2023-11-13T12:07:20-06:00 2022-12-31 990 2022-01-01 620528340 Fort Sanders Regional Medical Center FORT 8653743140 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 Joseph C Dolan EVP/CFO 8653746872 2023-11-08 Joseph Dolan 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z James D VanderSteeg 244 Ft Sanders W Blvd Knoxville TN 37922 382434516 0 X www.covenanthealth.com/fort-sanders-regional X 1954 TN Fort Sanders Regional Medical Center is a 541-bed full service acute care hospital located in the Fort Sanders community of downtown Knoxville, Tennessee. It is a member of the Covenant Health system. 23 22 2276 388 1196493 72814 8343567 5949207 350455589 368208650 106351 105587 3330477 3898453 362235984 378161897 75590 66529 0 0 110407202 112178764 0 0 0 247017479 283945158 357500271 396190451 4735713 -18028554 273614041 268289869 43783379 37997912 229830662 230291957 X Fort Sanders Regional Medical Center provides quality healthcare, in alignment with Covenant Health's mission to serve the community by improving the quality of life through better health, regardless of a patient's ability to pay. 0 0 385585926 66529 368169628 Fort Sanders Regional Medical Center ("Fort Sanders Regional") traces its beginnings to May 1919, when a group of physicians received a charter from the State of Tennessee for a new hospital to be built on the site of the Civil War Battle of Fort Sanders. Fort Sanders Regional has grown throughout its 100-year history to include 517 acute care beds serving 45 specialties, including the 73-bed Patricia Neal Rehabilitation Center, and 24 beds in the Fort Sanders Transitional Care Unit. SERVICEThe hospital is known for excellence in stroke care, neurosciences, cardiology, surgery, oncology, orthopedics, obstetrics, bariatrics, and rehabilitation medicine. In 2022, Fort Sanders Regional received an "A" Hospital Safety Grade from The Leapfrog Group. This national distinction celebrates Fort Sanders Regional's achievements in patient safety. Additionally, Fort Sanders Transitional Care Unit received a 5-star overall rating by the Centers for Medicare and Medicaid services.Fort Sanders Regional served 216,515 patients in 2022. Of these, 198,165 were outpatients and 18,350 were inpatients, with an average length-of-stay of 5.50 days.PUTTING PATIENTS FIRSTAs a neuroscience and rehabilitation center of excellence, Fort Sanders Regional has made a commitment to providing the latest advancements for neurological care, including stereotactic neurosurgery and neuro-interventional radiology. When coupled with its comprehensive inpatient rehabilitation center, the neuroscience and rehabilitation program provides programs to optimize clinical and functional patient outcomes.Neurologic technology at the hospital includes an innovative 3D-imaging system that uses global positioning technology to give physicians real-time views inside the body, without radiation, and facilitates less invasive and more precise surgeries. Fort Sanders Regional also offers diagnosis and treatment of epilepsy, Alzheimer's disease, dementia, Parkinson's disease and multiple sclerosis.Fort Sanders Regional continued to invest in technology and services to care for the people of East Tennessee. In 2022, the hospital announced the addition of a robotic-assisted bronchoscopy platform for minimally invasive lung biopsies. This technology is first of its kind in East Tennessee and allows specially trained Fort Sanders Regional physicians to obtain tissue samples in deep regions of the lung, where many early-stage tumors are found.Fort Sanders Regional is designated by The Joint Commission as a Comprehensive Stroke and Rehabilitation Center of Excellence specializing in the acute management of strokes, including advanced treatment and research. Fort Sanders Regional is the hub of Covenant Health's stroke hospital network, which links Covenant Health's member hospitals in providing access to collaborative, rapid, advanced stroke care throughout our region. Fort Sanders Regional is also home to the Patricia Neal Rehabilitation Center ("PNRC"), an award-winning rehabilitation center which serves more than 600 inpatients annually. PNRC is East Tennessee's recognized leader in helping stroke, spinal cord, brain injury, and orthopedic patients rebuild their lives through rehabilitation services. Opened in 1978, PNRC offers a comprehensive team-approach to care. Physical, occupational, recreational, behavioral medicine and speech language therapists work with rehabilitation nurses and physiatrists (doctors whose specialty is physical medicine and rehabilitation) to develop individual care plans to help patients reach their recovery potential as quickly as possible. PNRC holds 10 separate accreditations from the Commission on the Accreditation of Rehabilitation Facilities and provides an array of inpatient and outpatient services that would otherwise be unavailable in the community. In 2020, Covenant Health announced a joint venture with Encompass Health to own and operate Covenant Health's Patricia Neal Rehabilitation Center. Plans include building a new 51-bed, freestanding inpatient rehabilitation hospital on Covenant Health's Fort Sanders West campus in Knoxville, while renovating the existing Patricia Neal Rehabilitation Center to a 22-bed hospital-in-hospital structure. Both construction projects are underway. In 2022, Fort Sanders Regional earned a three-year accreditation from the National Accreditation Program for Rectal Cancer (NAPRC), a quality program of the American College of Surgeons. It is the first hospital in the state to receive the accreditation.Fort Sanders Regional's award-winning Heart Center offers comprehensive cardiovascular services that span the continuum of heart care, from testing and advanced diagnostics to interventional technologies, cardiovascular surgeries, clinical trials and cardiac rehabilitation. Fort Sanders Regional is also recognized for excellence in surgery. The bariatric surgery program, which helps people who are morbidly obese reverse or eliminate medical risks associated with obesity through surgical treatment, is accredited as a Comprehensive Center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Fort Sanders Regional has received the Blue Cross BlueShield Blue Distinction designation for bariatrics, spine surgery, knee and hip surgery, and maternity care. In 2022, a total of 10,967 patients underwent surgery at Fort Sanders Regional in specialty areas, including:- Cardiothoracic Surgery- Cardiovascular Surgery- Colon/Rectal Surgery- Neurosurgery- Orthopedic Surgery- Plastic Surgery- Sinus Surgery and other Ear, Nose, and Throat Procedures- Surgical Oncology- Thoracic Surgery- Vascular SurgeryFort Sanders Regional also offers surgical oncology, the surgical management of cancer. Surgical oncologists may specialize in thoracic or gynecological procedures, along with other sub-specialties to help cancer patients. IMPROVING THE COMMUNITY'S QUALITY OF LIFE THROUGH BETTER HEALTHFort Sanders Regional is committed to building a healthy community through these and other initiatives: - The Innovative Recreation Cooperative offers new and creative ways for individuals recovering from disabling illnesses or injuries to participate in adaptive sports and recreational activities.- Fort Sanders Regional's bariatric surgery seminars and support groups provide vital information to patients considering bariatric surgery, and offer pre- and post-surgical support. - The Fort Sanders Regional Joint Center offers joint replacement education opportunities prior to surgery.- The Stroke, Spinal Cord Injury, Brain Injury and Amputee support groups at Patricia Neal Rehabilitation Center help patients and families heal by bringing together those with common experiences who can provide group members with comfort, encouragement and advice. - Fort Sanders Regional's Teddy Bear University classes provide information and support for new parents, siblings and grandparents as they welcome a new baby. Class topics include pregnancy and childbirth, breastfeeding and more. Fort Sanders Regional is recognized as a Bronze Safe Sleep Hospital by Cribs for Kids for providing education and vital tools about safe sleep to the parents of newborns.COVENANT HEALTH Fort Sanders Regional is a member of Covenant Health. Covenant Health is a comprehensive, community-owned health system dedicated to improving the health of the people it serves. Established in 1996 by the consolidation of Fort Sanders Health System, Knoxville, Tennessee, and MMC HealthCare System in Oak Ridge, Covenant Health is governed by a voluntary board of directors comprised of community leaders and medical professionals. With more than 11,000 employees, affiliated physicians and volunteers, Covenant Health is the Knoxville area's largest employer and has been named a Best Employer by Forbes. Covenant Health includes nine acute care hospitals in East Tennessee: Methodist Medical Center of Oak Ridge, Fort Sanders Regional Medical Center and Parkwest Medical Center in Knoxville, Fort Loudoun Medical Center in Lenoir City, LeConte Medical Center in Sevierville, Morristown-Hamblen Healthcare System in Morristown, Roane Medical Center in Harriman, Claiborne Medical Center in Tazewell and Cumberland Medical Center in Crossville. It also includes Peninsula, a division of Parkwest Medical Center, a behavioral health hospital in Blount County, Tennessee. The health system also includes Covenant Medical Group, which includes more than 200 physicians and advanced practice clinicians in office locations throughout East Tennessee. 385585926 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 168 0 1 2276 1 1 1 0 0 0 0 0 0 0 0 0 X 23 22 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Amy DeLong 8653743140 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 Gerald Boyd Director 0.00 1.00 X 0 0 0 Willard Campbell MD Director 0.00 1.00 X 0 0 0 Michael Casey MD Director 0.00 1.00 X 0 0 0 Ronni Chandler Director 0.00 1.00 X 0 0 0 Mitchell Dickson MD Director 0.00 1.00 X 0 268 0 Stephanie Flood Director 0.00 1.00 X 0 849 0 James Gibson Director 0.00 1.00 X 0 74 0 Edgar Gray Director 0.00 1.00 X 0 1432 0 Leslye Hartsell Director 0.00 1.00 X 0 889 0 Donald Hickman Director 0.00 1.00 X 0 1538 0 Timothy Matthews Director 0.00 1.00 X 0 906 0 Janice McKinley Director 0.00 1.00 X 0 1097 0 Dave Miller Director 0.00 1.00 X 0 1208 0 Bill Myers Director 0.00 1.00 X 0 0 0 Alvin Nance Director 0.00 1.00 X 0 0 0 Linda Ogle Director 0.00 1.00 X 0 0 0 King Purnell Director/Chair 0.00 1.00 X X 0 1050 0 Jorge Sanabria Director 0.00 1.00 X 0 1485 0 William Seale Director 0.00 1.00 X 0 1251 0 Cosby Stone Director 0.00 1.00 X 0 1408 0 Joe Sutter Director 0.00 1.00 X 0 979 0 James Tramontana MD Director 0.00 1.00 X 0 1208 0 James D VanderSteeg President & CEO 0.00 50.00 X X 0 2346646 316057 John T Geppi EVP/CFO 0.00 50.00 X 0 1099851 33916 Keith N Altshuler President & CAO 44.00 6.00 X 0 653393 34275 Brian J Lett VP - Financial Services 42.00 8.00 X 198970 0 30390 Lynda J Watts Fmr VP - CNO (through Dec 2022) 50.00 0.00 X 292042 0 24618 Christopher S Hall VP - Support Services 50.00 0.00 X 226768 0 18203 Joseph M Bowling Medical Physicist 50.00 0.00 X 220726 0 46237 Michael P Sisi Neuroscience Unit Shift Leader 50.00 0.00 X 207854 0 1949 Shellie L Shock Administrative Supervisor 50.00 0.00 X 166706 0 39865 Pamela M Turner Clinical Specialist Pharmacist 50.00 0.00 X 156785 0 27092 Linda E Yoder Director Surgical Services 50.00 0.00 X 156360 0 28342 1626211 4115532 600944 76 0 1 0 Linen King 1521 W 36th Pl Tulsa OK 74170 Linen Services 2812011 Medic Regional Blood Center 1601 Ailor Avenue Knoxville TN 37921 Blood Processing Fees 1321909 Nurse Pro Plus LLC PO Box 549 Dellslow WV 26531 Staffing Services 1190093 Encompass Health Corporation 9001 Liberty Pkwy Birmingham AL 35242 Management Fees 1188193 Knoxville Contracting Co LLC 1601 N Central St Knoxville TN 37917 Equipment Repairs 1004222 54 74923 5871492 2792 25 5949207 Net Patient Revenue 622110 366616335 366616335 Laboratory 621500 1111074 1111074 Rental Income - Exempt Affiliates 531120 481241 481241 368208650 105587 105587 5033449 8757 4263862 8757 769587 0 769587 80038 689549 Cafeteria 722514 1570974 1570974 Gift Shop 459510 442218 442218 Management Fees 561000 413310 413310 702364 658742 5381 38241 3128866 378161897 368169628 1196493 2846569 X 50 50 66479 66479 790990 790990 92675474 91729589 945885 2688059 2665675 22384 9331571 9204805 126766 6692670 6573354 119316 34341326 33138673 1202653 336 336 76595677 74020506 2575171 243062 238755 4307 2183375 1523042 660333 8739659 7218842 1520817 65181 64637 544 59656 51774 7882 98523 98523 20829796 19722717 1107079 415720 405852 9868 Medical Supplies 101266413 101266413 UBI Tax 31000 31000 Bad Debt 21501808 21501808 Minor Equipment 12330213 11278196 1052017 5243413 4816236 427177 396190451 385585926 10604525 0 6183 5880 -1526388 -2356159 31806716 38618622 6143095 6221397 1410148 2170072 572953083 355944349 229303502 217008734 6470785 6621323 273614041 268289869 35909838 26503711 7873541 11494201 43783379 37997912 X 229830662 230291957 229830662 230291957 273614041 268289869 X -18028554 18489849 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 141706 7728 7728 141706 141706 4563 4563 141706 141706 5103 5103 141706 138346 3360 5608 5608 141706 135041 3305 7879 7879 138346 1.00000 0 1 1 8100822 8100822 318197626 167317744 150879882 842667 834322 8345 244777178 187792283 56984895 1034790 1034790 217008734 Due To Affiliates, Net 793668 Due to Third Party Payors 3829449 Long-term Deferred Compensation 647275 Long-term Reserve for Workers Comp 1550679 Operating and Finance Leases 4673130 11494201 X Part V, Line 4: Fort Sanders Foundation maintains two permanent endowments for the purpose of providing a permanent source of income for the following programs at Fort Sanders Regional Medical Center: The Pastoral Care Fund and the Caroline Can! Fund. The principal of the endowments will be kept intact in perpetuity. Only the income generated will be distributed to FSRMC to provide support for the aforementioned programs. Part X, Line 2: Excerpt from the consolidated audited financial statements of Covenant Health (Covenant), parent company to Fort Sanders Regional Medical Center: 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. 1 1 X 1 X 1 X 1 1 1 0 1 1 19674902 0 19674902 0.05250 75867852 54588662 21279190 0.05680 1491908 495225 996683 0.00270 97034662 55083887 41950775 0.11200 267854 36789 231065 0.00060 56327 9900 46427 0.00010 52113610 26700333 25413277 0.06780 78279 78279 0.00020 52516070 26747022 25769048 0.06870 149550732 81830909 67719823 0.18070 27516 27516 0.00010 5565 5565 0.00000 259 259 0.00000 33340 33340 0.00010 1 21501808 3455027 52517721 54235838 -1718117 X 1 1 1 1 Fort Sanders Regional Medical Center 1901 Clinch Avenue Knoxville TN 37916 www.covenanthealth.com/fort-sanders-re 00000043 X X X X Fort Sanders Regional Medical Center 0 0 1 X X X X X X X X 20 1 1 1 1 X See Part V, Page 8 X 1 20 1 See Part V, Page 8 0 1 X 200.000000000000 300.000000000000 X X 1 1 X X X 1 X https://www.covenanthealth.com/patients-visitors/financial-assistance/ X https://www.covenanthealth.com/patients-visitors/financial-assistance/ X https://www.covenanthealth.com/patients-visitors/financial-assistance/ X X X X X X 1 X 0 X X X 1 X 0 0 Fort Sanders Regional Medical Center Part V, Section B, Line 5: In conducting its most recent Community Health Needs Assessment ("CHNA"), Fort Sanders Regional Medical Center ("Fort Sanders Regional") partnered with the Knox County Health Department ("KCHD") and the Community Health Council ("Health Council"). Community hospitals worked collaboratively with KCHD and the Health Council along with local healthcare providers, governmental agencies, and dozens of community stakeholders.KCHD convened monthly data group meetings with assessment partners to organize and coordinate the qualitative and quantitative data collection efforts. The qualitative data consisted of 10 focus groups consisting of 66 participants, 10 key informant interviews, and a quality of life survey with more than 600 responses. A Behavioral Risk Factor Survey (BRFS) and Youth Risk Factor Survey (YRFS) were conducted as well. Epidemiology staff compared local and state level data, data from the surveys, and mortality and disease prevalence data. KCHD released a summary of initial Community Health Assessment findings to the public in June 2019. Feedback was solicited via presentations to community groups and an online and paper survey. Fort Sanders Regional Medical Center Part V, Section B, Line 6a: Knox County hospitals who participated in the "Together! Healthy Knox" initiative included Fort Sanders Regional Medical Center, Parkwest Medical Center, East Tennessee Children's Hospital, and The University of Tennessee Medical Center. Fort Sanders Regional Medical Center Part V, Section B, Line 6b: The CHNA could not have been completed without the leadership of KCHD and the "Together! Healthy Knox" Leadership Team. Their expertise, use of the national Mobilizing for Action through Planning and Partnerships (MAPP) process, meeting facilitation and guidance ultimately resulted in the most comprehensive health assessment process ever undertaken in Knox County. Other community organizations who participated in the CHNA process were Child and Family Tennessee, City of Knoxville, Knoxville Academy of Medicine, Knoxville Area Coalition on Childhood Obesity, Knoxville Chamber of Commerce, Knoxville Police Department, Knoxville Community Development Corporation, Helen Ross McNabb Center, Interfaith Health Clinic, Knox County Government, Metropolitan Drug Commission, and community members from many other organizations. A more extensive list is published in the assessment. Fort Sanders Regional Medical Center Part V, Section B, Line 11: Of the significant findings from the assessment, Fort Sanders Regional is focusing its resources on the following:1. Mental HealthBehavioral Health Services Expansion - Psych consult services using tele-video programming are now being supported by Peninsula Behavioral Health, a department of Parkwest Medical Center. Fort Sanders Regional partially subsidizes a psychiatrist and a nurse practitioner to provide in-house emergency department consultations on site. - Fort Sanders Regional, with funding support from the Covenant Health Department of Philanthropy, implemented an Emergency Department Diversion Program in 2021. A team of medical and behavioral specialists conducts a behavioral assessment and develops a treatment plan proposal to meet the identified needs. An outreach specialist follows up with patients to oversee the implementation plan.Interfaith Health Clinic Support - Fort Sanders Regional has a long-standing history of supporting the Interfaith Health Clinic of Knoxville. Interfaith provides primary care and mental health services for the uninsured working poor. In addition to $60,000 of financial support, Fort Sanders Regional also provides lab services and other diagnostic services for the clinic. Patients who need hospitalization are provided care on a sliding scale fee structure. 2. Substance AbusePeninsula Drug Treatment Program - Fort Sanders Regional can now refer their patients to the Peninsula Medication Assistance Treatment program's center for outpatient services for substance abuse. This program offers specialized medications and intensive therapy to treat substance abuse disorders. Opioid Lite Program - Fort Sanders Regional's Emergency Department is participating in a system-wide initiative to curb the use of hospital-prescribed opioids. Physicians are prescribing non-opioid drugs when indicated for pain management, during treatment and at hospital discharge.3. ObesityCovenant Health Knoxville Marathon - Fort Sanders Regional is a major supporter of the annual Covenant Health Knoxville Marathon which is held in partnership with the Knoxville Track Club. To prioritize community health and safety, the 18th annual event was held in person with a virtual option. Local neighborhoods, greenways, and trails are incorporated into the course. In 2022, 4,173 people participated in the event.HealthQuest Marathon Challenge - Fort Sanders Regional employees participated in the annual HealthQuest Marathon Challenge. Employees signed up to participate in one of the Covenant Health Knoxville Marathon events including the marathon, half-marathon, 2- or 4- person relay teams or a 5K. Teams competed with other Covenant Health hospital member organizations for points. Nearly 170 employees system-wide participated in 2022. - Fort Sanders Regional offers a bariatric surgery program to benefit morbidly obese people or those with obesity-related illness who have been unable to lose weight through other methods. Fort Sanders Regional Medical Center Part V, Section B, Line 16j: All other ways in which the hospital widely publicizes the FAP are discussed in detail in Part VI, Line 3. Part V, line 7a, CHNA website www.covenanthealth.com/fort-sanders-regional/chna/ Part V, line 10a, Implementation Strategy Website www.covenanthealth.com/fort-sanders-regional/chna/ Part V, Line 20d, Presumptive Eligibility Determinations The hospital follows the eligibility procedures as detailed within the FAP and does not make presumptive eligibility determinations. 17 1 - FSR Radiation Oncology Srvcs at TCSC 1915 White Avenue Knoxville TN 37916 Oncology Radiation Therapy 2 - FS Regional MRI at TCSC 1915 White Avenue Knoxville TN 37916 MRI Dept (Diagnostic) 3 - FSR Infusion Services at Oak Ridge 200 New York Ave Suite 230 Oak Ridge TN 37830 Pharmacy - Infusion Services 4 - FtSanders Ctr for Digestive Health 1819 Clinch Ave Ste 212 Knoxville TN 37916 Gastrointestinal Specialists 5 - Patricia Neal Rehabilitation Center 1901 Clinch Avenue Knoxville TN 37916 Rehabilitation Unit 6 - FS PET Services at Thompson 1915 White Avenue Knoxville TN 37916 PET Imaging Services 7 - Ft Sanders Wound Treatment Center 2001 Laurel Avenue Ste NG-6 Knoxville TN 37916 Wound Care 8 - FSR Infusion Services - Lenoir City 576 Ft Loudoun Med Ctr Dr Ste 204 Lenoir City TN 37772 Pharmacy - Infusion Services 9 - The Sleep Disorders Center at FSRMC 5501 20th St Suite 303 Knoxville TN 37916 Sleep Center 10 - Thompson Comprehensive Breast Center 1915 White Avenue Knoxville TN 37916 Diagnostic Breast Center 11 - FSR Transitional Care Unit 1901 Clinch Avenue Knoxville TN 37916 Skilled Nursing Facility 12 - FSR Gamma Knife Center 1915 White Avenue Knoxville TN 37916 Gamma Knife Center 13 - FS Regional Laser Center 1915 White Avenue Knoxville TN 37916 Center for Barrett's Esophagus 14 - FSR Cardiopulmonary Rehab 501 20th St Ste 301 Knoxville TN 37916 Cardiopulmonary Rehab Therapy Center 15 - FS Hyperbaric Oxygen Therapy Center 2001 Laurel Avenue Knoxville TN 37916 Hyperbaric Oxygen Therapy Center 16 - FSR Therapy Center Downtown 2001 Laurel Avenue Ste N504 Knoxville TN 37916 Physical Rehab Therapy Center 17 - FSR Therapy Center Powell 3515 Emory Rd Suite P-9 Powell TN 37918 Physical Rehab Therapy Center Part I, Line 3c: In addition to the Federal Poverty Guidelines ("FPG"), Fort Sanders Regional utilizes an asset test as a factor in determining eligibility for free or discounted care. Ten percent (10%) of the patient/guarantor's net assets will be added to income for determination of total annual income. The guidelines for determining assets include, but are not limited to, primary dwelling (and attached land), automobiles, liquid assets, investments, farm land, business property, rental property, farm and/or business equipment including livestock and crops. All real property will be considered at fair market value. The values of both real and personal property will be reduced by any existing liabilities incurred by the applicant in obtaining the assets (net assets) with the exception of primary dwelling. The primary dwelling net asset will be the amount of equity above $100,000. Actual or potential third party liability to the patient, hospital or the guarantor by common law, contract, statute or otherwise, shall be considered an asset and must be listed on the Hospital Financial Assistance application. Part I, Line 6a: Covenant Health, the parent company of Fort Sanders Regional and other affiliated acute care hospitals, prepares an annual Report to the Community on behalf of the entire system. Part I, Line 7: Amounts on Lines 7a-7c and certain program costs included on Line 7g are from the hospital's cost accounting system, which addresses all patient segments. Other community benefit expenses are at cost from the general ledger. Part I, Line 7g: Subsidized health services includes the difference between the cost of services and the payments received for those services. The cost of providing dialysis exceeded the payments received by $1,200,126 and the cost of services from the Patricia Neal O/P Clinics exceeded payments received by $5,377,525. The cost of providing OB and neonatal care exceeded payments by $1,029,597. The total also includes $17,741,074 in physician sponsorship fees. All subsidized health services included on line 7g are for services that would otherwise be unavailable in the community or be below the community's needs. Part I, Ln 7 Col(f): The Bad Debt expense included on Form 990, Part IX, Line 24a, but subtracted for purposes of calculating the percentage in this column is $21,501,808. Part II, Community Building Activities: Fort Sanders Regional cares for the whole person and recognizes that improved social and economic conditions may lead to the improved health and well-being of the community. The hospital's community building activities and those of its parent organization, Covenant Health, address many of the root causes of health problems, such as poverty and homelessness, and help find solutions to alleviate the symptoms.An allocation of the Parent's community building expenditures has been made to each member hospital in proportion to the financial contribution of each to the health system. Covenant Health is not a hospital and does not file Schedule H with its Form 990. Contributions in 2022 were made to organizations meeting the community's needs by providing: - The basic needs of life including temporary shelter, food and clothing (Ladies of Charity, City Shepherds, Safe Families for Children East TN and Second Harvest Food Bank) - Youth mentoring, development and after-school programs (Emerald Youth Foundation, Boys and Girls Club, Knox Education Foundation, First Tee of Greater Knoxville and Great Smoky Mountain Council) - Business recruitment and marketing initiatives that boost economic development (Knoxville Technology Council, Knoxville Zoological Garden and Pellissippi State Foundation) - Leadership development programs and workshops (Knoxville Area Urban League and Leadership Knoxville) - Assistance and special programs for at risk older adults, people with physical and mental challenges, and abused and neglected children (Senior Citizens Home Assist and Sertoma Center) - Improve access to health services (East TN Children's Hospital, Helen Ross McNabb Center, Interfaith Health Clinic, Knoxville Academy of Medicine, and Region II Emergency Medical Services) - Programs supporting patients and their families (Air Force Association, Alzheimer's Tennessee, American Cancer Society, American Heart Association, Angel Wings Memory Gowns, East TN Kidney Foundation, East TN Veteran Memorial Association, Juvenile Diabetes Research Foundation and Leukemia & Lymphoma Society, Wreaths Across America) Part III, Line 2: Bad debt expense on Part III, Line 2 is the amount recorded in the organization's financial statements. Discounts and payments on patient accounts are netted against bad debt. The allowance for bad debt is determined based on management's assessment of factors including the age of the accounts, historical collections data, and industry standards. Part III, Line 3: At regular intervals, the Vice President of Revenue Cycle analyzes all self-pay accounts receivables to identify patients who may have been eligible for charity care during a particular period or year. Because this analysis does not yield a final determination of eligibility due to various factors including but not limited to charity applications still in process, failure of eligible patients to submit their charity application, and applications still under consideration, further analysis of the accounts comprising the self-pay accounts receivable is conducted. The accounts for which a patient was contacted to apply for charity care include an identifier; these charity-identified accounts are then categorized according to status. A ratio of the dollar amounts of those accounts whose charity application is in process or has been approved divided by the total self-pay accounts receivable is computed. This ratio is applied to the bad debt expense total to determine the estimated amount of the bad debt expense attributable to patients eligible for charity care according to the hospital's policy. Part III, Line 4: Note B to the 2022 Audited Consolidated Financial Statements of the Covenant Health system, of which Fort Sanders Regional is a member, states: Patient accounts receivable are reported net of an estimated allowance for contractual adjustments and an allowance for implicit price concessions. Covenant's policy does not require collateral or other security for patient accounts receivable and Covenant routinely accepts assignment of, or is otherwise entitled to receive, patient benefits payable under health insurance programs, plans or policies. Part III, Line 8: Medicare Shortfall: Fort Sanders Regional believes that all of the $1.7M shortfall reported in Line 7 should be considered as community benefit. The IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in our community. This year, Medicare patients accounted for 19% of total patient days (17,383 out of 92,417 total). The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. Costing Methodology: Fort Sanders Regional used a combination of sources in calculating Medicare allowable costs on Part III, Line 6 including its cost accounting system, general ledger accounting system, and facility-specific analyses and calculations. Part III, Line 9b: Fort Sanders Regional utilizes a look-back method to determine amounts generally billed ("AGB") to establish the maximum amount that will be charged to individuals eligible under the financial assistance policy ("FAP") for emergency or other medically necessary care. Self-pay patients automatically receive a 69% discount on charges based on the facility's calculated AGB. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment assistance may qualify for charity care. A sliding scale is used for extending charity care utilizing the income levels reported under the federal poverty guidelines. Patients/guarantors with income that falls below 200% of the federal poverty guidelines receive 100% charity care. Patients/guarantors with income of 201-300% of the federal poverty guidelines receive 90% charity care. For catastrophic illness, exceptions to income and asset limitations may be made on a case-by-case basis. The amount considered for charity will be based upon the evaluation of the patient's/guarantor's ability to pay.Fort Sanders Regional makes reasonable efforts to determine a patient's eligibility under the facility FAP. All collection activity will be halted if a charity application is received and will remain on hold until a determination is made by FSRMC and communicated in writing to the responsible party. If the charity application is approved, all collection activities taken will be reversed and any amounts paid above the amount required will be refunded. Patients/guarantors who qualify for partial financial assistance are responsible for paying any balance remaining after the charity adjustment and third party payments. Fort Sanders Regional will not engage in extraordinary collection actions ("ECA") before it makes reasonable efforts to determine whether an individual who has an unpaid bill is eligible for financial assistance. Reasonable efforts to determine whether the individual who has an unpaid bill is eligible for financial assistance include notification to the individual of the FAP, contacting individuals who have submitted incomplete financial assistance applications regarding how to complete the application and allowing a reasonable time period to do so, and reviewing completed applications for financial assistance eligibility. Fort Sanders Regional does not sell any accounts receivable accounts to outside firms. All accounts remain property of and under the policies set by Fort Sanders Regional. Fort Sanders Regional will not defer or deny medically necessary care because of nonpayment for previously provided care whether it was covered or not covered under the charity program. Part VI, Line 2: While the CHNA is a formal means by which the health system assesses the needs of the community, there are many informal networks that give the Covenant Health hospitals a sense of community issues and needs. Fort Sanders Regional obtains additional community information through the service of its employees with organizations including the Interfaith Health Clinic, local Chambers of Commerce and Rotary clubs, the Knoxville Area Coalition on Childhood Obesity, Knox Area Project Access, and the United Way of Greater Knoxville. Covenant Health, the parent organization, maintains community benefit professionals working year-round to ensure that all hospitals are assessing and addressing the needs of the communities served. Part VI, Line 3: The FAP states that patients who are unable to pay or have exhausted all sources of payment assistance may be considered for charity care. Signage about the policy is posted in highly visible areas of the hospital, such as lobbies and registration areas. Information about the FAP is posted in patient booklets provided to patients during the registration process and communicated via patient billing statements. In addition, the FAP and application are available on the facility website. Fort Sanders Regional employs full time financial counselors to assist patients in applying for TennCare and screening for eligibility for financial assistance. Office hours and the phone number for the counselors are included on the signage. Wall signs informing patients about available financial assistance state the following: Covenant Health is committed to providing quality health services in a caring environment. It is the expressed philosophy of Covenant Health and its member hospitals that no one should be denied necessary medical care because of the inability to pay. In conjunction with this philosophy, counselors at Fort Sanders Regional Medical Center are available to assist you with your financial needs. If you are an uninsured person with no public or private source of payment for medical services Fort Sanders Regional Medical Center will provide, at a reduced rate, medically indicated services. A financial counselor is available to assist you with these matters by calling 865-331-1112, Monday through Friday between the hours of 8 a.m.-4 p.m. Additional information regarding financial assistance is also available on our website at FSRegional.com. Signage at the registration areas state the following:It is Fort Sanders Regional Medical Center's philosophy that no one shall be denied medically necessary services based on an inability to pay. Financial assistance applications for medically necessary services are available during the registration process, through a financial counselor, or on our website at FSRegional.com. A financial counselor is available to assist you with these matters by calling 865-331-1112, Monday through Friday between the hours of 8 a.m.-4 p.m. Part VI, Line 4: Fort Sanders Regional is located in downtown Knoxville, Tennessee. Although located in metropolitan Knox County, Fort Sanders Regional receives many specialty referrals from outlying hospitals and physicians and serves patients from 16 diverse counties, a mix of urban, suburban and rural. According to internal hospital data for 2022, 52% of the inpatients and 51% of outpatient cases were from Knox County. According to 2022 data from the County Health Ranking report of the Robert Wood Johnson Foundation, the population of Knox County is 470,313. The percent of the population that is 65 years or older constitute 16.2% of the residents. The unemployment rate in 2022 was 3.3%. According to the 2022 County Health Rankings Report by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, Knox County residents have the following health indicators that are at or above the national benchmarks: Knox - TN - National Adult Smoking: 19% - 20% - 16% Adult Obesity: 35% - 36% - 32% Drug Overdose Deaths: 59 - 34 - 23 per 100,000 population Teen Birthrate: 19 - 27 - 19 of every 1,000 teenage girls Part VI, Line 5: Fort Sanders Regional, in conjunction with its parent company, Covenant Health, uses any available surplus of receipts over disbursements to expand and modernize the facility and to support the education of healthcare professionals, both of which serve to improve patient care and serve the unmet needs of the community.Covenant Health's Board of Directors serves as Fort Sanders Regional's board. The board is comprised of independent community leaders with diverse educational and professional backgrounds. The board provides governance and oversight of Fort Sanders Regional.Fort Sanders Regional maintains an open medical staff, with privileges available to all qualified physicians. Additionally, the hospital operates an active and accessible emergency department that accepts all patients regardless of ability to pay. Part VI, Line 6: Fort Sanders Regional, as a member of the Covenant Health system, benefits from the collaboration among all affiliated organizations to promote quality improvement, patient safety and efficient delivery of care for the communities served. As a system, Covenant assures that business processes are in place at each facility to measure and report quality; to increase the role of compliance; and to integrate risk management, utilization review, peer review, mandatory reporting and quality improvement into one cohesive function. In this way the system is able to use analytic tools to help identify any systemic inability to satisfy the various requirements on the part of the facilities. Fort Sanders Regional, as a regional referral hospital, provides a wide range of acute care services, many of which are unique in the Covenant system. These services are therefore more easily accessible by other affiliated hospitals and health care organizations through transfer or referral, helping to create a seamless continuum of care. The hospital, through its Patricia Neal Rehabilitation Center division, is the only acute inpatient rehabilitation facility in the Covenant system and the largest such provider in the service area. Programming includes specialized services for stroke, brain injury, spinal cord injury and other difficult patient populations with the primary goal of returning the patient home with the greatest gain in functional ability possible. Fort Sanders Regional also provides hospital-based skilled nursing care which serves as either a bridge back home or as an important step along the continuum of care to other long-term care resources. Fort Sanders Regional provides other important services unique to the Covenant system including high risk obstetrical services and home infusion. These services are important to prevent unnecessary hospitalizations through the provision of effective community-based care. Fort Sanders Regional also provides other extensive outpatient services through its ambulatory infusion centers, physical therapy centers, a wound care center, and its cardiac and pulmonary rehabilitation programs. Fort Sanders Regional's patients benefit from the availability of and ease of access to Covenant affiliated entities for services not provided by the hospital itself. Transfer or referral to such services is expedited and coordinated to help create a seamless continuum of care. A full range of community mental health and psychiatric hospital services are available within the system which help support the hospital's emergency room as well as provide an accessible and efficient pathway for those patients who require such services post discharge. Home health and hospice services are also an important part of the continuum of care for a large portion of the hospital's patient population. The Covenant Health system also enhances the patient's access to care through the provision of outpatient services in a variety of settings located throughout the service area.The Fort Sanders Foundation ("the Foundation") seeks out community support for Fort Sanders Regional and other Covenant Health hospitals through a variety of fundraising mechanisms. For example, the Fort Sanders Foundation helps to arrange sponsorship for significant fundraising activities of the Patricia Neal Rehabilitation Center division of the hospital including an annual golf tournament that has become the largest, single day fundraising event in the state of Tennessee. The proceeds of these events help fund needed equipment and facilities for the center as well as to provide access to the center's services for uninsured or underinsured individuals who are in need of intensive rehabilitation but may otherwise be denied such services due to the lack of resources. The Fort Sanders Nursing Department at Tennessee Wesleyan College is an important affiliate of FSRMC. The school provides baccalaureate nursing education, helping to alleviate a shortage of registered nurses to serve a growing and aging population. It is a continuation of a nursing education tradition of the hospital that began more than eighty years ago. The hospital provides a substantial financial contribution to support the program. Training qualified nursing professionals to serve the current or future needs of the community is an important hospital mission.Through this combination of resources and the collective development, implementation and monitoring of clinical protocols and other improvement initiatives, the affiliated entities of Covenant Health are able to deliver higher quality care in a more efficient manner than could be achieved working independently. 1 Critical medications to indigent patients at discharge 188 64954 Cost Prescription medicines Patient assistance 118 1525 FMV Clothing, household goods and medical supplies Part I, Line 2: Grant funds are provided to charitable organizations for the purpose of enhancing and promoting health care and improving quality of life in the community. The organization has guidelines in place to review the eligibility of grantees, and all grants require written documentation and appropriate levels of approval. The organization also provides other post-hospital care assistance to eligible individuals. Funds are generally not tracked after being granted as the original eligibility and selection criteria have been met. X X 1 1 1 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 John T Geppi EVP/CFO 0 679719 0 309084 0 111048 0 11600 0 22316 0 1133767 0 0 Keith N Altshuler President & CAO 0 443841 0 142464 0 67088 0 11600 0 22675 0 687668 0 0 Lynda J Watts Fmr VP - CNO (through Dec 2022) 85048 0 43075 0 163919 0 10477 0 14141 0 316660 0 0 0 Joseph M Bowling Medical Physicist 219288 0 1220 0 218 0 13535 0 32702 0 266963 0 0 0 Christopher S Hall VP - Support Services 170159 0 33825 0 22784 0 8111 0 10092 0 244971 0 0 0 Brian J Lett VP - Financial Services 155611 0 24714 0 18645 0 7414 0 22976 0 229360 0 0 0 Michael P Sisi Neuroscience Unit Shift Leader 189032 0 16091 0 2731 0 0 0 1949 0 209803 0 0 0 Shellie L Shock Administrative Supervisor 164930 0 1720 0 56 0 8664 0 31201 0 206571 0 0 0 Linda E Yoder Director Surgical Services 153028 0 1220 0 2112 0 9308 0 19034 0 184702 0 0 0 Pamela M Turner Clinical Specialist Pharmacist 148729 0 1220 0 6836 0 9329 0 17763 0 183877 0 0 0 Part I, Line 1a Tax gross-up payments related to deferred compensation and reimbursement of fees for personal services for legal and financial planning are provided to certain executives and managers. Amounts are included in taxable compensation. Part I, Line 3 Covenant Health, the parent company of Fort Sanders Regional Medical Center, 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, Lines 4a-b Lynda Watts, Former VP Chief Nursing Officer, received a severance payment of $115,183 durring 2022. The amount is included in taxable compensation. Her termination date was December 16, 2022. 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). Choice Spine LP Family member of Keith N. Altshular - President and CAO 149725 Key employee Keith N. Altshular has a family relationship with Marty Altshular, Co-President of Choice Spine LP. Amount represents fair market value for services rendered to the organization and all transactions between Choice Spine LP and Fort Sanders Regional Medical Center are conducted at arms'-length fair market value. 0 Form 990, Part III, Line 4a Affiliated organizations include Thompson Cancer Survival Center, Thompson Oncology Group, Fortress Corporation and Subsidiaries, Covenant HomeCare, and Fort Sanders Perinatal Center. Philanthropic organizations include Fort Sanders Foundation and the Thompson Cancer Survival Center Foundation in Knoxville, Methodist Medical Center Foundation in Oak Ridge, Dr. Robert F. Thomas Foundation in Sevierville, and Morristown-Hamblen Hospital Foundation in Morristown. Funds raised by the foundations provide services, equipment and other resources for excellence in patient care. Fort Sanders Regional, as a member of the Covenant Health system, benefits from the collaboration among all affiliated organizations to promote quality improvement, patient safety and efficient delivery of care for the communities served. IMPACT OF COVID-19 In March 2020, the outbreak of the coronavirus disease 2019 ("COVID-19") was declared a public health emergency by the Department of Health and Human Services and declared a national pandemic by the World Health Organization. The COVID-19 pandemic had a major impact on the operations of all hospitals and affiliates included within the Covenant Health System. Three years later, although the overall number of hospital admissions due to the virus is significantly lower than the prior two years, COVID-19 continues to be a long-term problem. The stresses on the System which began in 2020 continue to have long-term and far-reaching implications, creating new challenges for every hospital in the System. The rapid rise in costs for supplies and equipment, unprecedented staffing shortages, and lower patient volumes continue to result in financial stress. Elective surgeries and diagnostic procedures have not yet returned to pre-COVID levels. Government subsidies in 2020 and 2021 helped offset the financial losses caused by significant declines in volumes due to cancelled and postponed procedures. In 2021 and 2022, Federal and state grants continued to be used to subsidize the rising costs of retaining staff and providing quality care. These federal and state grants were helpful but the financial pressures of rising costs across the System are ongoing. Early results from our focus groups for the Community Health Needs Assessments indicate that community problems such as substance abuse, mental illness, asthma and other respiratory diseases, and access to health care have gotten worse since COVID-19, thus stressing the health care System even more than usual. Covenant Health has put in place a number of changes to address these challenges. We are aggressively pursuing cost reductions in supplies across our hospitals and with our vendors. Covenant has increased nurse pay and implemented retention bonuses and other incentives to help reduce staff fatigue and turnover. A number of innovations, including a growing use of Tele-health capabilities, have assured that we continue to reach and serve patients in the community. Patient care continues to be our top priority despite the economic pressures. Form 990, Part VI, Section A, line 6 Covenant Health is the sole member of Fort Sanders Regional Medical Center. Form 990, Part VI, Section A, line 7a Covenant Health's board of directors also serves as the board of directors for Fort Sanders Regional Medical Center. Form 990, Part VI, Section A, line 7b Governance decisions of Fort Sanders Regional Medical Center are subject to approval of the sole member, Covenant Health. Form 990, Part VI, Section B, line 11b The Covenant Health board of directors has delegated to its Finance Committee the full power and authority of the board to receive, review, approve, authorize the filing of, address and resolve audit or review issues, and otherwise take all action required or appropriate relative to IRS Forms 990 and other applicable tax filings. Prior to filing Form 990, management reviews with the committee the returns, discusses any material variations in the Form 990 as compared to those to be filed by the organization's affiliates, and answers any questions. At the conclusion of review and discussion, the Finance Committee approves the Form 990. 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. Covenant Health distributes a board-approved Code of Conduct to all employees. The Code covers among other subjects, conflicts of interest, and requires disclosure and resolution of employee conflicts of interest. Additionally, officers, employed physicians, and highly compensated employees are required to complete and sign an annual conflict of interest disclosure statement. Board members' conflicts of interests are addressed in the corporate bylaws, and board members are required to complete and sign a conflict of interest questionnaire on an annual basis. The Integrity-Compliance Office maintains records that contain conflict of interest information obtained from board members, officers, and employees. These records are available to be queried prior to engaging in business transactions. The Chief Compliance Officer reviews conflict of interest data. Based on this information, the officer determines what conflicts of interest exist at that point in time. Between times when surveys are collected, board members are expected to disclose any new conflicts that have arisen that affect pending board decisions. Officers and other employees are expected to report conflicts to the Chief Compliance Officer as they arise. Depending on the nature of the conflict and the circumstances surrounding the conflict and transaction, the Chief Compliance Officer, senior leadership, or the board of directors may review the conflict of interest. When appropriate, these parties may also consult legal counsel. Restrictions imposed on persons with a conflict of interest are determined on a case by case basis. For Covenant Health employees, the Chief Compliance Officer in conjunction with Covenant Health Executive Leadership determines how to appropriately manage the conflict. In any conflict involving a board member, such member is expected to recuse himself or herself from voting on matters related to the conflict. Form 990, Part VI, Section B, line 15 Form 990, Part VI, Section B, Line 15a: Overall compensation policies for Fort Sanders Regional Medical Center, 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 990. The process for Fort Sanders Regional Medical Center's CEO is included in response to Part VI, Section B, line 15b. Form 990, Part VI, Section B, Line 15b: Base salary and annual bonus opportunities for Keith Altshuler, President and Chief Administrative Officer, are set by the Covenant Health 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 is reasonable and within a fair market value range. Salary ranges are based upon the recommendations of the Consultant made after comparison with similar jobs in similar size health systems across the nation. Bonuses are recommended by the CEO and reviewed with the Committee conditioned upon receipt of a written opinion from the Consultant that total compensation for the executive is reasonable and consistent with fair market value. Base salary is initially targeted at the 25th percentile and may vary according to market conditions, performance, tenure, experience, special skills or qualifications, recruitment and retention challenges, and other relevant factors. Annual bonuses are designed to award 0-35% of base salary based upon system performance and accomplishment of certain targets established by the CEO. Base salaries and annual bonus opportunities for other officers and key employees are based on targets established by historical compensation consultant data and the Covenant Health Compensation department. Salary ranges are based upon comparison with similar jobs in similar size health systems across the nation. Base salaries and bonuses are approved by Executive Leadership predicated upon performance, and are reasonable and consistent with fair market value. Base salaries are initially targeted at midpoint and may vary according to market conditions, performance, tenure, experience, special skills or qualifications, recruitment and retention challenges, and other relevant factors. Annual bonuses are designed to award 0-20% of base salary based upon system performance and accomplishment of certain targets established by Executive Leadership. Form 990, Part VI, Section C, line 19 Fort Sanders Regional Medical Center files a Joint Annual Report containing financial information with the Tennessee Department of Health. Per its tax-exempt bond provisions, Covenant Health, the parent company of the organization, is required to file quarterly and annual consolidated and obligated group financial statements and other documentation with various bond insurers and other agencies, including the Electronic Municipal Market Access (EMMA) service of the Municipal Securities Rulemaking Board (MSRB). Any member of such a repository has access to these financial statements. The organization's governing documents and conflict of interest policy are not made publicly available. Form 990, Part IX, line 11g Sponsorship Fees: Program service expenses 17,716,075. Management and general expenses 0. Fundraising expenses 0. Total expenses 17,716,075. Intercompany Purchased Services: Program service expenses 3,769,640. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,769,640. Other Purchased Services: Program service expenses 52,534,791. Management and general expenses 2,575,171. Fundraising expenses 0. Total expenses 55,109,962. Form 990, Part XI, line 9: Transfers of Capital 18,489,849. Advanced Care at Home 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 921149522 Physician Services TN 0 0 Fort Sanders Regional Medical Center Covenant Health 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621646734 Supporting organization TN 501(c)(3) Line 12b, II N/A 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 Covenant HomeCare 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621623114 Home health services TN 501(c)(3) Line 10 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 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 Fort Sanders Foundation 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621748601 Fundraising and patient outreach TN 501(c)(3) Line 12b, II 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 1 LeConte Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621114867 Acute care hospital 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 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 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 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 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 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 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 1 Knoxville Heart Group 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 271528941 Cardiology medical practice TN N/A C 1 East TN Cardiovascular Surgery Group Inc 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621018541 Cardiovascular surgical practice TN N/A C 1 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 1 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 Fort Sanders Perinatal Center A 440755 FMV Fort Sanders Perinatal Center L 166956 Cost Fort Sanders Perinatal Center Q 77568 Cost Covenant Medical Group Inc A 607009 FMV Knoxville Heart Group A 259278 FMV East Tennessee Cardiovascular Group A 106049 FMV