CUMBERLAND MEDICAL CENTER INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- CUMBERLAND MEDICAL CENTER INC (EIN 62-0790132)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-13
- IRS object ID
- 202333179349309583
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-13T15:56:34-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 620790132 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cumberland Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CUMB | BusinessNameControlTxt |
| Phone | 8653743140 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1420 Centerpoint Blvd Bldg C | AddressLine1Txt |
| City | Knoxville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 379321960 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Joseph C Dolan | PersonNm |
| Person Title | EVP/CFO | PersonTitleTxt |
| Phone | 8653746872 | PhoneNum |
| Signature | 2023-11-08 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Joseph | PersonFirstNm |
| Person Last | Dolan | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | James D VanderSteeg | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 244 Ft Sanders W Blvd | AddressLine1Txt |
| City | Knoxville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37922 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $93,623,995 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.covenanthealth.com/cumberland/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | Cumberland Medical Center is a 189-bed full service, acute care hospital located in Crossville, TN. It is a member of the Covenant Health system. | ActivityOrMissionDesc |
| Voting Members Governing Body | 23 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 22 | VotingMembersIndependentCnt |
| Total Employee | 792 | TotalEmployeeCnt |
| Total Volunteers | 79 | TotalVolunteersCnt |
| Total Gross UBI | $156,322 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $118,935 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,378,093 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,504,739 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $92,913,362 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $86,171,480 | CYProgramServiceRevenueAmt |
| PY Investment Income | $687,599 | PYInvestmentIncomeAmt |
| CY Investment Income | $113,494 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,056,608 | PYOtherRevenueAmt |
| CY Other Revenue | $1,278,747 | CYOtherRevenueAmt |
| PY Total Revenue | $102,035,662 | PYTotalRevenueAmt |
| CY Total Revenue | $93,068,460 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $25,070 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $10,100 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $40,175,833 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $42,538,774 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $53,426,312 | PYOtherExpensesAmt |
| CY Other Expenses | $59,373,153 | CYOtherExpensesAmt |
| PY Total Expenses | $93,627,215 | PYTotalExpensesAmt |
| CY Total Expenses | $101,922,027 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,408,447 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$8,853,567 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $90,595,447 | TotalAssetsBOYAmt |
| Total Assets EOY | $82,068,813 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,074,696 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,401,629 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $74,520,751 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $66,667,184 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Cumberland 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $98,125,490 | ExpenseAmt |
| Grant | $10,100 | GrantAmt |
| Revenue | $86,160,181 | RevenueAmt |
| Desc | Cumberland Medical Center ("Cumberland"), an acute-care hospital located on the Cumberland Plateau of Tennessee, has served the Cumberland community since 1950 and joined Covenant Health in 2014.SERVICECumberland offers specialized services not usually found in more rural areas, making health care resources more accessible to local residents. Currently licensed for 189 beds, Cumberland has more than 200 affiliated physicians working with nearly 700 employees and about 125 dedicated volunteers who deliver quality care to patients. Physician specialties include anesthesiology, cardiology, neurology, obstetrics, ophthalmology, oncology, orthopedics, pediatrics, radiology, radiation oncology and urology services.Cumberland served 125,108 patients in 2022. Of these, 120,904 were outpatients and 4,204 were inpatients with an average length-of-stay of 4.73 days.PUTTING PATIENTS FIRSTAdvanced medical and surgical care is provided at Cumberland, including telemetry-monitored beds and an intensive care unit. Additionally, Cumberland offers an outpatient diagnostics center, same-day surgery unit, cardiac and pulmonary rehab programs, a sleep disorders center, a breast center offering 3D mammography, a cancer center, and hyperbaric and wound care. The hospital also has a 12-bed maternity suite for labor and delivery. As a member of Covenant Health, Cumberland is part of the region's only stroke hospital network, which links Covenant Health's member hospitals in providing access to rapid diagnosis and treatment of stroke. Cumberland holds Advanced Primary Stroke Center certification from The Joint Commission. Cumberland has an in-house cardiac catheterization lab, inpatient dialysis services and an inpatient rehabilitation unit. A full-service laboratory, medical imaging department, physical therapy and cardiopulmonary services department are also available. Cumberland's surgery department includes six main operating rooms, four of which are equipped with high-definition endoscopic video equipment. Cumberland is accredited by The Joint Commission. It has also earned the Commission on Cancer's Accredited Cancer Program designation and is accredited by the American College of Radiology in Radiation Oncology, Positron Emission Tomography (PET) Imaging and Breast Imaging Center of Excellence. IMPROVING THE COMMUNITY'S QUALITY OF LIFE THROUGH BETTER HEALTHEmergency physicians are on duty 24 hours a day, seven days a week, while general and specialty surgeons provide around-the-clock coverage and treatment. A new emergency department was opened in 2016 that has allowed Cumberland to better serve patients with updated equipment and technology, new patient care rooms, and specialty cardiac and trauma rooms.In 2022, the hospital welcomed 24/7 interventional cardiology coverage, making it possible to provide emergent cardiac care "close to home" for those on the Cumberland Plateau. Outreach programs were adapted to support social distancing to reduce potential spread of COVID-19 in 2022; however, the following milestones were accomplished: - With patients' consent, Cumberland shared a variety of patient testimonial stories with the community on topics and education related to breast health, diabetes, stroke, active lifestyles, etc., moving more, etc. - Supported a "Hike for Health" 12-week series of walks on local one-mile paved trails - Held health fairs in Fairfield Glade and with Uplands Village - Provided free childbirth education classes - Partnered with the Cumberland County Health Department for a "Community Baby Shower" in support of safe sleep and breastfeeding awareness - Provided free prostate-specific antigen (PSA) screenings in support of a new Men's Health Awareness benefit golf tournament - Held a Breast Cancer Awareness luncheon and Breast Center open houses in both Fairfield Glade as well as the hospital in Crossville COVENANT HEALTH Cumberland 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.Cumberland, as a member of the Covenant Health system, benefits from the collaboration among all affiliated organizations to promote quality improvement, patient safety and efficient delivery of care for the communities served.IMPACT OF COVID-19In 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. | Desc |
| Total Program Service Expenses | $98,125,490 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 41 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 792 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 23 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 22 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Amy DeLong | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8653743140 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1420 Centerpoint Blvd Bldg C | AddressLine1Txt |
| City | Knoxville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 379321960 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Gerald Boyd | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Willard Campbell MD | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Michael Casey MD | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Ronni Chandler | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Mitchell Dickson MD | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $268 | $0 | |||
| Stephanie Flood | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $849 | $0 | |||
| James Gibson | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $74 | $0 | |||
| Edgar Gray | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,432 | $0 | |||
| Leslye Hartsell | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $889 | $0 | |||
| Donald Hickman | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,538 | $0 | |||
| Timothy Matthews | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $906 | $0 | |||
| Janice McKinley | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,097 | $0 | |||
| Dave Miller | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,208 | $0 | |||
| Bill Myers | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Alvin Nance | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Linda Ogle | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| King Purnell | |||||||||
| Director/Chair | 0.00 | 1.00 | Yes (X) | $0 | $1,050 | $0 | Yes (X) | ||
| Jorge Sanabria | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,485 | $0 | |||
| William Seale | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,251 | $0 | |||
| Cosby Stone | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,408 | $0 | |||
| Joe Sutter | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $979 | $0 | |||
| James Tramontana MD | |||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,208 | $0 | |||
| James D VanderSteeg | |||||||||
| President & CEO | 0.00 | 50.00 | Yes (X) | $0 | $2,346,646 | $316,057 | Yes (X) | ||
| John T Geppi | |||||||||
| EVP/CFO | 0.00 | 50.00 | $0 | $1,099,851 | $33,916 | Yes (X) | |||
| David V Bunch | |||||||||
| Fmr Pres & CAO (through Aug 2022) | 50.00 | 0.00 | $0 | $436,865 | $23,935 | Yes (X) | |||
| April A VonAchen | |||||||||
| VP - Financial Services | 50.00 | 0.00 | $169,061 | $0 | $35,200 | Yes (X) | |||
| Randall K Davis | |||||||||
| President & CAO | 50.00 | 0.00 | $0 | $83,961 | $0 | Yes (X) | |||
| Shana N Wyatt | |||||||||
| Chief Nursing Officer | 50.00 | 0.00 | $155,388 | $0 | $32,826 | Yes (X) | |||
| Thomas A Allingham MD | |||||||||
| Physician/Chief of Staff | 50.00 | 0.00 | $498,005 | $0 | $10,102 | Yes (X) | |||
| Ivan L Cordrey | |||||||||
| Senior Medical Physicist | 50.00 | 0.00 | $194,702 | $0 | $6,234 | Yes (X) | |||
| Robert S Cunningham | |||||||||
| Clinical Nurse III | 50.00 | 0.00 | $164,177 | $0 | $44 | Yes (X) | |||
| Jason L Chaston | |||||||||
| Clinical Nurse II | 50.00 | 0.00 | $162,820 | $0 | $28,170 | Yes (X) | |||
| Bonnie J Mathis | |||||||||
| Administrative Supervisor | 50.00 | 0.00 | $157,281 | $0 | $26,693 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,501,434 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,982,965 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $513,177 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 22 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Cardiosolution | |||||
| 4675 Cornell Rd Ste 100 | Cincinnati | OH | 45241 | Providers for Cardiac Caths | $1,407,581 |
| Restorix Health | |||||
| 445 Hamilton Avenue Suite 800 | White Plains | NY | 10601 | Wound Care Management Fees | $761,309 |
| Sanderling Renal Services | |||||
| 511 Union Street Ste 1800 | Nashville | TN | 37219 | Dialysis and Renal Telemedicine | $528,999 |
| Shared Medical Services | |||||
| 209 Limestone Pass | Cottage Grove | WI | 53527 | Imaging Services | $451,160 |
| Park Place International LLC | |||||
| 8401 Chagrin Road Suite 68 | Chagrin Falls | OH | 44023 | Cloud Based Server Storage | $371,294 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $11,400 | RelatedOrganizationsAmt |
| Government Grants | $5,438,029 | GovernmentGrantsAmt |
| All Other Contributions | $55,310 | AllOtherContributionsAmt |
| Total Contributions | $5,504,739 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Net Patient Revenue | 622110 | $86,135,193 | $86,135,193 | |
| Laboratory | 621500 | $36,287 | $36,287 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $86,171,480 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,499 | TotalRevenueColumnAmt |
| Exclusion | $26,499 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $782,009 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $529,429 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $252,580 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $252,580 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $120,035 | UnrelatedBusinessRevenueAmt |
| Exclusion | $132,545 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $113,101 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $26,106 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $86,995 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $86,995 | TotalRevenueColumnAmt |
| Exclusion | $86,995 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Wellness Center | 713940 | $536,344 | $536,344 |
| Cafeteria | 722514 | $387,153 | $387,153 |
| Medical Records | 561000 | $36,452 | $36,452 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $66,218 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,988 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $41,230 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,026,167 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $93,068,460 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $86,160,181 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $156,322 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,247,218 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,100 | TotalAmt |
| Program Services | $10,100 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $392,475 | TotalAmt |
| Management And General | $392,475 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,830,321 | TotalAmt |
| Program Services | $34,400,008 | ProgramServicesAmt |
| Management And General | $1,430,313 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $461,601 | TotalAmt |
| Program Services | $451,639 | ProgramServicesAmt |
| Management And General | $9,962 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,598,321 | TotalAmt |
| Program Services | $3,503,837 | ProgramServicesAmt |
| Management And General | $94,484 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,256,056 | TotalAmt |
| Program Services | $2,162,238 | ProgramServicesAmt |
| Management And General | $93,818 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,948,648 | TotalAmt |
| Program Services | $1,880,598 | ProgramServicesAmt |
| Management And General | $68,050 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,811,474 | TotalAmt |
| Program Services | $20,237,062 | ProgramServicesAmt |
| Management And General | $574,412 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,656 | TotalAmt |
| Program Services | $124,951 | ProgramServicesAmt |
| Management And General | $25,705 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345,659 | TotalAmt |
| Program Services | $185,728 | ProgramServicesAmt |
| Management And General | $159,931 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,395,323 | TotalAmt |
| Program Services | $1,377,775 | ProgramServicesAmt |
| Management And General | $17,548 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,669,000 | TotalAmt |
| Program Services | $1,920,157 | ProgramServicesAmt |
| Management And General | $748,843 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,027 | TotalAmt |
| Program Services | $38,312 | ProgramServicesAmt |
| Management And General | $4,715 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,458 | TotalAmt |
| Program Services | $36,124 | ProgramServicesAmt |
| Management And General | $19,334 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15 | TotalAmt |
| Program Services | $15 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,385,032 | TotalAmt |
| Program Services | $5,385,032 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,505 | TotalAmt |
| Program Services | $157,994 | ProgramServicesAmt |
| Management And General | $3,511 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| Unrelated Business Inco | $31,000 | $31,000 | |
| Medical Supplies | $13,272,335 | $13,272,335 | |
| Bad Debt | $8,866,763 | $8,866,763 | |
| Minor Equipment | $2,386,783 | $67,427 | $2,319,356 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,850,475 | TotalAmt |
| Program Services | $1,795,467 | ProgramServicesAmt |
| Management And General | $55,008 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,922,027 | TotalAmt |
| Program Services | $98,125,490 | ProgramServicesAmt |
| Management And General | $3,796,536 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,963,616 | BOYAmt |
| EOY | $2,964,803 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,520,309 | BOYAmt |
| EOY | $9,115,515 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $940,359 | BOYAmt |
| EOY | $1,032,573 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,141,982 | BOYAmt |
| EOY | $1,033,510 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $171,031,490 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $113,289,010 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,599,330 | BOYAmt |
| EOY | $57,742,480 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,082,209 | BOYAmt |
| EOY | $9,692,473 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,347,642 | BOYAmt |
| EOY | $487,459 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,595,447 | BOYAmt |
| EOY | $82,068,813 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,125,695 | BOYAmt |
| EOY | $10,612,106 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,759 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,949,001 | BOYAmt |
| EOY | $4,785,764 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,074,696 | BOYAmt |
| EOY | $15,401,629 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,520,751 | BOYAmt |
| EOY | $66,667,184 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,520,751 | BOYAmt |
| EOY | $66,667,184 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,595,447 | BOYAmt |
| EOY | $82,068,813 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$8,853,567 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $1,000,000 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $149,791 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $609 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $150,400 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $149,520 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $271 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $149,791 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $148,846 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $674 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $149,520 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $147,855 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $991 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $148,846 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $143,094 | BeginningYearBalanceAmt |
| Contributions | $4,000 | ContributionsAmt |
| Investment Earnings Or Losses | $761 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $147,855 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,601,369 | OtherCostOrOtherBasisAmt |
| Book Value | $2,601,369 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $90,666,885 | OtherCostOrOtherBasisAmt |
| Depreciation | $50,225,887 | DepreciationAmt |
| Book Value | $40,440,998 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,317,171 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,067,884 | DepreciationAmt |
| Book Value | $1,249,287 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $72,247,513 | OtherCostOrOtherBasisAmt |
| Depreciation | $60,995,239 | DepreciationAmt |
| Book Value | $11,252,274 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,198,552 | OtherCostOrOtherBasisAmt |
| Book Value | $2,198,552 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $57,742,480 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Affiliates, Net | $3,345,312 |
| Due to Third Party Payors | $824,857 |
| Long-Term Deferred Compensation | $103,858 |
| Long-Term Reserve for Workers Comp | $262,281 |
| Operating and Finance Leases | $239,793 |
| Security Deposits | $9,663 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,785,764 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | Cumberland Medical Center maintains three endowment funds for the purpose of supporting education of essential healthcare positions and provision of healthcare to children in need. The principal amount will be maintained in perpetuity and only the annual income generated will determine the number and amounts of expenditures each year. |
| Part X, Line 2: | Excerpt from the consolidated audited financial statements of Covenant Health (Covenant), parent company to Cumberland 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. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,887,242 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,279 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,882,963 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03100 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,985,203 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,054,515 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,930,688 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02070 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,872,445 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,058,794 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,813,651 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05170 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,868 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $28,868 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $94 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $94 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,962,065 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,962,065 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05330 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,400 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,400 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,002,427 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,002,427 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05370 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,874,872 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,058,794 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,816,078 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10540 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,107 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,107 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $810 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $810 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $38 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $38 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,955 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,955 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $8,866,763 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,064,012 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $23,063,348 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $23,651,102 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$587,754 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cumberland Medical Center Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 421 South Main St | AddressLine1Txt |
| City | Crossville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 38555 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.covenanthealth.com/cumberland/ | WebsiteAddressTxt |
| State License | 00000020 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cumberland Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Page 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Page 8 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.covenanthealth.com/patients-visitors/financial-assistance/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.covenanthealth.com/patients-visitors/financial-assistance/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.covenanthealth.com/patients-visitors/financial-assistance/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Cumberland Medical Center | Part V, Section B, Line 5: Cumberland Medical Center ("Cumberland") conducted its fourth Community Health Needs Assessment ("CHNA") in 2022. A Steering Committee was formed to guide the assessment process and included staff from the Cumberland County Health Department, United Fund, Cumberland Medical Center, Cumberland County Emergency Medical Services, Cumberland County government, Crossville Fire Department, Hilltoppers, Crossville City Manager, Cumberland Heights, Cumberland County Coordinated School Health, Cumberland Prevention Coalition, Uplands Village and Fairfield Glade Resident Services. Each of these community organizations serve the broader community and, in particular, the low-income, uninsured and chronically ill. The Steering Committee worked with the University of Tennessee-Knoxville Social Work Office of Research and Public Service ("UT-SWORPS") to devise a Cumberland County household survey and to host four focus groups of community leaders, each of which represented a part of the overall Cumberland County public health system. The household survey collected information from 469 Cumberland County residents. Participation in the survey was diverse and reflected the demographic profile of the county for the attributes of educational level, income, ethnicity and age. The primary research was analyzed and combined with county demographics, mortality, and secondary data for more than 60 health indicators. A Data Team was formed to analyze the data and determine the most significant findings from the assessment. The Data Team included Steering Committee members as well as representatives from the University of Tennessee/TN State University Extension Service, Coordinated School Health, Fair Park Senior Center, Chamber of Commerce, Crossville City Parks and Recreation. |
| Cumberland Medical Center | Part V, Section B, Line 6b: Though Cumberland's CHNA was issued as a stand-alone report, many non-hospital organizations assisted throughout the process. Research partners provided expertise on survey design, focus group facilitation, data collection, data sources, and analysis. UT-SWORPS was an integral contributor, as well as the Cumberland County Health Department and the Tennessee Department of Public Health (Nashville, TN).Additionally, focus groups were beneficial in discussing and identifying community needs in Cumberland County. Organizations and individuals participating in the focus groups included: - Cumberland County Health Department - Cumberland County United Fund- Cumberland County Schools - Crossville Fire Department- Cumberland County School Health Coordinator - Kids on the Rise - Cumberland Heights and Prevention Coalition - First Bank - Wyndridge Health and Rehabilitation Center - Young Pharmacy- Patient Family Advisory Council- Cumberland County Human Resources - Lake Tansi Recreation - Crossville Medical Group- Cumberland County Housing Authority - Uplands Village - Fairfield Glade Resident Services |
| Cumberland Medical Center | Part V, Section B, Line 11: At the conclusion of the 2022 assessment process, largely due to COVID-19, the Data Team consensus was to continue the five health priorities of the 2019 CHNA. Data Team members felt each priority area of the 2019 assessment have worsened. Communities were faced with increased uncertainty and stress, many resources were paused and healthcare organizations were pushed to the breaking point. Overall, the demand for health and human resources far outweighed the supply. The 2022 most significant health priorities for Cumberland County are as follows: Substance Abuse Disorder, Mental Health Access, Health Education for Chronic Diseases, Adverse Childhood Experiences and Insufficient Number of Primary Care, Specialist and Dental Providers. Cumberland updated its 2022 Implementation Plan based on the identified needs and plans to address four of the five identified issues in the following ways:1. Substance Abuse DisordersCumberland Prevention Coalition - Cumberland is staying on the forefront of the latest trends affecting the community (such as vaping) by supporting Cumberland Prevention Coalition with hospital resources as opportunities arise. Opioid Light Protocol - Cumberland has adopted the Covenant Health protocol to reduce the amount of narcotics prescribed in the Emergency Department. Narcotics are reserved for acute pain, and other non-narcotic methods of pain control are offered to patients with more chronic pain. Patient Education - Cumberland teaches inpatients how to better manage pain with alternatives like repositioning, ice packs and pain scales (1-10). 2. Mental Health Access Covenant Health - As a member of Covenant Health, Cumberland will advocate and support the system's behavioral health services, such as its partnership with Acadia Healthcare, to assist area residents. In 2021, Cumberland's Emergency Department implemented telehealth for psychiatric evaluations, which has improved the timeliness of administering medication and the ability to transport to psychiatric facilities. Inpatient Education - Cumberland Case Management helps educate patients and families with resources available for those struggling with addiction. Mobile Crisis Services - Cumberland works with local and statewide agencies like Tennessee Department of Mental Health & Substance Abuse Service's Mobile Crisis Services.3. Health Education for Chronic Disease ConditionsBreast Cancer Awareness Events - Cumberland offers annual Breast Cancer Awareness education for the community to hear guest speakers and receive educational information in support of annual mammogram screenings. Cancer Navigators - Cumberland has two nurse navigators serving in the Breast and Cancer Centers to provide education to patients going through cancer treatment. Community Baby Shower - Cumberland participates in a community wide baby shower in partnership with the Tennessee Health Department - Cumberland County. Expectant mothers are provided key information about their child's upcoming birth as well as vital community resource information to help those who are economically disadvantaged with resources such as the Women, Infant, and Children (WIC) offered through the Health Department. Diabetes - Cumberland Diabetes Center, a member of Covenant Medical Group, helps patients locally with diabetes prevention and care as well as other metabolic associated conditions. Health Fairs - Cumberland has annual health education and screening fairs across the community. Events are held at places upon request such as: Crossville Ceramics, Inc., Cumberland County Schools, Fair Park Senior Center, Fairfield Glade and Uplands Village. Patient Education - Signs and Symptoms on Stroke and Heart Attack are provided to every inpatient upon discharge. Additional education is specifically tailored to the patient based on their personalized plan of care. Support Groups & Continuity of Care Meetings - Cumberland holds various support groups for caregivers and patients with health areas of focus such as Breast Cancer, Chronic Obstructive Pulmonary Disease (COPD), Diabetes, and Sleep. - The hospital leads Continuity of Care meetings for key health care professionals within the community who represent industries such as nursing home and home health. This provides an opportunity to exchange knowledge for updates that better improve quality and transition of care within community. 4. Adverse Childhood Experiences (ACEs) - ACEs are outside the scope of care provided by Cumberland because it is an assessment performed in a physician office setting as part of the patient's overall health management. The hospital can be supportive as opportunities that bridge various community partners and awareness arise locally. 5. Recruit more primary care, specialist and dental providers - Cumberland will continue recruitment efforts for primary and specialty physicians as well as assist specialists like dentists, who can help further serve in meeting the community needs. - The hospital will cultivate relationships with Covenant Health specialists not available on the Cumberland Plateau. - Cumberland has embraced advancements for Virtual Care (telehealth) utilization, such as Cumberland Medical Center's implementation of Tele-ICU in 2021, to help expand care available to patients locally. |
| Cumberland 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/cumberland/chna/ |
| Part V, Line 10a, Implementation Strategy Website | https://www.covenanthealth.com/cumberland/chna/ |
| Part V, Line 20d, Presumptive Eligibility Determinations | The hospital follows the eligibility procedures as detailed within the FAP and does not make presumptive eligibility determinations. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 8 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - CMC Outpatient Imaging Center | ||||
| 28 Hayes St | Crossville | TN | 38555 | Medical Imaging and PET Scan |
| 2 - CMC Cancer Center | ||||
| 421 South Main St | Crossville | TN | 38555 | Oncology Radiation Therapy |
| 3 - CMC Specialty Surgery & Endoscopy Ctr | ||||
| 116 Brown Ave | Crossville | TN | 38555 | Outpatient Endoscopy Center |
| 4 - CMC Hyperbaric Medicine & Wound Ctr | ||||
| 124 Hayes St | Crossville | TN | 38555 | Wound and Hyperbaric Treatment |
| 5 - CMC Physical Medicine & Rehabilitation | ||||
| 118 Brown Ave Suite 104 | Crossville | TN | 38555 | Physical Therapy and Occupational Therapy |
| 6 - CMC at Fairfield Glade | ||||
| 130 Stonehenge Dr | Crossville | TN | 38555 | Wellness, Physical Therapy, X-ray and Mammography |
| 7 - Sleep Disorder Center | ||||
| 49 Cleveland St Suite 200 | Crossville | TN | 38555 | Sleep Study Center |
| 8 - Cumberland Physicians Group | ||||
| 133 Hayes St | Crossville | TN | 38555 | General and Specialty Physicians |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | In addition to the Federal Poverty Guidelines ("FPG"), Cumberland 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 Cumberland and other affiliated acute care hospitals, prepares an annual Report to the Community on behalf of the entire system. |
| Part I, Line 7: | Amounts on Lines 7a-7c and certain program costs included on Line 7g are from the hospital's cost accounting system, which addresses all patient segments. Other community benefit expenses are at cost from the general ledger. |
| Part I, Line 7g: | Subsidized health services includes the difference between the cost of services and the payments received for those services. The total includes $4,962,065 in physician sponsorship fees. All subsidized health services included on line 7g are for services that would otherwise be unavailable in the community or be below the community's needs.The physician offices include family, internal medicine, OB/GYN, surgeons, and other specialty physicians. Although patients with Medicare or commercial insurance coverage are provided services, these physician offices were established to provide services for patients without insurance coverage or with Tenncare/Medicaid. |
| 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 $8,866,763. |
| Part II, Community Building Activities: | Cumberland 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: | The amount reported on Line 3 was estimated by multiplying self-pay bad debt by the percentage of the population living below the poverty level on a county-by-county basis. Cumberland uses the most recent data available from the U.S. Department of Agriculture Economic Research Service. |
| Part III, Line 4: | Note B to the 2022 Audited Consolidated Financial Statements of the Covenant Health system, of which Cumberland 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: Cumberland believes that all of the $587,754 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 34% of total patient days (7,790 out of 22,589 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: Cumberland 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: | Cumberland utilizes a look-back method to determine amounts generally billed ("AGB") to establish the maximum amount that will be charged to individuals eligible under the financial assistance policy ("FAP") for emergency or other medically necessary care. Self-pay patients automatically receive a 67% discount on charges based on the facility's calculated AGB. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment assistance may qualify for charity care. A sliding scale is used for extending charity care utilizing the income levels reported under the federal poverty guidelines. Patients/guarantors with income that falls below 200% of the federal poverty guidelines receive 100% charity care. Patients/guarantors with income of 201-300% of the federal poverty guidelines receive 90% charity care. For catastrophic illness, exceptions to income and asset limitations may be made on a case-by-case basis. The amount considered for charity will be based upon the evaluation of the patient's/guarantor's ability to pay.Cumberland 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 Cumberland 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. Cumberland 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 financial assistance policy, 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.Cumberland does not sell any accounts receivable accounts to outside firms. All accounts remain property of and under the policies set by Cumberland. Cumberland 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. Cumberland obtains additional community information through the service of its employees with the Chamber of Commerce, the local Health Council, Rotary Clubs, and local not-for-profit boards. 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. Cumberland 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 Cumberland 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 Cumberland Medical Center will provide, at a reduced rate, medically indicated services. A financial counselor is available to assist you with these matters by calling 931-459-7281, Monday through Friday between the hours of 8 a.m.-5 p.m. Additional information regarding financial assistance is also available on our website at CMCHealthcare.org. Signage at the registration areas state the following:It is Cumberland 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 CMCHealthcare.org. A financial counselor is available to assist you with these matters by calling 931-459-7281, Monday through Friday between the hours of 8 a.m.-5 p.m. |
| Part VI, Line 4: | Cumberland County, Tennessee is located on the Cumberland Plateau and is home to the cities of Crossville, Crab Orchard and Pleasant Hill. Cumberland is a rural county located approximately 60 miles from the metropolitan Knoxville area. Cumberland County is the primary market for Cumberland Medical Center, the only hospital in the county. In 2022, 78.9% of the patient encounters (inpatient and outpatient) came from Cumberland County, the focus of the health assessment. The following statistics are taken from the 2022 County Health Rankings report of the Robert Wood Johnson Foundation. The population of Cumberland County is 62,451 people. Persons 65 years and over account for 31.2% of the population. The uninsured rate for adults is 15% and 4% for children. The unemployment rate is steadily improving and was at 3.6% in 2022. Education, health and social assistance make up 17.6% (2021) of the workforce and is the largest employer category in Cumberland County. In 2022, the median household income was $49,423.In support of the significant findings from the 2022 CHNA, the following data points support the conclusions of the 2022 assessment:Health Education for Chronic DiseasesOf the top 10 leading causes of death in Cumberland County, 9 are largely preventable: diseases of the heart, cancers, respiratory diseases, COVID-19, accidents, stroke, diabetes, flu and pneumonia and hypertension and renal disease.Substance Abuse Disorder- In a county with a population of 60,520 residents, 12,880 patients are receiving opioids for pain. This represents a decrease of 23% since the 2019 assessments.- In Cumberland County there were 900 prescriptions written for every 1000 residents. This represents a decrease of 34% since 2019.- Alcohol was involved in 23% of driving deaths in 2021. This represents a 30% decrease since 2019.- Sixty three percent of the survey respondents listed adult substance abuse (drugs and alcohol) as the number one health issue in Cumberland County.- Poverty and youth substance abuse (alcohol and drugs) was identified as the second and third most important health issue in Cumberland County.Mental Health Access- Residents were more dissatisfied with efforts to address mental health access than any other issue in the community survey.- In Cumberland County there is a ratio 2,800 residents per each mental health provider. The Tennessee statewide ratio is 700:1.Healthcare Providers for Specialty Services- Due to a very low wage index rating in the Cumberland service area, reimbursements are lower. Physician recruitment and retention are significant challenges.- In 2019, the wage index for several areas in Tennessee, including Cumberland County, was increased, which should help with specialty recruitment. |
| Part VI, Line 5: | Cumberland, 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 Cumberland's board. The board is comprised of independent community leaders with diverse educational and professional backgrounds. The board provides governance and oversight of Cumberland.Cumberland 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: | Cumberland, 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.Cumberland patients benefit from the availability of and ease of access to Covenant Health affiliated entities for services not provided by the hospital itself. Transfer or referral to such services is expedited and coordinated to help create a seamless continuum of care. A full range of community mental health and psychiatric hospital services are available within the system that help support the hospital's emergency room as well as provide an accessible and efficient pathway for those patients who require such services post discharge. Other specialized services such as inpatient rehabilitation, cardiac care, 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 a diabetes center, wound care center, bariatric surgery center, pulmonary rehabilitation programs and ambulatory infusion centers.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. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Fairfield Glade Community Club | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2000 | AddressLine1Txt |
| City | Crossville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 38558 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 710425507 | RecipientEIN |
| IRC Section | 501(c)(4) | IRCSectionDesc |
| Cash Grant | $10,000 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | Sponsorship | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 0 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| James D VanderSteeg | ||||||||||||||
| President & CEO | $0 | $1,425,507 | $0 | $742,500 | $0 | $178,639 | $0 | $284,975 | $0 | $31,082 | $0 | $2,662,703 | $0 | $0 |
| John T Geppi | ||||||||||||||
| EVP/CFO | $0 | $679,719 | $0 | $309,084 | $0 | $111,048 | $0 | $11,600 | $0 | $22,316 | $0 | $1,133,767 | $0 | $0 |
| Thomas A Allingham MD | ||||||||||||||
| Physician/Chief of Staff | $477,867 | $0 | $200 | $0 | $19,938 | $0 | $9,150 | $0 | $952 | $0 | $508,107 | $0 | $0 | $0 |
| David V Bunch | ||||||||||||||
| Fmr Pres & CAO (through Aug 2022) | $0 | $178,018 | $0 | $96,132 | $0 | $162,715 | $0 | $3,783 | $0 | $20,152 | $0 | $460,800 | $0 | $0 |
| April A VonAchen | ||||||||||||||
| VP - Financial Services | $129,459 | $0 | $29,763 | $0 | $9,839 | $0 | $5,120 | $0 | $30,080 | $0 | $204,261 | $0 | $0 | $0 |
| Ivan L Cordrey | ||||||||||||||
| Senior Medical Physicist | $192,701 | $0 | $1,220 | $0 | $781 | $0 | $5,830 | $0 | $404 | $0 | $200,936 | $0 | $0 | $0 |
| Jason L Chaston | ||||||||||||||
| Clinical Nurse II | $160,354 | $0 | $2,440 | $0 | $26 | $0 | $0 | $0 | $28,170 | $0 | $190,990 | $0 | $0 | $0 |
| Shana N Wyatt | ||||||||||||||
| Chief Nursing Officer | $121,248 | $0 | $24,759 | $0 | $9,381 | $0 | $4,656 | $0 | $28,170 | $0 | $188,214 | $0 | $0 | $0 |
| Bonnie J Mathis | ||||||||||||||
| Administrative Supervisor | $154,455 | $0 | $2,740 | $0 | $86 | $0 | $0 | $0 | $26,693 | $0 | $183,974 | $0 | $0 | $0 |
| Robert S Cunningham | ||||||||||||||
| Clinical Nurse III | $163,079 | $0 | $1,098 | $0 | $0 | $0 | $0 | $0 | $44 | $0 | $164,221 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | Covenant Health, the parent company of Cumberland 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 | David Bunch, Former President/CAO of Cumberland Medical Center, received a severance payment $120,200 during 2022. The amount is included in taxable compensation. His termination date was August 5, 2022. Covenant Health maintains a nonqualified deferred compensation ("NQDC") plan intended to support retention of President and CEO, James D. VanderSteeg. Employer contributions of $273,375 are reported as deferred compensation on Schedule J, Part II, Column C. Contributions along with 2022 earnings of $70,560 are subject to a substantial risk of forfeiture. Amounts are combined with other compensation and considered for reasonableness. Compensation procedures are discussed in detail in Schedule O (Form 990, Part VI, Section B, Line 15a). |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Franklin Aaron Wyatt | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Family member of Shana White - Chief Nursing Officer | RelationshipDescriptionTxt |
| Transaction | $77,659 | TransactionAmt |
| Transaction | Key employee Shana Wyatt, has a family relationship with Franklin Aaron White, an employee of Cumberland Medical Center. Amount represents fair market value compensation paid during 2022 for services rendered to the organization. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | Covenant Health is the sole member of Cumberland Medical Center. |
| Form 990, Part VI, Section A, line 7a | Covenant Health's board of directors also serves as the board of directors for Cumberland Medical Center. |
| Form 990, Part VI, Section A, line 7b | Governance decisions of Cumberland Medical Center are subject to approval of the sole member, Covenant Health. |
| Form 990, Part VI, Section B, line 11b | The Covenant Health Board of Directors has delegated to its Finance Committee the full power and authority of the Board to receive, review, approve, authorize the filing of, address and resolve audit or review issues, and otherwise take all action required or appropriate relative to IRS Forms 990 and other applicable tax filings. Prior to filing Form 990, management reviews with the committee the returns, discusses any material variations in the Form 990 as compared to those to be filed by the organization's affiliates, and answers any questions. At the conclusion of review and discussion, the Finance Committee approves the Form 990. |
| Form 990, Part VI, Section B, line 12c | Board members, officers, and employees are required to adhere to rules and policies regarding conflicts of interest. Covenant Health distributes a board-approved Code of Conduct to all employees. The Code covers among other subjects, conflicts of interest and requires disclosure and resolution of employee conflicts of interest. Additionally, officers, employed physicians, and highly compensated employees are required to complete and sign an annual conflict of interest disclosure statement. Board members' conflicts of interests are addressed in the corporate bylaws, and board members are required to complete and sign a conflict of interest questionnaire on an annual basis. The Integrity-Compliance Office maintains records that contain conflict of interest information obtained from board members, officers, and employees. These records are available to be queried prior to engaging in business transactions. The Chief Compliance Officer reviews conflict of interest data. Based on this information, the officer determines what conflicts of interest exist at that point in time. Between times when surveys are collected, board members are expected to disclose any new conflicts that have arisen that affect pending board decisions. Officers and other employees are expected to report conflicts to the Chief Compliance Officer as they arise. Depending on the nature of the conflict and the circumstances surrounding the conflict and transaction, the Chief Compliance Officer, senior leadership, or the board of directors may review the conflict of interest. When appropriate, these parties may also consult legal counsel. Restrictions imposed on persons with a conflict of interest are determined on a case by case basis. For Covenant Health employees, the Chief Compliance Officer in conjunction with Covenant Health Executive Leadership determines how to appropriately manage the conflict. In any conflict involving a board member, such member is expected to recuse himself or herself from voting on matters related to the conflict. |
| Form 990, Part VI, Section B, line 15 | Form 990, Part VI, Section B, Line 15a: Overall compensation policies for Cumberland 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's Health's 990. The process for Cumberland 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 Randall Davis, 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 | Cumberland 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 15,282,594. Management and general expenses 574,412. Fundraising expenses 0. Total expenses 15,857,006. Sponsorship Fees: Program service expenses 4,954,468. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,954,468. |
| Form 990, Part XI, line 9: | Transfers of Capital 1,000,000. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cumberland Physician Group LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1420 Centerpoint Blvd Bldg C | AddressLine1Txt |
| City | Knoxville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 379321960 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371539508 | EIN |
| Primary Activities | Physician services | PrimaryActivitiesTxt |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $45,250 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cumberland Medical Center | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | 0 | Covenant Health | |
| Covenant HomeCare | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 621623114 | Home health services | TN | 501(c)(3) | Line 10 | 0 | Covenant Health | |
| Fort Loudoun Medical Center | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 621373691 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Fort Sanders Regional Medical Center | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 620528340 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Fort Sanders Foundation | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 621748601 | Fundraising and patient outreach | TN | 501(c)(3) | Line 12b, II | 0 | Covenant Health | |
| Fort Sanders Perinatal Center | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 043760551 | High risk obstetrical services | TN | 501(c)(3) | Line 3 | 0 | Fort Sanders Regional Medical Center | |
| LeConte Medical Center | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 621114867 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Methodist Medical Center | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 620636239 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Morristown-Hamblen Hospital Association | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 620545814 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Parkwest Medical Center | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 581897274 | Acute care hospital and behavioral health services | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Roane County Medical Center | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 680673354 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Thompson Cancer Survival Center | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 621250943 | Cancer support center | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Thompson Oncology Group | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 621619239 | Oncology services | TN | 501(c)(3) | Line 3 | 0 | Thompson Cancer Survival Center | |
| 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 | 0 | Covenant Health | |
| 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 | 0 | Covenant Health | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 | Yes (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 | |||||||||
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Covenant Medical Group Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | A | TransactionTypeTxt |
| Involved | $440,057 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |