Norton Community Hospital

What it reported doing in 2020

Benefits of an Integrated Health System: Since 2010, more than 130 rural hospitals have closed in the United States, according to the North Carolina Rural Health Research Program. Studies have shown rural communities that lose their hospitals struggle with reductions in access to physicians, healthcare services and in overall health status. Through Ballad Health, the scale and ability for larger and more financially solvent hospitals to subsidize losses in smaller rural communities is a clear and convincing foundational public benefit. It is clear the steps Ballad Health has taken to reduce overhead cost, realign services, invest capital and prioritize high quality have led to the sustainability of services - expanding, rather than reducing access, as has been seen in rural regions throughout the nation. Ballad Health invested more than $200 million to adopt a common information technology platform for all their merged hospitals and care sites. With Epic as the single technology platform for Ballad Health, patient data will be controlled by patients and their providers, and it will be more secure than ever before. New services will be available to health information, transparency in pricing and, most importantly, better coordination between healthcare providers, regardless of where the providers are or what data systems they use. Mountain States Health Alliance (Mountain States) is one of only 29 organizations in the country participating in the Centers for Medicare & Medicaid Services (CMS) new initiative, Accountable Health Communities Model (referred to as AHC Program), aimed at improving the health of eligible Medicare and Medicaid beneficiaries. The Southwest Virginia Accountable Health Communities Program (AHC) is a collaboration between community groups and Ballad Health that seeks to improve the overall health of Medicare and Medicaid beneficiaries by helping address patients health-related social needs. As part of the program, Medicare and Medicaid patients in Southwest Virginia are screened for health-related social needs when they visit a Ballad Health facility. Once those needs are identified, Ballad Health tries to link those patients with resources and programs within their communities to resolve those needs.On March 10, 2020, Ballad Health executed its disaster plan in response to the coronavirus disease 2019 (COVID-19) global pandemic. This included the activation of its Corporate Emergency Operations Center to coordinate efforts across the system, including NCH, to rapidly plan for, and execute, ongoing response to the issues resulting from the pandemic. In May 2020, Ballad Health partnered with Premier, Inc. on a new program to ensure our team members and patients are always protected through the availability of personal protective equipment, such as gloves, gowns and masks. This program focused on investing in domestic manufacturers to enhance supply chains for essential medical products and PPE. This program led to Ballad Health acquiring a minority stake in Prestige Ameritech, the largest domestic manufacturer of face masks, including N95 respirators and surgical masks. PPE products critical for the daily operations of health systems are overwhelmingly sourced overseas. The risks associated with this overreliance on overseas providers came into focus twice in 2020, as the supply chain was disrupted when an overseas provider failed to meet FDA requirements for sterile gowns, and again as the COVID-19 pandemic swept across the globe. Prestige Ameritech operates primarily in the United States, where it obtains its raw materials. Ballad Health provides numerous services to improve the health of our communities. The following services are provided by the Ballad Health entity but funded by the various hospitals and other divisions within our health system. The funding levels by NCH for these services are reflected below: The Ballad Health parish nurse program is designed to provide holistic ministry and special

Financial Efficiency

• Mission deployment rate: 90.9%; rating input score 91
• Program expense ratio: 81.8%; rating input score 82
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 91.7%; rating input score 92; 6th percentile among comparable filings
• Pay-setting controls: 0 of 6 controls in place; rating input score 0
  • Compensation committee: Missing
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Missing
• Foreign activity oversight: Limited
• Grant itemization coverage: 76.7%; rating input score 77; 16th percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 0%; rating input score 0; 3rd percentile among comparable filings
• Governance controls: 7 of 9 controls in place; rating input score 78
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Fail
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: -11.1%; rating input score 7; 7th percentile among comparable filings
• Total-asset coverage ratio: 0; rating input score 0; 0th percentile among comparable filings
• Liabilities to assets ratio: Limited
• Officer compensation ratio: 7.3%; rating input score 30; 30th percentile among comparable filings

Growth

• Program expense growth: -1.7% per year; rating input score 0; 12th percentile among comparable filings
• Revenue growth: -0.1% per year; rating input score 0; 12th percentile among comparable filings
• Asset growth: -2.2% per year; rating input score 0; 7th percentile among comparable filings