2026-05-14T12:52:21-05:00 2025-06-30 621517792 PYA P C 6016 BROOKVALE LANE KNOXVILLE TN 37919 990 2024-07-01 626002604 EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION INC EAST 8655418154 PO BOX 15010 KNOXVILLE TN 379015010 ANDREW ROSENDAHL VP OF FINANCE AND CFO 8655418154 2026-05-14 1 1 DEBORAH O ERNSBERGER P00364912 8656730844 2024 2025-03-06 01:10:19Z MATTHEW SCHAEFER PO BOX 15010 KNOXVILLE TN 379015010 414860195 0 X HTTPS://WWW.ETCH.COM X 1937 TN AT ETCH, CHILDREN ARE OUR ONLY CONCERN, PROVIDING THE BEST HEALTHCARE TO EVERY CHILD SERVED. 25 22 2543 2630 32367 28230 18012623 26326189 297323142 326344624 7777291 -39190 42249170 61133342 365362226 413764965 102990 250985 0 0 164530879 181738322 0 0 3117625 153966975 169929837 318600844 351919144 46761382 61845821 665450671 740417732 214326420 204455470 451124251 535962262 X EAST TENNESSEE CHILDREN'S HOSPITAL IS A FREE-STANDING, INDEPENDENT, NOT-FOR-PROFIT PEDIATRIC HEALTH CARE SYSTEM WHICH SERVES THE EAST TENNESSEE REGION. CHILDREN'S HOSPITAL IS CERTIFIED BY THE STATE OF TENNESSEE AS A COMPREHENSIVE REGIONAL PEDIATRIC CENTER. OUR VISION IS TAKING CARE OF OUR FUTURE, ONE CHILD AT A TIME. 0 0 281188376 250985 385378735 EAST TENNESSEE CHILDREN'S HOSPITAL ("ETCH") IS THE ONLY COMPREHENSIVE REGIONAL PEDIATRIC CENTER IN EAST TENNESSEE. SINCE 1937, ETCH HAS PROVIDED EXCELLENT PEDIATRIC HEALTH CARE FOR CHILDREN FROM BIRTH TO 21 YEARS OF AGE. ETCH OFFERS MORE PEDIATRIC SUBSPECIALTIES THAN ANY OTHER HOSPITAL IN THE REGION, SERVING CHILDREN FROM EAST TENNESSEE, SOUTHWEST VIRGINIA, SOUTHEAST KENTUCKY AND WESTERN NORTH CAROLINA. THE SUBSPECIALTIES AVAILABLE AT ETCH INCLUDE: ADOLESCENT MEDICINECHILD ABUSE PEDIATRICS(SUBSPECIALTY LIST CONTINUED ON SCHEDULE O)DEVELOPMENTAL-BEHAVIORAL PEDIATRICSNEONATOLOGYPEDIATRICS/PRIMARY CAREPEDIATRIC ALLERGY & IMMUNOLOGYPEDIATRIC ANESTHESIOLOGYPEDIATRIC CARDIOLOGY CLINICAL GENETICSPEDIATRIC CRITICAL CAREPEDIATRIC DERMATOLOGYPEDIATRIC EMERGENCY MEDICINEPEDIATRIC ENDOCRINOLOGYPEDIATRIC FORENSIC MEDICINEPEDIATRIC GASTROENTEROLOGYPEDIATRIC HEMATOLOGY/ONCOLOGYPEDIATRIC INFECTIOUS DISEASEPEDIATRIC INPATIENT MEDICINEPEDIATRIC INTENSIVE CAREPEDIATRIC NEPHROLOGYPEDIATRIC NEUROLOGYPEDIATRIC NEUROSURGERYPEDIATRIC OPHTHALMOLOGYPEDIATRIC ORTHOPEDICSPEDIATRIC OTOLARYNGOLOGYPEDIATRIC PHYSIATRYPEDIATRIC PLASTIC/RECONSTRUCTIVE SURGERYPEDIATRIC PULMONOLOGYPEDIATRIC RADIOLOGYPEDIATRIC REHABILITATION SERVICESPEDIATRIC RHEUMATOLOGYPEDIATRIC SLEEP MEDICINEPEDIATRIC SURGERYPEDIATRIC UROLOGYPERINATOLOGYPSYCHOLOGYIN ADDITION, ETCH PROVIDES THE FOLLOWING: MEDICAL/SURGICAL SERVICES:THE EMERGENCY DEPARTMENT IS STAFFED WITH BOARD CERTIFIED PEDIATRIC PHYSICIANS, NURSING STAFF, AND DIAGNOSTIC CAPABILITIES TO PROVIDE TREATMENT FOR ALL TYPES OF EMERGENCIES 24 HOURS A DAY, SEVEN DAYS A WEEK. THE DEPARTMENT PROVIDES EVALUATION AND TREATMENT FOR PATIENTS UP TO 21 YEARS OF AGE WITH VARYING LEVELS OF ILLNESS AND INJURY, FROM MINOR TO LIFE THREATENING. THE HOSPITAL'S PEDIATRIC INTENSIVE CARE UNIT (PICU) PROVIDES COMPREHENSIVE, 24-HOUR-A-DAY TREATMENT FOR CRITICALLY ILL AND INJURED CHILDREN. THE PICU IS STAFFED WITH FELLOWSHIP TRAINED, BOARD CERTIFIED, CRITICAL CARE PHYSICIANS AND NURSES SPECIFICALLY TRAINED AND EXPERIENCED IN THE CARE OF CRITICALLY ILL CHILDREN. PATIENTS IN THE PICU RECEIVE A HIGH LEVEL OF MONITORING AND/OR TREATMENT UNTIL THEY ARE WELL ENOUGH TO BE TRANSFERRED TO A REGULAR PATIENT ROOM OR DISCHARGED HOME.IN THE NEONATAL INTENSIVE CARE UNIT (NICU), TINY AND FRAGILE INFANTS BORN PREMATURELY OR FACING LIFE-THREATENING ILLNESSES RECEIVE TREATMENT FROM A TEAM OF BOARD-CERTIFIED NEONATOLOGISTS, WITH VALUABLE ASSISTANCE FROM SPECIALLY TRAINED NURSES, RESPIRATORY THERAPISTS, LACTATION CONSULTANTS, AND OTHER MEDICAL PROFESSIONALS. THE NICU TREATS MORE THAN 900 NEWBORNS EACH YEAR.AS A REGIONAL REFERRAL CENTER FOR EAST TENNESSEE, ETCH OFFERS NEONATAL AND PEDIATRIC TRANSPORT FROM OUTLYING HOSPITALS IN LIFELINE, A MOBILE INTENSIVE CARE UNIT SPECIALLY DESIGNED TO MAINTAIN THE SAME QUALITY OF CARE DURING TRANSPORT AS PATIENTS RECEIVE IN THE HOSPITAL'S CRITICAL CARE UNITS. LIFELINE CARRIES MORE THAN 1,000 SUPPLIES TO ADMINISTER CARE TO PATIENTS, FROM THE TINIEST PREMATURE INFANT TO AN ADULT-SIZE PEDIATRIC PATIENT, DURING TRANSPORT TO THE HOSPITAL. IN ADDITION TO THE SPECIAL EQUIPMENT, THE LIFELINE MEDICAL TEAM MAY INCLUDE A NEONATOLOGIST, NEONATAL NURSE PRACTITIONER, PEDIATRIC/NEONATAL RN, RESPIRATORY THERAPIST, AN EMT, A-EMT, AND PARAMEDICS, DEPENDING ON THE CONDITION OF THE PATIENT.ETCH MEETS A WIDE RANGE OF PEDIATRIC SURGICAL NEEDS, FROM COMMON OUTPATIENT PROCEDURES SUCH AS TONSILLECTOMIES TO MORE COMPLICATED PROCEDURES, SUCH AS RECONSTRUCTIVE SURGERY OR NEUROSURGERY. FIVE DEPARTMENTS COMPRISE ETCH'S SURGICAL SERVICES: OPERATING ROOM, PRE/POST SURGERY (OUTPATIENT SURGERY), INPATIENT SURGERY, ANESTHESIA, AND STERILE PROCESSING. THESE DEPARTMENTS WORK TOGETHER TO MAKE SURE EACH CHILD'S SURGERY AND RECOVERY IS AS QUICK AND PAINLESS AS POSSIBLE. THE DOCTORS, NURSES, ANESTHESIOLOGISTS AND OTHER SURGICAL STAFF ARE TRAINED IN PEDIATRIC MEDICINE. AT ANY GIVEN TIME AND FOR VARIOUS REASONS, A CHILD MAY NEED TO BE ADMITTED TO ETCH AS AN INPATIENT. DOCTORS AND NURSES CONTINUOUSLY MONITOR AND TREAT INPATIENTS ACCORDING TO THEIR INDIVIDUAL NEEDS. ALONG WITH PROVIDING COMPREHENSIVE MEDICAL AND NURSING CARE, ETCH IS DEDICATED TO MAKING A CHILD'S STAY IN THE HOSPITAL AS COMFORTABLE AS POSSIBLE. EACH ROOM HAS A TV WITH ACCESS TO MOVIE CHANNELS, AND PLAY ROOMS ARE LOCATED ON EACH FLOOR. OTHER SERVICES SUCH AS CHILD LIFE, NUTRITION, PASTORAL CARE. REHABILITATION AND SOCIAL WORK PROVIDE FOR THE PHYSICAL AND EMOTIONAL NEEDS OF THE CHILD. THE RESPIRATORY CARE DEPARTMENT AT ETCH IS STAFFED WITH LICENSED AND ACCREDITED RESPIRATORY THERAPISTS WHOSE ROLES INCLUDE TREATING PATIENTS WITH LUNG AND/OR HEART DISEASES SUCH AS ASTHMA, PNEUMONIA, PREMATURE LUNGS AND CYSTIC FIBROSIS. TREATMENTS PROVIDED BY RESPIRATORY THERAPISTS INCLUDE AEROSOL MEDICATIONS, DELIVERY OF OXYGEN AND OTHER MEDICAL GASES, VENTILATOR MANAGEMENT AND MANY OTHER PROCEDURES. RESPIRATORY THERAPISTS HELP PATIENTS THROUGHOUT THE HOSPITAL, FROM THE EMERGENCY DEPARTMENT TO THE NICU. THEY ARE ALSO MEMBERS OF THE PEDIATRIC TRANSPORT TEAM THAT HELPS BRING SICK AND INJURED CHILDREN TO THE HOSPITAL FOR SPECIALIZED CARE. EDUCATION IS ALSO A KEY ROLE OF RESPIRATORY THERAPISTS; THEY TEACH PATIENTS AND THEIR FAMILIES HOW TO CARE FOR CERTAIN CONDITIONS AT HOME. THE PULMONARY FUNCTION LAB, A VITAL PART OF THE RESPIRATORY CARE DEPARTMENT, PERFORMS TESTS TO DIAGNOSE LUNG AND HEART DISEASES. THE DEPARTMENT IS STAFFED BY SPECIALLY TRAINED RESPIRATORY THERAPISTS. SERVICES PROVIDED INCLUDE SPIROMETRY TESTING, METABOLIC STUDIES, CARDIAC STRESS TESTING, LUNG VOLUMES AND THE CYSTIC FIBROSIS CLINIC. ECHOCARDIOGRAMS ARE PERFORMED IN THE ECHO LAB. PATIENTS IN A VARIETY OF HOSPITAL DEPARTMENTS MAY BENEFIT FROM SEDATION DURING SOME PAINFUL TESTS AND PROCEDURES. IN ADDITION, YOUNG CHILDREN MAY NEED SEDATION TO REMAIN STILL DURING LONG TESTS, SUCH AS A MAGNETIC RESONANCE IMAGING (MRI). TO MEET THESE NEEDS, ETCH OFFERS PEDIATRIC ANALGESIA AND SEDATION SPECIALISTS (PASS). WHILE THE HOSPITAL CANNOT ELIMINATE PAIN FOR SOME CHILDREN, IT IS OUR GOAL TO KEEP PAINFUL OR UNCOMFORTABLE SITUATIONS TO A MINIMUM. PASS IS A DEDICATED SERVICE THAT UTILIZES THE MOST CURRENT SEDATION TECHNIQUES TO HELP CHILDREN UNDERGOING LENGTHY OR PAINFUL PROCEDURES AT ETCH. A MULTISPECIALTY TEAM SEES EACH CHILD, INCLUDING A PEDIATRIC SEDATION PHYSICIAN AND PEDIATRIC NURSES WHO ARE SPECIFICALLY PREPARED TO WORK WITH PEDIATRIC SEDATION. DIAGNOSTIC SERVICES:THE CLINICAL LAB IS RESPONSIBLE FOR ALL DIAGNOSTIC TESTING, WHICH INCLUDES THE FOLLOWING AREAS: HEMATOLOGY, CHEMISTRY, MICROBIOLOGY, IMMUNOLOGY, SEROLOGY AND BLOOD BANK.NEUROLOGY LAB - THE NEUROLOGY LAB OFFERS A VARIETY OF DIAGNOSTIC TESTS FOR PATIENTS DEALING WITH SEIZURES, HEARING PROBLEMS, SLEEP DISORDERS AND OTHER CONDITIONS INVOLVING THE BRAIN. THE MOST COMMON TESTS OFFERED IN THE NEUROLOGY LABORATORY ARE THE ELECTROENCEPHALOGRAM (EEG) FOR CHILDREN HAVING SEIZURES AND OTHER NEUROLOGICAL PROBLEMS AND THE BRAINSTEM AUDITORY EVOKED RESPONSE (BAER) HEARING TEST, OFFERED MOST OFTEN TO INFANTS WHO FAIL NEWBORN HEARING SCREENINGS AND TODDLERS WHO ARE SPEECH DELAYED. CHILDREN'S SLEEP MEDICINE CENTER - THE CHILDREN'S SLEEP MEDICINE CENTER OFFERS SLEEP STUDY TESTING FOR CHILDREN WHO ARE HAVING PROBLEMS WITH SLEEP. THE SLEEP STUDIES TAKE PLACE OVERNIGHT, DURING THE CHILD'S REGULAR SLEEP CYCLE, TO FIND THE CAUSE OF PROBLEMS SUCH AS SLEEP DISORDERED BREATHING AND PARASOMNIAS (NIGHT TERRORS, SLEEPWALKING). ETCH IS ACCREDITED BY THE AMERICAN ACADEMY OF SLEEP MEDICINE AS THE ONLY SLEEP MEDICINE CENTER DEDICATED TO PEDIATRICS IN EAST TENNESSEE.THE RADIOLOGY DEPARTMENT SERVES AS AN "IMAGING" CENTER FOR CHILDREN. 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RECEIVABLES 60261008 OTHER RECEIVABLES 997193 RIGHT OF USE ASSETS - OPERATING LEASE 4977694 DUE FROM INTERMEDIARIES 47694024 113929919 NET INVESTMENT IN SUBSIDIARIES 53365364 OPERATING LEASE LIABILITY 5274838 DUE TO THIRD PARTIES 1235366 59875568 X PART X, LINE 2: PER THE EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC. AND SUBSIDIARIES AUDITED CONSOLIDATED FINANCIAL STATEMENTS: FEDERAL INCOME TAXES: THE HOSPITAL IS CLASSIFIED AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS RELATED TO THE 501(C)(3) ORGANIZATION. PRIMARY CARE AND CIK ARE TAXABLE ENTITIES. THE HOSPITAL HAS NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2025 AND 2024. AT JUNE 30, 2025, TAX RETURNS FILED FOR FISCAL YEARS 2022 THROUGH 2024 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. FANTASY OF TREES 1918510 805043 1113467 144087 834269 GOLF TOURNAMENT 188572 146100 42472 1729 40763 10035 2107082 951143 1155939 1729 184850 844304 1030883 125056 71083 5642 4797 1 1.00000 71083 5642 4797 10439 60644 TN 1 0 1 0 1.00000 ANDREW ROSENDAHL PO BOX 15010 KNOXVILLE TN 379015010 0 ANGIE HOWELL ANGIE HOWELL IS THE EVENTS AND CAUSE MARKETING MANAGER AND THE COORDINATOR FOR THE FANTASY OF TREES. THE DEVELOPMENT DEPARTMENT IS RESPONSIBLE FOR THE FANTASY OF TREES EVENT. THE RAFFLE TREE IS THE GAMING EVENT HELD WITHIN THE FANTASY OF TREES. THE DEVELOPMENT DEPARTMENT FOSTERS THE RELATIONSHIP WITH RAFFLE SPONSORS AND DECIDES WHERE/ HOW THE AREA IS DESIGNED ON THE FLOOR. THE DEVELOPMENT DEPARTMENT RECRUITS VOLUNTEERS TO SELL RAFFLE TICKETS, LOCK THE DRUM, AND ARRANGE THE TICKET DRAWING AND DELIVERY. X 1 1 1 1 X 250.000000000000 1 X 1 1 1 0 1 1 4389872 4389872 0.01270 181988732 90291681 91697051 0.26440 186378604 90291681 96086923 0.27710 15142 910073 12650 897423 0.00260 2155 2990757 169905 2820852 0.00810 67 40256 0 40256 0.00010 60032 437010 2840 434170 0.00130 77396 4378096 185395 4192701 0.01210 77396 190756700 90477076 100279624 0.28920 126 9963 4000 5963 0.00000 0 471 471 0.00000 6 247661 247661 0.00070 132 258095 4000 254095 0.00070 1 2024421 2355 10826 -8471 X 1 1 1 CHILDREN'S WEST SURGERY CENTER LLC MEDICAL SURGERY CENTER 0.50000 0.50000 1 1 EAST TENNESSEE CHILDREN'S HOSPITAL PO BOX 15010 KNOXVILLE TN 379015010 HTTP://WWW.ETCH.COM/ X X EAST TENNESSEE CHILDREN'S HOSPITAL 1 0 0 1 X X X X X X X X X 24 1 0 0 1 X SEE PART V, PAGE 8 X 1 24 1 SEE PART V, PAGE 8 0 1 X 250.000000000000 400.000000000000 0 1 X X X 1 X HTTPS://WWW.ETCH.COM/YOUR-VISIT/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.ETCH.COM/YOUR-VISIT/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.ETCH.COM/YOUR-VISIT/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ X X 1 0 X 1 X 0 0 EAST TENNESSEE CHILDREN'S HOSPITAL PART V, SECTION B, LINE 5: THE FOLLOWING FOCUS GROUPS PARTICIPATED IN THE ETCH 2025 CHNA:FOUR FOCUS GROUPS WERE CONDUCTED BY EXPERT EVALUATORS FROM THE COLLEGE OF SOCIAL WORK OFFICE OF RESEARCH AND PUBLIC SERVICE (SWORPS) AT THE UNIVERSITY OF TENNESSEE. THE FOCUS GROUPS WERE CONDUCTED WITH: 1. EAST TENNESSEE CHILDREN'S HOSPITAL FAMILY ADVISORY COUNCIL2. REGIONAL COORDINATED SCHOOL HEALTH COORDINATORS3. NATIVE SPANISH SPEAKERS4. EAST TENNESSEE CHILDREN'S HOSPITAL PEER DIRECTORS GROUP AND A GROUP OF ETCH MANAGERS INCLUDING SOME NURSES AND PHYSICIANSA SURVEY FOR THE GENERAL POPULATION WAS CREATED TO GAIN INPUT FROM COMMUNITY RESIDENTS AND KEY STAKEHOLDERS ABOUT THE TOP HEALTH NEEDS AND PRIORITIES OF CHILDREN IN OUR COMMUNITY. A SURVEY WAS PROMOTED BY PROVIDING A SURVEY LINK ON THE CHILDREN'S HOSPITAL WEBSITE AND SOCIAL MEDIA OUTLETS TO ENCOURAGE PEOPLE TO TAKE A FEW MINUTES TO COMPLETE AN ONLINE, CONFIDENTIAL SURVEY.DATA FROM THE FOCUS GROUPS AND COMMUNITY SURVEY WERE ANALYZED TO TRIANGULATE FINDINGS AND IDENTIFY COMMON THEMES. FOUR PRIMARY HEALTH ISSUES OF CONCERN EMERGED: NUTRITION, SUBSTANCE ABUSE, MENTAL, SOCIAL AND BEHAVIORAL HEALTH, AND HEALTHCARE AFFORDABILITY AND ACCESS. EAST TENNESSEE CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11: WHILE NUTRITION, SUBSTANCE ABUSE, MENTAL, SOCIAL AND BEHAVIORAL HEALTH, AND HEALTHCARE AFFORDABILITY AND ACCESS HAVE BEEN THE MOST UNIVERSALLY IDENTIFIED THUS FAR, MANY OTHER IMPORTANT HEALTH ISSUES AND SOCIAL DETERMINANTS HAVE BEEN DISCUSSED IN THE COURSE OF THE CHNA PROCESS AND ARE WORTHY OF CONSIDERATION IN THE LATER STRATEGIC PLANNING PHASE. THESE ISSUES INCLUDE BUT ARE NOT LIMITED TO: - ACCESS TO TRANSPORTATION- PARENTAL NEGLECT- DOMESTIC ABUSE- TOBACCO USE AND VAPING- PHYSICAL FITNESS- GUN SAFETY- VISION CARE ACCESS- DENTAL CARE ACCESS- SEXUALLY TRANSMITTED INFECTIONS AMONG TEENS- HEALTH EDUCATION FOR PARENTS/KIDS- EDUCATION ON PARENTING/SUPERVISION- HEALTHY USE OF SCREEN TIMES- IMMUNIZATIONS AND VACCINATIONS- FOOD INSECURITIES- AFFORDABLE HEALTH CARE- ACCESS TO REPRODUCTIVE CARE- EMPLOYMENT FOR PARENTS- SUBSTANCE ABUSEWHILE CHILDREN'S HOSPITAL WOULD CONTINUE FOCUS ON THE MAJORITY OF EFFORTS OUTLINED IN OUR IMPLEMENTATION STRATEGY, ALL NEEDS IDENTIFIED WILL BE REVIEWED FOR FUTURE CONSIDERATION AND COLLABORATION. THESE AREAS, WHILE STILL IMPORTANT TO THE HEALTH OF CHILDREN IN THE COMMUNITY, WILL BE MET THROUGH OTHER HEALTH CARE ORGANIZATIONS WITH ASSISTANCE FROM CHILDREN'S HOSPITAL AS NEEDED. THE COMMUNITY NEEDS NOT ADDRESSED BY CHILDREN'S HOSPITAL WILL CONTINUE TO BE ADDRESSED BY GOVERNMENTAL AGENCIES AND EXISTING COMMUNITY-BASED ORGANIZATIONS. PART V, LINE 7A, CHNA: HTTPS://WWW.ETCH.COM/APP/FILES/PUBLIC/A4D17816-4FD8-4C32-ACED-E2531B4497F5/DOCUMENTS/ETCH%202025%20CHNA%20V3_FINAL.PDF PART V, LINE 10A, IMPLEMENTATION PLAN: HTTPS://WWW.ETCH.COM/APP/FILES/PUBLIC/A4D17816-4FD8-4C32-ACED-E2531B4497F5/DOCUMENTS/ETCH%202025%20CHNA%20V3_FINAL.PDF 1 1 - CAH MANAGEMENT COMPANY LLC 2018 CLINCH AVENUE KNOXVILLE TN 37916 PHYSICIAN SERVICES / URGENT CARE PART I, LINE 7: A COST-TO-CHARGE RATIO, DERIVED FROM THE SCHEDULE H APPLICABLE WORKSHEETS, INCLUDING WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES, WAS USED TO DETERMINE CHARITY CARE. ACTUAL EXPENSE DATA IS ACCUMULATED WITHIN THE ETCH GENERAL LEDGER WHICH ADDRESSES ALL PATIENT SEGMENTS INCLUDING INPATIENT, OUTPATIENT, EMERGENCY ROOM, COMMERCIAL INSURANCE, GOVERNMENT INSURANCE, UNINSURED AND SELF-PAY. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO INDIGENT AND CHARITY CARE CHARGES TO ARRIVE AT COST.THE STATE OF TENNESSEE'S COVERKIDS PROGRAM PROVIDES COVERAGE FOR THE VAST MAJORITY OF CHILDREN WHO REQUIRE MEDICAL CARE BUT ARE UNINSURED. ETCH REPRESENTATIVES WORK EXTENSIVELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND AVAILABILITY OF STATE AID AND TO ASSIST THEM IN BECOMING ENROLLED IN THE PROGRAM. FOR THAT REASON, THE AMOUNT OF TRUE "CHARITY CARE" RENDERED BY ETCH IS CONSIDERABLY SMALLER THAN LEVELS EXPERIENCED BY COMMUNITY HOSPITALS OR OTHER FACILITIES SERVING THE ADULT POPULATION. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5,152,509. PART II, COMMUNITY BUILDING ACTIVITIES: ETCH PROVIDES NUMEROUS BENEFITS TO THE PUBLIC AND PROMOTES THE HEALTH OF THE COMMUNITY IN THE FOLLOWING WAYS:1. COMMUNITY SUPPORT: ETCH EMPLOYEES VOLUNTEER TIME TO THE FOLLOWING NEIGHBORHOOD SUPPORT GROUPS: RONALD MCDONALD HOUSE, SHOES FOR SCHOOLS, UNITED WAY AND BOARD SUPPORT FOR ORGANIZATIONS.2. COALITION BUILDING AND COMMUNITY HEALTH IMPROVEMENT ADVOCACY: ETCH PARTICIPATED IN THE FOLLOWING COMMUNITY COALITIONS TO ADDRESS HEALTH AND SAFETY ISSUES SPECIFIC TO CHILDREN. A. EAST TENNESSEE CHILDHOOD OBESITY COALITION WHOSE MISSION IS TO PREVENT AND REDUCE CHILDHOOD OBESITY BY PROMOTING HEALTHY, ACTIVE LIFESTYLES THROUGH FAMILY, COMMUNITY AND INTER-PROFESSIONAL COLLABORATIONS. ETCH PROMOTES THESE ACTIVITIES THROUGH THE HEALTHY KIDS CLUB PROGRAM TO AREA ELEMENTARY SCHOOLS. B. SAFEKIDS. THE ETCH INJURY PREVENTION PROGRAM IS THE LEADER OF A COALITION TO PREVENT ACCIDENTAL INJURY. THE SAFE TRAVELS PROGRAM TRAINS LOCAL AGENCY MEMBERS ON CHILD PASSENGER SAFETY AND DISTRIBUTES CAR SEATS TO THOSE IN NEED ALONG WITH INSTALLATION TRAINING. THE PROGRAM ALSO PROVIDES BIKE HELMETS AND HELPS EDUCATE KIDS AND PARENTS ABOUT HELMET USE AND INJURY PREVENTION. ALSO, WE PROVIDE A WIDE SCOPE OF PUBLIC EDUCATION ON WATER SAFETY AND HEAT STROKE PREVENTION. C. ETCH PROVIDES TRAINING FOR AED USAGE AND CPR ADMINISTRATION IN MANY PUBLIC/PRIVATE SCHOOLS AND AREAS. D. ETCH PROVIDES ASTHMA SCREENINGS IN LOCAL COMMUNITY THROUGH THE BREATHE EASY PROGRAM ALONG WITH FOLLOW-UP CALLS TO THOSE WHO HAVE AN ABNORMAL SCREENING RESULT. E. OTHER ACTIVITIES INCLUDE SAFESITTER CLASSES, CPR TRAINING, CAMPS FOR CHILDREN, MEDIC BLOOD DRIVES, VOLUNTEEN PROGRAM AND INFANT AND CHILD TRAINING FOR ADULT HOSPITALS AND EMERGENCY AGENCIES.3. WORKFORCE DEVELOPMENT: ETCH RECRUITS PHYSICIAN SPECIALTIES AND OTHER HEALTH PROFESSIONALS DEDICATED TO SERVING THE CHILD & ADOLESCENT POPULATION TO MEDICAL SHORTAGE AREAS OR OTHER AREAS DESIGNATED AS UNDERSERVED. PROJECT SEARCH IS A YEAR-LONG PROGRAM PROVIDING ADULTS WITH DISABILITIES THE EDUCATION AND EXPERIENCE THEY NEED FOR SUCCESSFUL EMPLOYMENT.4. EDUCATION OF HEALTH PROFESSIONALS: ETCH PROVIDES EDUCATIONAL PROGRAMS FOR PHYSICIANS, RESIDENTS, NURSES, NURSING STUDENTS AND OTHER HEALTH PROFESSIONALS.5. RESEARCH: ETCH PARTICIPATES IN RESEARCH IN HEMATOLOGY, PULMONOLOGY AND ENDOCRINOLOGY. PART III, LINE 4: A COST-TO-CHARGE RATIO WAS ALSO USED TO DETERMINE BAD DEBT COST. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO THE BAD DEBT EXPENSE TO ARRIVE AT COST.ETCH'S FINANCIAL STATEMENTS READ AS FOLLOWS: USING A PORTFOLIO APPROACH, THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. IN ADDITION, FOR UNINSURED PATIENTS, THE HOSPITAL REDUCES CHARGES FROM CURRENT RATES BASED ON AVERAGE DISCOUNTS PROVIDED TO CERTAIN THIRD-PARTY PAYERS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY EXPLICIT PRICE CONCESSIONS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. ADJUSTMENTS FOR SUCH CHANGES IN THE ESTIMATED TRANSACTION PRICE WERE NOT SIGNIFICANT FOR THE YEARS ENDED JUNE 30, 2025 AND 2024. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE OR PROVISION FOR CREDIT LOSSES. NO SIGNIFICANT AMOUNT OF BAD DEBT EXPENSE OR PROVISION FOR CREDIT LOSSES WAS REPORTED FOR THE YEARS ENDED JUNE 30, 2025 AND 2024. PART III, LINE 8: A COST-TO-CHARGE RATIO WAS USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO MEDICARE CHARGES TO ARRIVE AT COST.THE SHORTFALL OF $8,471 AS REPORTED IN PART III, LINE 7, SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE, ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. ALSO, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS, AND THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: UNDER ETCH'S POLICIES AND PROCEDURES, ETCH UNDERTAKES MEASURES TO COMMUNICATE WITH THE FAMILIES OF PATIENTS WITH SELF-PAY BALANCES. IN MANY CASES, ETCH AND FAMILIES WORK TOGETHER TO OBTAIN COVERAGE THROUGH THE STATE OF TENNESSEE'S COVERKIDS PROGRAM. IN CASES WHERE COVERKIDS COVERAGE IS NOT AVAILABLE, ETCH SEEKS TO OBTAIN INFORMATION NECESSARY TO DETERMINE THE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER ETCH'S CHARITY CARE PROGRAM. ONCE A PATIENT'S ELIGIBILITY FOR FREE OR DISCOUNTED CARE HAS BEEN DETERMINED, THE BALANCE ON THE PATIENT'S ACCOUNT IS ADJUSTED ACCORDINGLY. IN ADDITION, ETCH PERSONNEL WORK CLOSELY WITH FAMILIES TO DETERMINE THEIR ABILITY TO PAY THE ADJUSTED BALANCES; SUCH EFFORTS OFTEN RESULT IN PAYMENT PLANS INTENDED TO PERMIT THE GRADUAL PAYMENT OF AMOUNTS DUE WITHOUT IMPOSING UNDUE FINANCIAL HARDSHIP ON FAMILIES ALREADY DEALING WITH THE CHALLENGES OF CHILDREN'S HEALTH ISSUES. UNFORTUNATELY, THERE REMAIN CIRCUMSTANCES WHERE PATIENTS CANNOT BE DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE DUE TO THE INACCESSIBILITY OF THE FAMILY OR THE FAMILY'S INABILITY OR REFUSAL TO PROVIDE THE REQUIRED INFORMATION. IN SUCH CASES, ETCH FOLLOWS AN ESTABLISHED MULTI-STEP PROCESS CONSISTING OF MAILED NOTICES AND PHONE CALLS IN AN EFFORT TO REACH OUT TO THE FAMILY AND PROVIDE THEM WITH INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE PROGRAM. ETCH'S COLLECTION PRACTICES APPLY TO ALL PATIENTS, CHARITY CARE AND NON-CHARITY CARE PATIENTS. ACCOUNTS ARE SENT TO COLLECTIONS (ETCH CONTRACTS WITH AN ORGANIZATION WITH SUBSTANTIAL EXPERIENCE IN COLLECTION OF PATIENT ACCOUNTS) ONLY AFTER ALL ESTABLISHED STEPS HAVE BEEN UNDERTAKEN, WITHOUT SUCCESS. PART VI, LINE 2: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS IS THE FOUNDATION FOR IMPROVING AND PROMOTING THE HEALTH STATUS OF OUR COMMUNITY'S CHILDREN. THE PLANNING, ACTIVITIES AND DATA REVIEW NECESSARY FOR THE DEVELOPMENT OF THE MOST RECENT ASSESSMENT TOOK PLACE BEGINNING IN THE SUMMER OF 2024 THROUGH SPRING 2025. THE PROCESS INCLUDED THE COLLECTION OF PRIMARY DATA OBTAINED THROUGH SURVEYS AND INTERVIEWS WITH INDIVIDUALS FROM LOCAL COMMUNITIES AND SECONDARY DATA FOR STATE AND COUNTY-SPECIFIC STATISTICS.THROUGHOUT THE CHNA, HIGH PRIORITY WAS GIVEN TO DETERMINING THE HEALTH STATUS AND AVAILABLE RESOURCES WITHIN A 16-COUNTY SERVICE AREA INCLUDING ANDERSON, BLOUNT, CAMPBELL, CLAIBORNE, COCKE, GRAINGER, HAMBLEN, JEFFERSON, KNOX, LOUDON, MONROE, MORGAN, ROANE, SCOTT, SEVIER AND UNION. THESE COUNTIES WERE IDENTIFIED AS CORE COUNTIES BASED ON PATIENT POPULATION DATA.AFTER CAREFUL EVALUATION OF ALL PRIMARY AND SECONDARY DATA, HEALTH PRIORITIES WERE IDENTIFIED.THE PLANNING PROCESS FOR THE FISCAL YEAR 2025 CHNA BEGAN IN EARLY 2024. AN INTERNAL TEAM WAS FORMED TO IDENTIFY AND APPROVE RESOURCES AND TIMELINES FOR CONDUCTING THE NECESSARY STEPS FOR COMPLETION OF THE NEEDS ASSESSMENT. A TIMELINE WAS ESTABLISHED TO ALLOW SUFFICIENT TIME AND RESOURCES TO IDENTIFY AND ENGAGE COMMUNITY PARTNERS IN KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. THE INTERNAL TEAM USED A MODIFIED VERSION OF THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS. THIS PROCESS IS COMMONLY USED TO ASSIST COMMUNITY HEALTH ORGANIZATIONS DURING THE NEEDS ASSESSMENT PROCESS. THE MAPP PROCESS PROVIDED THE FRAMEWORK FOR CHILDREN'S HOSPITAL TO ORGANIZE, VISUALIZE, ASSESS, STRATEGIZE, FORMULATE GOALS AND TAKE ACTION. PART VI, LINE 3: ETCH RECOGNIZES THAT UNEXPECTED MEDICAL PROBLEMS CAN CREATE UNEXPECTED FINANCIAL PROBLEMS. ETCH IS AVAILABLE TO ASSIST PATIENTS' FAMILIES IN FINDING RESOURCES THAT HELP TO COVER MEDICAL EXPENSES. AS INDICATED ABOVE, ETCH WORKS CLOSELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND AND ENROLL IN MEDICAL ASSISTANCE PROGRAMS AVAILABLE THROUGH THE STATE OF TENNESSEE AND, WHERE APPROPRIATE, FEDERAL PROGRAMS. WHERE SUCH PROGRAMS ARE NOT AVAILABLE, HOWEVER, PATIENTS MAY BE ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER ETCH'S ESTABLISHED POLICIES AND PROCEDURES. THE AVAILABILITY OF FINANCIAL ASSISTANCE IS PUBLICIZED THROUGHOUT THE ETCH FACILITY AND THROUGH VARIOUS MEASURES, INCLUDING INFORMATION ON ETCH'S WEBSITE AND WRITTEN BROCHURES OR OTHER MATERIALS PROVIDED TO PATIENT'S FAMILIES. INFORMATION (IN BOTH ENGLISH AND SPANISH) IS MADE AVAILABLE AT ALL POINTS OF REGISTRATION (INTAKE AND DISCHARGE) AS WELL AS ON THE ETCH WEBSITE. THE MOST SIGNIFICANT EDUCATION, HOWEVER, OCCURS IN DIRECT DIALOGUE BETWEEN PATIENT FAMILIES AND ETCH'S TRAINED PATIENT ACCOUNT REPRESENTATIVES. ETCH MAKES EXTENSIVE EFFORTS TO PERMIT FACE-TO-FACE DIALOGUE, AS WELL AS COMMUNICATION VIA TELEPHONE AND OTHER MEANS, AS NECESSARY TO ENSURE THAT FAMILIES ARE PROVIDED WITH SUFFICIENT INFORMATION REGARDING FREE OR DISCOUNTED CARE, AS WELL AS THE BILLING AND COLLECTION PROCESS. ALL STAFF WITH PATIENT CONTACT ARE KNOWLEDGEABLE ABOUT THE CHARITY CARE POLICY (ADMITTING AND BILLING CLERKS, NURSING AND MEDICAL STAFF, SOCIAL WORKERS, ETC.). PART VI, LINE 4: ALTHOUGH ETCH SERVES THE ENTIRE EAST TENNESSEE REGION AS A COMPREHENSIVE REGIONAL PEDIATRIC CENTER, NEARLY HALF OF ETCH'S TOTAL PATIENT VISITS ARE FROM KNOX COUNTY RESIDENTS. CHILDREN RESIDING IN NEIGHBORING BLOUNT AND SEVIER COUNTIES GENERATE THE NEXT HIGHEST PATIENT VISITS.THERE ARE SIGNIFICANT DISPARITIES IN SOCIOECONOMIC CONDITIONS BETWEEN THE 16 COUNTIES SERVED BY EAST TENNESSEE CHILDREN'S HOSPITAL. THE RATE OF CHILDREN LIVING IN POVERTY IS EQUIVALENT OR EXCEEDS 25% OF THE CHILDHOOD POPULATION IN 10 OF THE 16 COUNTIES. THE PERCENTAGE OF CHILDREN WHO ARE PARTICIPATING IN FREE OR REDUCED LUNCH PROGRAMS AT SCHOOL APPROACHES 50% FOR ALL COUNTIES AND EXCEEDS 70% IN FOUR COUNTIES. POVERTY AND FOOD INSECURITY ARE GROWING CONCERNS BECAUSE OF THE LINKAGES BETWEEN THESE SOCIAL DETERMINANTS AND POOR HEALTH OUTCOMES. PART VI, LINE 5: ETCH'S PHILOSOPHY IS THAT, BECAUSE CHILDREN ARE SPECIAL, THEY DESERVE THE BEST POSSIBLE HEALTH CARE GIVEN IN A POSITIVE, CHILD/FAMILY CENTERED ATMOSPHERE OF FRIENDLINESS AND COOPERATION REGARDLESS OF RACE, RELIGION, OR ABILITY TO PAY. ETCH IS COMMITTED TO CARING FOR VULNERABLE POPULATIONS SUCH AS CHILDREN WITH SPECIAL MEDICAL NEEDS, ADVOCATING FOR THE HEALTH AND SAFETY OF CHILDREN AS PART OF THE COMMON GOOD AND EFFECTIVELY STEWARDING COMMUNITY RESOURCES. ETCH OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS, WITHOUT REGARD TO THE ABILITY TO PAY. ETCH USES ANY SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND, OR IMPROVE ITS FACILITIES, AND ADVANCE ITS MEDICAL TRAINING, EDUCATION AND RESEARCH PROGRAMS. ETCH'S BOARD OF DIRECTORS CONSISTS PRIMARILY OF INDIVIDUALS REPRESENTING THE COMMUNITY. ETCH MAINTAINS AN OPEN MEDICAL STAFF, WITH MEMBERSHIP AND PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS AND HEALTH CARE PROFESSIONALS. IN THESE AND OTHER RESPECTS, ETCH IS ORGANIZED AND OPERATED IN A MANNER THAT PROMOTES THE HEALTH OF THE COMMUNITY AND, THEREFORE, FULFILLS CHARITABLE PURPOSES WITHIN THE MEANING OF INTERNAL REVENUE CODE SECTION 501(C)(3).ADDITIONALLY, PLEASE REFER TO THE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS AS PROVIDED IN SCHEDULE O FOR FURTHER DOCUMENTATION REGARDING ETCH'S COMMITMENT WITHIN ITS COMMUNITY. PART VI, LINE 6: ETCH IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES TN 1 HELEN ROSS MCNABB FOUNDATION INC 200 TECH CENTER DR KNOXVILLE TN 37912 237213935 501(C)(3) 0 133531 FAIR MARKET VALUE RENT IN-KIND ASSISTANCE KNOXVILLE CHAMBER OF COMMERCE 17 MARKET SQUARE SUITE 201 KNOXVILLE TN 37902 620262640 501(C)(6) 10000 0 GENERAL SUPPORT 1 1 PART I, LINE 2: THE ORGANIZATION HAS GUIDELINES IN PLACE THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY OF GRANTEES. ALL GRANTS REQUIRE WRITTEN DOCUMENTATION AND APPROPRIATE LEVELS OF APPROVAL. 1 X X X X 0 1 0 0 0 0 0 0 0 JULIA G ARANA MD BOARD MEMBER 182406 0 144513 0 1240 0 3865 0 0 0 332024 0 0 0 MATT SCHAEFER BOARD MEMBER/PRESIDENT & CEO 680002 0 191607 0 1260 0 107067 0 20895 0 1000831 0 0 0 WILLIAM GLAZE VAUGHAN MD BOARD MEMBER 654098 0 42371 0 6858 0 8625 0 20895 0 732847 0 0 0 CARYN HAWTHORNE VP/CHIEF FINANCIAL OFFICER 382870 0 81909 0 10668 0 48154 0 18087 0 541688 0 0 0 ADAM COOK VP INSTITUTIONAL ADVANCEMENT 284306 0 61226 0 955 0 65367 0 25862 0 437716 0 0 0 CATHERINE SHUCK VP LEGAL SERVICES 192867 0 58744 0 3236 0 31007 0 0 0 285854 0 0 0 JEANANN PARDUE CHIEF QUALITY OFFICER 263230 0 31671 0 0 0 7897 0 0 0 302798 0 0 0 KELLY DERANEY VP AMBULATORY SERVICES 215224 0 48685 0 74531 0 26809 0 25862 0 391111 0 0 0 ROBERT BAUER VP HUMAN RESOURCES 280282 0 60276 0 91517 0 36673 0 22514 0 491262 0 0 0 RON MCKINNON VP INFORMATION TECHNOLOGY 270233 0 55284 0 2632 0 7678 0 15826 0 351653 0 0 0 RONALD J PHILLIPS VP PATIENT SERVICES/CNO 210756 0 82993 0 6312 0 4287 0 15073 0 319421 0 0 0 STEVEN GODBOLD VP OPERATIONS 347438 0 74822 0 1820 0 46793 0 25862 0 496735 0 0 0 SUZANNE RYBCZYNSKI VP MEDICAL PROGRAMS 428943 0 75381 0 3612 0 45668 0 25862 0 579466 0 0 0 ERIC JENSEN MD PEDIATRIC SURGEON 655355 0 6857 0 2322 0 8625 0 25862 0 699021 0 0 0 RHYS W IRVINE MD PEDIATRIC UROLOGIST 533158 0 258839 0 540 0 8625 0 25862 0 827024 0 0 0 SUMEET SHARMA MD PEDIATRIC CARDIOLOGIST 339516 0 590746 0 1242 0 20723 0 22514 0 974741 0 0 0 QUYNH VU WISNIEWSKI MD PEDIATRICIAN 241234 0 489211 0 886 0 7089 0 25862 0 764282 0 0 0 DANIEL LEVIN MD PEDIATRIC SURGEON 636244 0 0 0 540 0 6900 0 0 0 643684 0 0 0 PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED EXECUTIVE RETIREMENT PLAN: THE SUPPLEMENTAL EXECUTIVE 457(F) RETIREMENT PLAN IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES AND TO OFFER A COMPETITIVE TOTAL RETIREMENT BENEFIT. THESE BENEFITS ARE PART OF A RETIREMENT PROGRAM THAT PROVIDES RETIREMENT INCOME FOR THE EXECUTIVE'S TOTAL YEARS OF SERVICE WITH THE ORGANIZATION PURSUANT TO A WRITTEN PLAN AGREEMENT AS APPROVED BY INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THESE BENEFITS ARE AT RISK AND WILL NOT BE PAID UNLESS THE EXECUTIVE PROVIDES SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION IN ACCORDANCE WITH A VESTING SCHEDULE. AN ESTIMATE OF THE ANNUAL INCREASE IN ACTUARIAL VALUE IS REPORTED AS DEFERRED COMPENSATION IN PART VII AND IN SCHEDULE J, COLUMN (C) FOR THE APPLICABLE EXECUTIVES. EMPLOYER CONTRIBUTION TO 457(F) EXECUTIVE RETIREMENT BENEFIT PLAN: MATT SCHAEFER $101,160 STEVEN GODBOLD $36,443 CATHERINE SHUCK $25,221 CARYN HAWTHORNE $37,804 ROBERT BAUER $28,098 KELLY DERANEY $22,389 ADAM COOK $56,657 SUZANNE RYBCZYNSKI $41,659 SUMEET SHARMA $10,373 A THE HEALTH EDUCATIONAL AND HOUSING FACILITY BOARD OF KNOX COUNTY TENNESSEE 621220275 NONEAVAIL 2019-02-14 117260000 CAPITAL PROJECT 0 0 0 A 117260000 581910 1 0 0 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 1 US BANK NATIONAL ASSOCIATION 1.000000000000 1 0 0 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: THE HEALTH EDUCATIONAL AND HOUSING FACILITY BOARD OF KNOX COUN DATE THE REBATE COMPUTATION WAS PERFORMED: 03/06/2024 0 X MISCELLANEOUS 31 23100 MARKET VALUE X EVENT SUPPLIES 111 16300 MARKET VALUE X GIFTCARDS 1 1000 MARKET VALUE 0 1 0 FORM 990, PART III, LINE 4A, CONTINUED OUTPATIENT SERVICES: CHILDREN'S HOSPITAL HOME HEALTH CARE, WHICH IS A HOSPITAL-BASED HOME HEALTH AGENCY, SUPPORTS THE PHILOSOPHY, MISSION AND POLICIES OF ETCH AND IS DEDICATED TO MEETING THE NEEDS OF CHILDREN. HOME HEALTH PROVIDES FOLLOW-UP SUPPORTIVE CARE TO PATIENTS NEWBORN TO 21 YEARS OF AGE WHO DO NOT REQUIRE HOSPITALIZATION OR CONSTANT SKILLED SUPERVISION. HOME HEALTH IS LICENSED TO PROVIDE SERVICES IN 16 EAST TENNESSEE COUNTIES. ALL PATIENTS ARE ACCEPTED ON THE BASIS OF PHYSICIAN REFERRAL, THE ABILITY OF HOME HEALTH TO MEET THE PATIENT'S SPECIFIC NEEDS, AND WHEN THE PHYSICIAN, CHILD'S FAMILY AND THE HOME HEALTH STAFF AGREE THAT IN-HOME CARE WOULD BE AN APPROPRIATE AND EFFECTIVE MEANS OF TREATMENT. AVAILABLE SERVICES INCLUDE REGISTERED NURSING, RESPIRATORY THERAPY, HOME INFUSION, NUTRITIONAL SUPPORT, HOME MEDICAL EQUIPMENT, SUPPLIES, PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY AND SOCIAL WORK. THE COLLECTIVE REHABILITATION SERVICES DEPARTMENTS ARE STAFFED WITH LICENSED PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS, AND SPEECH-LANGUAGE PATHOLOGISTS WHOSE ROLES INCLUDE EVALUATING AND TREATING PATIENTS WITH A VARIETY OF PHYSICAL IMPAIRMENTS AND DEVELOPMENTAL DELAYS. THERAPISTS WORK WITH CHILDREN IN THE INPATIENT SETTING, IN MULTI-DISCIPLINARY CLINICS AND IN OUTPATIENT SETTINGS. ETCH OFFERS OUTPATIENT REHABILITATION SERVICES AT FIVE LOCATIONS IN THE EAST TENNESSEE REGION, BRINGING THESE SERVICES CLOSER TO OUR PATIENTS. ALL TREATMENT SESSIONS ARE PROVIDED WITH FAMILY-CENTERED CARE, WITH A FOCUS ON ACTIVE CAREGIVER PARTICIPATION TO ENHANCE FAMILY EDUCATION. IN ADDITION TO REHABILITATION SERVICES, THESE OUTPATIENT CENTERS OFFER SOCIAL WORK, INTERPRETIVE SERVICES, PSYCHOLOGY AND NUTRITION SERVICES. OPTIONAL REHABILITATION SERVICES ARE AVAILABLE TO BE OFFERED VIRTUALLY AS WELL AS IN PERSON. ETCH ALSO PROVIDES COMPREHENSIVE CONSULTATION, EVALUATION, DIAGNOSTIC SERVICES AND TREATMENT FOR PEDIATRIC PATIENTS WITH ACUTE, CHRONIC AND/OR COMPLEX CONDITIONS THROUGH THE OUTPATIENT CARE CENTER. SEVERAL CLINICS FOR SPECIFIC CONDITIONS ARE OFFERED INCLUDING CRANIOFACIAL, CYSTIC FIBROSIS, DERMATOLOGY, DIABETES, GYNECOLOGY, HEMATOLOGY/ONCOLOGY, HIGH RISK, INFECTIOUS DISEASES, METABOLIC DISEASES, MULTISPECIALITY, PULMONARY, RHEUMATOLOGY, SPECIAL ATTENTION AND SPASTICITY. A CLINIC VISIT MAY INCLUDE TREATMENT AND CONSULTATION WITH PHYSICIANS, NURSES AND STAFF FROM NUTRITION, SOCIAL WORK, CHILD LIFE, REHABILITATION, RESPIRATORY CARE OR OTHERS. ADDITIONAL SERVICES: THE SOCIAL WORK DEPARTMENT AT ETCH HELPS PATIENTS AND THEIR FAMILIES DEAL WITH EMOTIONAL STRESS CAUSED BY ILLNESS, INJURY OR THE HOSPITALIZATION ITSELF. SOCIAL WORK SERVICES INCLUDE INFORMATION AND REFERRAL; SHORT-TERM SUPPORTIVE COUNSELING FOR PATIENTS AND PARENTS; CRISIS INTERVENTION ASSISTANCE; DISCHARGE PLANNING; FINANCIAL ASSISTANCE; INFORMATION ON SUPPORT AND ADVOCACY GROUPS; AND ASSISTANCE WITH CONCRETE NEEDS, INCLUDING RONALD MCDONALD HOUSE REFERRALS. THE DEPARTMENT ALSO COORDINATES TRANSLATION OF MUCH OF THE HOSPITAL'S PRINTED MATERIAL INTO SPANISH TO GIVE THE HISPANIC POPULATION COMMUNICATION ACCESS WHEN MEDICAL SERVICES ARE PROVIDED. SOCIAL WORK ALSO PROVIDES SEVERAL INTERPRETATION SERVICES FOR ETCH. OPTIMAL PHONE INTERPRETERS IS A TELEPHONE SERVICE THAT PROVIDES INTERPRETERS IN MORE THAN 204 LANGUAGES AND DIALECTS. INTERPRETERS CAN BE ARRANGED FOR FACE-TO-FACE INTERACTIONS BETWEEN SPANISH-SPEAKING PATIENTS AND PARENTS AND THE PHYSICIAN AND/OR OTHER HOSPITAL STAFF MEMBER. SIGN LANGUAGE INTERPRETERS ARE ALSO AVAILABLE FOR HEARING IMPAIRED PATIENTS AND FAMILIES. THE CARE COORDINATION DEPARTMENT AT ETCH HELPS PATIENTS AND THEIR FAMILIES DEAL WITH EMOTIONAL STRESS CAUSED BY ILLNESS, INJURY OR THE HOSPITALIZATION ITSELF. SOCIAL WORK SERVICES INCLUDE INFORMATION AND REFERRAL; SHORT-TERM SUPPORTIVE COUNSELING FOR PATIENTS AND PARENTS; CRISIS INTERVENTION ASSISTANCE, INCLUDING ASSESSMENT OF BEHAVIORAL HEALTH PATIENTS AND PLACEMENT; DISCHARGE PLANNING; FINANCIAL ASSISTANCE; INFORMATION ON SUPPORT AND ADVOCACY GROUPS; AND ASSISTANCE WITH CONCRETE NEEDS, INCLUDING RONALD MCDONALD HOUSE REFERRALS. THE INTERPRETIVE SERVICES PORTION OF THE DEPARTMENT PROVIDES NEARLY AROUND THE CLOCK IN-PERSON SPANISH INTERPRETATION FOR OUR SPANISH-SPEAKING FAMILIES AND COORDINATES TRANSLATION OF MUCH OF THE HOSPITAL'S PRINTED MATERIAL INTO SPANISH, AS WELL. THEY ALSO CONTRACT WITH LANGUAGE SERVICES PROVIDERS FOR ACCESS TO IN-PERSON, VIDEO AND TELEPHONE INTERPRETATION IN 230+ LANGUAGES TO MEET THE COMMUNICATION NEEDS OF DEAF AND HEARING IMPAIRED AND LIMITED ENGLISH PROFICIENT PATIENTS AND FAMILIES. CARE COORDINATION ALSO PROVIDES NURSE NAVIGATION AND CASE MANAGEMENT IN AN EFFORT TO ENHANCE PARENTS' EXPERIENCES IN NAVIGATING THEIR CHILD'S SUDDEN ENTRANCE INTO COMPLEX MEDICAL SERVICES DUE TO ACUTE OR CHRONIC ILLNESS. THE CASE MANAGEMENT STAFF ASSISTS WITH THE TIMELY DISCHARGE OF PATIENTS, IN ORDER TO SUPPORT THE IMPROVEMENT IN QUALITY OF LIFE THAT IS ATTAINED BY BEING CARED FOR IN ONE'S HOME ENVIRONMENT. HOSPITALIZATION, MEDICAL PROCEDURES, ILLNESS AND PAIN ARE OFTEN FEARFUL TIMES FOR PEOPLE OF ALL AGES. THE CHILD LIFE DEPARTMENT AT ETCH IS RESPONSIBLE FOR HELPING CHILDREN COPE WITH THEIR HOSPITALIZATION THROUGH EDUCATION, MEDICAL PLAY AND ACTIVITIES. THE CHILD LIFE STAFF ASSESSES THE CHILD'S FEARS AND NEEDS, EXPLAIN PROCEDURES IN LANGUAGE CHILDREN CAN UNDERSTAND AND USE DISTRACTIONS TO MAKE PROCEDURES, SUCH AS THE PLACEMENT OF AN IV LINE, LESS INTIMIDATING. THE CHILD LIFE STAFF MEMBERS HOLD DEGREES IN EDUCATION, CHILD DEVELOPMENT OR THERAPEUTIC RECREATION. THEY HAVE EXPERTISE IN DEALING WITH A CHILD'S CONCERNS AND REACTIONS TO THE HOSPITAL AND HIS OR HER ILLNESS. IN ADDITION TO ITS WORK WITHIN THE HOSPITAL, THE CHILD LIFE DEPARTMENT ALSO COORDINATES SEVERAL ACTIVITIES FOR CHILDREN IN THE COMMUNITY. PASTORAL CARE - CHAPLAINS ARE AVAILABLE 24 HOURS A DAY TO PROVIDE SPIRITUAL AND EMOTIONAL SUPPORT TO PATIENTS, FAMILIES AND STAFF AT ETCH. CHAPLAINS ALSO PROVIDE CONSULTATION CONCERNING ETHICAL ISSUES RELATED TO PATIENT CARE. FOOD AND NUTRITION SERVICES - ETCH'S CAFETERIA IS OPEN DAILY. VENDING MACHINES ON THE GROUND FLOOR NEAR THE DINING ROOM PROVIDE SANDWICHES, SNACKS AND BEVERAGES 24 HOURS A DAY. FOR PATIENTS WITH NO DIETARY RESTRICTIONS, FOOD AND NUTRITION SERVICES OFFERS A SELECTIVE MENU OF IN-ROOM MEALS. ALSO, REGISTERED DIETITIANS PROVIDE CLINICAL NUTRITION SERVICES, AND MEDICAL NUTRITION THERAPY IS AVAILABLE TO INPATIENTS AND OUTPATIENTS WHO ATTEND SPECIALTY CLINICS OR WHO HAVE INDIVIDUAL APPOINTMENTS. THESE SERVICES INCLUDE NUTRITION ASSESSMENT, FEEDING RECOMMENDATIONS, INTAKE EVALUATION AND NUTRITION COUNSELING. ETCH'S HEALTHY KIDS PROGRAM IS A COMMUNITY EDUCATION INITIATIVE OF THE COMMUNITY BENEFITS DEPARTMENT. THE PROGRAM SERVES AS AN EDUCATION RESOURCE FOR PARENTS, GRANDPARENTS AND OTHER CARETAKERS BY OFFERING CLASSES, LITERATURE AND OTHER OPPORTUNITIES FOR LEARNING HOW TO IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 AND RELATED SCHEDULES ARE PREPARED BY AN UNRELATED, INDEPENDENT ACCOUNTING FIRM AND THEN SUBMITTED TO THE ETCH CHIEF FINANCIAL OFFICER AND CHIEF LEGAL OFFICER FOR INTERNAL REVIEW. A DRAFT FORM IS ALSO PROVIDED TO SENIOR ADMINISTRATION AND TO ALL ETCH BOARD OF DIRECTORS MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD OF DIRECTORS IS ASKED TO REVIEW THE CONFLICT OF INTEREST POLICY AND PROVIDE DISCLOSURE OF ANY ACTIVITIES WHICH COULD CONSTITUTE A CONFLICT OF INTEREST OR POTENTIAL CONFLICT OF INTEREST ANNUALLY. THESE CONFLICT OF INTEREST DISCLOSURES ARE REVIEWED BY ETCH'S GENERAL COUNSEL TO ASSURE COMPLIANCE. ADDITIONALLY, BOARD MEMBERS ARE ASKED TO RECUSE THEMSELVES ON ANY MATTERS OF INTEREST BEFORE THE BOARD IN WHICH A CONFLICT OF INTEREST MAY EXIST. ANY SUCH RECUSAL IS DOCUMENTED WITHIN THE MINUTES OF THE BOARD OR COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE ETCH BOARD OF DIRECTORS UTILIZES THE SERVICES OF INDEPENDENT, OUTSIDE COMPENSATION CONSULTANTS TO PROVIDE THE COMMITTEE WITH RELEVANT MARKET DATA FROM STATE AND NATIONAL SALARY SURVEYS FOR COMPARABLE MARKETS. WITH THIS DATA AND THE ADVICE OF OUTSIDE CONSULTANTS, THE ETCH BOARD OF DIRECTORS EXECUTIVE COMMITTEE MAKES RECOMMENDATIONS ON PAY AND BENEFITS FOR THE ETCH PRESIDENT/CEO. FORM 990, PART VI, SECTION C, LINE 19 ALL ETCH GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. ADDITIONALLY, FINANCIAL STATEMENTS ARE PROVIDED TO BONDHOLDERS, LOCAL HOSPITALS AND DONORS. THE CONFLICT OF INTEREST POLICY IS POSTED ON ETCH'S INTRANET. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 8,960,724. MANAGEMENT AND GENERAL EXPENSES 9,578,161. FUNDRAISING EXPENSES 853,677. TOTAL EXPENSES 19,392,562. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 17,173,522. MANAGEMENT AND GENERAL EXPENSES 65,535. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,239,057. FORM 990, PART XI, LINE 9: BOOK/TAX DIFFERENCE FOR PASSTHROUGH INVESTMENT -366,113. 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