2023-11-14T06:37:41-06:00 2022-12-31 990 2022-01-01 581897274 Parkwest Medical Center PARK 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 402613306 0 X www.covenanthealth.com/parkwest/ X 1990 TN Parkwest Medical Center operates a full-service acute care hospital located in west Knoxville, Tennessee, and a psychiatric hospital in neighboring Blount County, TN with a combined total of 456 beds. It is a member of the Covenant Health system. 23 22 2602 116 272888 0 3067271 6120253 411962302 390400411 92852 137550 2663034 2723709 417785459 399381923 291562 294947 0 0 126551642 119823080 0 0 0 259497638 287340915 386340842 407458942 31444617 -8077019 331847569 314311866 49011401 38347125 282836168 275964741 X Parkwest 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 the patient's ability to pay. 0 0 401354054 294947 379789656 Parkwest Medical Center ("Parkwest") admitted its first patient on December 10, 1973. It became a not-for-profit hospital in 1990 and joined the Covenant Health system in 1996. Peninsula, a division of Parkwest Medical Center ("Peninsula") is the behavioral services division of Parkwest Medical Center and the region's largest provider of behavioral health services. Peninsula has a 119-bed hospital in Blount County providing mental health services for adolescents and adults. Peninsula also provides outpatient services in four counties. SERVICEWest Knoxville's largest medical center, Parkwest has an organizational culture focused on treating every patient and visitor with courtesy, compassion and respect. It is best known for excellence in orthopedics, cardiology, surgical and behavioral health. Parkwest Medical Center and Peninsula Behavioral Hospital, a division of Parkwest, served 255,633 patients in 2022. Of these, 237,377 were outpatients and 18,256 were inpatients with an average length-of-stay of 5.12 days. PUTTING PATIENTS FIRSTIn 2022, Parkwest was recognized by U.S. News & World Report as the #4 Best hospital in Tennessee, and the #1 hospital in Knoxville metro area, and rated as a high-performing hospital by US News & World Report for: hip and knee replacements, hip fractures, COPD, colon cancer surgery, heart attack and heart failure measures, Heart Bypass surgery, AAA repair, and stroke care.BlueCross BlueShield gave the hospital a Blue Distinction Center+ designation for knee replacement and hip surgery, spine surgery, maternity care, and a Blue Distinction Center designation for bariatric surgery. Parkwest was named a Top 50 Cardiovascular Hospital by IBM Watson Health.The Joint Commission has designated the hospital as an Advanced Primary Stroke Center, and Parkwest is a member of Covenant Health's stroke hospital network, which links Covenant Health's member hospitals in providing rapid diagnosis and treatment of stroke. Parkwest was recognized with GoldPlus Stroke Quality Achievement Award by the American Heart Association/American Stroke Association. Parkwest has earned the GoldPlus Quality Award from the American Heart Association, recognizing consistent compliance with evidence-based quality measures for care of patients experiencing heart attacks, and a Gold award for non-STEMI quality measures.IMPROVING THE COMMUNITY'S QUALITY OF LIFE THROUGH BETTER HEALTHIn 2022, Parkwest provided over $170,000 worth of transportation through Priority Ambulance for patients to receive treatments and over $24,000 worth of taxi/transportation fees to patients who had been discharged and needed transportation home.In 2022, Parkwest participated in the Greater Knoxville Heart Walk, raising funds and awareness for heart disease. Parkwest also participates in local health fair screenings for area businesses and groups, providing carotid ultrasound screenings and physical therapy ergonomic education, as well as stroke education. In 2022, the employees at Parkwest also raised money for our internal employee chaplain's fund which helps employees who are experiencing unusual or extraordinary financial needs.As a member of Covenant Health, Parkwest and Peninsula have adopted the "We Honor Veterans" program, recognizing and celebrating patients and employees who are veterans, in our facility. When a patient is identified as a veteran they are recognized with a certificate and pinning ceremony. Supporting Mental HealthPeninsula is the behavioral services division of Parkwest Medical Center and provides a variety of inpatient and outpatient services for children, adolescents and adults. Peninsula's 119-bed inpatient hospital is located in Blount County, with outpatient centers in Knox, Blount, Loudon and Sevier Counties. Peninsula also offers care specifically designed for seniors with co-existing psychiatric and medical conditions at the Senior Behavioral Center located at Parkwest Medical Center. Peninsula has helped thousands of people recover from disorders and dependencies, and lead healthy, positive and productive lives.In addition to inpatient and outpatient services that require payment, Peninsula offers several no-cost programs for community members.ComPASS (Communicating the Pain as Suicide Survivors)ComPASS is an ongoing community support group for those who have lost a family member, friend or coworker to suicide. The group provides a safe environment for survivors to share feelings and experiences, affirms suicide bereavement, educates survivors in healthy coping and healing strategies and provides opportunities to learn from other survivors. Peninsula also hosted Survivors of Suicide Loss Day in 2022 to provide resources and support for those affected by suicide. Independent Living ProgramThe Independent Living Program provides emergency financial assistance to persons diagnosed with a mental illness. An application providing financial information is required and must be assessed and approved by the program coordinator.Peer Support AcademiesPeninsula's Peer Support Academies are peer support centers offering support for hundreds of individuals in Blount, Knox and Sevier counties. Men and women age 18 and older who have a mental illness are eligible to apply to participate in the program, which is offered free of charge. Peer Support Academies provide socialization opportunities, education and support groups to enhance wellness for adults who struggle with addiction, dependency and other mental and behavioral issues. The academies are staffed by peer support specialists who are certified by the State of Tennessee.Recovery LinkRecovery Link is designed to bridge the gap between addiction and recovery by connecting people who suffer from addiction to treatment programs. The program serves East Tennessee residents, and will assist anyone, free of charge, in finding the treatment program that is right for them.Support GroupsPeninsula offers several types of support groups which are open to the community. Most support groups meet at the Peninsula Lighthouse campus at 1451 Dowell Springs Blvd. in Knoxville.Women in TreatmentWomen in Treatment is appropriate for uninsured women age 18-64 who suffer from addiction. The intensive outpatient program focuses on women's issues in recovery and co-occurring disorders, with priority placement is given to pregnant injecting drug abusers, pregnant substance abusers and injecting drug users. One in four people in East Tennessee suffer from a mental health illness. However, there is a significant gap in funding for programs to serve these individuals compared to other diseases and diagnoses. Artsclamation! is Peninsula's only fundraiser and helps to fill some of the gaps left in those funding sources. Proceeds in past years have funded garden courtyards for adult patients, vans for transporting clients in outpatient programs, play areas for hospitalized children, therapeutic games and activity supplies. 401354054 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 156 0 1 2602 1 1 1 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 M Scott Hamilton VP - Financial Services 40.00 10.00 X 247377 0 41607 Michael R Belbeck Jr Interim Pres & CAO-PWMC/EVP-Hosp Ops 20.00 30.00 X 0 898340 88783 Devan C Johnson President & CAO 50.00 0.00 X 0 191777 8105 Elizabeth Clary VP - Behavioral Health 50.00 0.00 X 212850 0 26966 W Jason Draper VP - Support Services 50.00 0.00 X 213847 0 39271 Michael Cavacos VP - Chief Nursing Officer 50.00 0.00 X 274771 0 19916 Rajendra T Raman MD Physician - Behavioral 50.00 0.00 X 384197 0 48429 John G Kupfner MD Physician - Behavioral 50.00 0.00 X 364674 0 47067 Mujeeb H Khan MD Physician - Behavioral 50.00 0.00 X 321718 0 29469 Surendra K Sharma MD Physician - Behavioral 50.00 0.00 X 326734 0 48369 Shyam P Vuyyuru MD Physician - Behavioral 50.00 0.00 X 345207 0 46215 Neil A Heatherly Fmr Pres & CAO 0.00 0.00 X 0 480721 24684 2691375 5032977 818854 105 1 1 0 Blount Excavating 3700 Garner Circle Maryville TN 37803 Construction Services 2633587 Linen King 1521 W 36th Place Tulsa OK 74170 Linen Services 2515309 Volunteer Perfusion LLC PO Box 30092 Knoxville TN 37930 Perfusion Services 1743831 Medic Regional Blood Center 1601 Ailor Avenue Knoxville TN 37921 Blood Processing Fees 1232545 Bio Medical Applications of TN PO Box 101518 Atlanta GA 30392 Hemodialysis Services 968673 39 253058 5849695 17500 6120253 Net Patient Revenue 622110 379428529 379428529 Pharmacy 456110 10695203 282443 11738 10401022 Laboratory 621500 261150 261150 Rental Income - Exempt Affiliate 531120 15529 15529 390400411 139365 139365 3745478 3229568 515910 515910 515910 1815 -1815 -1815 -1815 Cafeteria 722514 1662517 1662517 Gift Shop 459420 437400 437400 Support Services 900099 82768 63155 19613 25114 25114 2207799 399381923 379789656 272888 13199126 X 19207 19207 275740 275740 1076605 1076605 98524852 97451921 1072931 2778041 2756347 21694 10382410 9852587 529823 7061172 6879806 181366 37894870 37046936 847934 171310 171310 62314984 62010821 304163 273071 267828 5243 2057773 1734114 323659 8845724 8154977 690747 138907 130776 8131 128434 118733 9701 55827 55827 22700985 22583188 117797 410828 394073 16755 Medical Supplies 127924854 127924854 Bad Debt 14687396 14687396 Minor Equipment 3432761 3194148 238613 Food & Dietary 2400732 2400732 3902459 3414043 488416 407458942 401354054 6104888 0 8836 8836 -3077176 -3837288 43744586 42503118 5437626 5541347 1847878 2087107 588698823 338849155 262538924 249849668 21346895 18159078 331847569 314311866 39542776 29672976 9468625 8674149 49011401 38347125 X 282836168 275964741 282836168 275964741 331847569 314311866 X -8077019 1205592 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 175019 1908 9604 9604 176928 172338 2681 5596 5596 175019 169498 2840 6163 6163 172338 166295 3203 6783 6783 169498 163863 2431 9524 9524 166295 0.00000 1.00000 0.00000 0 1 1 26642729 26642729 295247854 131205804 164042050 10274650 6369865 3904785 256478785 201273486 55205299 54805 54805 249849668 Due from Affiliates, Net 11350939 Long-Term Deferred Compensation 999596 Long-Term Deposits 842659 Operating and Finance Leases 4090749 Other Receivables 875135 18159078 Due to Third Party Payors 2564016 Long-Term Deferred Compensation 999596 Long-Term Reserve for Workers Comp 968156 Other Long-Term Liabilities 4140782 Unclaimed Property 1599 8674149 X Part V, Line 4: Fort Sanders Foundation maintains two permanent endowment funds on behalf of Parkwest Medical Center. The Wayne Heatherly Excellence in Patient Care Endowment Fund was established to promote and encourage excellence in clinical quality and patient care by providing educational assistance to employees, recognizing and awarding nominated employees for their commitment to patient care excellence, and to help meet patient care needs. The Lewis S. Howard Endowment Fund was established to support patient scholarships for deserving phase II outpatient cardiac rehab patients at Fort Sanders Regional Medical Center and Parkwest Medical Center. The principal of the permanent endowments will be kept intact in perpetuity and only the income generated will be distributed for endowment fund purposes. Part X, Line 2: Excerpt from the consolidated audited financial statements of Covenant Health (Covenant), parent company to Parkwest 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 11931075 11931075 0.03040 51768064 34477974 17290090 0.04400 6352606 3229981 3122625 0.00800 70051745 37707955 32343790 0.08240 487372 487372 0.00120 2309 2309 0.00000 24051059 4195364 19855695 0.05060 98379 98379 0.00030 24639119 4195364 20443755 0.05210 94690864 41903319 52787545 0.13450 30150 30150 0.00010 6098 6098 0.00000 284 284 0.00000 36532 36532 0.00010 1 14687396 2712020 76971444 86224691 -9253247 X 1 1 2 1 Parkwest Medical Center 9352 Park West Blvd Knoxville TN 37923 www.covenanthealth.com/parkwest/ 00000042 X X X A 2 Peninsula a division of PW Med Ctr 2347 Jones Bend Road Louisville TN 37777 www.covenanthealth.com/peninsula/ 00000042 X Behavioral Hospital A Parkwest 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 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Parkwest Medical Center, - Facility 2: Peninsula, a division of PW Med Ctr. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 5: Facility Group AIn conducting its most recent Community Health Needs Assessment ("CHNA"), Parkwest Medical Center ("Parkwest") 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. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 6a: Part V, Section B, line 6a: Facility Group AKnox County hospitals who participated in the "Together! Healthy Knox" initiative included Parkwest Medical Center, Fort Sanders Regional Medical Center, East Tennessee Children's Hospital, and The University of Tennessee Medical Center. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 6b: Part V, Section B, line 6b: Facility Group AThe CHNA could not have been completed without the leadership of the Knox County Health Department 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. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 11: Part V, Section B, line 11: Facility Group AOf the significant findings from the assessment, Parkwest is focusing its resources on the following:1. Mental HealthBehavioral Health Services Expansion - Psych consult services are now being provided for patients in the Emergency Department and for inpatients at Parkwest via tele-video through Peninsula, a Division of Parkwest Medical Center. - Parkwest, with funding support from the Covenant Health Office 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 will follow up with patients to oversee the implementation plan.ComPASS Support Group - Peninsula provides a monthly support group for those who have lost a family member, friend, or co-worker to suicide. This group provides a safe place of support, understanding and education during the journey of loss following the suicide death of a loved one. Survivors of Suicide Loss Day - Parkwest annually hosts Survivors of Suicide Loss Day on the Saturday before Thanksgiving in conjunction with the Tennessee Suicide Prevention Network. This day, designated by the United States Congress, is a day to provide support and healing to those affected by suicide. Knox Area Rescue Ministries - Covenant HomeCare and Peninsula are providing onsite physical and mental health services to clients of Knox Area Rescue Ministries. Clients are predominantly homeless and living in shelters and on the street. Peninsula has an outreach specialist on-site at KARM once a week and is currently expanding services in conjunction with Covenant HomeCare. 2. Substance AbusePeninsula Drug Treatment Program - Parkwest 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 - Parkwest'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 - Parkwest 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 - Parkwest 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, two or four person relay teams or the 5K. Teams competed with other Covenant Health hospital member organizations for points. Nearly 170 employees system-wide participated in 2022.Center for Bariatric Surgery - Parkwest offers bariatric surgery to benefit morbidly obese people or those with obesity-related illness who have been unable to lose weight through other methods. Additionally, monthly support group meetings are available to provide insight and perspectives from people who are able to share their real-world experiences. Group A-Facility 1 -- Parkwest 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 https://www.covenanthealth.com/parkwest/chna/ Part V, line 10a, Implementation Strategy Website https://www.covenanthealth.com/parkwest/chna/ Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Parkwest Medical Center, - Facility 2: Peninsula, a division of PW Med Ctr. 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. 12 1 - Parkwest Cardiac Diagnostics 9320 Park West Blvd Knoxville TN 37923 Cardiac Diagnostic Services 2 - Thompson Radiation Oncology Services 9711 Sherrill Blvd Knoxville TN 37932 Oncology Radiation Therapy 3 - Thompson PET Services 9711 Sherrill Blvd Knoxville TN 37932 PET Imaging Services 4 - Peninsula Outpatient Center - Knox 1451 Dowell Springs Blvd Knoxville TN 37919 Outpatient Mental Health & Rehabilitation Facility 5 - Parkwest Comprehensive Breast Center 9330 Park West BlvdSuite 103 Knoxville TN 37923 Breast Imaging Center 6 - Hyperbaric Center at Parkwest 9300 Park West Blvd Knoxville TN 37923 Outpatient Wound Care Services 7 - Peninsula Knox Outpatient Pharmacy 1451 Dowell Springs Blvd Knoxville TN 37919 Pharmacy 8 - Therapy Center West 280 Fort Sanders West Blvd 201 Knoxville TN 37922 Physical, Occupational & Speech Therapy 9 - Cardiac & Pulmonary Rehab 220 Fort Sanders West Blvd 205 Knoxville TN 37922 Cardiac & Pulmonary Rehabilitation 10 - Peninsula Outpatient Center - Blount 210 Simmons Street Maryville TN 37801 Outpatient Mental Health Facility 11 - Peninsula Outpatient Center - Sevier 1104 Foxwood Drive Sevierville TN 37862 Outpatient Mental Health Facility 12 - Peninsula Outpatient Center - Loudon 423 Medical Park Drive Suite 400 Lenoir City TN 37772 Outpatient Mental Health Facility Part I, Line 3c: In addition to the Federal Poverty Guidelines ("FPG"), Parkwest 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 Parkwest 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 in 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 in-patient and out-patient psych services exceeded the payments received by $3,028,436. The organization has also included $16,827,259 in physician sponsorship fees in total subsidized health services. 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 $14,687,396. Part II, Community Building Activities: Parkwest 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 Parkwest 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: Parkwest believes that all of the $9.25 million 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 22% of total patient days, (22,269 out of 101,629 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: Parkwest 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: Parkwest 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 of Parkwest automatically receive a 69% discount on charges based on the facility's calculated AGB. Self-pay patients of Peninsula receive a 59% discount. 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.Parkwest 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 Parkwest 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. Parkwest 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.Parkwest does not sell any accounts receivable accounts to outside firms. All accounts remain property of and under the policies set by Parkwest. Parkwest 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. Parkwest obtains additional community information through the service of its employees with the United Way of Greater Knoxville, local chambers of commerce and Rotary clubs, the Metropolitan Drug Commission, a local alternative high school, the Legacy Parks Foundation, and the Knoxville Area Coalition on Childhood Obesity. 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. Parkwest 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 Parkwest 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 Parkwest Medical Center will provide, at a reduced rate, medically indicated services. A financial counselor is available to assist you with these matters by calling 865-373-1244, Monday through Friday between the hours of 8 a.m.-4:30 p.m. Additional information regarding financial assistance is also available on our website at TreatedWell.com. Signage at the registration areas state the following:It is Parkwest 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 TreatedWell.com. A financial counselor is available to assist you with these matters by calling 865-373-1244, Monday through Friday between the hours of 8 a.m.-4:30 p.m. Part VI, Line 4: Parkwest is located in the west area of Knoxville, Tennessee. Although located in metropolitan Knox County, Parkwest 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, 45% of the inpatient and 49% of the outpatient cases came from Knox County residents.Parkwest also provides mental health services to the region through its behavioral health division, Peninsula. Peninsula is East Tennessee's leading provider of behavioral healthcare services. Peninsula offers a complete range of mental health and alcohol/drug treatment programs. In addition to outpatient centers in Blount, Knox, Loudon and Sevier counties, care is also offered at Peninsula, a 155-bed inpatient facility which serves on average more than 5,000 patients annually.According to 2022 data from the County Health Ranking report from the Robert Wood Johnson Foundation, the population of Knox County is 486,697. The percent of the population that is 65 years or older constitute 16.3% 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: Parkwest, 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 Parkwest's board. The board is comprised of independent community leaders with diverse educational and professional backgrounds. The board provides governance and oversight of Parkwest.Parkwest 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: Parkwest, 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.Parkwest operates a 456-bed acute care hospital in Knoxville, Tennessee, and provides a full range of inpatient and outpatient hospital services. Parkwest offers a full cardiovascular service line that includes coronary bypass surgery, a structural heart program, and diagnostic and interventional cardiac procedures. Patients may also receive treatment in one of Parkwest's specialty centers, which include: - The Senior Behavioral Center, a 16-bed unit for older psychiatric patients - A Bariatric Surgery Center of Excellence - A Joint Replacement Center - A surgical center that utilizes the latest technology, including robotics, for spine, brain, and ENT surgery.Parkwest also owns and operates Peninsula, a 155-bed psychiatric hospital located in Louisville, Tennessee. Peninsula has outpatient centers in Knox, Blount, Sevier and Loudon Counties. Peninsula is a valuable resource providing support for emergency rooms at the system's nine acute care hospitals. The affiliation makes for an accessible and efficient pathway for patients who require mental health services post-discharge.Parkwest and Peninsula patients benefit from the availability and ease of access to Covenant Health affiliated entities for services not provided by the hospitals themselves. Transfer or referral to such services is expedited and coordinated to help create a seamless continuum of care. Specialized services such as inpatient rehabilitation, cancer treatment, home health and hospice services are provided by affiliated entities. 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. These include diabetes, wound care, and ambulatory infusion centers.The Fort Sanders Foundation seeks out community financial support for Parkwest and Peninsula. Funds are used for indigent patient care, medical equipment, outreach programs, services and staff.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 Knoxville Medical Missions Foundation 1932 Historic Ferry Way Knoxville TN 37922 300197352 501c(3) 7500 5107 Cost Pharmacy supplies General support 1 0 Patient transportation, gas cards 1295 24377 Pharmaceuticals for outpatients 2047 49000 Mental health support 39 711 Rent & utilities 191 62599 Patient assistance 1006 139052 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 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 Michael R Belbeck Jr Interim Pres & CAO-PWMC/EVP-Hosp Ops 0 549996 0 243955 0 104389 0 55427 0 33356 0 987123 0 0 Neil A Heatherly Fmr Pres & CAO 0 0 0 0 0 480721 0 11600 0 13084 0 505405 0 0 Rajendra T Raman MD Physician - Behavioral 373101 0 8000 0 3096 0 17400 0 31029 0 432626 0 0 0 John G Kupfner MD Physician - Behavioral 362864 0 1000 0 810 0 17400 0 29667 0 411741 0 0 0 Shyam P Vuyyuru MD Physician - Behavioral 336611 0 5500 0 3096 0 17400 0 28815 0 391422 0 0 0 Surendra K Sharma MD Physician - Behavioral 321161 0 750 0 4823 0 17400 0 30969 0 375103 0 0 0 Mujeeb H Khan MD Physician - Behavioral 306574 0 6000 0 9144 0 0 0 29469 0 351187 0 0 0 Michael Cavacos VP - Chief Nursing Officer 193536 0 42000 0 39235 0 9580 0 10336 0 294687 0 0 0 M Scott Hamilton VP - Financial Services 191681 0 39975 0 15721 0 9440 0 32167 0 288984 0 0 0 W Jason Draper VP - Support Services 163869 0 25845 0 24133 0 7326 0 31945 0 253118 0 0 0 Elizabeth Clary VP - Behavioral Health 137367 0 31854 0 43629 0 8014 0 18952 0 239816 0 0 0 Devan C Johnson President & CAO 0 149370 0 25000 0 17407 0 0 0 8105 0 199882 0 0 Part I, Line 1a Tax gross-up payments related to deferred compensation are provided to certain executives and managers. Amounts are included in taxable compensation. Part I, Line 3 Covenant Health, the parent company of Parkwest 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 Neil Heatherly, Former President/CAO of Parkwest Medical Center, received a severance payment of $430,116 during 2022. The amount is included in taxable compensation. His termination date was November 22, 2021. Covenant Health maintains a nonqualified deferred compensation ("NQDC") plan intended to support retention of President and CEO, James D. VanderSteeg. Employer contributions of $198,750 are reported as deferred compensation on Schedule J, Part II, Column C. Contributions along with 2021 earnings of $54,440 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). Covenant Health maintains a nonqualified deferred compensation ("NQDC") plan intended to support retention of EVP of Hospital Operations, Michael R. Belbeck. Employer contributions of $43,827 are reported as deferred compensation on Schedule J, Part II, Column C. Contributions along with 2022 earnings of $1,493 are subject to a substantial risk of forfeiture. Amounts are combined with other compensation and considered for reasonableness. 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. COVENANT HEALTH Parkwest Hospital 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. Parkwest Hospital, 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. Form 990, Part VI, Section A, line 6 Covenant Health is the sole member of Parkwest Medical Center. Form 990, Part VI, Section A, line 7a Covenant Health's board of directors also serves as the board of directors for Parkwest Medical Center. Form 990, Part VI, Section A, line 7b Governance decisions of Parkwest 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 bodies 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 Parkwest 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 Parkwest 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 Devan Johnson, 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 Parkwest 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 Other Purchased Services: Program service expenses 17,874,103. Management and general expenses 304,163. Fundraising expenses 0. Total expenses 18,178,266. Intercompany Purchased Services: Program service expenses 1,493,424. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,493,424. Sponsorship Fees: Program service expenses 17,102,259. Management and general expenses 0. Fundraising expenses 0. Total expenses 17,102,259. Temporary Staffing: Program service expenses 19,745,988. Management and general expenses 0. Fundraising expenses 0. Total expenses 19,745,988. Physician Fees: Program service expenses 5,795,047. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,795,047. Form 990, Part XI, line 9: Transfers of Capital 1,205,592. 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 Regional Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 620528340 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 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 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 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 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 1 0 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 Covenant Medical Group Inc A 704824 FMV