2019-11-11T12:31:58-06:00 2018-12-31 990 2018-01-01 621114867 LeConte Medical Center LECO 8653743140 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 JOHN T GEPPI EVP/CFO 8653746872 2019-10-03 168.85.177.4 2019-11-11 13:31:21 ES P 9FAA1952C08CFF6F9E2CB5A334C8BD7C4DA173D5 9FAA1952C08CFF6F9E2CB5A334C8BD7C4DA173D5 2018 2020-03-31 21:24:44Z James D VanderSteeg 100 Ft Sanders W Blvd Knoxville TN 37922 118054252 0 X www.lecontemedicalcenter.com X 1981 TN LeConte Medical Center is a 79-bed full service acute care hospital located in Sevier County, Tennessee. It is a member of the Covenant Health system. 18 16 800 188 593858 193091 94383 57562 140110735 116666271 14068 17854 1087634 833032 141306820 117574719 48302 79740 0 0 31685519 30691936 0 0 0 98775181 73862567 130509002 104634243 10797818 12940476 86138930 91157188 8567842 9057099 77571088 82100089 X LeConte Medical Center provides quality healthcare, in alignment with Covenant Health's mission to serve the community by improving the quality of life through better health, regardless of the patient's ability to pay. 0 0 102891015 79740 116073385 LeConte Medical Center ("LeConte") provides care to residents of Sevier County. As a member of the former Fort Sanders Health Alliance, it became a member of Covenant Health when it was established in 1996. Located in the foothills of the Great Smoky Mountains, it is a full-service, state-of-the-art hospital.SERVICEThe hospital is best known for its women's services, including labor and delivery; emergency department; outpatient diagnostic services; and cardiopulmonary rehabilitation. The American College of Radiology recognizes LeConte as one of only 29 facilities in Tennessee designated as a Lung Cancer Screening Center. LeConte's Comprehensive Breast Center is an American College of Radiology Breast Imaging Center of Excellence. The Dolly Parton Birthing Unit is a family-centered facility featuring state-of-the-art monitoring systems for the safety of moms and babies. LeConte is certified as a "Safe Sleep" hospital for providing education and information about safe sleep to the parents of newborns. In 2018 the hospital saw 102,558 patients. Of these, 95,903 were outpatients and 6,655 were inpatients with an average length-of-stay of 4.17 days. PUTTING PATIENTS FIRSTAs part of a growing community and a popular vacation destination for visitors from around the country, the emergency department at LeConte is one of the busiest in the region and is open 24 hours a day, seven days a week. It is equipped with a helicopter pad and an observation area. As part of Covenant Health's stroke hospital network, LeConte provides rapid diagnosis and treatment of stroke and is certified by The Joint Commission as an Advanced Primary Stroke Center. IMPROVING THE COMMUNITY'S QUALITY OF LIFE THROUGH BETTER HEALTHLocated inside the Dolly Parton Center for Women's Services, the LeConte Comprehensive Breast Center offers 3D mammography, stereotactic breast biopsy, bone density screenings, and has certified patient navigators available to help cancer patients manage their health care regimen. The center's "Paint the Mountains Pink" program educates the community about the importance of regular mammograms and provides mammograms to women in Sevier County who qualify for mammography screening but cannot afford it. The LeConte Wellness Center is a full-service fitness center located at the Pigeon Forge Community Center. It offers members a safe and family-friendly atmosphere in which to exercise in addition to hosting health and education programs throughout the year. LeConte's certified sports medicine trainers work with coaches and students at high schools in Sevier County and surrounding counties, bringing awareness of injury prevention and safety issues on and off the field. Since starting the athletic training program, Sevier County's re-injury rate for student athletes has dropped from over 25 percent to a record low of less than one percent. Every year for the last nine years, LeConte has partnered with Dollywood's Splash Country (a 35-acre water park located in nearby Pigeon Forge) to host a Water Safety Day. This event is designed to provide children and parents with life-saving water safety skills and builds awareness about the importance of teaching children to swim. Participants also learn about boating safety, skin cancer prevention, emergency first aid, general water safety, and recognizing the signs of stroke. COVENANT HEALTH SYSTEMLeConte 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 10,000 employees, affiliated physicians and volunteers, Covenant Health is the Knoxville area's largest employer and has been named by Forbes as a Best Employer four years in a row. 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.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.LeConte, 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. 102891015 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 89 0 1 800 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 18 16 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Amy DeLong 8653743140 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 Gerald Boyd Director 0.00 1.00 X 0 1237 0 Willard Campbell MD Director 0.00 1.00 X 0 0 0 Michael Casey MD Director 0.00 1.00 X 0 1572 0 Ronni Chandler Director 0.00 1.00 X 0 0 0 Mitchell Dickson MD Director 0.00 1.00 X 0 1612 0 James Fitzsimmons Director/Chair 0.00 1.00 X X 0 1081 0 James Gibson Director 0.00 1.00 X 0 1081 0 Eddie Mannis Former Director (through March 2018) 0.00 1.00 X 0 0 0 Timothy Matthews Director 0.00 1.00 X 0 1438 0 Larry Mauldin Director 0.00 1.00 X 0 1429 0 Joseph Metcalf MD Director 0.00 1.00 X 0 14046 0 Linda Ogle Director 0.00 1.00 X 0 0 0 Roger Osborne Director 0.00 1.00 X 0 0 0 Cosby Stone Director 0.00 1.00 X 0 0 0 Carl Storms Director 0.00 1.00 X 0 1563 0 Richard Swanson Director 0.00 1.00 X 0 0 0 David C Verble Director 0.00 1.00 X 0 0 0 Amber Wisner Director 0.00 1.00 X 0 1438 0 James D VanderSteeg President & CEO 0.00 50.00 X X 0 1578890 192255 John T Geppi EVP/CFO 0.00 50.00 X 0 951309 27744 Anthony L Spezia CEO - Emeritus 0.00 40.00 X 0 606147 15119 Elissa G Jolly President & CAO 50.00 0.00 X 0 303545 28035 Jacqueline H Hounshell VP - Financial Services 50.00 0.00 X 153257 0 25467 Carol A Pahde Former VP - Chief Nursing Officer 50.00 0.00 X 163566 0 12875 Alexander V Usynin Medical Physicist 50.00 0.00 X 168925 0 31071 Claudia D Ogburn Pharmacy Manager 50.00 0.00 X 142339 0 24742 Diane R Bailey Pharmacist 50.00 0.00 X 129400 0 15671 Melissa S Rutherford Pharmacist 50.00 0.00 X 117292 0 11080 Kasey D Smith Pharmacist 50.00 0.00 X 115102 0 20350 Rick A Carringer Fmr LMC VP - Finance; Curr MMC VP-Fin. 0.00 50.00 X 0 217563 15354 Patricia J Ketterman Fmr LMC VP - CNO; Curr Claiborne Pres. 0.00 50.00 X 0 201156 21874 Lori A Myers Fmr LMC VP - CNO; Curr CH Clin Qual RN 0.00 50.00 X 0 139070 14248 Jennifer L Hanson Former President & CAO 0.00 0.00 X 0 118300 10290 989881 4142477 466175 14 1 1 0 Southeastern Emergency Physicians 265 Brookview Centre Way Ste 400 Knoxville TN 37919 Physician Services 620616 GE Healthcare 500 West Monroe St Floor 21 Chicago IL 60661 Maintenance & Support 463378 Angelica Textile Services Inc 1105 Lakewood Parkway Ste 210 Alpharetta GA 30009 Linen Services 393043 Medic Regional Blood Center 1601 Ailor Avenue Knoxville TN 37921 Blood Processing 325218 Functional Pathways LLC 10133 Sherrill Blvd Ste 200 Knoxville TN 37932 Physical & Occupational Therapy 310137 13 57562 57562 Medical Services 622110 114919195 114919195 Community Health 900099 1056653 1056653 Laboratory 621511 593858 593858 Rental Income-Exempt Affiliate 531120 96565 96565 116666271 17854 17854 227651 123755 103896 103896 103896 355778 355778 0 Cafeteria 722514 246502 246502 Fitness Center 713940 148111 148111 Thrift Shop 453310 131417 131417 203106 972 202134 729136 117574719 116073385 593858 849914 X 25330 25330 54410 54410 355165 355165 24324249 23950830 373419 723379 714633 8746 3548391 3478173 70218 1740752 1694571 46181 9698051 9570901 127150 11460 11460 11533070 11372908 160162 192963 187986 4977 617163 385895 231268 2459360 2243982 215378 38830 37071 1759 63132 59509 3623 4859 4859 4436274 4436274 134747 128542 6205 Unrelated Business Inco 71982 71982 Medical Supplies 31132141 31132141 Bad Debt 9861500 9861500 Minor Equipment 2445612 2445612 1161423 1105888 55535 104634243 102891015 1743228 0 2185 2585 -316733 -79921 11812527 12507133 1651307 1762741 384849 555692 133880713 57980506 72300321 75900207 110163 107929 194311 400822 86138930 91157188 7508330 7882555 1059512 1174544 8567842 9057099 X 77571088 82100089 77571088 82100089 86138930 91157188 X 12940476 -12651 -8398824 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 790000 790000 80263701 18787623 61476078 121149 95471 25678 52653453 39097412 13556041 52410 52410 75900207 Capital Lease Obligations 98581 Due to Affiliates, net 223397 Due to Third Party Payors 303733 Long-term Deferred Compensation 102224 Long-term Reserve for Workers Comp 446609 1174544 X Part X, Line 2: Excerpt from the consolidated audited financial statements of Covenant Health (Covenant), parent company to LeConte 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, 2018. As such, no interest or penalties were recognized in the consolidated financial statements related to unrecognized tax benefits. At December 31, 2018, tax returns for 2015 through 2018 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, 2018. 1 1 X 1 X 1 X 1 1 1 0 1 1 12204799 4189063 8015736 0.08460 28569487 26168623 2400864 0.02530 34757 46202 0 0.00000 40809043 30403888 10416600 0.10990 40888 40888 0.00040 3500 3500 0.00000 3518452 3518452 0.03710 41461 41461 0.00040 3604301 3604301 0.03790 44413344 30403888 14020901 0.14780 93 93 0.00000 3246 3246 0.00000 18986 18986 0.00020 451 451 0.00000 22776 22776 0.00020 1 9861500 2327314 15538685 17320922 -1782237 X 1 1 1 1 LeConte Medical Center 742 Middle Creek Road Sevierville TN 37862 www.lecontemedicalcenter.com 00000103 X X X LeConte Medical Center 1 0 0 1 X X X X X X X X 17 1 0 1 1 X See Part V, Page 8 X 1 17 1 See Part V, Page 8 0 1 X 200.000000000000 300.000000000000 X X 1 1 X X X 1 X https://www.lecontemedicalcenter.com/financialassistance/ X https://www.lecontemedicalcenter.com/financialassistance/ X https://www.lecontemedicalcenter.com/financialassistance/ X X X X X X 1 X 0 X X X 1 X 0 0 LeConte Medical Center Part V, Section B, Line 5: LeConte Medical Center ("LMC") was guided in the assessment process by representatives of several community organizations whose expertise and relationships helped the hospital access the general population as well as the most vulnerable residents of Sevier County. Assessment partners were recruited from the broader public health system including staff from the local health department, United Way director, local school system, court system, public safety, senior programs, and social service organizations that serve the needs of the community's most vulnerable and at-risk population. The assessment process began with a half-day community health forum using an assessment tool "Forces of Change" by the Center for Disease Control. Nearly thirty participants representing a diverse make up of stakeholders gave input into the significant issues facing Sevier County. The Data Team members represented the health department, Coordinated School Health, a Hispanic advocate, and the Good Hope Mountain Clinic. These community leaders analyzed and distilled volumes of data into a short list of the most significant health issues affecting Sevier County.Part V, Section B, Line 4:It was determined per audit that while the Community Health Needs Assessment ("CHNA") was prepared as of December 31, 2016, it was completed on May 8, 2017 with board approval. LeConte Medical Center Part V, Section B, Line 6b: LMC's 2017 CHNA was conducted with the following organizations: - Sevier County Health Department - Salvation Army - Hispanic Advocate - community member - Leadership Sevier - Douglas Cherokee Adult Cooperative - Sevier County Food Ministry - Sevier County Government - Gatlinburg Ministerial Alliance - The Tennessee Smokies - Good Samaritan Clinic - Dr. Robert F. Thomas Foundation - CASA - Sevier County Sheriff Department - Cherokee Health System - East Tennessee Human Resource Agency - Sevier County Parks and Recreation Department LeConte Medical Center Part V, Section B, Line 11: Of the five significant findings from the assessment, LMC is focusing its resources on the following: Obesity - Dogwood Trails/Patch Program - Beginning in 2016 Covenant Health initiated a program with the Knoxville Dogwood Arts organization to encourage residents to get out and walk local Dogwood Trails and other public trails and greenways. Participants agree to walk 25 miles during a two month period, record their trails and distances, and redeem their hard work for an embroidered patch. Each subsequent year will have a new patch to be earned. LMC and Covenant Health promote this program to employees and to the community at large. The inaugural year had 424 participants. In 2018 there were 141 participants with plans to add more sites to Sevier County in 2019. - Covenant Health Biggest Winner Program - On a twice-yearly basis LMC participates with other Covenant Health organizations in a Biggest Winner employee health improvement program. Each program cycle can include up to 20 employees who focus on weight loss and improving personal health biometrics. Local greenways and trails are used for the exercise component. Pre- and post-testing are provided for participants to track their health improvements. In 2018, 15 employees joined the program. - Covenant Kids Run - Each year, as part of the Covenant Health Knoxville Marathon, school children from kindergarten thru eighth grade have the opportunity to complete a marathon of 26.2 miles over the course of several months. The final mile is held before the Covenant Health Knoxville Marathon in the spring. Students completing the 26.2 miles earn a certificate and medal when they cross the finish line. Twenty-six students participated from Sevier County in 2018. - Community Hikes - To encourage adults to be more active, LMC will cosponsor and lead a series of community hikes each spring and fall in the Great Smoky Mountains National Park. This is an ongoing collaboration with the Friends of the Smokies organization. In 2018, staff led a series of 4 hikes in the spring, and another 4 hikes in October. Every hike fills to capacity at 50 persons. LMC held a beginners hiking program and provided safety kits for each hiker. Prescription Drug Abuse - HEAL Coalition - LMC continues to support and participate in this multi-disciplinary coalition to address the incidence of Neonatal Abstinence Syndrome in Sevier County. - Women's Recovery Support Group - LMC will continue its Women's Recovery Support Group for women dealing with addiction. The group is held each Monday at the medical center. LeConte has chosen not to develop a specific strategy for the following needs: - Teen pregnancy - LMC chooses not to develop strategies or tactics for the health priority of teenage pregnancy prevention. LMC does not provide specific teen pregnancy prevention services and does not have the community resources for this priority. - Dental care - this is not a service that the hospital provides; however, the hospital will support providers of these services, resources permitting. - Mental Health - LMC chooses not to develop stratgies or tactics for the health priority mental health. LMC does not provide mental health services and does not have the community resources for this priority. LeConte 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.lecontemedicalcenter.com/community-health-needs-assessment/ Part V, Line 10a, Implementation Strategy Website https://www.lecontemedicalcenter.com/community-health-needs-assessment/ Part V, Line 20d, Presumptive Eligibility Determinations The hospital follows the eligibility procedures as detailed within the FAP and does not make presumptive eligibility determinations. 12 1 - Thompson Infusion Services Downtown 1915 White Avenue Knoxville TN 37916 Infusion Services 2 - LeConte Medical Center Infusion Svcs 710 Middle Creek Road Sevierville TN 37862 Infusion Services 3 - Thompson Infusion Services West 9711 Sherrill Blvd Suite 202 Knoxville TN 37932 Infusion Services 4 - Thompson Infusion Services Maryville 220 Blount Memorial Hosp Cancer Ctr Maryville TN 37804 Infusion Services 5 - LeConte Medical Center Rad Oncolog 710 Middle Creek Road Sevierville TN 37862 Radiation Oncology 6 - The Breast Center at LeConte Medical Ctr 740 Middle Creek Road Suite 106 Sevierville TN 37862 Breast Imaging Center 7 - Fort Sanders Sevier Nursing Home 731 Middle Creek Road Sevierville TN 37862 Nursing Home 8 - Thompson PET Services 710 Middle Creek Road Sevierville TN 37862 PET Imaging Services 9 - Sevier County Wellness Center 717 Middle Creek Road Sevierville TN 37862 Occupational Health 10 - LeConte Cardio-Pulmonary Rehab Ctr 740 Middle Creek Road Suite 112 Sevierville TN 37862 Rehabilitation & Therapy Services 11 - LeConte Therapy Services-Seymour 127 W Macon Lane Seymour TN 37865 Rehabilitation & Therapy Services 12 - Pigeon Forge Fitness Center 170 Community Center Drive Pigeon Forge TN 37863 Fitness Center Part I, Line 3c: In addition to the FPG (federal poverty guidelines), LMC 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). Part I, Line 6a: Covenant Health, the parent company of LMC 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 organization has included $3,479,992 in physician sponsorship fees and $38,460 for costs to provide transportation assistance to patients in total subsidized health services. All subsidized health services included on line 7g are for services that would otherwise be unavailable in the community or be below the community's needs. Part I, Ln 7 Col(f): The Bad Debt expense included on Form 990, Part IX, Line 24a, but subtracted for purposes of calculating the percentage in this column is $9,861,500. Part II, Community Building Activities: LMC 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 2018 were made to organizations meeting the community's needs by providing: - The basic needs of life including temporary shelter, food and clothing (Catholic Charities and Ladies of Charity) - Youth mentoring, development and after-school programs (Emerald Youth Foundation, Boys and Girls Club, The Change Center, Young Life, Williams Creek Youth Foundation and the Dollywood Foundation) - Business recruitment and marketing initiatives that boost economic development (East Tennessee Economic Development Agency and Knoxville Urban League) - Leadership development programs and workshops (Leadership Knoxville and Junior Achievement) - Assistance and special programs for at risk older adults, people with physical and mental challenges, and abused and neglected children (Senior Citizens Home Assist, Sertoma Center, Inc., East TN Technology Access Center, and Variety-The Children's Charity of Eastern Tennessee) - Improve access to health services (Interfaith Health Clinic, St. Mary's Legacy Clinic, and Knoxville Academy of Medicine) - Programs supporting patients and their families (Alzheimer's Tennessee, Cancer Support Community, Inc. and Random Acts of Flowers) Part III, Line 2: Bad debt expense on Part III, Line 2 is the amount recorded in the organization's financial statements. Discounts and payments on patient accounts are netted against bad debt. The allowance for bad debt is determined based on management's assessment of factors including the age of the accounts, historical collections data, and industry standards. Part III, Line 3: At regular intervals, the Vice President of Patient Account Services analyzes all self-pay accounts receivables to identify patients who may have been eligible for charity care during a particular period or year. Because this analysis does not yield a final determination of eligibility due to various factors including but not limited to charity applications still in process, failure of eligible patients to submit their charity application, and applications still under consideration, further analysis of the accounts comprising the self-pay accounts receivable is conducted. The accounts for which a patient was contacted to apply for charity care include an identifier; these charity-identified accounts are then categorized according to status. A ratio of the dollar amounts of those accounts whose charity application is in process or has been approved divided by the total self-pay accounts receivable is computed. This ratio is applied to the bad debt expense total to determine the estimated amount of the bad debt expense attributable to patients eligible for charity care according to the hospital's policy. Part III, Line 4: Note B to the 2018 Audited Consolidated Financial Statements of the Covenant Health system, of which LeConte Medical Center 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: LMC believes that all of the $1.78 million shortfall reported in Line 7 should be considered as community benefit. The IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in our community. This year, Medicare patients accounted for 27% of total patient days (4,373 out of 16,040 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: LMC 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: LMC 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 71% 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.LMC 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 LMC 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. LMC 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. LMC does not sell any accounts receivable accounts to outside firms. All accounts remain property of and under the policies set by LMC. LMC 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. LMC obtains additional community information through the service of its employees with the Chamber of Commerce, Sevier County Health Council, and Rotary Club, and through partnerships with the Boys and Girls Club and the Mountain Hope Good Shepherd Clinic for the uninsured. 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: LMC informs patients and other persons who may be billed for patient care about its financial assistance policies by posting signs in highly visible areas of the hospital and including information about the FAP in patient booklets placed in all inpatient rooms. In addition, the FAP and application are available via the facility website and notice of the availability of financial assistance is communicated via patient billing statements. The following sign is posted in the main registration area and at the Emergency Department registration entrance:Financial Assistance: 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, staffs of LeConte 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, LeConte Medical Center, in compliance with Tennessee Code Annotated, Title 47, Chapter 18 and Title 68, will provide at a reduced rate, medically indicated services. A financial counselor is available to assist you with these matters by calling 865-446-8687, Monday through Friday between the hours of 8:00 a.m. and 4:00 p.m.Signs are also posted at each registration desk and at Customer Service stating:Financial Assistance: It is LeConte 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 or through our Financial Counselor's office. To apply for financial aid, please ask our registration staff or contact the Counselor's office at 865-446-8687. The Financial Counselor is available Monday - Friday, 8:00 a.m. - 4:00 p.m.The FAP states that patients who are unable to pay and have exhausted all sources of payment assistance may be screened for potential charity care eligibility. According to the policy, the financial counselors initiate screening of the patient and/or guarantor by obtaining income and other financial information to determine eligibility for charity care or discounted services. Part VI, Line 4: Sevier County, Tennessee, is the primary market for LMC. It is a rural community within close proximity to the metropolitan Knoxville area. LMC is the only hospital in the county. According to internal hospital data for 2018, 81% of the patient encounters, inpatient and outpatient, originate from Sevier County, the focus of the assessment.The following statistics are taken from the 2018 County Health Rankings data of the Robert Wood Johnson Foundation. The population of Sevier County numbers roughly 96,673 people and is predominantly female(51%). Persons over the age of 65 account for 18.9% of the population. Nearly 21% of adults are uninsured as are 6% of children. The unemployment rate is 5%. Three-fourths of the population works in the hospitality/tourism sector, and the median household income is $45,300.According to the 2018 County Health Rankings Report of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, Sevier County residents have the following health indicators that are above the national benchmarks: Sevier - TN - National Adult Smoking: 21% - 22% - 14% Adult Obesity: 34% - 32% - 26% Children in Poverty: 25% - 23% - 12% Teen Birthrate: 43 - 36 - 15 of every 1,000 teenage girls Poor or Fair Health: 20% - 19% - 12% Physical Inactivity: 40% - 30% - 20% Drug Overdose Deaths 25 - 22 - 10 per 100,000 population Part VI, Line 5: LMC, 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 LMC's board. The board is comprised of independent community leaders with diverse educational and professional backgrounds. The board sets policies and provides oversight of LMC. LeConte 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: LMC, 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.LMC's 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.LMC utilized Covenant departments and Center for Community Health and Senior Services to assist with community healthcare related programs and health screenings such as Community Health Fairs and Senior Health Fairs. In addition, Senior Services publishes and sends a senior health related newsletter, Passport, to nearly 2,000 Sevier County residences. When promoting health screenings & programs to the community, LMC utilized the services of Covenant Health Graphic Services for producing advertisements, fliers, etc. LMC also worked with Covenant Marketing to include such information on its website.Thompson Cancer Survival Center participates with LMC in educating the community about cancer prevention and treatment by providing information and materials at the Sevier County annual Relay for Life event. The Robert F. Thomas Foundation ("Foundation"), a not-for-profit fundraising organization, conducts fundraising events. A portion of the funds are donated to LMC for the purpose of purchasing healthcare related equipment. In addition, the Foundation donates funds to be used for the continuing education of physical therapists employed by LMC.Through this combination of resources and the collective development, implementation and monitoring of clinical protocols and other improvement initiatives, the affiliated entities of Covenant Health are able to deliver higher quality care in a more efficient manner than could be achieved working independently. 1 Boys & Girls Club of the Smoky Mountains PO Box 5743 Sevierville TN 37864 621507789 501(c)(3) 5000 Support program in Sevier County United Way of Sevier County PO Box 6458 Sevierville TN 378646458 621225078 501(c)(3) 8080 Smoky Mountain First Responders Challenge 2 0 Patient transportation 708 38460 Educational scholarships 4 3500 Post-hospital rehabilitation 3 12450 Part I, Line 2: Grant funds are provided to charitable organizations for the purpose of enhancing and promoting health care in the community. The organization has guidelines in place to review the eligibility of grantees, and all grants require written documentation and appropriate levels of approval. The organization also provides other post-hospital care assistance to eligible individuals. Funds are generally not tracked after being granted as the original eligibility and selection criteria have been met. Scholarship assistance is both merit-based and needs-based, and funds are contingent upon on-going satisfactory academic progress. X 1 1 1 1 0 0 0 0 0 0 0 James D VanderSteeg President & CEO 0 1023861 0 420000 0 135029 0 169408 0 22847 0 1771145 0 0 John T Geppi EVP/CFO 0 605182 0 251100 0 95027 0 10800 0 16944 0 979053 0 0 Anthony L Spezia CEO - Emeritus 0 49155 0 0 0 556992 0 10800 0 4319 0 621266 0 0 Elissa G Jolly President & CAO 0 215389 0 48825 0 39331 0 10287 0 17748 0 331580 0 0 Jacqueline H Hounshell VP - Financial Services 108152 0 14592 0 30513 0 5159 0 20308 0 178724 0 0 0 Carol A Pahde Former VP - Chief Nursing Officer 48680 0 16065 0 98821 0 5570 0 7305 0 176441 0 0 0 Alexander V Usynin Medical Physicist 168699 0 0 0 226 0 10328 0 20743 0 199996 0 0 0 Claudia D Ogburn Pharmacy Manager 136750 0 0 0 5589 0 8527 0 16215 0 167081 0 0 0 Rick A Carringer Fmr LMC VP - Finance; Curr MMC VP-Fi 0 166298 0 28000 0 23265 0 7464 0 7890 0 232917 0 0 Patricia J Ketterman Fmr LMC VP - CNO; Curr Claiborne Pre 0 165990 0 23400 0 11766 0 7083 0 14791 0 223030 0 0 Lori A Myers Fmr LMC VP - CNO; Curr CH Clin Qual 0 113585 0 25000 0 485 0 7044 0 7204 0 153318 0 0 Jennifer L Hanson Former President & CAO 0 0 0 0 0 118300 0 10290 0 0 0 128590 0 0 Part I, Line 1a Tax gross-up payments related to deferred compensation are provided to certain executives and managers. Amounts are included in taxable compensation. Part I, Line 3 Covenant Health, the parent company of LeConte 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 Part I, Line 4a: Jennifer Hanson, President and CAO in 2017, received severance pay of $118,300 in 2018. Carol Pahde, Former Chief Nursing Officer, received severance pay of $68,850 in 2018. Severance amounts are reported as taxable compensation in Part II(B)(iii). Part I, Line 4b: Covenant Health maintains a nonqualified deferred compensation ("NQDC") plan intended to support retention of President and CEO, James D. VanderSteeg. Employer contributions of $158,608 are reported as deferred compensation on Schedule J, Part II, Column C. Contributions along with 2018 earnings of $19,018 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). Anthony L. Spezia retired as President and CEO in 2016 after serving Covenant Health for twenty years. Mr. Spezia was named CEO-Emeritus and continued serving the organization through early 2018 as a consultant. During 2018, Mr. Spezia received distributions from two NQDC plans resulting from contributions and associated earnings on contributions. Amounts vested in 2018 total $476,126 and are included in other reportable compensation on Schedule J, Part II, Column B(iii). Form 990, Part VI, Section A, line 4 In 2018, the Covenant Health system-wide bylaws were amended to provide that new directors who have not previously served on the board will be elected to an initial one-year term instead of three years (the previous standard). Amendments also grant authority to the compensation committee to negotiate and approve the CEO's compensation. The bylaws were also amended to authorize the board to establish special board committees which may be terminated by resolution of the board. The chairman of the board may establish special board committees to advise executive leadership, other board committees or the full board. Committees may be composed of elected or ex-officio board members. Also in 2018, Covenant Health adopted system-wide medical staff bylaws. The bylaws created two new committees: System Quality Committee and System Credentials and Clinical Standard Committee. The System Quality Committee consists of licensed physician voting board members, other appointed voting board members, Covenant Health's CEO, and the chiefs of staff of Covenant Health system hospitals. The committee shall review quality of patient care, perform other duties assigned in the system-wide medical staff documents, receive and review proposed amendments to the medical staff documents and make recommendations to the board, initiate quality-related investigations, and act as a Quality Improvement Committee as defined under Tennessee law. The System Credentials and Clinical Standard Committee consists of licensed physician voting board members and other appointed board members. Covenant Health's VP of Hospital Operations, Chief Medical Officer, and Chief Nursing Officer shall also serve as non-voting members of the committee. The committee shall develop and implement system-wide clinical standards, perform other duties as outlined in the medical staff documents, make determinations regarding routine credentialing matters and medical staff appointments/terminations, and act as a Quality Improvement Committee as defined under Tennessee law. Other 2018 amendments to the governing documents were not considered significant. Form 990, Part VI, Section A, line 6 Covenant Health is the sole member of LeConte Medical Center. Form 990, Part VI, Section A, line 7a Covenant Health's board of directors also serves as the board of directors for LeConte Medical Center. Form 990, Part VI, Section A, line 7b Governance decisions of LeConte 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, the parent company of the organization, distributes a board-approved Code of Conduct to all employees. The Code covers among other subjects, conflicts of interest. Additionally, managers are required to complete and sign a bi-annual management certification that addresses conflicts of interest. 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 key employees. These records are available to be queried prior to engaging in business transactions. The Chief Compliance Officer initially reviews all 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 LeConte Medical Center, Covenant Health (Parent Company), and affiliates are set by the Compensation Committee of the board of directors, ("the Committee"), which is comprised of independent members of the board. The Committee is guided in its decision-making process by an independent, nationally-recognized executive compensation consultant experienced in advising nonprofit hospital boards. The Covenant Health CEO is compensated by Covenant Health, and a detailed description of the compensation process is included on Covenant Health's Form 990. The process for LeConte 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 Elissa Jolly, President and Chief Administrative Officer, are set by the Covenant Health CEO in consultation with the Senior Vice President-Human Resources, subject to approval of the Compensation Committee of the Covenant Health board of directors ("the Committee"), 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 approved by 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 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 0-35% 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 LeConte 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 Intercompany Purchased Services: Program service expenses 1,620,784. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,620,784. Other Purchased Services: Program service expenses 5,959,754. Management and general expenses 160,162. Fundraising expenses 0. Total expenses 6,119,916. Sponsorship Fees: Program service expenses 3,792,370. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,792,370. Form 990, Part XI, line 9: Transfers of Capital -8,398,824. 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