2023-11-13T17:00:33-06:00 2022-12-31 990 2022-01-01 621748601 Fort Sanders Foundation FORT 8653743140 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 Joseph C Dolan EVP/CFO 8653743140 2023-10-13 Joseph Dolan 999009999 1 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Kathy May-Martin 280 Ft Sanders West Knoxville TN 37922 2015292 0 X www.fortsandersfoundation.org X 1998 TN To support the programs and services of Covenant Health through charitable contributions. 15 14 0 87 0 0 1042921 1140954 0 0 417026 695672 -1546 -2856 1458401 1833770 1013455 1045527 0 0 0 0 0 0 178154 242540 246184 1255995 1291711 202406 542059 17490375 15615561 103671 212420 17386704 15403141 X Fort Sanders Foundation raises and distributes funds in support of patient care, equipment, programs, services and staff not otherwise funded by Covenant Health and its affiliates. The Foundation's mission is to provide charitable support to further Covenant Health's mission to serve the community by improving the quality of life through better health. 0 0 333240 333240 Covenant HomeCare and Hospice:Donors to Fort Sanders Foundation provide funding for a partnership between Covenant HomeCare and Knoxville Area Rescue Mission (KARM) to reduce frequent hospitalizations among the homeless community. In 2022, just over $209,000 was distributed to support that project which provides onsite medical care, clinic facilities, medication management and case management at the KARM shelter. Since opening in 2019, the program has served over 200 patients. Following participation in these services, patients show a more than 40% reduction in emergency department visits and the avoidance of almost 7,000 inpatient hospitalization days. As a result of these shelter-based services, the patients at KARM are leading healthier lives.Another $73,900 was distributed to underwrite professional education opportunities for staff, fund membership in the National Hospice and Palliative Care organization, provide medical/hospice housing for indigent patients, provide patient education materials, fund grief counseling services, and conduct the annual memorial service for families of deceased Hospice patients.Covenant Hospice's annual Katerpillar Kids Camp programming continued to be funded by the Foundation in 2022. Approximately $44,000 was distributed to support free weekend day camp experiences and grief support for 63 children who have experienced the death of a loved one. Approximately 125 parents, guardians, and siblings were also impacted by camp services. The annual camp provides grieving children and teens a safe, understanding environment to express their grief and learn that they are not alone in their grief journey.Just under $6,500 was distributed from the HomeCare Hope fund which assisted 225 patients in crisis with emergency funds for housing, transportation, utilities, meals, medicines/medical supplies, and funeral expenses. 261628 261628 Employee and Patient Emergency Assistance:Each year funds are contributed, primarily through Covenant Health's annual WeCare Employee Giving Campaign, to assist employees and patients in times of crisis. Support includes assistance with housing, transportation, food, clothing, medicines/medical supplies, utilities, childcare, and unexpected funeral expenses. In 2022, assistance was distributed to assist 3,708 individuals at Claiborne Medical Center (11), Covenant parent company (92), Covenant HomeCare (225), Cumberland Medical Center (19), Fort Sanders Regional Medical Center (1,896), Fort Loudoun Medical Center (7), LeConte Medical Center (33), Methodist Medical Center (214), Morristown-Hamblen Healthcare System (19), Parkwest Medical Center (78), Peninsula (42), Roane Medical Center (18), and Thompson Cancer Survival Center (1,054). 235964 235964 Behavioral Health Care at Peninsula:In 2022, funds raised through the annual Artsclamation! fine art sale and other donations supported behavioral health care at Peninsula. Approximately $131,000 supported Peninsula's emergency room diversion project which places a team of behavioral specialists in Covenant Health emergency departments to assess patients who make repeated non-emergency visits to the emergency room. These specialists develop a personalized treatment plan for patients, proposing alternative options to visiting the ED and providing follow-up support and resources to these patients. Another $49,000 provided discharge medications to patients who need a supply of prescriptions when they leave the hospital to maintain their health until they are set up on TennCare or other payer sources for ongoing maintenance medications. Approximately $45,000 supported the placement of behavioral health staff in Covenant HomeCare's onsite clinic at Knoxville Area Rescue Ministries (KARM) to provide counseling and case management services to those clients. Peninsula patients were supported with just over $10,000 in emergency assistance to help with necessary living expenses such as utilities, food, housing, and transportation. 214695 214695 The Foundation supports a variety of other patient care programs throughout Covenant Health. The most significant distributions in 2022, which were directed to Fort Sanders Regional Medical Center, patient care scholarships, and the Fellowship Outpatient Lodging Program, are detailed below:Fort Sanders Foundation's distributions to Fort Sanders Regional Medical Center in 2022 primarily supported the Patricia Neal Rehabilitation Center. Approximately $57,000 was directed to the Center's programs and services, including staff education, upgraded rehabilitation therapy equipment, the annual operating and equipment expenses of the Innovative Recreation Cooperative which provides adaptive sports and recreation opportunities throughout the community, several patient support groups, and community brain injury and concussion education/prevention programs. An additional approximately $9,400 provided for maternal/infant education materials in both English and Spanish which are provided to new parents at discharge. Just over $4,000 was distributed to support the hospital's chaplaincy program, including the annual ethics conference and training for critical care staff.The Fellowship Outpatient Lodging Program, which is supported entirely by contributions, offers free hotel accommodations and transportation to treatment for patients and families coping with serious illnesses. The program primarily serves Thompson Cancer Survival Center patients and their families who live more than 30 miles from Knoxville. In 2022, approximately $22,700 in distributions supported the program. The program housed 62 guests in 2022 providing 223 nights of free lodging. The Foundation raises funds to support scholarships for Patricia Neal Rehabilitation Center patients in need of care who do not have insurance coverage or any other ability to pay for care. Center staff vet patients both clinically and financially before selection for scholarship-funded care. Distributions of approximately $41,000 in 2022 supported patients who were provided with inpatient and outpatient care.The Foundation receives grant funds annually from the Will Rogers Institute to support pulmonary rehabilitation across Covenant Health. The grant funds provide scholarships to assist outpatient pulmonary rehab patients without insurance coverage or the ability to pay. In 2022, approximately $15,200 in funding benefited 72 patients at Roane, Parkwest, Methodist, LeConte, and Fort Sanders Regional outpatient pulmonary rehabilitation clinics.Outpatient cardiac rehabilitation patients with no insurance coverage or ability to pay are provided care through distributions from the Foundation's Lewis S. Howard Memorial Fund. Nineteen patient requests for care at the Parkwest and Fort Sanders Regional outpatient cardiac rehabilitation clinics received almost $12,000 in assistance in 2022. 214695 214695 1045527 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 23 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 15 14 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 TN X Amy DeLong 8653743140 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 Andy Johnson Fmr Director/Chair(through Jan 2022) 1.00 0.00 X X 0 0 0 Kathy May-Martin Director/Chair 1.00 0.00 X X 0 0 0 Matt Ballard Director/Vice-Chair 1.00 0.00 X X 0 0 0 Shohreh Nazzy Hashemian Director/Secretary 1.00 0.00 X X 0 0 0 Jim Atchley Director 1.00 0.00 X 0 0 0 Linda Gay Blanc Fmr Director (through Jan 2022) 1.00 0.00 X 0 0 0 Mary Child Director 1.00 0.00 X 0 0 0 Rob Del Moro Director 1.00 0.00 X 0 0 0 Mary E Dillon MD Director/FSRMC Medical Dir 1.00 0.00 X 0 0 0 Marty Gibbs Director 1.00 0.00 X 0 0 0 Charles Griffin Director 1.00 0.00 X 0 0 0 Alan Hill Director 1.00 0.00 X 0 0 0 Rachel Hurt Director 1.00 0.00 X 0 0 0 Tyler Janow Director 1.00 0.00 X 0 0 0 Mike Swift Fmr Director (through Jan 2022) 1.00 0.00 X 0 0 0 James D VanderSteeg President & CEO 1.00 50.00 X 0 2346646 316057 Patrick J Birmingham IV VP of Philanthrophy 8.00 42.00 X 0 263688 39709 0 2610334 355766 0 0 1 0 0 307745 8190 825019 6320 1140954 695672 695672 178666 307745 181522 -2856 -2856 1833770 0 0 692816 700599 700599 344928 344928 206223 33605 172618 1850 1850 977 977 2599 2599 18019 18019 2070 1366 704 2371 2371 1111 1111 Bank Fees 6979 6979 Meals 2021 2021 Fundraising 1825 1825 Dues and Licenses 130 130 9 9 1291711 1045527 68030 178154 162067 571313 750 750 1100 1232 1614354 1409194 132822 205160 17033544 14814505 160092 22601 17490375 15615561 103671 212420 103671 212420 X 11424563 9215240 5962141 6187901 17386704 15403141 17490375 15615561 X 542059 -2523337 -2285 X 0 1 X 1 0 X X 7 Fort Sanders Regional Med Ctr 620528340 3 1 70367 25 Parkwest Medical Center 581897274 3 1 253033 25 Thompson Cancer Survival Center 621250943 3 1 22681 0 Covenant HomeCare 621623114 10 1 333240 0 LeConte Medical Center 621114867 3 1 1589 0 Cumberland Medical Center 620790132 3 1 11400 0 Roane County Medical Center 680673354 3 1 3794 0 7 696104 50 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 Part IV, Section A, Line 1: The Charter of Fort Sanders Foundation designates its supported organizations by class. They include organizations that are specifically named in the Charter of its Member, which is Covenant Health, that are exempt from Federal income taxation under Section 501(c)(3) of the Code and described in Section 509(a)(1) or (2) of the Code. The Foundation's supported organizations also include any other organizations of which Covenant Health is the sole member and that are (i) organized and operated exclusively for religious, charitable, educational and scientific purposes and (ii) qualified as exempt from Federal income taxation under Section 501(c)(3) of the Code and described in Section 509(a)(1) or (2) of the Code. Part IV, Section A, Line 6: Fort Sanders Foundation provided grants to individuals in 2022, in the form of emergency assistance to employees, patients and patient families. Part IV, Section C, Line 1: Covenant Health is the sole member of Fort Sanders Foundation. The supported organizations of the Foundation are governed by Covenant Health's board of directors. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5962141 1080115 59008 720863 192499 6187902 5837459 1094427 37361 791592 215514 5962141 5614448 1332425 38668 1010172 137910 5837459 5807393 1169472 43760 1144382 261795 5614448 6154772 1103999 57234 1330187 178425 5807393 0.00000 0.06410 0.93590 0 1 1 198863 198863 1391393 1391393 0 24098 17801 6297 205160 Annuities Payable 7543 Other Liabilities 21101 Due to Affiliates, Net 183776 212420 X Part V, Line 4: Fort Sanders Foundation maintains five permanent endowments for the purpose of providing a permanent source of income for programs at Fort Sanders Regional Medical Center, Parkwest Medical Center, and the Fort Sanders School of Nursing at Tennessee Wesleyan. The Pastoral Care Fund and the Caroline Can! Fund were established for the benefit of Fort Sanders Regional Medical Center, the Wayne Heatherly Excellence in Patient Care Fund for Parkwest Medical Center, and the Ruth Crawley R.N. Scholarship Award Fund for Tennessee Wesleyan Fort Sanders School of Nursing. The Lewis S. Howard Fund was established to benefit Cardiac Rehab patients at Fort Sanders Regional and Parkwest. The principal of all five permanent endowments will be kept intact in perpetuity and only the income generated will be distributed to support programs at these institutions. Part X, Line 2: Excerpt from the consolidated audited financial statements of Covenant Health (Covenant), parent company to Fort Sanders Foundation: Covenant and certain of its subsidiaries or controlled entities are exempt from income taxes pursuant to Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for income taxes on qualifying activities has been made for these entities in the accompanying consolidated financial statements. However, certain entities and operations are subject to income taxes. Covenant had no unrecognized tax benefits at December 31, 2022 and 2021. As such, no interest or penalties were recognized in the consolidated financial statements related to unrecognized tax benefits. At December 31, 2022 and 2021, tax returns for 2019 through 2022 are subject to examination by the Internal Revenue Service. Covenant has no uncertain tax positions that would require financial statement recognition or disclosure under GAAP at December 31, 2022 and 2021. PATRICIA NEAL GOLF CLASSIC 293218 221650 71568 31611 12380 21408 2470 278 3143 ARTSCLAMATION! 193193 86095 107098 3921 18714 87597 486411 307745 178666 31611 12380 25329 21184 278 90740 181522 -2856 1 Fort Sanders Regional Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 620528340 501(c)(3) 70367 25 FMV Gift Card Support Patricia Neal Rehab patients, other rehab patients, and the Innovative Recreation Cooperative. Parkwest Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 581897274 501(c)(3) 253033 25 FMV Gift Card Support ED Diversion Program at Peninsula, provide patient medication for discharge as needed, and equipment for Pulmonary Rehab program Thompson Cancer Survival Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621250943 501(c)(3) 22681 0 Provide support for the operation of the Fellowship Center Covenant HomeCare 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621623114 501(c)(3) 333240 0 Support HomeCare Hospice Program, Katerpillar Kids Camp, and Knoxville Area Rescue Ministry health program Cumberland Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 620790132 501(c)(3) 11400 0 Provide two Transport Vents for Cumberland Medical Center patients 5 0 Employee/patient assistance 3708 261628 Academic scholarships 9 15400 Patient medical assistance not covered by insurance or any other means 107 67900 Part I, Line 2: Fort Sanders Foundation provides support to several emergency assistance funds throughout the Covenant Health system to assist patients and patient families, as well as Covenant Health system employees who have fallen on hard times, according to their needs. Such needs include the cost of medical treatment, housing, food, and clothes. There are social service committees in place to evaluate requests, select and process this distribution of funds. Scholarship assistance is both merit-based and needs-based, and funds are contingent upon on-going satisfactory academic progress. Support is also provided to Covenant Health facilities. Facilities submit annual requests for foundation funding and these requests are evaluated and selected by facility and company executive leadership. Once a facility is granted its request, funds are provided on a reimbursement basis, with the foundation matching the expense to the approved funding request form. 0 1 0 0 0 0 0 0 0 James D VanderSteeg President & CEO 0 1425507 0 742500 0 178639 0 284975 0 31082 0 2662703 0 0 Patrick J Birmingham IV VP of Philanthrophy 0 181629 0 41000 0 41059 0 10260 0 29449 0 303397 0 0 Part I, Line 3 Covenant Health, the parent company of Fort Sanders Foundation, used the following methods in establishing the compensation of President/CEO, James D. VanderSteeg: compensation committee, independent compensation consultant, written employment contract, compensation survey or study, and approval by the board or compensation committee. Additional detail is provided in response to Form 990, Part VI, Section B, Lines 15a and 15b within Schedule O. Part I, Line 4b Covenant Health maintains a nonqualified deferred compensation ("NQDC") plan intended to support retention of President and CEO, James D. VanderSteeg. Employer contributions of $273,375 are reported as deferred compensation on Schedule J, Part II, Column C. Contributions along with 2022 earnings of $70,560 are subject to a substantial risk of forfeiture. Amounts are combined with other compensation and considered for reasonableness. Compensation procedures are discussed in detail in Schedule O (Form 990, Part VI, Section B, Line 15a). Form 990, Part VI, Section A, line 6 Fort Sanders Foundation has one member, Covenant Health, a Tennessee nonprofit corporation. Form 990, Part VI, Section A, line 7a The members of the board of directors, other than the ex officio members, shall be elected by Covenant Health from a slate of nominees nominated by the board of directors of the Foundation and recommended to the Member for election. The sole member, Covenant Health, has the exclusive right to vote on the election, appointment of, or removal of directors. Form 990, Part VI, Section A, line 7b The sole member, Covenant Health, must approve all appointments to the board of directors, and any amendments to the bylaws. Subject in all events to the rights of the Member, the policymaking powers of the Corporation are vested in and exercised by the Corporations's board of directors. Form 990, Part VI, Section B, line 11b A draft Form 990 was presented to and approved by the board of directors. Management reviews and approves the final version of Form 990 prior to filing. Form 990, Part VI, Section B, line 12c Board members, officers and employees are required to adhere to rules and policies regarding conflicts of interest. The conflict of interest policy is presented before the full Board for review on an annual basis. It is part of orientation for new Fort Sanders Foundation Board Members. Form 990, Part VI, Section B, line 15 Overall compensation policies for Covenant Health (Parent Company) and affiliates are set by the Covenant Health Chief Executive Officer (CEO) in consultation with appropriate Executive Vice Presidents and the Senior Vice President-Human Resources, after review by and discussion with the executive compensation consultant ("the Consultant") to ensure that total compensation for each executive is reasonable and within a fair market value range. The Covenant Health CEO is compensated by Covenant Health, and a detailed description of the compensation process is included on Covenant Health's Form 990. Form 990, Part VI, Section C, line 19 Fort Sanders Foundation makes its governing documents and financial statements available to the public upon request. The organization's conflict of interest policy is not made publicly available. Form 990, Part XI, line 9: Change in Value of Trusts -2,285. Covenant Health 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621646734 Supporting organization TN 501(c)(3) Line 12b, II N/A 0 LeConte Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621114867 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Sanders Regional Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 620528340 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Parkwest Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 581897274 Acute care hospital and behavioral health services TN 501(c)(3) Line 3 Covenant Health 0 Methodist Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 620636239 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Roane County Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 680673354 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Loudoun Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621373691 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Thompson Cancer Survival Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621250943 Cancer support center TN 501(c)(3) Line 3 Covenant Health 0 Thompson Oncology Group 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621619239 Oncology services TN 501(c)(3) Line 3 Thompson Cancer Survival Center 0 Covenant HomeCare 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621623114 Home health services TN 501(c)(3) Line 10 Covenant Health 0 Fort Sanders Perinatal Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 043760551 High risk obstetrical services TN 501(c)(3) Line 3 Fort Sanders Regional Medical Center 0 Morristown-Hamblen Hospital Association 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 620545814 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Thompson Cancer Survival Center Foundation 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 582130450 Fundraising and patient outreach TN 501(c)(3) Line 12b, II Covenant Health 0 Cumberland Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 620790132 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Claiborne Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 464420358 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 The Dr Robert F Thomas Foundation Inc 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 581537582 Fundraising and patient outreach TN 501(c)(3) Line 12a, I Covenant Health 0 Covenant-AmSurg ASC Ventures LLC 1A Burton Hills Blvd Nashville TN 37215 884134388 Management Company TN N/A 0 0 Covenant-KEC ASC Ventures LLC 1A Burton Hills Blvd Nashville TN 37215 920539400 Management Company TN N/A 0 0 TEC North LLC 1A Burton Hills Blvd Nashville TN 37215 201871076 Physician Services TN N/A 0 0 The Endoscopy Center of Knoxville LLC 1A Burton Hills Blvd Nashville TN 37215 621512837 Physician Services TN N/A 0 0 Fortress Corporation 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621308885 Management company TN N/A C 0 Covenant Medical Group Inc 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621282917 Physician practice management TN N/A C 0 Knoxville Heart Group 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 271528941 Cardiology medical practice TN N/A C 0 East TN Cardiovascular Surgery Group Inc 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621018541 Cardiovascular surgical practice TN N/A C 0 VortexT Analytics Inc 1420 Centerpoint Blvd Bldg C knoxville TN 379321960 475296949 Computer programming services TN N/A C 0 TenHats LLC 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 814563094 Data storage TN N/A C 0 0 1 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1