESSES AND NONPROFITS IN ORDER TO AVOID DUPLICATING RESOURCES AND PROVIDE EARLY SCREENINGS FOR THE UNINSURED OR UNDERINSURED OVERALL THE COMMUNITY MEMBERS GAVE MSHAS CORE SERVICE AREA A HEALTH STATUS RANKING OF 424 OUT OF 10 1 BEING THE LOWEST 10 BEING THE HIGHEST ALSO ALL 67 PARTICIPANTS AGREED THAT OBESITY CANCER HEART DISEASE AND DIABETES WERE THE TOP HEALTH PRIORITIES IN EACH COUNTY AHR REPORTS THAT TENNESSEE AND VIRGINIA BOTH SAW AN INCREASE IN DIABETES AND OBESITY WITHIN THE PAST TEN YEARS TENNESSEE ALSO RANKED 44TH FOR CARDIOVASCULAR DISEASE AND 46TH FOR CANCER DEATHS VIRGINIA OVERALL HAD A BETTER RANKING IN THESE TWO CATEGORIES BUT AS STATED EARLIER SOUTHWEST VIRGINIA CLOSELY RESEMBLES TENNESSEE MSHA PLANS TO USE THE AVAILABLE RESOURCES TO START IMPROVING THE HEALTH STATUS OF NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI PART VI LINE 3 NCH PROVIDES COMMUNICATION OF FINANCIAL ASSISTANCE ON ITS WEBSITE AND ON POSTERS LOCATED IN PROMINENT AREAS OF THE HOSPITAL SUCH AS ADMITTING AND THE EMERGENCY DEPARTMENT PRINTED EDUCATIONAL MATERIALS INCLUDING FINANCIAL ASSISTANCE CONTACT INFORMATION ARE ALSO PROVIDED IN EACH PATIENTS PAPERWORK POSTERS AND REFERENCE MATERIALS ARE WRITTEN IN BOTH ENGLISH AND SPANISH ADMITTING STAFF ARE TRAINED TO EDUCATE PATIENTS ON NCHS FINANCIAL ASSISTANCE POLICY NCH ALSO HAS FINANCIAL COUNSELORS TO PROVIDE FURTHER INFORMATION AND ASSISTANCE TO NCH PATIENTS REGARDING NCHS FINANCIAL ASSISTANCE POLICY THESE COUNSELORS ALSO HELP UNINSURED PATIENTS DETERMINE SOURCES OF PAYMENT FOR MEDICAL BILLS AND HELP PATIENTS DETERMINE ELIGIBILITY FOR PROGRAMS SUCH AS MEDICAID IN ADDITION NCH CONTRACTS WITH THE COMPANY FIRSTSOURCE SOLUTIONS USA TO WORK WITH SELFPAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES FIRSTSOURCE SOLUTIONS DETERMINES A PATIENTS ELIGIBILITY IN MEDICAL COVERAGE OPTIONS AND ASSISTS WITH THEIR ENROLLMENT NCH BEARS THE COST FOR THE FIRSTSOURCE SOLUTIONS PROGRAM COMMUNITY INFORMATION PART VI PART VI LINE 4 NCH IS LOCATED IN NORTON WISE COUNTY WHICH IS IN RURAL SOUTHWEST VIRGINIA BOTH NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA SWVA ARE LOCATED WITHIN THE APPALACHIAN MOUNTAINS SPECIFICALLY THE BLUE RIDGE MOUNTAIN REGION AND TENNESSEE VALLEY SWVA IS CONSIDERED RURAL AND MUCH DIFFERENT THAN THE REST OF THE STATE SWVA HAS BEEN AND REMAINS A MAJOR COAL MINING REGION WISE COUNTY HAS A HIGH RATE OF INDIVIDUALS WHO ARE UNINSURED THE POPULATION OF WISE COUNTY IS JUST OVER 41770 AND THE CITY OF NORTON HAS A POPULATION OF 3713 THE MEDIAN AGE OF RESIDENTS OF NORTON IS 40 WHICH IS OLDER THAN THE AVERAGE AGE OF 372 IN THE UNITED STATES NORTON HAS A MEDIAN HOUSEHOLD INCOME OF 33662 WHICH IS SIGNIFICANTLY BELOW VIRGINIAS MEDIAN HOUSEHOLD INCOME 32 OF NORTONS CHILDREN LIVE IN POVERTY COMPARED TO 14 STATEWIDE HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI NORTON COMMUNITY HOSPITAL IS DEDICATED TO OPERATING EFFICIENTLY SO THAT WASTE IS MINIMIZED NCHS LEADERSHIP REMAINS MINDFUL OF MANAGING THE HOSPITALS LIMITED RESOURCES SO THAT ADEQUATE FACILITIES AND EQUIPMENT ARE AVAILABLE FOR THE CARE OF OUR PATIENTS VARIOUS CHECKS AND BALANCES ARE ESTABLISHED TO ENSURE THAT EXPENDITURES FOR OPERATING EXPENSES AND CAPITAL COSTS ARE REASONABLE AND NECESSARY THE MAJORITY OF NCHS GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATIONS PRIMARY SERVICE AREA PHYSICIANS THAT REQUEST PRIVILEGES WHO ARE QUALIFIED AND CREDENTIALED ARE EXTENDED PRIVILEGES BY NCH AFFILIATED HEALTH CARE INFORMATION PART VI PART VI LINE 6 NCH IS A 129BED ACUTECARE FACILITY OPERATED UNDER THE DIRECTION OF A 13MEMBER BOARD OF DIRECTORS PRIMARILY COMPRISED OF LOCAL COMMUNITY RESIDENTS NCH IS ACCREDITED BY THE AMERICAN OSTEOPATHIC ASSOCIATION NCH IS MAJORITY OWNED BY MOUNTAIN STATES HEALTH ALLIANCE MSHA BASED IN JOHNSON CITY TENNESSEE MSHA IS INTEGRATED BOTH VERTICALLY AND HORIZONTALLY AND IS THE LARGEST REGIONAL HEALTHCARE SYSTEM WITH 13 HOSPITALS MSHA PROVIDES CARE TO PEOPLE IN 29 COUNTIES IN TENNESSEE VIRGINIA KENTUCKY AND NORTH CAROLINA NCH SERVES AS THE COUNTYS PRIMARY HEALTH SERVICE PROVIDER PATIENTS BENEFIT FROM NCHS AFFILIATION WITH A HEALTHCARE SYSTEM WHERE THEY CAN BE EFFICIENTLY MOVED ALONG AN INTEGRATED COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES PATIENTS CAN BE MOVED TO THE SYSTEMS FLAGSHIP FACILITY JOHNSON CITY MEDICAL CENTER WHICH IS A TERTIARY CARE FACILITY PROVIDING ADVANCED TREATMENT OPTIONS LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED PART VI VIRGINIA NORTON COMMUNITY HOSPITAL LINE NUMBER 1 PART V LINE 3 PART V LINE 3 MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING NCH LOCATED IN NINE COUNTIES WITHIN MSHAS CORE SERVICE AREA EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS NURSES NONPROFIT DIRECTORS COMMUNITY DEVELOPERS FAITH BASED LEADERS PUBLIC OFFICIALS AND SCHOOL REPRESENTATIVES EACH GROUP RANGED IN ATTENDANCE FROM 6 TO 21 INDIVIDUALS PARTICIPANTS WERE GIVEN SURVEYS TO DETERMINE A COUNTYS HEALTH STATUS RATING AVAILABLE RESOURCES TOP HEALTH PRIORITIES AND SUGGESTIONS FOR IMPROVEMENT OPEN DISCUSSION FOLLOWED THE COLLECTED INFORMATION WAS THEN PAIRED WITH STATISTICAL DATA IN ORDER TO PRIORITIZE HEALTH NEEDS THE SPECIFIC NEEDS FOR EACH COUNTY WERE INCLUDED IN THE APPRORIATE FACILITY IMPLEMENTATION PLAN NORTON COMMUNITY HOSPITAL LINE NUMBER 1 PART V LINE 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES DICKENSON COUNTY COMMUNITY HOSPITAL AND NORTON COMMUNITY HOSPITAL ALSO HAD ONE COMMUNITY GROUP SURVEYED THESE TWO COUNTIES SERVE SIMILAR COMMUNITIES AND HAVE SIMILAR HEALTH RANKINGS ACCORDING TO AMERICAS HEALTH RANKINGS EVEN THOUGH ONLY TWO COMMUNITY GROUPS SERVED ON BEHALF OF THE FOUR HOSPITALS LISTED STATISTICAL DATA WAS COLLECTED FOR EACH INDIVIDUALLY NCHS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE JOHNSON CITY MEDICAL CENTER FRANKLIN WOODS COMMUNITY HOSPITAL WOODRIDGE PSYCHIATRIC HOSPITAL JAMES H CECILE C QUILLEN REHABILITATION HOSPITAL INDIAN PATH MEDICAL CENTER SYCAMORE SHOALS HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL LINE NUMBER 1 PART V LINE 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH HOSPITALS BOARD APPROVED THE IMPLEMENTATION PLAN DURING THE MONTHS OF MAY AND JUNE 2012 NOW THAT THE IMPLEMENTATION PLANS HAVE BEEN ADOPTED MSHA WILL BE ABLE TO BEGIN TAKING ACTION TO IMPROVE THE HEALTH PRIORITIES IN EACH COUNTY THOUGH AT THIS POINT NOT ALL OF THE PRIORITIES HAVE BEEN ADDRESSED DUE TO LACK OF RESOURCES SOME OF MSHA FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED NORTON COMMUNITY HOSPITAL LINE NUMBER 1 PART V LINE 13G PART V LINE 13G DURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISE THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY NORTON COMMUNITY HOSPITAL LINE NUMBER 1 PART V LINE 19D PART V LINE 19D UNINSURED PATIENTS RECEIVE A 50 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT true ST MARY'S HEALTH WAGON 119 NUMBER 10 STREET CLINCHO VA 24226 043739083 501 100000 INDIGENT SUPPORT UNIVERSITY OF VIRGINIA AT WISE ONE COLLEGE AVE WISE VA 24293 541638774 501 25000 EDUCATION 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES SCHEDULE I, PAGE 1, PART I, LINE 2 GRANTS ARE APPROVED BY THE BOARD OF DIRECTORS. FUNDING MAY BE PROVIDED TO LOCAL 501(C)(3)ORGANIZATIONS WHOSE FOCUS IS ON HEALTH AND EDUCATION. false true false false false false false false false MARVIN EICHORN 440258 157892 74334 14700 20843 708027 ANN FLEMING 345309 116778 39233 47553 19175 568048 EMORY ALLEN MULLINS 257798 14921 286 7503 21662 302170 JOHN DOYLE 182858 40956 17362 11532 25227 277935 MARK LEONARD 195657 46958 4352 14079 23004 284050 ISAM ZIBDEH MD 408000 20328 7425 18265 454018 DAVID NAUSS MD 409744 480 7351 27005 444580 MATTHEW CUSANO MD 302625 85566 248 8132 24135 420706 GAYLE VEST MD 283746 1949 7354 24208 317257 BERNIE SERGENT MD 201123 59942 20169 7639 17241 306114 FRINGE OR EXPENSE EXPLANATION SCHEDULE J, PAGE 1, PART I, LINE 1A FIRST-CLASS OR CHARTER TRAVEL IS NOT A COVERED TRAVEL EXPENSE FOR EXECUTIVES; THEY ARE LIMITED TO BUSINESS OR COACH CLASS FARES ON COMMERCIAL FLIGHTS. SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 ANN FLEMING 0 35,303 0 MARK LEONARD 0 10,087 0 OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III PART I, LINE 3 NCH'S CEO'S SALARY AND BENEFITS ARE SUBJECT TO THE MOUNTAIN STATES HEALTH ALLIANCE (MSHA) COMPENSATION COMMITTEE PROCESS, WHEREBY THE MSHA CEO RECOMMENDS THE SALARY AND IT IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE, BASED UPON MARKET DATA, MADE AVAILABLE BY THIRD PARTY CONSULTANTS. THE COMPENSATION COMMITTEE HAS FINAL APPROVAL OF MSHA'S CEO RECOMMENDATIONS FOR PAY AND BENEFITS FOR THE NCH CEO AND ALL OTHER EXECUTIVES WITHIN MSHA. PART I, LINE 4B ANN FLEMING AND MARK LEONARD PARTICIPATED IN A 457(F) RETIREMENT PLAN PROVIDED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA). THE 457(F)PLAN IS A NONQUALIFIED TAX-DEFERRED COMPENSATION PLAN AVAILABLE TO A SELECT GROUP OF KEY EXECUTIVES FOR THE INTENT OF SUPPORTING RETENTION AND TO OFFER A COMPETITIVE TOTAL RETIREMENT PROGRAM. ACCOUNT BALANCES HAVE A "SUBSTANTIAL RISK OF FORFEITURE." IN ADDITION TO CREDITOR RISK, SUBSTANTIAL RISK OF FORFEITURE IS CREATED THROUGH DEFAULT RISK IF THE PARTICIPANT'S EMPLOYMENT WITH MSHA IS TERMINATED PRIOR TO AGE 65. HOWEVER, THE 457(F) PLAN CONTAINS A NON-COMPETE PROVISION THAT PROVIDES THE ACCOUNT BALANCE TO BE PAID IN A LUMP SUM AFTER THE EXECUTIVE SATISFIES THE TWO-YEAR NON-COMPETE PERIOD. THIS PROVISION APPLIES TO EMPLOYER CONTRIBUTIONS IF THE EXECUTIVE HAS PROVIDED ELIGIBLE SERVICE FOR SIX OR MORE YEARS. (ELIGIBLE SERVICE IS OFFICER SERVICE THAT PERMITTED THE EXECUTIVE TO PARTICIPATE IN THE PLAN.) THE EXECUTIVE WILL RECEIVE THE ENTIRE ACCOUNT BALANCE IF HE/SHE BECOMES DISABLED, DIES OR IF THE EXECUTIVE TERMINATES FOR "GOOD REASON" OR IS INVOLUNTARILY TERMINATED WITHOUT "GOOD CAUSE" WITHIN A 24 MONTH PERIOD AFTER A CHANGE-OF-CONTROL OCCCURS. DISTRIBUTIONS FROM THIS PLAN ARE SUBJECT TO FEDERAL, STATE, AND LOCAL TAXES ON THE ENTIRE ACCOUNT BALANCE UPON DISTRIBUTION. JAMIE FLEMING FAMILY MEMBER 31847 FAMILY MBR OF BD MBR false MARK LEONARD CEO OF NCH 10800 RENT PROP. FROM NCH false ADDITIONAL INFORMATION SCHEDULE L PART V BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS 1A NAME OF PERSON JAMIE FLEMING 1B RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION FAMILY MEMBER OF JAMES MANICURE NORTON COMMUNITY HOSPITAL NCHBOARD MEMBER 1D DESCRIPTION OF TRANSACTION JAMES MANICURE BOARD MEMBER OF NCH IS A FAMILY MEMBER OF JAMIE FLEMING AN EMPLOYEE OF NCH 2A NAME OF PERSON MARK LEONARD 2B RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION MARK LEONARD IS THE CEO OF NCH 2D DESCRIPTION OF TRANSACTION MARK LEONARD RENTS PROPERTY FROM NCH THE RENTAL RATE WAS DETERMINED AT FAIR MARKET VALUE ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION PART I, LINE 1 THE MISSION OF NORTON COMMUNITY HOSPITAL (NCH) IS TO BE A LEADER IN IMPROVING THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY. WORKING TOGETHER AS A TEAM DEDICATED TO EXCELLENCE, WE ENDEAVOR TO: - PROVIDE A CONTINUUM OF HIGH QUALITY AND COST EFFECTIVE MEDICAL CARE FOCUSING ON THE NEEDS OF OUR PATIENTS AND THEIR FAMILIES. - CONTINUOUSLY IMPROVE HEALTH CARE IN OUR COMMUNITY THROUGH NEW PROGRAMS, SERVICES, AND TECHNOLOGIES. - FOCUS ON WELLNESS AND PREVENTION THROUGH COMMUNITY EDUCATION AND HEALTH AWARENESS PROGRAMS. - SERVE AS A CENTER FOR THE TRAINING OF AREA HEALTHCARE PROFESSIONALS. - FORGE HEALTH CARE ALLIANCES WITH OUR COMMUNITY IN ORDER TO CONTRIBUTE TO ITS GROWTH AND DEVELOPMENT. FIRST ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4A THE INTERNAL MEDICINE RESIDENTS OF THIS PROGRAM ROTATE THROUGH ALL AREAS OF MEDICINE, FROM HEALTH MAINTENANCE TO CRITICAL CARE. THE RESIDENTS ASSIST OUR PHYSICIANS IN PROVIDING QUALITY HANDS ON PATIENT CARE, THROUGH OBSERVATIONS, EDUCATION AND BY PARTICIPATING IN GRAND ROUNDS. IN ADDITION TO THESE SERVICES WITHIN THE HOSPITAL SETTING, THE RESIDENTS ARE ALSO EXPOSED TO TREATING PATIENTS IN AN OFFICE SETTING AT THE COMMUNITY CLINIC (RESIDENT CONTINUITY CLINIC)IN WISE, VIRGINIA. TO IMPROVE ACCESS TO PRIMARY CARE, NORTON COMMUNITY HOSPITAL, INC. OPERATES SEVERAL CLINICS: COMMUNITY PHYSICIANS-NORTON, COMMUNITY PHYSICIANS-COEBURN, COMMUNITY PHYSICIANS-WISE, COMMUNITY ORTHOPEDICS, NORWISE OB/GYN, COMMUNITY CLINIC-WISE (RESIDENT CONTINUITY CLINIC), OCCUMED HEALTH CENTER AND THE WISE PROFESSIONAL OFFICE BUILDING WHICH OFFERS PHYSICIAN OFFICE SPACE AND IS HOME TO OUR COMPREHENSIVE HOME HEALTH SERVICES. OUR MEDICAL STAFF CONSISTS OF OVER 130 PHYSICIANS AND SURGEONS WITH SPECIALTY TRAINING IN: FAMILY PRACTICE, INTERNAL MEDICINE, EAR-NOSE-THROAT, GENERAL SURGERY, UROLOGY, PEDIATRICS, EMERGENCY MEDICINE, GERIATRIC MEDICINE, CRITICAL CARE, CARDIOLOGY, PULMONOLOGY, RADIOLOGY, ONCOLOGY, NEUROLOGY, ORTHOPEDICS, GASTROENTEROLOGY, OPTHALMOLOGY, OBSTETRICS, GYNECOLOGY AND DENTISTRY. PROGRAMS AND SERVICES INCLUDE INTENSIVE CARE/CRITICAL CARE/CORONARY CARE, 24-HOUR EMERGENCY ROOM SERVICES, PEDIATRIC CARE, LASER SURGERY, OUTPATIENT SURGERY, LITHOTRIPSY SERVICES, HOME HEALTH, HYPERBARIC MEDICINE, DIETARY/NUTRITION SUPPORT, PHARMACY, INPATIENT AND OUTPATIENT SURGICAL SERVICES, 12-BED INTENSIVE CARE UNIT, PASTORAL CARE, VOLUNTEER SERVICES, HELPING HANDS GIFT SHOP, COMMUNITY OUTREACH AND EDUCATION PROGRAMS, SCREENING SERVICES, AND UVA TELEMEDICINE AND PAIN MANAGEMENT. OUR RADIOLOGICAL SERVICES INCLUDE ANGIOGRAPHY, MAMMOGRAPHY, ULTRASOUND, STEREOTACTIC BREAST BIOPSY, NUCLEAR MEDICINE, PET SCANS, IN-HOUSE MAGNETIC RESONANCE IMAGING UNIT (MRI), AND CT SCANNER. IN 2012 OUR RADIOLOGY DEPARTMENT RECEIVED ACCREDITATION FOR ITS PET SERVICES THROUGH THE AMERICAN COLLEGE OF RADIOLOGY. THIS LATEST ACR ACCREDITATION IS ONE OF SEVERAL THE RADIOLOGY DEPARTMENT HAS RECEIVED OVER THE LAST YEAR. THE OTHERS INCLUDE NUCLEAR MEDICINE, MAMMOGRAPHY AND MRI, WITH MRI STAFF OBTAINING THEIR CERTIFICATION THIS YEAR AS WELL. THE FAMILY BIRTHING CENTER HAS SIX (6)SEMI-PRIVATE GYNECOLOGICAL SUITES AND SEVEN (7) LABOR, DELIVERY, RECOVERY, AND POSTPARTUM SUITES THAT OFFER COMFORT, CARE, AND COMPASSION THAT IS UNPARALLELED IN THE REGION. WE OFFER PREPARED CHILDBIRTH, PARENTING, SIBLING AND SAFE-SITTER CLASSES, INCLUDING EDUCATION ON BREASTFEEDING AND WOMEN'S HEALTH. THE CENTER ALSO OFFERS A SPECIAL AREA FOR CESAREAN SECTIONS AND ROUTINE GYNECOLOGICAL PROCEDURES. OUR CARDIOPULMONARY SERVICES DEPARTMENT PROVIDES AN EXTENSIVE LINE OF CARDIAC, PULMONARY AND NEURO-DIAGNOSTIC SERVICES. THEY ALSO PROVIDE A COMPREHENSIVE SLEEP MEDICINE PROGRAM AS WELL AS AN APPROVED SITE FOR THE DEPARTMENT OF LABOR'S FEDERAL BLACK LUNG PROGRAM. THE REGIONAL REHAB CENTER OFFERS OCCUPATIONAL THERAPY, PHYSICAL THERAPY, SPEECH THERAPY, PULMONARY REHAB, ANODYNE THERAPY, CARDIAC REHABILITATION, CARDIOPULMONARY REHAB, SMOKING CESSATION CLASSES AND FIT-ONE, A COMMUNITY WELLNESS PROGRAM. OUR THREE-YEAR, CARF ACCREDITED (COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES), 11-BED INPATIENT REHABILITATION UNIT PROVIDES A RESPONSIVE, CARING ENVIRONMENT THAT ENHANCES RECOVERY AND SPEEDS THE RETURN TO NORMAL LIFE FOR PATIENTS SUFFERING FROM STROKE, PARKINSON'S DISEASE, POLYNEUROPATHY, BRAIN INJURY AND HIP FRACTURES. NORTON COMMUNITY HOSPITAL HAS ENABLED BUSINESSES TO LOWER THEIR MEDICAL CARE COSTS THROUGH OUR COMPREHENSIVE OCCUPATIONAL MEDICINE PROGRAM AT OCCUMED HEALTH CENTER. OCCUMED OFFERS NURSING CASE MANAGEMENT, WORK-RELATED INJURY TREATMENT AND FOLLOW-UP, PRE-EMPLOYMENT PHYSICALS, DRUG SCREENINGS, VACCINATIONS, WORK-SITE SAFETY ANALYSIS, GENERAL HEALTH SCREENINGS, OSHA REGULATION COMPLIANCE ASSISTANCE, AND INDUSTRIAL REHABILITATION. COMMUNITY HOME CARE OFFERS DURABLE MEDICAL EQUIPMENT SUCH AS LIFT CHAIRS, MOTORIZED SCOOTERS, LIMB BRACES, DIABETIC SUPPLIES, TURBANS, AND A PRIVATE FITTING ROOM FOR MASTECTOMY FITTINGS. THE WANDA WAMPLER CENTER FOR WOMEN'S HEALTH HOUSES OUR COMPREHENSIVE WOMEN'S HEALTH SERVICES. THE CENTER OFFERS STEREOTACTIC BREAST BIOPSY, BONE DENSITOMETRY, AND DIGITAL MAMMOGRAPHY. NORTON COMMUNITY HOSPITAL IS ALSO AN APROVED TRAINING CENTER FOR THE AMERICAN HEART ASSOCIATION (AHA). WE PROVIDE AHA HEARTSAVER PROGRAMS TO THE COMMUNITY AS WELL AS BASIC AND ADVANCED LIFE SUPPORT COURSES TO MEMBERS OF THE MEDICAL COMMUNITY. NCH HAS PARTNERED WITH THE COMPANY FIRSTSOURCE SOLUTIONS USA TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY12, FIRSTSOURCE REPRESENTATIVES WERE AVAILABLE AT NCH TO ASSIST PATIENTS. THE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID OR TENNCARE) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. DURING FY12, 543 PATIENTS WERE APPROVED FOR COVERAGE. ONCE A PERSON IS APPROVED FOR MEDICAID OR TENNCARE THROUGH THE PROGRAM OFFERED THROUGH NCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. FIRSTSOURCE IS COMPENSATED BY NCH. DURING FY12, NCH'S COST FOR THIS PROGRAM WAS 119,512. CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 MOUNTAIN STATES HEALTH ALLIANCE IS THE 50.1% MEMBER OF NORTON COMMUNITY HOSPITAL, INC. NORTON COMMUNITY HEALTH FOUNDATION IS THE 49.9% MEMBER OF NORTON COMMUNITY HOSPITAL, INC. ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A THE MOUNTAIN STATES HEALTH ALLIANCE(MSHA)CLASS IS ELECTED BY THE MSHA BOARD OF DIRECTORS AND THE NORTON COMMUNITY HOSPITAL CLASS IS ELECTED BY THE COMMUNITY HEALTHCARE FOUNDATION BOARD OF DIRECTORS. NEITHER SIDE CAN VETO AN APPOINTMENT. DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE BOARD ARE, PURSUANT TO CHARTER AND VIRGINIA STATUTE, SUBJECT TO APPROVAL OF THE MEMBERS. THESE DECISIONS INCLUDE: DISSOLUTION OF THE CORPORATION; MERGER OF THE CORPORATION; NON-ORDINARY COURSE OF BUSINESS SALE OF ASSETS; ETC. NO ORDINARY, DAY TO DAY DECISIONS ARE SUBJECT TO MEMBER APPROVAL. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE CFO REVIEWED THE FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO FILING AND THE RETURN WAS MADE AVAILABLE TO EACH BOARD MEMBER IN AN ELECTRONIC FORMAT PRIOR TO THE REVIEW. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY, THE AUDIT AND COMPLIANCE DEPARTMENT PROVIDES THE POLICY AND THE CONFLICT OF INTEREST DISCLOSURE FORMS TO ALL COVERED PERSONS. EACH PERSON IS REQUIRED TO PROVIDE A COMPLETED DISCLOSURE FORM, NOTING ANY CONFLICTS OR ATTESTING THEY HAVE "NONE," AND THEN FORWARD THOSE BACK TO THE AUDIT AND COMPLIANCE DEPARTMENT. ANY NOTED DISCLOSURES ARE FORWARDED TO THE APPROPRIATE MANAGEMENT OR BOARD PERSONNEL TO EVALUATE AND UTILIZE WHEN A TRANSACTION INVOLVING A CONFLICTED PERSON ARISES. ADDITIONALLY, PERSONNEL WHO HAVE A CONFLICT ARISE BETWEEN THE ANNUAL DISTRIBUTION OF THE POLICY AND FORMS ARE REQUIRED TO DISCLOSE THE CONFLICT, AND WOULD BE DISCIPLINED IN ANY INSTANCE WHERE THEY HAVE NOT DISCLOSED AND ENGAGED IN A CONFLICTED TRANSACTION. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE CEO COMPENSATION IS SUBJECT TO THE MSHA COMPENSATION COMMITTEE PROCESS, WHEREBY THE MSHA CEO RECOMMENDS THE SALARY AND IT IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE, BASED UPON MARKET DATA MADE AVAILABLE BY THIRD PARTY CONSULTANTS, JUST LIKE ANY OTHER MSHA EXECUTIVE BELOW THE MSHA CEO AND CFO LEVEL. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B THE BOARD ALSO APPROVES PAY AND BENEFITS FOR THE CFO. THE COMPENSATION COMMITTEE REVIEWS AND HAS FINAL APPROVAL OF CEO RECOMMENDATIONS FOR PAY AND BENEFITS FOR ALL OTHER EXECUTIVES. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM. FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM, AND THEY ARE MADE AVAILABLE TO THOSE PARTIES WHO OWN INDEBTEDNESS OF THE COMPANY ON A QUARTERLY BASIS. OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 PENSION AND POST LIABILITY ADJUSTMENT 2,216,371 NET UNREALIZED GAINS ON INVESTMENTS 384,274 FY12 CAPITAL CONTRIBUTION TO DCH 1,864,930 ADJUSTMENT TO CLOSE COMM. PHYS. SVCS. CORP. 4,455 CHANGE IN RESTRICTED GRANT ASSETS (300,150) OTHER ADJUSTMENT TO NET ASSETS (2,260) TOTAL TO FORM 990, PART XI, LINE 5: 4,167,620 NORTON COMMUNITY PHYSICIAN SVCS LLC 96 15TH ST NW NORTON VA 24273 260868690 MED. SERV. 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