2023-11-13T18:12:51-06:00 2022-12-31 990 2022-01-01 043760551 Fort Sanders Perinatal Center FORT 8653743140 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 Joseph C Dolan EVP/CFO 8653746872 2023-11-08 Joseph Dolan 999009999 1 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z James D VanderSteeg 244 Ft Sanders W Blvd Knoxville TN 37922 24314929 0 X https://www.covenanthealth.com/ X 2002 TN Fort Sanders Perinatal Center works closely with the women's services department at Fort Sanders Regional Medical Center providing comprehensive obstetrical services to women, including women with high-risk pregnancies. Fort Sanders Perinatal Center is located in the Fort Sanders community of downtown Knoxville, Tennessee, and is a member of the Covenant Health system. 23 22 198 22 0 0 1401675 1937422 18987907 22048887 502867 328620 392 0 20892841 24314929 0 0 0 0 17202162 20168272 0 0 0 3436879 3707147 20639041 23875419 253800 439510 10128344 9153580 14410410 13074436 -4282066 -3920856 X Fort Sanders Perinatal 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 the patient's ability to pay. 0 0 22843744 22048887 Fort Sanders Perinatal Center (the "Center") provides a full range of quality healthcare services to women in East Tennessee. The Center specializes in providing obstetrical care to women with high risk and complicated pregnancies as well as routine obstetrical/gynecological services to the area. For the last 25 years, the Center has provided comprehensive high-risk pregnancy services and delivered over 26,000 high-risk babies at Fort Sanders Regional Medical Center ("FSRMC"). The main office is located at FSRMC with additional offices in West Knoxville, Morristown and Sevierville, Tennessee, to ensure access to OB/GYN care and high-risk pregnancy services without the need to travel to downtown Knoxville.The Center partners with East Tennessee Children's Hospital ("ETCH") to provide complete care for women and their babies. Through our collaboration with the neonatologists at ETCH, we can provide emergent care and medical services for infants, including a neonatal intensive care unit, neonatologists and a comprehensive newborn nursery.Fort Sanders Perinatal Center provides care to those in need regardless of method of payment or ability to pay. During 2022, 44.5% of the Center's patients were covered by TennCare, Tennessee's Medicaid program, under which costs exceed reimbursement. In 2022, the Center had 90,134 office visits and performed 2,730 deliveries.SERVICEThe Centers' OB/GYN specialists participate with deliveries at FSRMC and receive transports from other hospitals in the area with pregnant patients experiencing a complication requiring a higher level of care.Multiple gestations, advanced maternal age, or pregnancies experiencing problems with the fetus are considered to be high-risk pregnancies. In addition, medical conditions such as diabetes, hypertension, obesity, or other medical or genetic conditions can create complications relating to pregnancy and delivery. The Center physicians use a team approach for all patients that includes a combination of Sonographers, Nurse Practitioners, Genetic Counselors, Diabetic Educators and Perinatologists. Prenatal screening and diagnostic testing is performed to evaluate the health of babies in utero and checks for birth defects. While most babies are born healthy, a small number (1%) are born with major birth defects, and 3 to 4% are born with birth defects that may be caused by genetic, environmental or other factors. Three genetic counselors are available to provide guidance about different screening and diagnostic testing options unique to the mothers' needs. Our genetic counselors have master's degrees in genetic counseling, are licensed by the State of Tennessee Division of Health Related Boards, and are certified by the American Board of Genetic Counseling. They have extensive knowledge in human genetics, genetic disease, patterns of inheritance and birth defects. They also are trained in counseling skills to help deal with critical decision-making and the emotional effects of a genetic disease. High-resolution ultrasounds are conducted by a team of sonographers who have experience ranging from 5 to 30 years in obstetric imaging and are certified by the American Registry of Diagnostic Medical Sonographers. This certification is not required for all sonographers, but the team at Fort Sanders Perinatal Center is dedicated to expertise in women's health by maintaining required and elective certifications and staying informed of the latest advances in imaging techniques.In addition, our sonographers have specialized training and certification for early detection of chromosome anomalies and fetal anatomical abnormalities, known as Fetal Nuchal Translucency/Nasal Bone Assessment. This first trimester ultrasound is performed at approximately 12 weeks of pregnancy. They also are certified to perform Maternal Cervical Assessment to aid in prevention of early delivery and miscarriage that otherwise may not be detected.Our team was the first obstetrical ultrasound department in Knoxville to be accredited by the American Institute of Ultrasound in Medicine in 1996. This is important because AIUM develops educational guidelines and protocols in imaging for medical professionals that ensures our sonographers and physicians are performing obstetrical ultrasound techniques above and beyond the standard of care. We are currently one of the largest maternal fetal medicine imaging labs in East Tennessee.Many women develop gestational diabetes during pregnancy and require diabetes counseling. Diabetic educators employed by the Center help with pregnancies complicated by diabetes or nutritional deficiencies. COVENANT HEALTHThe Center 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.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 Perinatal, 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. 22843744 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 12 0 1 198 1 0 0 0 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 6.00 44.00 X 0 653393 34275 Brian J Lett VP - Financial Services 8.00 42.00 X 0 198970 30390 Periclis Roussis MD Perinatologist 50.00 0.00 X 1627368 0 39741 Gary W Stephens MD Perinatologist 50.00 0.00 X 1172470 0 39523 Steven A Andrade MD High-risk OB/GYN 50.00 0.00 X 920917 0 51923 F Robb McKeown III MD High-risk OB/GYN 50.00 0.00 X 664093 0 46923 Danielle M Pipkin MD High-risk OB/GYN 50.00 0.00 X 656917 0 46923 5041765 4314502 639671 29 0 1 0 JAC Consulting 4007 Meadowland Dr Prospect KY 40059 Consulting Services 245875 1 537422 1400000 1937422 Net Patient Revenue 622110 22048887 22048887 22048887 328620 328620 24314929 22048887 0 328620 17277427 16657745 619682 834788 816634 18154 1248391 1206307 42084 807666 778698 28968 216736 216736 679673 656515 23158 10393 10393 152554 100963 51591 830964 829379 1585 34492 34492 72736 72736 372327 372327 141329 141329 Medical Supplies 450712 450712 Minor Equipment 266290 263028 3262 Bad Debt 228099 228099 Malpractice Expense 207900 207900 42942 26880 16062 23875419 22843744 1031675 0 830 830 -129270 -261091 376863 879580 101895 118479 5527021 3875178 1573604 1651843 8204422 6763939 10128344 9153580 6202730 6303820 8207680 6770616 14410410 13074436 X -4282066 -3920856 -4282066 -3920856 10128344 9153580 X 439510 -78300 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1107544 757332 350212 4419477 3117846 1301631 1651843 Long-Term Deferred Compensation 6676453 Operating Lease 87486 6763939 Operating Lease 87486 Long-Term Deferred Compensation 6676453 Due to Affiliates, Net 6677 6770616 X Part X, Line 2: Excerpt from the consolidated audited financial statements of Covenant Health (Covenant), parent company to Fort Sanders Perinatal: 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. 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 Periclis Roussis MD Perinatologist 1566708 0 49992 0 10668 0 17400 0 22341 0 1667109 0 0 0 Gary W Stephens MD Perinatologist 1166926 0 0 0 5544 0 17400 0 22123 0 1211993 0 0 0 John T Geppi EVP/CFO 0 679719 0 309084 0 111048 0 11600 0 22316 0 1133767 0 0 Steven A Andrade MD High-risk OB/GYN 637161 0 283000 0 756 0 17400 0 34523 0 972840 0 0 0 F Robb McKeown III MD High-risk OB/GYN 379161 0 283000 0 1932 0 17400 0 29523 0 711016 0 0 0 Danielle M Pipkin MD High-risk OB/GYN 373161 0 283000 0 756 0 17400 0 29523 0 703840 0 0 0 Keith N Altshuler President & CAO 0 443841 0 142464 0 67088 0 11600 0 22675 0 687668 0 0 Brian J Lett VP - Financial Services 0 155611 0 24714 0 18645 0 7414 0 22976 0 229360 0 0 Part I, Line 3 Covenant Health, the parent company of Fort Sanders Perinatal 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, 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 III, Line 4a 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 Perinatal 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 Perinatal Center. Form 990, Part VI, Section A, line 7b Governance decisions of Fort Sanders Perinatal 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 Perinatal, 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. The process for Fort Sanders Perinatal'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 Perinatal 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 XI, line 9: Transfers of Capital -78,300. 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