2022-05-12T12:43:58-05:00 2021-06-30 621517792 PYA P C ONE CHEROKEE MILLS 2220 SUTHERLAND AVE KNOXVILLE TN 379192363 990 2020-07-01 626002604 EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION INC EAST 8655418154 PO BOX 15010 KNOXVILLE TN 379015010 CARYN HAWTHORNE VP OF FINANCE AND CFO 8655418154 2022-05-12 1 CARYN HAWTHORNE 999009999 DEBORAH O ERNSBERGER P00364912 8656730844 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MATTHEW SCHAEFER PO BOX 15010 KNOXVILLE TN 379015010 235961845 0 X HTTPS://WWW.ETCH.COM X 1937 TN AT ETCH, CHILDREN ARE OUR ONLY CONCERN, PROVIDING THE BEST HEALTHCARE TO EVERY CHILD SERVED. 21 16 2119 1287 27277 23649 9861813 9670334 193801049 208960131 13203014 12338731 3550117 3846588 220415993 234815784 71365 74438 0 0 109699246 114955120 0 0 2103199 87932312 98481525 197702923 213511083 22713070 21304701 527630957 589733118 201451391 213424849 326179566 376308269 X AT EAST TENNESSEE CHILDREN'S HOSPITAL ("ETCH"), CHILDREN ARE OUR ONLY CONCERN, AND THAT DRIVES OUR MISSION TO IMPROVE THE HEALTH OF CHILDREN THROUGH EXCEPTIONAL, COMPREHENSIVE FAMILY-CENTERED CARE, WELLNESS AND EDUCATION. IT IS A MISSION THAT CENTERS ON A PROFOUND AND UNCHANGING COMMITMENT TO THE PHYSICAL, EDUCATIONAL AND EMOTIONAL NEEDS OF EACH CHILD. 0 0 167668737 74438 211338874 EAST TENNESSEE CHILDREN'S HOSPITAL ("ETCH") IS THE ONLY COMPREHENSIVE REGIONAL PEDIATRIC CENTER IN EAST TENNESSEE. SINCE 1937, ETCH HAS PROVIDED EXCELLENT PEDIATRIC HEALTH CARE FOR CHILDREN FROM BIRTH TO 21 YEARS OF AGE. ETCH OFFERS MORE PEDIATRIC SUBSPECIALTIES THAN ANY OTHER HOSPITAL IN THE REGION, SERVING CHILDREN FROM EAST TENNESSEE, SOUTHWEST VIRGINIA, SOUTHEAST KENTUCKY AND WESTERN NORTH CAROLINA. THE SUBSPECIALTIES AVAILABLE AT ETCH INCLUDE: ADOLESCENT GYNECOLOGYADOLESCENT MEDICINE(SUBSPECIALTY LIST CONTINUED ON SCHEDULE O)CHILD ABUSE PEDIATRICSDEVELOPMENTAL-BEHAVIORAL PEDIATRICSNEONATOLOGYPEDIATRICS/PRIMARY CAREPEDIATRIC ALLERGY & IMMUNOLOGYPEDIATRIC ANESTHESIOLOGYPEDIATRIC CARDIOLOGY CLINICAL GENETICSPEDIATRIC CRITICAL CAREPEDIATRIC DENTISTRY/PEDODONTICSPEDIATRIC DERMATOLOGYPEDIATRIC EMERGENCY MEDICINEPEDIATRIC ENDOCRINOLOGYPEDIATRIC FORENSIC MEDICINEPEDIATRIC GASTROENTEROLOGYPEDIATRIC AND ADOLESCENT GYNECOLOGYPEDIATRIC HEMATOLOGY/ONCOLOGYPEDIATRIC INFECTIOUS DISEASEPEDIATRIC NEPHROLOGYPEDIATRIC NEUROLOGYPEDIATRIC NEUROSURGERYPEDIATRIC OPHTHALMOLOGYPEDIATRIC ORTHOPEDICSPEDIATRIC OTOLARYNGOLOGYPEDIATRIC PHYSIATRYPEDIATRIC PLASTIC/RECONSTRUCTIVE SURGERYPEDIATRIC PULMONOLOGYPEDIATRIC RADIOLOGYPEDIATRIC REHABILITATION SERVICESPEDIATRIC RHEUMATOLOGYPEDIATRIC SLEEP MEDICINEPEDIATRIC SURGERYPEDIATRIC UROLOGYPERINATOLOGYPSYCHOLOGYIN ADDITION, ETCH PROVIDES THE FOLLOWING: MEDICAL/SURGICAL SERVICES:THE EMERGENCY DEPARTMENT IS STAFFED WITH BOARD CERTIFIED PEDIATRIC PHYSICIANS, NURSING STAFF, AND DIAGNOSTIC CAPABILITIES TO PROVIDE TREATMENT FOR ALL TYPES OF EMERGENCIES 24 HOURS A DAY, SEVEN DAYS A WEEK. THE DEPARTMENT PROVIDES EVALUATION AND TREATMENT FOR PATIENTS UP TO 21 YEARS OF AGE WITH VARYING LEVELS OF ILLNESS AND INJURY, FROM MINOR TO LIFE THREATENING. THE HOSPITAL'S PEDIATRIC INTENSIVE CARE UNIT (PICU) PROVIDES COMPREHENSIVE, 24-HOUR-A-DAY TREATMENT FOR CRITICALLY ILL AND INJURED CHILDREN. THE PICU IS STAFFED WITH FELLOWSHIP TRAINED, BOARD CERTIFIED, CRITICAL CARE PHYSICIANS AND NURSES SPECIFICALLY TRAINED AND EXPERIENCED IN THE CARE OF CRITICALLY ILL CHILDREN. PATIENTS IN THE PICU RECEIVE A HIGH LEVEL OF MONITORING AND/OR TREATMENT UNTIL THEY ARE WELL ENOUGH TO BE TRANSFERRED TO A REGULAR PATIENT ROOM OR DISCHARGED HOME.IN THE NEONATAL INTENSIVE CARE UNIT (NICU), TINY AND FRAGILE INFANTS BORN PREMATURELY OR FACING LIFE-THREATENING ILLNESSES RECEIVE TREATMENT FROM A TEAM OF BOARD-CERTIFIED NEONATOLOGISTS, WITH VALUABLE ASSISTANCE FROM SPECIALLY TRAINED NURSES, RESPIRATORY THERAPISTS, LACTATION CONSULTANTS, AND OTHER MEDICAL PROFESSIONALS. THE NICU TREATS MORE THAN 900 NEWBORNS EACH YEAR.AS A REGIONAL REFERRAL CENTER FOR EAST TENNESSEE, ETCH OFFERS NEONATAL AND PEDIATRIC TRANSPORT FROM OUTLYING HOSPITALS IN LIFELINE, A MOBILE INTENSIVE CARE UNIT SPECIALLY DESIGNED TO MAINTAIN THE SAME QUALITY OF CARE DURING TRANSPORT AS PATIENTS RECEIVE IN THE HOSPITAL'S CRITICAL CARE UNITS. LIFELINE CARRIES MORE THAN 1,000 SUPPLIES TO ADMINISTER CARE TO PATIENTS, FROM THE TINIEST PREMATURE INFANT TO AN ADULT-SIZE PEDIATRIC PATIENT, DURING TRANSPORT TO THE HOSPITAL. IN ADDITION TO THE SPECIAL EQUIPMENT, THE LIFELINE MEDICAL TEAM MAY INCLUDE A NEONATOLOGIST, NEONATAL NURSE PRACTITIONER, PEDIATRIC/NEONATAL RN, RESPIRATORY THERAPIST, AN EMT, A-EMT, AND PARAMEDICS, DEPENDING ON THE CONDITION OF THE PATIENT. THE HOSPITAL'S TWO LIFELINE VEHICLES TRAVELED MORE THAN 32,000 MILES IN FY20 TO DOZENS OF DIFFERENT HOSPITALS IN 16 COUNTIES IN TENNESSEE, VIRGINIA, AND KENTUCKY TO TRANSPORT HUNDREDS OF PEDIATRIC PATIENTS TO ETCH.ETCH MEETS A WIDE RANGE OF PEDIATRIC SURGICAL NEEDS, FROM COMMON OUTPATIENT PROCEDURES SUCH AS TONSILLECTOMIES TO MORE COMPLICATED PROCEDURES, SUCH AS RECONSTRUCTIVE SURGERY OR NEUROSURGERY. FIVE DEPARTMENTS COMPRISE ETCH'S SURGICAL SERVICES: OPERATING ROOM, PRE/POST SURGERY (OUTPATIENT SURGERY), INPATIENT SURGERY, ANESTHESIA, AND STERILE PROCESSING. THESE DEPARTMENTS WORK TOGETHER TO MAKE SURE EACH CHILD'S SURGERY AND RECOVERY IS AS QUICK AND PAINLESS AS POSSIBLE. THE DOCTORS, NURSES, ANESTHESIOLOGISTS AND OTHER SURGICAL STAFF ARE TRAINED IN PEDIATRIC MEDICINE. AT ANY GIVEN TIME AND FOR VARIOUS REASONS, A CHILD MAY NEED TO BE ADMITTED TO ETCH AS AN INPATIENT. DOCTORS AND NURSES CONTINUOUSLY MONITOR AND TREAT INPATIENTS ACCORDING TO THEIR INDIVIDUAL NEEDS. ALONG WITH PROVIDING COMPREHENSIVE MEDICAL AND NURSING CARE, ETCH IS DEDICATED TO MAKING A CHILD'S STAY IN THE HOSPITAL AS COMFORTABLE AS POSSIBLE. EACH ROOM HAS A TV WITH ACCESS TO MOVIE CHANNELS, AND PLAY ROOMS ARE LOCATED ON EACH FLOOR. OTHER SERVICES SUCH AS CHILD LIFE, NUTRITION, PASTORAL CARE. REHABILITATION AND SOCIAL WORK PROVIDE FOR THE PHYSICAL AND EMOTIONAL NEEDS OF THE CHILD. THE RESPIRATORY CARE DEPARTMENT AT ETCH IS STAFFED WITH LICENSED AND ACCREDITED RESPIRATORY THERAPISTS WHOSE ROLES INCLUDE TREATING PATIENTS WITH LUNG AND/OR HEART DISEASES SUCH AS ASTHMA, PNEUMONIA, PREMATURE LUNGS AND CYSTIC FIBROSIS. TREATMENTS PROVIDED BY RESPIRATORY THERAPISTS INCLUDE AEROSOL MEDICATIONS, DELIVERY OF OXYGEN AND OTHER MEDICAL GASES, VENTILATOR MANAGEMENT AND MANY OTHER PROCEDURES. RESPIRATORY THERAPISTS HELP PATIENTS THROUGHOUT THE HOSPITAL, FROM THE EMERGENCY DEPARTMENT TO THE NICU. THEY ARE ALSO MEMBERS OF THE PEDIATRIC TRANSPORT TEAM THAT HELPS BRING SICK AND INJURED CHILDREN TO THE HOSPITAL FOR SPECIALIZED CARE. EDUCATION IS ALSO A KEY ROLE OF RESPIRATORY THERAPISTS; THEY TEACH PATIENTS AND THEIR FAMILIES HOW TO CARE FOR CERTAIN CONDITIONS AT HOME. THE PULMONARY FUNCTION LAB, A VITAL PART OF THE RESPIRATORY CARE DEPARTMENT, PERFORMS TESTS TO DIAGNOSE LUNG AND HEART DISEASES. THE DEPARTMENT IS STAFFED BY SPECIALLY TRAINED RESPIRATORY THERAPISTS. SERVICES PROVIDED INCLUDE SPIROMETRY TESTING, METABOLIC STUDIES, CARDIAC STRESS TESTING, LUNG VOLUMES AND THE CYSTIC FIBROSIS CLINIC. ECHOCARDIOGRAMS ARE PERFORMED IN THE ECHO LAB. PATIENTS IN A VARIETY OF HOSPITAL DEPARTMENTS MAY BENEFIT FROM SEDATION DURING SOME PAINFUL TESTS AND PROCEDURES. IN ADDITION, YOUNG CHILDREN MAY NEED SEDATION TO REMAIN STILL DURING LONG TESTS, SUCH AS A MAGNETIC RESONANCE IMAGING (MRI). TO MEET THESE NEEDS, ETCH OFFERS PEDIATRIC ANALGESIA AND SEDATION SPECIALISTS (PASS). WHILE THE HOSPITAL CANNOT ELIMINATE PAIN FOR SOME CHILDREN, IT IS OUR GOAL TO KEEP PAINFUL OR UNCOMFORTABLE SITUATIONS TO A MINIMUM. PASS IS A DEDICATED SERVICE THAT UTILIZES THE MOST CURRENT SEDATION TECHNIQUES TO HELP CHILDREN UNDERGOING LENGTHY OR PAINFUL PROCEDURES AT ETCH. A MULTISPECIALTY TEAM SEES EACH CHILD, INCLUDING A PEDIATRIC SEDATION PHYSICIAN AND PEDIATRIC NURSES WHO ARE SPECIFICALLY PREPARED TO WORK WITH PEDIATRIC SEDATION. DIAGNOSTIC SERVICES:THE CLINICAL LAB IS RESPONSIBLE FOR ALL DIAGNOSTIC TESTING, WHICH INCLUDES THE FOLLOWING AREAS: HEMATOLOGY, CHEMISTRY, MICROBIOLOGY, IMMUNOLOGY, SEROLOGY AND BLOOD BANK.NEUROLOGY LAB - THE NEUROLOGY LAB OFFERS A VARIETY OF DIAGNOSTIC TESTS FOR PATIENTS DEALING WITH SEIZURES, HEARING PROBLEMS, SLEEP DISORDERS AND OTHER CONDITIONS INVOLVING THE BRAIN. THE MOST COMMON TESTS OFFERED IN THE NEUROLOGY LABORATORY ARE THE ELECTROENCEPHALOGRAM (EEG) FOR CHILDREN HAVING SEIZURES AND OTHER NEUROLOGICAL PROBLEMS AND THE BRAINSTEM AUDITORY EVOKED RESPONSE (BAER) HEARING TEST, OFFERED MOST OFTEN TO INFANTS WHO FAIL NEWBORN HEARING SCREENINGS AND TODDLERS WHO ARE SPEECH DELAYED. CHILDREN'S SLEEP MEDICINE CENTER - THE CHILDREN'S SLEEP MEDICINE CENTER OFFERS SLEEP STUDY TESTING FOR CHILDREN WHO ARE HAVING PROBLEMS WITH SLEEP. THE SLEEP STUDIES TAKE PLACE OVERNIGHT, DURING THE CHILD'S REGULAR SLEEP CYCLE, TO FIND THE CAUSE OF PROBLEMS SUCH AS SLEEP DISORDERED BREATHING AND PARASOMNIAS (NIGHT TERRORS, SLEEPWALKING). ETCH IS ACCREDITED BY THE AMERICAN ACADEMY OF SLEEP MEDICINE AS THE ONLY SLEEP MEDICINE CENTER DEDICATED TO PEDIATRICS IN EAST TENNESSEE.THE RADIOLOGY DEPARTMENT SERVES AS AN "IMAGING" CENTER FOR CHILDREN. THESE IMAGES INCLUDE X-RAY, ULTRASOUND, CT SCAN, NUCLEAR MEDICINE, MRI, AND FLUOROSCOPY. 167668737 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 1 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 302 6 1 2119 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 21 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 TN X CARYN HAWTHORNE 8655418154 PO BOX 15010 KNOXVILLE TN 379015010 X ANDREA ANNE WHITE VICE CHAIR 2.00 X 0 0 0 BARBARA SUMMERS MD BOARD MEMBER 2.00 X 0 0 0 BOB BASKERVILLE BOARD MEMBER 2.00 X 0 0 0 BRIAN T FERGUSON BOARD MEMBER 2.00 X 0 0 0 BRYAN THOMAS DANIELS BOARD MEMBER 2.00 X 0 0 0 CAMERON J SEARS MD BOARD MEMBER 2.00 X 0 0 0 CATHY ACKERMANN BOARD MEMBER 2.00 X 0 0 0 DANIEL K CARTER BOARD MEMBER 2.00 X 0 0 0 DAVID D STEVENS BOARD MEMBER 2.00 X 0 0 0 JAMES B CLAYTON BOARD MEMBER 2.00 X 0 0 0 JOHN Q BUCHHEIT MD BOARD MEMBER 2.00 X 0 0 0 KEITH D GOODWIN FORMER PRESIDENT & CEO 40.00 X 768355 0 28395 KIM WOOD BOARD MEMBER 2.00 X 0 0 0 LARRY B MARTIN CHAIRMAN 2.00 X 0 0 0 MATT SCHAEFER BOARD MEMBER/PRES & CEO 40.00 X X 263579 0 7958 NIKITIA THOMPSON BOARD MEMBER 2.00 X 0 0 0 RANDALL L GIBSON BOARD MEMBER 2.00 X 0 0 0 RYAN L REDMAN MD BOARD MEMBER 2.00 X 0 0 0 SCOTT DANIEL BOARD MEMBER 2.00 X 0 0 0 SCOTT W BRICE MD BOARD MEMBER 2.00 X 0 0 0 STEVEN D HARB SECRETARY/TREASURER 2.00 X 0 0 0 VICTORIA NIEDERHAUSER BOARD MEMBER 2.00 X 0 0 0 CARYN HAWTHORNE VP/CHIEF FINANCIAL OFFICER 40.00 X 340780 0 66664 CARLTON LONG VP DEVELOPMENT 40.00 X 287939 0 48523 CATHY SHUCK VP OF LEGAL SERVICES 40.00 X 208368 0 27609 HELLA EWING FORMER VP OF PATIENT SERVICES/CNO 40.00 X 314883 0 48682 RONALD J PHILLIPS VP OF PATIENT SERVICES/CNO 40.00 X 288742 0 20667 STEVEN GODBOLD VP OPERATIONS 40.00 X 446382 0 64876 SUE WILBURN VP HUMAN RESOURCES 40.00 X 223431 0 46262 CARLOS A ANGEL MD PEDIATRIC SURGEON 40.00 X 621357 0 26426 DAVID HURST MD PEDIATRIC CARDIOLOGIST 40.00 X 612006 0 34723 ERIC JENSEN MD PEDIATRIC SURGEON 40.00 X 586434 0 43796 SUMEET SHARMA MD PEDIATRIC CARDIOLOGIST 40.00 X 909419 0 51970 WILLIAM GLAZE VAUGHAN MD PEDIATRIC SURGEON 40.00 X 625931 0 40320 6497606 0 556871 115 1 1 0 CHILDREN'S ANESTHESIOLOGISTS PC 2018 W CLINCH AVENUE KNOXVILLE TN 37916 PHYSICIAN SERVICES 10617755 SOUTHEASTERN EMERGENCY PHYSICIANS LLC 265 BROOKVIEW CENTRE WAY 400 KNOXVILLE TN 37919 PHYSICIAN SERVICES 4370694 OAK RIDGE PEDIATRIC CLINIC PC 145 EAST VANCE ROAD OAK RIDGE TN 37830 PHYSICIAN SERVICES 3229851 QUEST DIAGNOSTICS 900 E OAK HILL AVE KNOXVILLE TN 37917 LAB SERVICES 2527077 BLOUNT PEDIATRIC ASSOCIATES 414 GREENBELT DRIVE MARYVILLE TN 37801 PHYSICIAN SERVICES 1579937 44 491651 465574 8713109 9670334 PATIENT CARE REVENUE 621990 203103883 203076606 27277 CARES ACT RELIEF FUNDING 621990 4193515 4193515 OTHER HEALTHCARE SRVCS 621990 1556043 1556043 PASSTHROUGH REVENUE 621110 106690 106690 208960131 12600215 12600215 1200115 0 1200115 1200115 1200115 100226 361710 -261484 -261484 -261484 77015 491651 128670 -51655 -51655 68286 30237 38049 38049 634838 625444 9394 9394 MISCELLANEOUS 900099 1467389 1467389 CAFETERIA SALES 621110 1183296 1183296 2650685 234815784 211338874 27277 13779299 X 74438 74438 3454408 2582858 580481 291069 87014551 71003420 15246641 764490 1911888 1554581 335000 22307 15885365 12916595 2783425 185345 6688908 5438837 1172027 78044 169073 169073 95330 95330 29320855 23745858 5099651 475346 3028164 62115 2966049 156415 96162 56418 3835 3422446 3422446 11218141 9993392 1224575 174 1434671 1434671 SUPPLIES 29927746 28020214 1837608 69924 MAINTENANCE AND RENTAL 9762567 3832021 5872377 58169 BAD DEBT 7121551 7121551 2824566 962292 1707778 154496 213511083 167668737 43739147 2103199 19138225 17174367 3864292 5379177 24464606 28547155 1052505 1045168 3698563 4140850 1495635 2079479 316484787 134909777 161340454 181575010 203375834 249434555 26124078 29436887 83076765 70920470 527630957 589733118 27395949 31125701 1093523 1093523 123323480 122987193 49638439 58218432 201451391 213424849 X 290172707 333795702 36006859 42512567 326179566 376308269 527630957 589733118 X 21304701 31946510 -3122508 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 18294555 65153 18359708 18244675 49880 18294555 18209392 35283 18244675 18188295 21097 18209392 18164211 24084 18188295 1.00000 0 0 1697537 8567238 10264775 191397511 66024737 125372774 99863207 68885040 30978167 14959294 14959294 181575010 INTERCOMPANY RECEIVABLES 58140914 OTHER RECEIVABLES 2891689 UNAMORTIZED BOND EXPENSE 678823 TRUSTEED BOND FUNDS 5151731 RIGHT OF USE ASSETS - OPERATING LEASE 4057313 70920470 NET INVESTMENT IN SUBSIDIARIES 52779070 ESTIMATED THIRD PARTY PAYABLE 1291896 OPERATING LEASE LIABILITY 4147466 58218432 X PART X, LINE 2: PER THE EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC. AND SUBSIDIARIES AUDITED CONSOLIDATED FINANCIAL STATEMENTS: FEDERAL INCOME TAXES: THE HOSPITAL IS CLASSIFIED AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS RELATED TO THE 501(C)(3) ORGANIZATION. CHILDREN'S PRIMARY CARE CENTER AND COLLECTOR'S, INC. OF KNOXVILLE ARE TAXABLE ENTITIES. THE HOSPITAL HAS NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2021. AT JUNE 30, 2021, TAX RETURNS FOR FISCAL YEARS 2018 THROUGH 2020 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. FANTASY OF TREES 244171 167156 77015 61121 GOLF TOURNAMENT 191266 191266 35880 17368 1 133229 133229 1000 13301 568666 491651 77015 36880 91790 128670 -51655 68286 10744 19493 1 1.00000 68286 10744 19493 30237 38049 TN 1 0 1 0 1.00000 LESA HAWKINS PO BOX 15010 KNOXVILLE TN 379015010 0 PATRICIA SCOTT PATRICIA SCOTT IS THE COMMUNITY DEVELOPMENT OFFICER AND THE COORDINATOR FOR THE FANTASY OF TREES. THE DEVELOPMENT DEPARTMENT IS RESPONSIBLE FOR THE FANTASY OF TREES EVENT. THE RAFFLE TREE IS THE GAMING EVENT HELD WITHIN THE FANTASY OF TREES. THE DEVELOPMENT DEPARTMENT FOSTERS THE RELATIONSHIP WITH RAFFLE SPONSORS AND DECIDES WHERE/ HOW THE AREA IS DESIGNED ON THE FLOOR. THE DEVELOPMENT DEPARTMENT RECRUITS VOLUNTEERS TO SELL RAFFLE TICKETS, LOCK THE DRUM, AND ARRANGE THE TICKET DRAWING AND DELIVERY. X 1 1 1 1 X 250.000000000000 1 X 1 1 1 0 1 1 1167494 1167494 0.00570 111471877 87596963 23874914 0.11570 112639371 87596963 25042408 0.12140 159004 2763297 198098 2565199 0.01240 2641 3064686 6246 3058440 0.01480 173053 2680 170373 0.00080 137908 742394 1993 740401 0.00360 299553 6743430 209017 6534413 0.03160 299553 119382801 87805980 31576821 0.15300 37538 0 37538 0.00020 36372 0 36372 0.00020 8236 8078 0 8078 0.00000 12 541995 0 541995 0.00260 8248 623983 623983 0.00300 1 2513412 15083 118327 -103244 X 1 1 1 CHILDREN'S WEST SURGERY CENTER LLC MEDICAL SURGERY CENTER 0.50000 0.50000 1 1 EAST TENNESSEE CHILDREN'S HOSPITAL PO BOX 15010 KNOXVILLE TN 379015010 HTTP://WWW.ETCH.COM/ X X EAST TENNESSEE CHILDREN'S HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X HTTPS://WWW.ETCH.COM X 1 18 1 HTTPS://WWW.ETCH.COM/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX 0 1 X 250.000000000000 400.000000000000 0 1 X X X 1 X HTTP://WWW.ETCH.COM/ X HTTP://WWW.ETCH.COM/ X HTTP://WWW.ETCH.COM/ X X 1 0 X 1 X 0 0 EAST TENNESSEE CHILDREN'S HOSPITAL PART V, SECTION B, LINE 5: THE FOLLOWING FOCUS GROUPS PARTICIPATED IN THE ETCH 2019 CHNA:SIX FOCUS GROUPS WERE CONDUCTED BY EXPERT EVALUATORS FROM THE COLLEGE OF SOCIAL WORK OFFICE OF RESEARCH AND PUBLIC SERVICE (SWORPS) AT THE UNIVERSITY OF TENNESSEE. THE FOCUS GROUPS WERE CONDUCTED WITH: 1. EAST TENNESSEE CHILDREN'S HOSPITAL FAMILY ADVISORY COUNCIL2. REGIONAL COORDINATED SCHOOL DIRECTORS3. REGIONAL HEALTH DEPARTMENT DIRECTORS4. PRIMARY CARE PHYSICIANS5. EAST TENNESSEE CHILDREN'S HOSPITAL BOARD OF DIRECTORS6. EAST TENNESSEE CHILDREN'S HOSPITAL MANAGEMENT TEAMA SURVEY FOR THE GENERAL POPULATION WAS CREATED TO GAIN INPUT FROM COMMUNITY RESIDENTS AND KEY STAKEHOLDERS ABOUT THE TOP HEALTH NEEDS AND PRIORITIES OF CHILDREN. WE PROMOTED THE SURVEY ON THE CHILDREN'S HOSPITAL WEBSITE AND SOCIAL MEDIA TO ENCOURAGE PEOPLE TO COMPLETE AN ONLINE, CONFIDENTIAL SURVEY.THE GATHERING AND ANALYZING PHASE OF THE CHNA INCLUDES INTERVIEWING KEY INFORMANTS, CONDUCTING FOCUS GROUPS AND COLLECTING INFORMATION THROUGH AN ONLINE SURVEY. DATA FROM THE KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND COMMUNITY SURVEY WERE ANALYZED TO TRIANGULATE FINDINGS AND IDENTIFY COMMON THEMES. THREE PRIMARY HEALTH ISSUES OF CONCERN EMERGED: MENTAL AND BEHAVIORAL HEALTH, OBESITY, AND SUBSTANCE ABUSE-RELATED ISSUES -- INCLUDING, BUT NOT LIMITED TO: NEONATAL ABSTINENCE SYNDROME (NAS), ADDICTION AND INCARCERATION OF PARENTS, AND DRUG EXPERIMENTATION BY CHILDREN. EAST TENNESSEE CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11: THE NEEDS ASSESSMENT PROCESS ALLOWS CHILDREN'S HOSPITAL TO IDENTIFY THE PEDIATRIC HEALTH CARE NEEDS IN OUR REGION AND DIRECT OUR COMMITMENT TO PROVIDING RESOURCES TO HELP POSITIVELY IMPACT CHILD HEALTH. IN ADDITION TO THE MANY VALUABLE, INNOVATIVE PROGRAMS AND SERVICES AVAILABLE AT CHILDREN'S HOSPITAL, THE HEALTH NEEDS IDENTIFIED THROUGH THE INFORMATION GATHERING PROCESS INCLUDE: CHILDHOOD OBESITY, MENTAL AND BEHAVIORAL HEALTH, AND NAS. IN MAY 2019, THE CHILDREN'S HOSPITAL BOARD OF DIRECTORS UNANIMOUSLY APPROVED THE PRIORITIZED FOCUS AREAS DESCRIBED BELOW TO BE THE FOUNDATION OF OUR IMPLEMENTATION STRATEGY.WHILE MENTAL AND BEHAVIORAL HEALTH, OBESITY, AND SUBSTANCE ABUSE-RELATED ISSUES HAVE BEEN THE MOST UNIVERSALLY IDENTIFIED THUS FAR, MANY OTHER IMPORTANT HEALTH ISSUES AND SOCIAL DETERMINANTS HAVE BEEN DISCUSSED IN THE COURSE OF THE CHNA PROCESS AND ARE WORTHY OF CONSIDERATION IN THE LATER STRATEGIC PLANNING PHASE. THESE ISSUES INCLUDE BUT ARE NOT LIMITED TO: - ACCESS TO TRANSPORTATION- ADVERSE CHILDHOOD EXPERIENCES (ACESS)- ASTHMA AND ALLERGIES- ATTENTION DEFICIT AND HYPERACTIVITY- AUTISM AND SENSORY PROCESSING DISORDERS- DENTAL CARE ACCESS- DOMESTIC VIOLENCE- DURABLE MEDICAL EQUIPMENT FOR CHILDREN WITH SPECIAL NEEDS- ECONOMIC UNDERDEVELOPMENT- FOOD INSECURITY- LOW-QUALITY HOUSING- MULTI-GENERATIONAL POVERTY- PARENTING EDUCATION- SEX EDUCATION- SMOKING AND NICOTINE VAPING- SOCIAL MEDIA AND CYBERBULLYING- SUICIDE PREVENTION- UNEMPLOYMENTWHILE CHILDREN'S HOSPITAL WOULD CONTINUE FOCUS ON THE MAJORITY OF EFFORTS OUTLINED IN OUR IMPLEMENTATION STRATEGY, ALL NEEDS IDENTIFIED WILL BE REVIEWED FOR FUTURE CONSIDERATION AND COLLABORATION. THESE AREAS, WHILE STILL IMPORTANT TO THE HEALTH OF CHILDREN IN THE COMMUNITY, WILL BE MET THROUGH OTHER HEALTH CARE ORGANIZATIONS WITH ASSISTANCE FROM CHILDREN'S HOSPITAL AS NEEDED. THE COMMUNITY NEEDS NOT ADDRESSED BY CHILDREN'S HOSPITAL WILL CONTINUE TO BE ADDRESSED BY GOVERNMENTAL AGENCIES AND EXISTING COMMUNITY-BASED ORGANIZATIONS. PART I, LINE 7: A COST-TO-CHARGE RATIO, DERIVED FROM THE SCHEDULE H APPLICABLE WORKSHEETS, INCLUDING WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES, WAS USED TO DETERMINE CHARITY CARE. ACTUAL EXPENSE DATA IS ACCUMULATED WITHIN THE ETCH GENERAL LEDGER WHICH ADDRESSES ALL PATIENT SEGMENTS INCLUDING INPATIENT, OUTPATIENT, EMERGENCY ROOM, COMMERCIAL INSURANCE, GOVERNMENT INSURANCE, UNINSURED AND SELF-PAY. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO INDIGENT AND CHARITY CARE CHARGES TO ARRIVE AT COST. THE STATE OF TENNESSEE'S COVERKIDS PROGRAM PROVIDES COVERAGE FOR THE VAST MAJORITY OF CHILDREN WHO REQUIRE MEDICAL CARE BUT ARE UNINSURED. ETCH REPRESENTATIVES WORK EXTENSIVELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND AVAILABILITY OF STATE AID AND TO ASSIST THEM IN BECOMING ENROLLED IN THE PROGRAM. FOR THAT REASON, THE AMOUNT OF TRUE "CHARITY CARE" RENDERED BY ETCH IS CONSIDERABLY SMALLER THAN LEVELS EXPERIENCED BY COMMUNITY HOSPITALS OR OTHER FACILITIES SERVING THE ADULT POPULATION. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 7,121,551. PART II, COMMUNITY BUILDING ACTIVITIES: ETCH PROVIDES NUMEROUS BENEFITS TO THE PUBLIC AND PROMOTES THE HEALTH OF THE COMMUNITY IN THE FOLLOWING WAYS:1. COMMUNITY SUPPORT: ETCH EMPLOYEES VOLUNTEER TIME TO THE FOLLOWING NEIGHBORHOOD SUPPORT GROUPS: RONALD MCDONALD HOUSE, SHOES FOR SCHOOLS, UNITED WAY AND BOARD SUPPORT FOR ORGANIZATIONS. 2. COALITION BUILDING AND COMMUNITY HEALTH IMPROVEMENT ADVOCACY: ETCH PARTICIPATED IN THE FOLLOWING COMMUNITY COALITIONS TO ADDRESS HEALTH AND SAFETY ISSUES SPECIFIC TO CHILDREN. A. EAST TENNESSEE CHILDHOOD OBESITY COALITION WHOSE MISSION IS TO PREVENT AND REDUCE CHILDHOOD OBESITY BY PROMOTING HEALTHY, ACTIVE LIFESTYLES THROUGH FAMILY, COMMUNITY AND INTER-PROFESSIONAL COLLABORATIONS. ETCH PROMOTES THESE ACTIVITIES THROUGH THE HEALTH KIDS CLUB PROGRAM TO AREA ELEMENTARY SCHOOLS. B. SAFEKIDS. THE ETCH INJURY PREVENTION PROGRAM IS THE LEADER OF A COALITION TO PREVENT ACCIDENTAL INJURY. THE SAFE TRAVELS PROGRAM TRAINS LOCAL AGENCY MEMBERS ON CHILD PASSENGER SAFETY AND DISTRIBUTES CAR SEATS TO THOSE IN NEED ALONG WITH INSTALLATION TRAINING. THE PROGRAM ALSO PROVIDES BIKE HELMETS AND HELPS EDUCATE KIDS AND PARENTS ABOUT HELMET USE AND INJURY PREVENTION. ALSO, WE PROVIDE A WIDE SCOPE OF PUBLIC EDUCATION ON WATER SAFETY AND HEAT STROKE PREVENTION. C. ETCH PROVIDES TRAINING FOR AED USAGE AND CPR ADMINISTRATION IN MANY PUBLIC SCHOOLS AND AREAS. D. ETCH PROVIDES ASTHMA SCREENINGS IN LOCAL COMMUNITY THROUGH THE BREATHE EASY PROGRAM ALONG WITH FOLLOW-UP CALLS TO THOSE WHO HAVE AN ABNORMAL SCREENING RESULT. E. OTHER ACTIVITIES INCLUDE SAFESITTER CLASSES, CPR TRAINING, CAMPS FOR CHILDREN, HELLO HOSPITAL, MEDIC BLOOD DRIVES, VOLUNTEEN PROGRAM AND INFANT AND CHILD TRAINING FOR ADULT HOSPITALS AND EMERGENCY AGENCIES.3. WORKFORCE DEVELOPMENT: ETCH RECRUITS PHYSICIAN SPECIALTIES AND OTHER HEALTH PROFESSIONALS DEDICATED TO SERVING THE CHILD & ADOLESCENT POPULATION TO MEDICAL SHORTAGE AREAS OR OTHER AREAS DESIGNATED AS UNDERSERVED. PROJECT SEARCH IS A YEAR-LONG PROGRAM PROVIDING ADULTS WITH DISABILITIES THE EDUCATION AND EXPERIENCE THEY NEED FOR SUCCESSFUL EMPLOYMENT. 4. EDUCATION OF HEALTH PROFESSIONALS: ETCH PROVIDES EDUCATIONAL PROGRAMS FOR PHYSICIANS, RESIDENTS, NURSES, NURSING STUDENTS AND OTHER HEALTH PROFESSIONALS. 5. RESEARCH: ETCH PARTICIPATES IN RESEARCH IN HEMATOLOGY, PULMONOLOGY AND ENDOCRINOLOGY. PART III, LINE 4: A COST-TO-CHARGE RATIO WAS ALSO USED TO DETERMINE BAD DEBT COST. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO THE BAD DEBT EXPENSE TO ARRIVE AT COST.ETCH'S FINANCIAL STATEMENTS READ AS FOLLOWS: USING A PORTFOLIO APPROACH, THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. IN ADDITION, FOR UNINSURED PATIENTS, THE HOSPITAL REDUCES CHARGES FROM CURRENT RATES BASED ON AVERAGE DISCOUNTS PROVIDED TO CERTAIN THIRD-PARTY PAYERS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. ADJUSTMENTS FOR SUCH CHANGES IN THE ESTIMATED TRANSACTION PRICE WERE NOT SIGNIFICANT FOR THE YEAR ENDED JUNE 30, 2021. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. NO SIGNIFICANT AMOUNT OF BAD DEBT EXPENSE WAS REPORTED FOR THE YEARS ENDED JUNE 30, 2021 AND 2020. PART III, LINE 8: A COST-TO-CHARGE RATIO WAS USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO MEDICARE CHARGES TO ARRIVE AT COST.THE SHORTFALL OF $103,244 AS REPORTED IN PART III, LINE 7, SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE, ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. ALSO, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS, AND THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: UNDER ETCH'S POLICIES AND PROCEDURES, ETCH UNDERTAKES MEASURES TO COMMUNICATE WITH THE FAMILIES OF PATIENTS WITH SELF-PAY BALANCES. IN MANY CASES, ETCH AND FAMILIES WORK TOGETHER TO OBTAIN COVERAGE THROUGH THE STATE OF TENNESSEE'S COVERKIDS PROGRAM. IN CASES WHERE COVERKIDS COVERAGE IS NOT AVAILABLE, ETCH SEEKS TO OBTAIN INFORMATION NECESSARY TO DETERMINE THE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER ETCH'S CHARITY CARE PROGRAM. ONCE A PATIENT'S ELIGIBILITY FOR FREE OR DISCOUNTED CARE HAS BEEN DETERMINED, THE BALANCE ON THE PATIENT'S ACCOUNT IS ADJUSTED ACCORDINGLY. IN ADDITION, ETCH PERSONNEL WORK CLOSELY WITH FAMILIES TO DETERMINE THEIR ABILITY TO PAY THE ADJUSTED BALANCES; SUCH EFFORTS OFTEN RESULT IN PAYMENT PLANS INTENDED TO PERMIT THE GRADUAL PAYMENT OF AMOUNTS DUE WITHOUT IMPOSING UNDUE FINANCIAL HARDSHIP ON FAMILIES ALREADY DEALING WITH THE CHALLENGES OF CHILDREN'S HEALTH ISSUES. UNFORTUNATELY, THERE REMAIN CIRCUMSTANCES WHERE PATIENTS CANNOT BE DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE DUE TO THE INACCESSIBILITY OF THE FAMILY OR THE FAMILY'S INABILITY OR REFUSAL TO PROVIDE THE REQUIRED INFORMATION. IN SUCH CASES, ETCH FOLLOWS AN ESTABLISHED MULTI-STEP PROCESS CONSISTING OF MAILED NOTICES AND PHONE CALLS IN AN EFFORT TO REACH OUT TO THE FAMILY AND PROVIDE THEM WITH INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE PROGRAM. ETCH'S COLLECTION PRACTICES APPLY TO ALL PATIENTS, CHARITY CARE AND NON-CHARITY CARE PATIENTS. ACCOUNTS ARE SENT TO COLLECTIONS (ETCH CONTRACTS WITH AN ORGANIZATION WITH SUBSTANTIAL EXPERIENCE IN COLLECTION OF PATIENT ACCOUNTS) ONLY AFTER ALL ESTABLISHED STEPS HAVE BEEN UNDERTAKEN, WITHOUT SUCCESS. PART VI, LINE 2: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS IS THE FOUNDATION FOR IMPROVING AND PROMOTING THE HEALTH STATUS OF OUR COMMUNITY'S CHILDREN. THE PLANNING, ACTIVITIES AND DATA REVIEW NECESSARY FOR THE DEVELOPMENT OF THE MOST RECENT ASSESSMENT TOOK PLACE BEGINNING JANUARY 2018 AND EXTENDED THROUGH SPRING 2019 AND INCLUDES STATE AND COUNTY-SPECIFIC DATA COLLECTION AND PRIMARY DATA OBTAINED THROUGH SURVEYS AND INTERVIEWS WITH INDIVIDUALS FROM LOCAL COMMUNITIES.THROUGHOUT THE CHNA, HIGH PRIORITY WAS GIVEN TO DETERMINING THE HEALTH STATUS AND AVAILABLE RESOURCES WITHIN A 16-COUNTY SERVICE AREA INCLUDING ANDERSON, BLOUNT, CAMPBELL, CLAIBORNE, COCKE, GRAINGER, HAMBLEN, JEFFERSON, KNOX, LOUDON, MONROE, MORGAN, ROANE, SCOTT, SEVIER AND UNION. THESE COUNTIES WERE IDENTIFIED AS CORE COUNTIES BASED ON PATIENT POPULATION DATA. AFTER CAREFUL EVALUATION OF ALL PRIMARY AND SECONDARY DATA, HEALTH PRIORITIES WERE IDENTIFIED. THE PLANNING PROCESS FOR THE FISCAL YEAR 2019 CHNA BEGAN IN JANUARY 2018. AN INTERNAL TEAM WAS FORMED TO IDENTIFY AND APPROVE RESOURCES AND TIMELINES FOR CONDUCTING THE NECESSARY STEPS FOR FORMATION OF THE NEEDS ASSESSMENT. A SCHEDULE WAS ESTABLISHED TO ALLOW SUFFICIENT TIME AND RESOURCES TO IDENTIFY AND ENGAGE COMMUNITY PARTNERS IN KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. THE INTERNAL TEAM USED A MODIFIED VERSION OF THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS. THIS PROCESS IS COMMONLY USED TO ASSIST COMMUNITY HEALTH ORGANIZATIONS DURING THE NEEDS ASSESSMENT PROCESS. THE MAPP PROCESS PROVIDED THE FRAMEWORK FOR CHILDREN'S HOSPITAL TO ORGANIZE, VISUALIZE, ASSESS, STRATEGIZE, FORMULATE GOALS AND TAKE ACTION. KEY INFORMANTS WERE IDENTIFIED IN SIXTEEN COUNTIES AND BY USING THE FOLLOWING CRITERIA:1. THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; 2. AT LEAST ONE STATE, LOCAL, TRIBAL, OR REGIONAL GOVERNMENT PUBLIC HEALTH DEPARTMENT (OR EQUIVALENT DEPARTMENT OR AGENCY) OR STATE OFFICE OF RURAL HEALTH WITH KNOWLEDGE, INFORMATION, OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THAT COMMUNITY; 3. MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, OR INDIVIDUAL OR ORGANIZATIONS SERVING OR REPRESENTING THE INTEREST OF SUCH POPULATIONS; 4. MEMBERS OF MEDICALLY UNDERSERVED POPULATIONS INCLUDE POPULATIONS EXPERIENCING HEALTH DISPARITIES OR AT RISK OF NOT RECEIVING ADEQUATE MEDICAL CARE AS A RESULT OF BEING UNINSURED OR UNDERINSURED OR DUE TO GEOGRAPHIC, LANGUAGE, FINANCIAL OR OTHER BARRIERS. EACH INTERVIEWER WAS CONTACTED USING A UNIFORM SCRIPT. THESE FACE-TO-FACE INTERVIEWS WERE CONDUCTED BY CHILDREN'S HOSPITAL ADMINISTRATIVE AND COMMUNITY BENEFIT STAFF AT SCHEDULED TIMES. PART VI, LINE 3: ETCH RECOGNIZES THAT UNEXPECTED MEDICAL PROBLEMS CAN CREATE UNEXPECTED FINANCIAL PROBLEMS. ETCH IS AVAILABLE TO ASSIST PATIENTS' FAMILIES IN FINDING RESOURCES THAT HELP TO COVER MEDICAL EXPENSES. AS INDICATED ABOVE, ETCH WORKS CLOSELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND AND ENROLL IN MEDICAL ASSISTANCE PROGRAMS AVAILABLE THROUGH THE STATE OF TENNESSEE AND, WHERE APPROPRIATE, FEDERAL PROGRAMS. WHERE SUCH PROGRAMS ARE NOT AVAILABLE, HOWEVER, PATIENTS MAY BE ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER ETCH'S ESTABLISHED POLICIES AND PROCEDURES. THE AVAILABILITY OF FINANCIAL ASSISTANCE IS PUBLICIZED THROUGHOUT THE ETCH FACILITY AND THROUGH VARIOUS MEASURES, INCLUDING INFORMATION ON ETCH'S WEBSITE AND WRITTEN BROCHURES OR OTHER MATERIALS PROVIDED TO PATIENT'S FAMILIES. INFORMATION (IN BOTH ENGLISH AND SPANISH) IS MADE AVAILABLE AT ALL POINTS OF REGISTRATION (INTAKE AND DISCHARGE) AS WELL AS ON THE ETCH WEBSITE. THE MOST SIGNIFICANT EDUCATION, HOWEVER, OCCURS IN DIRECT DIALOGUE BETWEEN PATIENT FAMILIES AND ETCH'S TRAINED PATIENT ACCOUNT REPRESENTATIVES. ETCH MAKES EXTENSIVE EFFORTS TO PERMIT FACE-TO-FACE DIALOGUE, AS WELL AS COMMUNICATION VIA TELEPHONE AND OTHER MEANS, AS NECESSARY TO ENSURE THAT FAMILIES ARE PROVIDED WITH SUFFICIENT INFORMATION REGARDING FREE OR DISCOUNTED CARE, AS WELL AS THE BILLING AND COLLECTION PROCESS. ALL STAFF WITH PATIENT CONTACT ARE KNOWLEDGEABLE ABOUT THE CHARITY CARE POLICY (ADMITTING AND BILLING CLERKS, NURSING AND MEDICAL STAFF, SOCIAL WORKERS, ETC.). PART VI, LINE 4: ALTHOUGH ETCH SERVES THE ENTIRE EAST TENNESSEE REGION AS A COMPREHENSIVE REGIONAL PEDIATRIC CENTER, NEARLY HALF OF ETCH'S TOTAL PATIENT VISITS ARE FROM KNOX COUNTY RESIDENTS. CHILDREN RESIDING IN NEIGHBORING BLOUNT AND SEVIER COUNTIES GENERATE THE NEXT HIGHEST PATIENT VISITS.THERE ARE SIGNIFICANT DISPARITIES IN SOCIOECONOMIC CONDITIONS BETWEEN THE 16 COUNTIES SERVED BY EAST TENNESSEE CHILDREN'S HOSPITAL. THE RATE OF CHILDREN LIVING IN POVERTY IS EQUIVALENT OR EXCEEDS 25% OF THE CHILDHOOD POPULATION IN 10 OF THE 16 COUNTIES. THE PERCENTAGE OF CHILDREN WHO ARE PARTICIPATING IN FREE OR REDUCED LUNCH PROGRAMS AT SCHOOL APPROACHES 50% FOR ALL COUNTIES AND EXCEEDS 70% IN FOUR COUNTIES. POVERTY AND FOOD INSECURITY ARE GROWING CONCERNS BECAUSE OF THE LINKAGES BETWEEN THESE SOCIAL DETERMINANTS AND POOR HEALTH OUTCOMES. PART VI, LINE 5: ETCH'S PHILOSOPHY IS THAT, BECAUSE CHILDREN ARE SPECIAL, THEY DESERVE THE BEST POSSIBLE HEALTH CARE GIVEN IN A POSITIVE, CHILD/FAMILY CENTERED ATMOSPHERE OF FRIENDLINESS AND COOPERATION REGARDLESS OF RACE, RELIGION, OR ABILITY TO PAY. ETCH IS COMMITTED TO CARING FOR VULNERABLE POPULATIONS SUCH AS CHILDREN WITH SPECIAL MEDICAL NEEDS, ADVOCATING FOR THE HEALTH AND SAFETY OF CHILDREN AS PART OF THE COMMON GOOD AND EFFECTIVELY STEWARDING COMMUNITY RESOURCES. ETCH OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS, WITHOUT REGARD TO THE ABILITY TO PAY. ETCH USES ANY SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND, OR IMPROVE ITS FACILITIES, AND ADVANCE ITS MEDICAL TRAINING, EDUCATION AND RESEARCH PROGRAMS. ETCH'S BOARD OF DIRECTORS CONSISTS PRIMARILY OF INDIVIDUALS REPRESENTING THE COMMUNITY. ETCH MAINTAINS AN OPEN MEDICAL STAFF, WITH MEMBERSHIP AND PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS AND HEALTH CARE PROFESSIONALS. IN THESE AND OTHER RESPECTS, ETCH IS ORGANIZED AND OPERATED IN A MANNER THAT PROMOTES THE HEALTH OF THE COMMUNITY AND, THEREFORE, FULFILLS CHARITABLE PURPOSES WITHIN THE MEANING OF INTERNAL REVENUE CODE SECTION 501(C)(3).ADDITIONALLY, PLEASE REFER TO THE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS AS PROVIDED IN SCHEDULE O FOR FURTHER DOCUMENTATION REGARDING ETCH'S COMMITMENT WITHIN ITS COMMUNITY. PART VI, LINE 6: ETCH IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES TN 1 THE RONALD MCDONALD HOUSE 1705 WEST CLINCH AVENUE KNOXVILLE TN 37916 581510276 501(C)(3) 5000 GOLF TOURNAMENT SPONSORSHIP VARIETY OF EASTERN TENNESSEE 101 BLOUNT AVENUE KNOXVILLE TN 37920 331025696 501(C)(3) 5000 GENERAL SUPPORT KNOXVILLE AREA CHAMBER PARTNERSHIP 17 MARKET SQUARE 201 KNOXVILLE TN 37902 620262640 501(C)(6) 5000 GENERAL SUPPORT BOYS & GIRLS CLUBS OF THE TENNESSEE VALLEY 967 IRWIN ST KNOXVILLE TN 37917 620475743 501(C)(3) 7333 GENERAL SUPPORT THE UNIVERSITY OF TENNESSEE FOUNDATION INC 1200 VOLUNTEER BLVD KNOXVILLE TN 379964180 621844686 501(C)(3) 6500 GENERAL SUPPORT CHILDREN'S EMERGENCY CARE ALLIANCE OF TENNESSEE 3841 GREEN HILLS VILLAGE DRIVE SUITE 3048 NASHVILLE TN 37215 202802786 501(C)(3) 22500 GENERAL SUPPORT 5 1 PART I, LINE 2: THE ORGANIZATION HAS GUIDELINES IN PLACE THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY OF GRANTEES. ALL GRANTS REQUIRE WRITTEN DOCUMENTATION AND APPROPRIATE LEVELS OF APPROVAL. 1 X X X X 0 1 0 0 0 0 0 0 0 KEITH D GOODWIN FORMER PRESIDENT & CEO 408192 0 137000 0 223163 0 15411 0 12984 0 796750 0 215367 0 MATT SCHAEFER BOARD MEMBER/PRES & CEO 228288 0 35000 0 291 0 441 0 7517 0 271537 0 0 0 CARYN HAWTHORNE VP/CHIEF FINANCIAL OFFICER 333209 0 0 0 7571 0 46850 0 19814 0 407444 0 0 0 CARLTON LONG VP DEVELOPMENT 214246 0 0 0 73693 0 31162 0 17361 0 336462 0 70612 0 CATHY SHUCK VP OF LEGAL SERVICES 206694 0 0 0 1674 0 27009 0 600 0 235977 0 0 0 HELLA EWING FORMER VP OF PATIENT SERVICES/CNO 278079 0 0 0 36804 0 31321 0 17361 0 363565 0 36435 0 RONALD J PHILLIPS VP OF PATIENT SERVICES/CNO 270741 0 15119 0 2882 0 3306 0 17361 0 309409 0 0 0 STEVEN GODBOLD VP OPERATIONS 287185 0 0 0 159197 0 40028 0 24848 0 511258 0 158238 0 SUE WILBURN VP HUMAN RESOURCES 220261 0 0 0 3170 0 31269 0 14993 0 269693 0 0 0 CARLOS A ANGEL MD PEDIATRIC SURGEON 592369 0 21866 0 7122 0 17957 0 8469 0 647783 0 0 0 DAVID HURST MD PEDIATRIC CARDIOLOGIST 304403 0 307107 0 496 0 12360 0 22363 0 646729 0 0 0 ERIC JENSEN MD PEDIATRIC SURGEON 585144 0 0 0 1290 0 18948 0 24848 0 630230 0 0 0 SUMEET SHARMA MD PEDIATRIC CARDIOLOGIST 324502 0 489466 0 95451 0 29607 0 22363 0 961389 0 94650 0 WILLIAM GLAZE VAUGHAN MD PEDIATRIC SURGEON 588549 0 33681 0 3701 0 17957 0 22363 0 666251 0 0 0 PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED EXECUTIVE RETIREMENT PLAN: THE SUPPLEMENTAL EXECUTIVE 457(F) RETIREMENT PLAN IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES AND TO OFFER A COMPETITIVE TOTAL RETIREMENT BENEFIT. THESE BENEFITS ARE PART OF A RETIREMENT PROGRAM THAT PROVIDES RETIREMENT INCOME FOR THE EXECUTIVE'S TOTAL YEARS OF SERVICE WITH THE ORGANIZATION PURSUANT TO A WRITTEN PLAN AGREEMENT AS APPROVED BY INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THESE BENEFITS ARE AT RISK AND WILL NOT BE PAID UNLESS THE EXECUTIVE PROVIDES SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION IN ACCORDANCE WITH A VESTING SCHEDULE. AN ESTIMATE OF THE ANNUAL INCREASE IN ACTUARIAL VALUE IS REPORTED AS DEFERRED COMPENSATION IN PART VII AND IN SCHEDULE J, COLUMN (C) FOR THE APPLICABLE EXECUTIVES. EMPLOYER CONTRIBUTION TO 457(F) EXECUTIVE RETIREMENT BENEFIT PLAN: STEVEN GODBOLD $28,401 CATHY SHUCK $19,874 CARYN HAWTHORNE $33,527 HELLA EWING $26,913 SUE WILBURN $21,904 CARLTON LONG $22,281 SUMEET SHARMA $16,542 EMPLOYER PAYMENT FROM 457(F) PLAN (INCLUDING VESTED EARNINGS ON PREVIOUSLY REPORTED COMPENSATION): KEITH GOODWIN $215,367 STEVEN GODBOLD $158,238 HELLA EWING $36,435 CARLTON LONG $70,612 SUMEET SHARMA $94,650 A THE HEALTH EDUCATIONAL AND HOUSING FACILITY BOARD OF KNOX COUNTY TENNESSEE 621220275 NONEAVAIL 2019-02-14 117260000 CAPITAL PROJECT 0 0 0 A 117260000 772829 1 0 0 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 1 US BANK NATIONAL ASSOCIATION 1.000000000000 1 0 0 A 1 X 2 19400 MARKET VALUE X 3 499373 MARKET VALUE X 5000 354122 MARKET VALUE X 2504 2550 MARKET VALUE X MISCELLANEOUS 892 15337 MARKET VALUE X TOYS 1411 13450 MARKET VALUE X EVENT SUPPLIES 2 10080 MARKET VALUE X GIFTCARDS 358 7787 MARKET VALUE 0 1 0 FORM 990, PART III, LINE 4A, CONTINUED OUTPATIENT SERVICES: CHILDREN'S HOSPITAL HOME HEALTH CARE, WHICH IS A HOSPITAL-BASED HOME HEALTH AGENCY, SUPPORTS THE PHILOSOPHY, MISSION AND POLICIES OF ETCH AND IS DEDICATED TO MEETING THE NEEDS OF CHILDREN. HOME HEALTH PROVIDES FOLLOW-UP SUPPORTIVE CARE TO PATIENTS NEWBORN TO 21 YEARS OF AGE WHO DO NOT REQUIRE HOSPITALIZATION OR CONSTANT SKILLED SUPERVISION. HOME HEALTH IS LICENSED TO PROVIDE SERVICES IN 16 EAST TENNESSEE COUNTIES. ALL PATIENTS ARE ACCEPTED ON THE BASIS OF PHYSICIAN REFERRAL, THE ABILITY OF HOME HEALTH TO MEET THE PATIENT'S SPECIFIC NEEDS, AND WHEN THE PHYSICIAN, CHILD'S FAMILY AND THE HOME HEALTH STAFF AGREE THAT IN-HOME CARE WOULD BE AN APPROPRIATE AND EFFECTIVE MEANS OF TREATMENT. AVAILABLE SERVICES INCLUDE REGISTERED NURSING, RESPIRATORY THERAPY, HOME INFUSION, NUTRITIONAL SUPPORT, HOME MEDICAL EQUIPMENT, SUPPLIES, PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY AND SOCIAL WORK. THE COLLECTIVE REHABILITATION SERVICES DEPARTMENTS ARE STAFFED WITH LICENSED PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS, AND SPEECH-LANGUAGE PATHOLOGISTS WHOSE ROLES INCLUDE EVALUATING AND TREATING PATIENTS WITH A VARIETY OF PHYSICAL IMPAIRMENTS AND DEVELOPMENTAL DELAYS. THERAPISTS WORK WITH CHILDREN IN THE INPATIENT SETTING, IN MULTI-DISCIPLINARY CLINICS AND IN OUTPATIENT SETTINGS. ETCH OFFERS OUTPATIENT REHABILITATION SERVICES AT FOUR LOCATIONS IN THE EAST TENNESSEE REGION, BRINING THESE SERVICES CLOSER TO OUR PATIENTS. ALL TREATMENT SESSIONS ARE PROVIDED WITH FAMILY-CENTERED CARE, WITH A FOCUS ON ACTIVE CAREGIVER PARTICIPATION TO ENHANCE FAMILY EDUCATION. IN ADDITION TO REHABILITATION SERVICES, THESE OUTPATIENT CENTERS OFFER SOCIAL WORK, INTERPRETIVE SERVICES, PSYCHOLOGY AND NUTRITION SERVICES. OPTIONAL REHABILITATION SERVICES ARE AVAILABLE TO BE OFFERED VIRTUALLY AS WELL AS IN PERSON. ETCH ALSO PROVIDES COMPREHENSIVE CONSULTATION, EVALUATION, DIAGNOSTIC SERVICES AND TREATMENT FOR PEDIATRIC PATIENTS WITH ACUTE, CHRONIC AND/OR COMPLEX CONDITIONS THROUGH THE OUTPATIENT CARE CENTER. SEVERAL CLINICS FOR SPECIFIC CONDITIONS ARE OFFERED INCLUDING CRANIOFACIAL, CYSTIC FIBROSIS, DERMATOLOGY, DIABETES, GYNECOLOGY, HEMATOLOGY/ONCOLOGY, HIGH RISK, INFECTIOUS DISEASES, METABOLIC DISEASES, MULTISPECIALITY, PULMONARY, RHEUMATOLOGY, SPECIAL ATTENTION AND SPASTICITY. A CLINIC VISIT MAY INCLUDE TREATMENT AND CONSULTATION WITH PHYSICIANS, NURSES AND STAFF FROM NUTRITION, SOCIAL WORK, CHILD LIFE, REHABILITATION, RESPIRATORY CARE OR OTHERS. ADDITIONAL SERVICES: THE SOCIAL WORK DEPARTMENT AT ETCH HELPS PATIENTS AND THEIR FAMILIES DEAL WITH EMOTIONAL STRESS CAUSED BY ILLNESS, INJURY OR THE HOSPITALIZATION ITSELF. SOCIAL WORK SERVICES INCLUDE INFORMATION AND REFERRAL; SHORT-TERM SUPPORTIVE COUNSELING FOR PATIENTS AND PARENTS; CRISIS INTERVENTION ASSISTANCE; DISCHARGE PLANNING; FINANCIAL ASSISTANCE; INFORMATION ON SUPPORT AND ADVOCACY GROUPS; AND ASSISTANCE WITH CONCRETE NEEDS, INCLUDING RONALD MCDONALD HOUSE REFERRALS. THE DEPARTMENT ALSO COORDINATES TRANSLATION OF MUCH OF THE HOSPITAL'S PRINTED MATERIAL INTO SPANISH TO GIVE THE HISPANIC POPULATION COMMUNICATION ACCESS WHEN MEDICAL SERVICES ARE PROVIDED. SOCIAL WORK ALSO PROVIDES SEVERAL INTERPRETATION SERVICES FOR ETCH. OPTIMAL PHONE INTERPRETERS IS A TELEPHONE SERVICE THAT PROVIDES INTERPRETERS IN MORE THAN 204 LANGUAGES AND DIALECTS. INTERPRETERS CAN BE ARRANGED FOR FACE-TO-FACE INTERACTIONS BETWEEN SPANISH-SPEAKING PATIENTS AND PARENTS AND THE PHYSICIAN AND/OR OTHER HOSPITAL STAFF MEMBER. SIGN LANGUAGE INTERPRETERS ARE ALSO AVAILABLE FOR HEARING IMPAIRED PATIENTS AND FAMILIES. THE CARE COORDINATION DEPARTMENT AT ETCH HELPS PATIENTS AND THEIR FAMILIES DEAL WITH EMOTIONAL STRESS CAUSED BY ILLNESS, INJURY OR THE HOSPITALIZATION ITSELF. SOCIAL WORK SERVICES INCLUDE INFORMATION AND REFERRAL; SHORT-TERM SUPPORTIVE COUNSELING FOR PATIENTS AND PARENTS; CRISIS INTERVENTION ASSISTANCE, INCLUDING ASSESSMENT OF BEHAVIORAL HEALTH PATIENTS AND PLACEMENT; DISCHARGE PLANNING; FINANCIAL ASSISTANCE; INFORMATION ON SUPPORT AND ADVOCACY GROUPS; AND ASSISTANCE WITH CONCRETE NEEDS, INCLUDING RONALD MCDONALD HOUSE REFERRALS. THE INTERPRETIVE SERVICES PORTION OF THE DEPARTMENT PROVIDES NEARLY AROUND THE CLOCK IN-PERSON SPANISH INTERPRETATION FOR OUR SPANISH-SPEAKING FAMILIES AND COORDINATES TRANSLATION OF MUCH OF THE HOSPITAL'S PRINTED MATERIAL INTO SPANISH, AS WELL. THEY ALSO CONTRACT WITH LANGUAGE SERVICES PROVIDERS FOR ACCESS TO IN-PERSON, VIDEO AND TELEPHONE INTERPRETATION IN 230+ LANGUAGES TO MEET THE COMMUNICATION NEEDS OF DEAF AND HEARING IMPAIRED AND LIMITED ENGLISH PROFICIENT PATIENTS AND FAMILIES. CARE COORDINATION ALSO PROVIDES NURSE NAVIGATION AND CASE MANAGEMENT IN AN EFFORT TO ENHANCE PARENTS' EXPERIENCES IN NAVIGATING THEIR CHILD'S SUDDEN ENTRANCE INTO COMPLEX MEDICAL SERVICES DUE TO ACUTE OR CHRONIC ILLNESS. THE CASE MANAGEMENT STAFF ASSISTS WITH THE TIMELY DISCHARGE OF PATIENTS, IN ORDER TO SUPPORT THE IMPROVEMENT IN QUALITY OF LIFE THAT IS ATTAINED BY BEING CARED FOR IN ONE'S HOME ENVIRONMENT. HOSPITALIZATION, MEDICAL PROCEDURES, ILLNESS AND PAIN ARE OFTEN FEARFUL TIMES FOR PEOPLE OF ALL AGES. THE CHILD LIFE DEPARTMENT AT ETCH IS RESPONSIBLE FOR HELPING CHILDREN COPE WITH THEIR HOSPITALIZATION THROUGH EDUCATION, MEDICAL PLAY AND ACTIVITIES. THE CHILD LIFE STAFF ASSESSES THE CHILD'S FEARS AND NEEDS, EXPLAIN PROCEDURES IN LANGUAGE CHILDREN CAN UNDERSTAND AND USE DISTRACTIONS TO MAKE PROCEDURES, SUCH AS THE PLACEMENT OF AN IV LINE, LESS INTIMIDATING. THE CHILD LIFE STAFF MEMBERS HOLD DEGREES IN EDUCATION, CHILD DEVELOPMENT OR THERAPEUTIC RECREATION. THEY HAVE EXPERTISE IN DEALING WITH A CHILD'S CONCERNS AND REACTIONS TO THE HOSPITAL AND HIS OR HER ILLNESS. IN ADDITION TO ITS WORK WITHIN THE HOSPITAL, THE CHILD LIFE DEPARTMENT ALSO COORDINATES SEVERAL ACTIVITIES FOR CHILDREN IN THE COMMUNITY. PASTORAL CARE - CHAPLAINS ARE AVAILABLE 24 HOURS A DAY TO PROVIDE SPIRITUAL AND EMOTIONAL SUPPORT TO PATIENTS, FAMILIES AND STAFF AT ETCH. CHAPLAINS ALSO PROVIDE CONSULTATION CONCERNING ETHICAL ISSUES RELATED TO PATIENT CARE. FOOD AND NUTRITION SERVICES - ETCH'S CAFETERIA IS OPEN DAILY. VENDING MACHINES ON THE GROUND FLOOR NEAR THE DINING ROOM PROVIDE SANDWICHES, SNACKS AND BEVERAGES 24 HOURS A DAY. FOR PATIENTS WITH NO DIETARY RESTRICTIONS, FOOD AND NUTRITION SERVICES OFFERS A SELECTIVE MENU OF IN-ROOM MEALS. ALSO, REGISTERED DIETITIANS PROVIDE CLINICAL NUTRITION SERVICES, AND MEDICAL NUTRITION THERAPY IS AVAILABLE TO INPATIENTS AND OUTPATIENTS WHO ATTEND SPECIALTY CLINICS OR WHO HAVE INDIVIDUAL APPOINTMENTS. THESE SERVICES INCLUDE NUTRITION ASSESSMENT, FEEDING RECOMMENDATIONS, INTAKE EVALUATION AND NUTRITION COUNSELING. ETCH'S HEALTHY KIDS PROGRAM IS A COMMUNITY EDUCATION INITIATIVE OF THE COMMUNITY BENEFITS DEPARTMENT. THE PROGRAM SERVES AS AN EDUCATION RESOURCE FOR PARENTS, GRANDPARENTS AND OTHER CARETAKERS BY OFFERING CLASSES, LITERATURE AND OTHER OPPORTUNITIES FOR LEARNING HOW TO IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 AND RELATED SCHEDULES ARE PREPARED BY AN UNRELATED, INDEPENDENT ACCOUNTING FIRM AND THEN SUBMITTED TO THE ETCH CHIEF FINANCE OFFICER FOR INTERNAL REVIEW. A DRAFT FORM IS ALSO PROVIDED TO SENIOR ADMINISTRATION AND TO ALL ETCH BOARD OF DIRECTORS MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD OF DIRECTORS IS ASKED TO REVIEW THE CONFLICT OF INTEREST POLICY AND PROVIDE DISCLOSURE OF ANY ACTIVITIES WHICH COULD CONSTITUTE A CONFLICT OF INTEREST OR POTENTIAL CONFLICT OF INTEREST ANNUALLY. THESE CONFLICT OF INTEREST DISCLOSURES ARE REVIEWED BY ETCH'S GENERAL COUNSEL TO ASSURE COMPLIANCE. ADDITIONALLY, BOARD MEMBERS ARE ASKED TO RECUSE THEMSELVES ON ANY MATTERS OF INTEREST BEFORE THE BOARD IN WHICH A CONFLICT OF INTEREST MAY EXIST. ANY SUCH RECUSAL IS DOCUMENTED WITHIN THE MINUTES OF THE BOARD OR COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE ETCH BOARD OF DIRECTORS UTILIZES THE SERVICES OF INDEPENDENT, OUTSIDE COMPENSATION CONSULTANTS TO PROVIDE THE COMMITTEE WITH RELEVANT MARKET DATA FROM STATE AND NATIONAL SALARY SURVEYS FOR COMPARABLE MARKETS. WITH THIS DATA AND THE ADVICE OF OUTSIDE CONSULTANTS, THE ETCH BOARD OF DIRECTORS EXECUTIVE COMMITTEE MAKES RECOMMENDATIONS ON PAY AND BENEFITS FOR THE ETCH PRESIDENT/CEO. FORM 990, PART VI, SECTION C, LINE 19 ALL ETCH GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. ADDITIONALLY, FINANCIAL STATEMENTS ARE PROVIDED TO BONDHOLDERS, LOCAL HOSPITALS AND DONORS. THE CONFLICT OF INTEREST POLICY IS POSTED ON ETCH'S INTRANET. FORM 990, PART VII, SECTION A, COMPENSATION: KEITH D. GOODWIN, FORMER MEMBER OF ETCH'S BOARD OF DIRECTORS, RECEIVED REPORTABLE COMPENSATION AS THE FORMER PRESIDENT AND CEO OF ETCH. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,678,858. MANAGEMENT AND GENERAL EXPENSES 5,020,417. FUNDRAISING EXPENSES 475,346. TOTAL EXPENSES 10,174,621. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 19,067,000. MANAGEMENT AND GENERAL EXPENSES 79,234. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,146,234. FORM 990, PART XI, LINE 9: BOOK/TAX DIFFERENCE FOR PASSTHROUGH INVESTMENT -3,123,617. OTHER ADJUSTMENT 1,109. CAH MANAGEMENT COMPANY LLC 265 BROOKVIEW CENTRE WAY STE 400 KNOXVILLE TN 37919 822241257 MEDICAL SERVICES TN ETCH RELATED -271036 692566 0 0 0.51000 CHILDREN'S PRIMARY CARE CENTER PO BOX 15010 KNOXVILLE TN 37901 621573297 PEDIATRIC CLINIC HOLDING COMPANY TN EAST TENNESEE CHILDREN'S HOSPITAL ASSOCIATION INC C 1.00000 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 CHILDREN'S PRIMARY CARE CENTER R 3021331 COST