2018-11-14T13:13:51-06:00 2017-12-31 990 2017-01-01 581897274 Parkwest Medical Center PARK 8653746864 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 JOHN T GEPPI EVP/CFO 8653746872 2018-11-14 168.85.177.4 2018-11-14 14:06:06 ES P F4919464179932DABC08F68C8485D564CA479FAE 469132092D82E9B9F729922824776EAC2989A597 2017 2019-02-21 02:37:17Z James D VanderSteeg 100 Ft Sanders W Blvd Knoxville TN 37922 383409142 0 X www.treatedwell.com X 1990 TN See Schedule O.Parkwest Medical Center operates a full-service acute care hospital located in west Knoxville, Tennessee, and a psychiatric hospital in neighboring Blount County, with a combined total of 462 beds. It is a member of the Covenant Health system. 20 18 2271 150 890386 130673 500134 489717 358217498 376509877 31230 89128 3518270 3710779 362267132 380799501 290520 360716 0 0 99517710 103748511 0 0 0 223163423 235060305 322971653 339169532 39295479 41629969 188859057 201160048 32057571 31653585 156801486 169506463 X Parkwest Medical Center provides quality healthcare, in alignment with Covenant Health's mission to serve the community by improving the quality of life through better health, regardless of the patient's ability to pay. 0 0 72619063 84843062 Cardiology: During 2017, Parkwest Medical Center performed 581 open heart surgeries. In addition, the cardiac cath lab performed 3,378 inpatient and 4,764 outpatient procedures for a total of 8,142 procedures.The Heart Hospital at Parkwest is a Joint Commission top performer in heart, pneumonia and surgical care and consistently receives excellent safety and customer satisfaction ratings from multiple survey sources. 47011374 55904053 Orthopedics: During 2017, Parkwest Medical Center performed 4,764 orthopedic surgeries - 3,347 inpatient and 1,399 outpatient. Among these surgeries, 734 total hip replacements were done, as well as 1,512 total knee replacements. 30730861 28084055 Psychiatry: Peninsula, a division of Parkwest, is the region's largest provider of behavioral health services. Peninsula provides outpatient services in four counties and inpatient services at a 155 bed facility. The Parkwest Senior Behavioral Center provides an advanced level of care for older psychiatric patients.At the Peninsula campus, admissions totaled 4,690, with 30,625 inpatient days. Outpatient visits totaled 82,518. Parkwest's Senior Behavioral Center saw 440 admissions in 2017 resulting in 5,514 patient days. 181430474 360716 199900740 As a full-service acute care hospital, Parkwest Medical Centertreats patients across a broad spectrum of medical specialties. 181430474 360716 199900740 331791772 1 1 0 0 0 0 0 0 0 1 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 1 1 0 0 1 408 0 1 2271 1 1 1 0 0 0 0 0 0 0 0 0 X 20 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Nancy Beck 8653746864 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 James D VanderSteeg President & CEO 0.00 50.00 X X 0 1444249 177701 Ed Anderson Director 0.00 1.00 X 0 1296 0 Patrick Birmingham Director/VP of Philanthropy 0.00 50.00 X 0 13846 0 Gerald Boyd Director 0.00 1.00 X 0 1437 0 Dr Willard Campbell Director 0.00 1.00 X 0 0 0 Dr Michael Casey Director 0.00 1.00 X 0 1971 0 Ronni Chandler Director 0.00 1.00 X 0 1193 0 Dr Mitchell Dickson Director 0.00 1.00 X 0 2014 0 James Fitzsimmons Chairman 0.00 1.00 X 0 1415 0 Jim Johnson Jr Director 0.00 1.00 X 0 948 0 Amber Krupacs Director 0.00 1.00 X 0 1031 0 Eddie Mannis Director 0.00 1.00 X 0 0 0 Timothy Matthews Director 0.00 1.00 X 0 0 0 Larry Mauldin Director 0.00 1.00 X 0 661 0 Dr Joseph Metcalf Director 0.00 1.00 X 0 29957 0 Alvin Nance Director 0.00 1.00 X 0 1402 0 Linda Ogle Director 0.00 1.00 X 0 0 0 Roger Osborne Director 0.00 1.00 X 0 692 0 Carl Storms Director 0.00 1.00 X 0 1169 0 Richard Swanson Director 0.00 1.00 X 0 0 0 David C Verble Director 0.00 1.00 X 0 0 0 John T Geppi EVP/CFO 0.00 50.00 X 0 884318 28575 Anthony L Spezia CEO - Emeritus 0.00 40.00 X 0 513410 27087 Neil Heatherly President & CAO 50.00 0.00 X 0 450537 23701 Michael S Hamilton VP-Financial Services 40.00 10.00 X 187306 0 32630 Emlyn Cobble VP-Chief Support Officer 50.00 0.00 X 166510 0 14854 Lynn Cagle VP-Chief Nursing Officer 50.00 0.00 X 154051 0 28851 John Kupfner Physician - Behavioral 40.00 0.00 X 329635 0 40368 Donna McKenzie Physician - Behavioral 40.00 0.00 X 301261 0 17765 Shyam Vuyyuru Physician - Behavioral 40.00 0.00 X 289303 0 40797 Melanie Fuertes-Hunt Physician - Behavioral 40.00 0.00 X 258135 0 37931 Rajendra Raman Physician - Behavioral 40.00 0.00 X 250891 0 39745 Janice McKinley Former Chief Nursing Officer 0.00 50.00 X 0 340664 26075 1937092 3692210 536080 52 1 1 0 GE Healthcare PO Box 96483 Chicago IL 60693 Equipment Maintenance/Service 3382403 Earl Swenson Associates PO Box 410628 Nashville TN 37241 Architectual Services 2710777 Mobile Hyperbaric Centers Stark 600 Superior Ave East Cleveland OH 44114 HBOT Treatment Services 1843887 Medic Regional Blood Center 1601 Ailor Ave Knoxville TN 379216702 Blood Processing 1745572 Angelica Textile Services Inc PO Box 535122 Atlanta GA 303535122 Linen Services 1332852 49 108314 287025 94378 75 489717 Medical Services 622110 367577101 367577101 Pharmacy 446110 7768059 248944 281912 7237203 Laboratory 621511 577312 577312 Meaningful Use 900099 575585 575585 Rental Inc - Affiliate 531120 11820 11820 376509877 92485 92485 3254737 2606284 648453 648453 31162 617291 3357 -3357 -3357 -3357 Cafeteria 722514 2010871 2010871 Gift Shop 453220 551690 551690 Miscellaneous 900090 252576 168066 84510 247189 150394 96795 3062326 380799501 368731910 890386 10687488 13328 13328 347388 347388 401301 401301 85986877 84281452 1705425 2557656 2515816 41840 8680088 8215792 464296 6122589 5964498 158091 26741127 25963391 777736 271249 271249 24499469 23786361 713108 270448 265138 5310 2893045 2415631 477414 6497974 5319328 1178646 206278 189621 16657 204768 177477 27291 6303 6303 13788636 13630317 158319 511019 379438 131581 Supplies & Equipment 103112885 102767689 345196 Unrelated Business Inco 130927 130927 Charity Care 30936451 30936451 Bad Debt 10835350 10835350 14154376 13781003 373373 339169532 331791772 7377760 0 7870 7945 -2512440 -2041618 33269164 33665592 6194544 6476726 1261368 1414710 429572989 268920104 149672291 160652885 966260 983808 188859057 201160048 27438940 27583763 142543 110571 4476088 3959251 32057571 31653585 X 156801486 169506463 156801486 169506463 188859057 201160048 X 41629969 -28924992 X X 0 1 X 1 0 X 156155 7707 9355 9355 163863 65512 90643 2227 2227 156155 64918 594 1913 1913 65512 62293 2625 3003 3003 64918 61422 871 1918 1918 62293 0.00000 1.00000 0.00000 0 1 1 20600002 20600002 35635600 178666630 111892144 102410086 797516 749274 48242 190204028 152718711 37485317 3669213 3559975 109238 160652885 Due to Affiliates 406305 Due to Third Party Payors 1283704 Long-term Deferred Compensation 613449 Long-term Reserve for Workers Comp 1642751 Other liabilities 13042 3959251 X Part V, Line 4: Fort Sanders Foundation maintains a permanent endowment fund on behalf of Parkwest Medical Center. The Wayne Heatherly Excellence in Patient Care Endowment Fund was established to promote and encourage excellence in clinical quality and patient care by providing educational assistance to employees, recognizing and awarding nominated employees for their commitment to patient care excellence, and to help meet patient care needs. The principal of the permanent endowment will be kept intact in perpetuity, and only the income generated will be distributed to provide support for Parkwest Medical Center. Part X, Line 2: Note B to the consolidated audited financial statements of Covenant Health, parent company to Parkwest Medical Center, reads in part: "Income Taxes: 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 (see Note G). Note G reads in part: "Covenant had no unrecognized tax benefits at December 31, 2017 and 2016. As such, no interest or penalties were recognized in the Consolidated Statements of Operations and Changes in Net Assets related to unrecognized tax benefits. At December 31, 2017, tax returns for 2014 through 2017 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, 2017 or 2016." 1 1 X 1 X 1 X 1 1 1 0 1 1 15838071 6373954 9464117 0.02880 52481482 43550677 8930805 0.02720 5441789 4536234 905555 0.00280 73761342 54460865 19300477 0.05880 347388 347388 0.00110 9745631 2573770 7171861 0.02180 103083 103083 0.00030 10196102 2573770 7622332 0.02320 83957444 57034635 26922809 0.08200 226 226 0.00000 26881 26881 0.00010 75101 75101 0.00020 4155 4155 0.00000 283 283 0.00000 106646 106646 0.00030 1 10835350 3922397 75264258 84991941 -9727683 X 1 1 1 None 2 1 Parkwest Medical Center 9352 Park West Blvd Knoxville TN 37923 www.treatedwell.com 00000042 X X X Behavioral Health A 2 Peninsula Hospital 2347 Jones Bend Road Louisville TN 37777 www.peninsulabehavioralhealth.org 00000042 X Behavioral Hospital A Facility Reporting Group - A 0 0 1 X X X X X X X 17 1 1 1 1 X http://www.treatedwell.com X 1 17 1 http://www.treatedwell.com 0 1 X 200.000000000000 300.000000000000 X X 1 1 X X X 1 X https://www.treatedwell.com/financial-assistance/ X https://www.treatedwell.com/financial-assistance/ X https://www.treatedwell.com/financial-assistance/ X X X X X X 1 X 0 X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Parkwest Medical Center, - Facility 2: Peninsula Hospital Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 5: In 2014, the Knox County Health Department convened monthly data group meetings with assessment partners to organize and coordinate the qualitative and quantitative data collection efforts. The qualitative data consisted of 12 focus groups, 26 key informant interviews and a quality of life survey with more than 2,000 responses. A Behavioral Risk Factor Survey (BRFS) and Youth Risk Factor Survey (YRFS) were conducted as well. Epidemiology staff compared local and state level data, data from the surveys, and mortality and disease prevalence data. All data were evaluated and priority health issues were narrowed down to 14 topic areas that represent the 20 priority health issues for Knox County. Public input on a summary of the assessment was sought in person and online in June 2015.In 2015 the Community Health Council assembled subject matter experts on the top 20 issues and held a retreat in June to score the health priorities by 1) size of the problem, 2) seriousness of the problem, 3) effectiveness of interventions, and 4) feasibility of available interventions in our community. The three highest-scored issues were adopted as the most significant health priorities for Knox County.In August 2015, representatives from the Community Health Council and the Knox County Health Department met with area hospital executives and administrators of large physician practice groups to present the June 2015 retreat outcomes. There was overwhelming feedback that the fourth-highest scoring issue, mental health, needed to be included. Thus, the final top four priority goals are:1. Increase access to mental health resources2. Decrease opioid abuse3. Decrease tobacco use among youth and pregnant women4. Increase access to safe greenways, sidewalks, and parksPart V, Section B, Line 4. It was determined per audit that while the CHNA was prepared as of December 31, 2016, it was completed on May 8, 2017 with board approval. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 6a: Knox County hospitals who participated in the "Together! Healthy Knox" initiative included Parkwest Medical Center, Fort Sanders Regional Medical Center, East Tennessee Children's Hospital, and The University of Tennessee Medical Center. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 6b: This process could not have been done without the leadership of the Knox County Health Department and the Together! Healthy Knox Leadership Team. Their expertise, use of the MAPP process, meeting facilitation and guidance ultimately resulted in the most comprehensive health assessment process ever undertaken in Knox County. Other community organizations who participated in the CHNA process were Child and Family Tennessee, City of Knoxville, Knoxville Academy of Medicine, Knoxville Area Coalition on Childhood Obesity, Knoxville Chamber, Knoxville Police Department, Knoxville Community Development Corporation, Helen Ross McNabb Center, Interfaith Health Clinic, Knox County Government, Metropolitan Drug Commission, and community members from many other organizations. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 11: Of the significant findings from the assessment, Parkwest Medical Center is focusing its resources on the following:Mental Health* Peninsula Hospital, a division of Parkwest Medical Center, became a Health Link provider beginning in 2016, serving 678 mental health consumers in our region. This program ensures that clients receive comprehensive case management, care coordination, health promotion, patient and family care support and referrals to additional support as needed. In 2017, Peninsula served 1,361 clients.* Women in Treatment - provides comprehensive treatment to uninsured women aged 18-64 who are currently battling addiction. Forty-four women were served in 2017.* KARM Partnership - Peninsula Hospital employs a staff member to serve as a liaison between the hospital inpatients and the Knoxville Area Rescue Mission. Peninsula contines to employ an outreach specialist to work with Knoxville Area Rescue Mission clients in 2017.* Youth Indigent Program - Peninsula Hospital admits an average of 4-5 children and adolescents without a funding source each year. Total cost of care to facility is $12,600-$15,750 per year.Decrease Opioid Abuse* Peninsula Hospital no longer prescribes opioids in its outpatient clinics.Decrease Tobacco use among youth and pregnant women* Peninsula Hospital Peer Support Program in Blount, Knox and Sevier Counties all offer smoking cessation classes using a curriculum approved by the State of Tennessee.Increase access to safe greenways, sidewalks and parks* Parkwest Hospital is a major sponsor of the annual Covenant Health Knoxville Marathon. In 2017, the Covenant Health Knoxville Marathon had 8,993 participants in the various events including a Kids Run, 5K, Relay Teams and half and full marathons. This was the 13th year of supporting the marathon at a cost of nearly $80,000. At the end of the event each year $15,000 - 18,000 is given back to the community from the event proceeds to support additional greenways, walking trails and programs that promote physical activity.* Dogwood Patch Program - The second annual Dogwood Patch program was held in 2017 in collaboration with the Dogwood Arts organization. Residents who walk 25 miles or more of Dogwood Trails during a two month period earn an embroidered patch. A new patch is designed each year. In 2017, 332 residents participated.* Covenant Health Biggest Winner Program - a twice a year program for employees to focus on weight loss and improving their personal health biometrics. Local trails are used for the exercise component. The program culminates in the participants finishing their program by participating in either the 5K run/walk of the Covenant Health Knoxville Marathon or the Subway Race for Cancer 5K run/walk. In 2017, 22 employees participated in the Biggest Winner Program. Group A-Facility 1 -- Parkwest Medical Center Part V, Section B, line 16j: Please see the explanation to Part VI, Line 3. Group A-Facility 2 -- Peninsula Hospital Part V, Section B, line 5: In 2014, the Knox County Health Department convened monthly data group meetings with assessment partners to organize and coordinate the qualitative and quantitative data collection efforts. The qualitative data consisted of 12 focus groups, 26 key informant interviews and a quality of life survey with more than 2,000 responses. A Behavioral Risk Factor Survey (BRFS) and Youth Risk Factor Survey (YRFS) were conducted as well. Epidemiology staff compared local and state level data, data from the surveys, and mortality and disease prevalence data. All data were evaluated and priority health issues were narrowed down to 14 topic areas that represent the 20 priority health issues for Knox County. Public input on a summary of the assessment was sought in person and online in June 2015.In 2015 the Community Health Council assembled subject matter experts on the top 20 issues and held a retreat in June to score the health priorities by 1) size of the problem, 2) seriousness of the problem, 3) effectiveness of interventions, and 4) feasibility of available interventions in our community. The three highest-scored issues were adopted as the most significant health priorities for Knox County.In August 2015, representatives from the Community Health Council and the Knox County Health Department met with area hospital executives and administrators of large physician practice groups to present the June 2015 retreat outcomes. There was overwhelming feedback that the fourth-highest scoring issue, mental health, needed to be included. Thus, the final top four priority goals are:1. Increase access to mental health resources2. Decrease opioid abuse3. Decrease tobacco use among youth and pregnant women4. Increase access to safe greenways, sidewalks, and parksPart V, Section B, Line 4: It was determined per audit that while the CHNA was prepared as of December 31, 2016, it was completed on May 8, 2017 with board approval. Group A-Facility 2 -- Peninsula Hospital Part V, Section B, line 6a: Knox County hospitals who participated in the "Together! Healthy Knox" initiative included Parkwest Medical Center, Fort Sanders Regional Medical Center, East Tennessee Children's Hospital, and The University of Tennessee Medical Center. Group A-Facility 2 -- Peninsula Hospital Part V, Section B, line 6b: This process could not have been done without the leadership of the Knox County Health Department and the Together! Healthy Knox Leadership Team. Their expertise, use of the MAPP process, meeting facilitation and guidance ultimately resulted in the most comprehensive health assessment process ever undertaken in Knox County. Other community organizations who participated in the CHNA process were Child and Family Tennessee, City of Knoxville, Knoxville Academy of Medicine, Knoxville Area Coalition on Childhood Obesity, Knoxville Chamber, Knoxville Police Department, Knoxville Community Development Corporation, Helen Ross McNabb Center, Interfaith Health Clinic, Knox County Government, Metropolitan Drug Commission, and community members from many other organizations. Group A-Facility 2 -- Peninsula Hospital Part V, Section B, line 11: Of the significant findings from the assessment, Peninsula is focusing its resources on the following:Mental Health* Peninsula Hospital, a division of Parkwest Medical Center, became a Health Link provider beginning in 2016, serving 678 mental health consumers in our region. This program ensures that clients receive comprehensive case management, care coordination, health promotion, patient and family care support and referrals to additional support as needed. In 2017, Peninsula served 1,361 clients.* Women in Treatment - provides comprehensive treatment to uninsured women aged 18-64 who are currently battling addiction. Forty-four women were served in 2017.* KARM Partnership - Peninsula Hospital employs a staff member to serve as a liaison between the hospital inpatients and the Knoxville Area Rescue Mission. Peninsula contines to employ an outreach specialist to work with Knoxville Area Rescue Mission clients in 2017.* Youth Indigent Program - Peninsula Hospital admits an average of 4-5 children and adolescents without a funding source each year. Total cost of care to facility is $12,600-$15,750 per year.Decrease Opioid Abuse* Peninsula Hospital no longer prescribes opioids in its outpatient clinics.Decrease Tobacco use among youth and pregnant women* Peninsula Hospital Peer Support Program in Blount, Knox and Sevier Counties all offer smoking cessation classes using a curriculum approved by the State of Tennessee.Increase access to safe greenways, sidewalks and parks* Parkwest Hospital is a major sponsor of the annual Covenant Health Knoxville Marathon. In 2017, the Covenant Health Knoxville Marathon had 8,993 participants in the various events including a Kids Run, 5K, Relay Teams and half and full marathons. This was the 13th year of supporting the marathon at a cost of nearly $80,000. At the end of the event each year $15,000 - 18,000 is given back to the community from the event proceeds to support additional greenways, walking trails and programs that promote physical activity.* Dogwood Patch Program - The second annual Dogwood Patch program was held in 2017 in collaboration with the Dogwood Arts organization. Residents who walk 25 miles or more of Dogwood Trails during a two month period earn an embroidered patch. A new patch is designed each year. In 2017, 332 residents participated.* Covenant Health Biggest Winner Program - a twice a year program for employees to focus on weight loss and improving their personal health biometrics. Local trails are used for the exercise component. The program culminates in the participants finishing their program by participating in either the 5K run/walk of the Covenant Health Knoxville Marathon or the Subway Race for Cancer 5K run/walk. In 2017, 22 employees participated in the Biggest Winner Program. Group A-Facility 2 -- Peninsula Hospital Part V, Section B, line 16j: Please see the explanation to Part VI, Line 3. 15 1 - Thompson Radiation Oncology Services 9711 Sherrill Blvd Knoxville TN 37932 Oncology Radiation Therapy 2 - Peninsula Outpatient Center - Knox 1451 Dowell Springs Blvd Knoxville TN 37919 Outpatient mental health facility 3 - Thompson PET Services 9711 Sherrill Blvd Knoxville TN 37932 PET Imaging Services 4 - Parkwest Comprehensive Breast Center 9330 Park West BlvdSuite 103 Knoxville TN 37923 Breast imaging center 5 - Peninsula Knox Outpatient Pharmacy 1451 Dowell Springs Blvd Knoxville TN 37919 Pharmacy 6 - Peninsula Outpatient Center - Blount 210 Simmons Street Maryville TN 37801 Outpatient mental health facility 7 - PWMC Boulevard Surgery Center 9300 Park West Blvd Knoxville TN 37923 Ambulatory surgery center 8 - Therapy Center West 280 Fort Sanders West Blvd 201 Knoxville TN 37922 Physical, Occupational & Speech Therapy 9 - CROPPROP 280 Fort Sanders West Blvd 205 Knoxville TN 37922 Cardiac & Pulmonary Rehabilitation 10 - Peninsula Outpatient Center - Sevier 1104 Foxwood Drive Sevierville TN 37862 Outpatient mental health facility 11 - Peninsula Outpatient Center - Loudon 423 Medical Park Drive Suite 400 Lenoir City TN 37772 Outpatient mental health facility 12 - Peninsula Adult IOP 1451 Dowell Springs Blvd Knoxville TN 37919 Outpatient Alcohol & Drug Rehabilitation 13 - Peninsula Adolescent IOP 1451 Dowell Springs Blvd Knoxville TN 37919 Outpatient Alcohol & Drug Rehabilitation 14 - Hyperbaric Center at Parkwest 9300 Park West Blvd Knoxville TN 37923 Outpatient Wound Care Services 15 - Parkwest Cardiac Diagnostics 9320 Park West Blvd Knoxville TN 37923 Cardiac Diagnostic Services Part I, Line 3c: In addition to the FPG (federal poverty guidelines), Parkwest Medical Center 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 Parkwest Medical Center and other affiliated acute care hospitals, prepares an annual Report to the Community on behalf of the entire system. Part I, Line 7: Amounts on Lines 7a-7c and certain program costs included in Line 7g are from the hospital's cost accounting system, which addresses all patient segments. Other community benefit expenses are at cost from the general ledger. Part I, Line 7g: The organization has included $7,097,138 in physician sponsorship fees in total subsidized health services. 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 $ 10,835,350. Part II, Community Building Activities: Parkwest Medical Center 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 2017 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 Sacred Heart Church *Youth mentoring, development and after-school programs - Emerald Youth Foundation, and Great Smoky Mountain Council - Boy Scouts of America *Business recruitment and marketing initiatives that boost economic development - Innovation Valley, Inc. and East Tennessee Economic Development Agency *Leadership development programs and workshops - Leadership Knoxville and YWCA *Assistance and special programs for at risk, physically challenged, abused and neglected children - Sertoma Center, Inc. and Variety of Eastern Tennessee (local chapter of Variety-The Children's Charity) *Improve access to health services - Interfaith Health Clinic, Knoxville Medical Mission Foundation and St. Mary's Legacy Clinic *Programs targeting cancer patients and their families - Cancer Support Community, Inc. and Komen Knoxville Race for Cure 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 hospital complies with the 2016 change in IRC Section 501(r) requirements for reporting charity care. 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 2017 Audited Consolidated Financial Statements of the Covenant Health system, of which Parkwest Medical Center is a member, reads in part: "Patient accounts receivable are reported net of both an estimated allowance for uncollectible accounts and an estimated allowance for contractual adjustments. The contractual allowance represents the difference between established billing rates and estimated reimbursement from Medicare, TennCare and other third-party payment programs. The allowance for uncollectible accounts is estimated based upon the age of the patient accounts receivable, prior experience and any unusual circumstances (such as local, regional or national economic conditions) which affect the collectability of receivables, including management's assumptions about conditions it expects to exist and courses of action it expects to take. Covenant's policy does not require collateral or other security for patient accounts receivable and Covenant routinely accepts assignment of, or is otherwise entitled to receive, patient benefits payable under health insurance programs, plans or policies." Part III, Line 8: Medicare Shortfall: Parkwest Medical Center believes that all of the $9.7 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 29% of total patient days (31,305 out of 107,891 total). The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. Costing Methodology: Parkwest Medical Center used a combination of sources in calculating Medicare allowable costs on Part III, Line 6 including its cost accounting system, general ledger accounting system, and facility-specific analyses and calculations. Part III, Line 9b: Parkwest Medical Center utilizes a look-back method to determine the AGB (amounts generally billed) to establish the maximum amount that will be charged to FAP-eligible individuals for emergency or other medically necessary care. Self-pay patients of Parkwest Medical Center automatically receive a 70% discount on charges based on the facility's calculated AGB. Self-pay patients of Peninsula Hospital receive a 59% discount. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment assistance may qualify for charity care. A sliding scale is used for extending charity care utilizing the income levels reported under the federal poverty guidelines. Patients/guarantors with income that falls below 200% of the federal poverty guidelines receive 100% charity care. Patients/guarantors with income of 201-300% of the federal poverty guidelines receive 90% charity care. For catastrophic illness, exceptions to income and asset limitations may be made on a case-by-case basis. The amount considered for charity will be based upon the evaluation of the patient's/guarantor's ability to pay.Parkwest Medical Center makes reasonable efforts to determine a patient's eligibility under the facility FAP. All collection activity will be halted if a charity application is received and will remain on hold until a determination is made by Parkwest Medical Center 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. Once an account has been processed internally through routine collection channels, it may be assigned to an attorney or agency for collection. Parkwest Medical Center does not sell any accounts receivable accounts to outside firms. All accounts remain property of and under the policies set by Parkwest Medical Center. Parkwest Medical Center 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 Community Health Needs Assessment is a formal means by which the health system assesses the needs of the community, there are many informal linkages that give the Covenant Health hospitals a sense of community issues and needs. Parkwest Medical Center obtains additional community information through the service of its employees with the United Way of Greater Knoxville, local chambers of commerce and Rotary clubs, the Metropolitan Drug Commission, a local alternative high school, the Legacy Parks Foundation, and the Knoxville Area Coalition on Childhood Obesity. Part VI, Line 3: Parkwest Medical Center 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 financial assistance policy 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 all lobby areas: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 Parkwest Medical Center are available to assist you with your financial needs. If you are an uninsured person with no public or private source of payment for medical services, Parkwest Medical Center, 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 865-373-1244, Monday through Friday between the hours of 8:00 a.m. and 4:30 p.m. Parkwest Medical Center employs a financial counselor who meets with uninsured patients. In addition, Parkwest Medical Center directs inpatients and observation patients on how to apply for Tenncare and provides instructions for joining the Healthcare exchange. The Charity Care Policy 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.Inpatient and observation patients without insurance receive a packet of information from the case managers on the nursing units. This packet includes a Financial Assistance Application, "How to Apply for Tenncare and instructions on the Healthcare Exchange. Tenncare applications are made online or by phone through the Healthcare Exchange process. Also included in the packet is how to apply for the Qualified Medicare Beneficiary program. Part VI, Line 4: Parkwest Medical Center is located in the west area of Knoxville, Tennessee. Although located in metropolitan Knox County, Parkwest Medical Center receives many specialty referrals from outlying hospitals and physicians and serves patients from 16 diverse counties, a mix of urban, suburban and rural. According to internal hospital data for 2017, more than 51% of the inpatient and outpatient cases came from Knox County residents.Parkwest Medical Center also provides mental health services to the region through its behavioral health division, Peninsula Hospital("Peninsula"). Peninsula is East Tennessee's leading provider of behavioral healthcare services. Peninsula offers a complete range of mental health and alcohol/drug treatment programs. In addition to outpatient centers in Blount, Knox, Loudon and Sevier counties, care is also offered at Peninsula Hospital, a 155-bed inpatient facility which serves more than 5,000 patients annually.According to 2017 data from the County Health Ranking report from the Robert Wood Johnson Foundation the population of Knox County is 451,324. The percent of the population that is 65 years or older constitute 14.8% of the residents. The unemployment rate in 2017 was 4.8%. According to the 2017 County Health Rankings Report by the Robert Wood Johnson Foundation/University of Wisconsin Population Health Institute, Knox County residents ranked 9 out of 95 Tennessee Counties in overall health. Knox County residents have the following health indicators that are at or above the national benchmarks: Knox - TN - National Adult Smoking: 19% - 22% - 14% Adult Obesity: 30% - 32% - 26% Drug Overdose Deaths: 28 - 20 - 9 per 100,000 population Teen Birthrate: 20 - 42 - 17 of every 1,000 teenage girls Part VI, Line 5: Parkwest Medical Center ("Parkwest"), in conjunction with its parent company, Covenant Health, uses any available surplus of receipts over disbursements to expand and modernize the facility and to support the education of healthcare professionals, both of which serve to improve patient care and serve the unmet needs of the community.Covenant Health's Board of Directors serves as Parkwest's board. It is comprised of independent community leaders with diverse educational and professional backgrounds. The board sets policies and provides oversight of Parkwest.Parkwest maintains an open medical staff, with privileges available to all qualified physicians. Additionally, the hospital operates an active and accessible emergency department that accepts all patients regardless of ability to pay. Part VI, Line 6: Parkwest Medical Center, as a member of the Covenant Health system, benefits from the collaboration among all affiliated organizations to promote quality improvement, patient safety and efficient delivery of care for the communities served.As a system, Covenant assures that business processes are in place at each facility to measure and report quality; to increase the role of compliance; and to integrate risk management, utilization review, peer review, mandatory reporting and quality improvement into one cohesive function. In this way, the system is able to use analytic tools to help identify any systemic inability to satisfy the various requirements on the part of the facilities.Parkwest operates a 462-bed acute care hospital in Knoxville, Tennessee, and provides a full range of inpatient and outpatient hospital services. It has been named as one of the nation's top 100 cardiovascular hospitals seven times of the award's eight-year history and offers a full cardiovascular service line that includes coronary bypass surgery, diagnostic and interventional cardiac procedures. Patients may also receive treatment in one of Parkwest's specialty centers, which include: --The Senior Behavioral Center, a 16-bed unit for older psychiatric patients --A Bariatric Surgery Center of Excellence --A Joint Replacement Center --A surgical center utilizing the BrainSUITE system for brain, spine, ear, nose and throat surgery.Parkwest also owns and operates Peninsula Hospital (Peninsula), a 155-bed psychiatric hospital located in Louisville, Tennessee. Peninsula has outpatient centers in Knox, Blount, Sevier and Loudon Counties. Peninsula is a valuable resource providing support for emergency rooms at the system's seven acute care hospitals. The affiliation makes for an accessible and efficient pathway for patients who require mental health services post-discharge.Parkwest and Peninsula patients benefit from the availability and ease of access to Covenant Health affiliated entities for services not provided by the hospitals themselves. Transfer or referral to such services is expedited and coordinated to help create a seamless continuum of care. Specialized services such as inpatient rehabilitation, cancer treatment, home health and hospice services are provided by affiliated entities. The Covenant Health system also enhances the patient's access to care through the provision of outpatient services in a variety of settings located throughout the service area. These include diabetes, wound care, and ambulatory infusion centers.Fort Sanders Foundation seeks out community financial support for Parkwest Medical Center and Peninsula Hospital. Funds are used for indigent patient care, medical equipment, outreach programs, services and staff.Through this combination of resources and the collective development, implementation and monitoring of clinical protocols and other improvement initiatives, the affiliated entities of Covenant Health are able to deliver higher quality care in a more efficient manner than could be achieved working independently. 1 Knoxville Medical Mission Foundation 1932 Historic Ferry Way Knoxville TN 37922 300197352 501(c)(3) 7500 General support 1 0 Patient assistance with transportation, food, medicine, utilities, rent, dialysis treatment and medical equipment 4423 347388 Part I, Line 2: Donations are given at the discretion of the Administration and Marketing departments for the purpose of enhancing and promoting healthcare within the communities of East Tennessee and medical missions to populations in need. The organization maintains records of check requests authorizing gifts and donations. Recipients are trusted to use the funds for the purposes for which they were given. X 1 1 0 1 0 0 0 0 0 0 0 James D VanderSteeg President & CEO 0 915074 0 405000 0 124175 0 154000 0 23701 0 1621950 0 0 John T Geppi EVP/CFO 0 575805 0 214200 0 94313 0 10600 0 17975 0 912893 0 0 Anthony L Spezia CEO - Emeritus 0 216489 0 0 0 296921 0 10600 0 16487 0 540497 0 0 Neil Heatherly President & CAO 0 394821 0 50000 0 5716 0 0 0 23701 0 474238 0 0 Michael S Hamilton VP-Financial Services 156601 0 20000 0 10705 0 6998 0 25632 0 219936 0 0 0 Emlyn Cobble VP-Chief Support Officer 140050 0 15000 0 11460 0 6069 0 8785 0 181364 0 0 0 Lynn Cagle VP-Chief Nursing Officer 123836 0 15000 0 15215 0 5440 0 23411 0 182902 0 0 0 John Kupfner Physician - Behavioral 323095 0 6000 0 540 0 15900 0 24468 0 370003 0 0 0 Donna McKenzie Physician - Behavioral 291029 0 8000 0 2232 0 9219 0 8546 0 319026 0 0 0 Shyam Vuyyuru Physician - Behavioral 280652 0 8000 0 651 0 15900 0 24897 0 330100 0 0 0 Melanie Fuertes-Hunt Physician - Behavioral 249281 0 8000 0 854 0 14733 0 23198 0 296066 0 0 0 Rajendra Raman Physician - Behavioral 241569 0 8000 0 1322 0 14307 0 25438 0 290636 0 0 0 Janice McKinley Former Chief Nursing Officer 0 220883 0 80000 0 39781 0 10600 0 15475 0 366739 0 0 Part I, Line 1a Tax gross-up payments related to deferred compensation are provided to certain executives and managers. These are treated as taxable compensation to the recipients. Part I, Line 3 Covenant Health, the parent company of Parkwest Medical Center, used one or more of the methods listed in establishing the compensation of James D. VanderSteeg. Please see the statement to Core Part VI, Section B, Line 15a on Schedule O. Part I, Line 4b James VanderSteeg, President & CEO, was a participant in a nonqualified deferred compensation (NQDC) plan. The NQDC plan was established in 2016. Employer contributions to the plan during 2017 totaled $143,400, which is reported in Col. C of Schedule J, Part II. Interest earned during 2017 of $10,080 is not required to be reported in compensation in Part II, as Mr. VanderSteeg is not vested in the plan. Anthony Spezia, CEO-Emeritus, was a participant in two nonqualified deferred compensation plans, which are referred to as Plan A and Plan B. In 2011 Mr. Spezia vested in Plan A, and the accumulated balance as of August 1, 2011 was included in his 2011 taxable income. An Amendment to Plan A was adopted effective August 1, 2011 which terminated further accruals (contributions) to the plan. However, the Amendment allowed the accrual of interest on undistributed amounts which were subject to risk of forfeiture until such time as indicated in the Amendment. Interest earned by Plan A and Plan B during 2017 was $199,910 and is not required to be reported in compensation in Part II as Mr. Spezia is not vested in the 2017 earnings on Plan A or Plan B. There were no employer contributions to Plan A during 2017. Plan B was established in 2011. Interest earned by Plan B during 2017 is included in the Plan A 2017 earnings amount. It is not required to be reported in compensation in Part II as Mr. Spezia is not vested in the 2017 additions to Plan B. There were no employer contributions to Plan B during 2017. Form 990, Part III, Line 1 2017 Report to the Community Covenant Health is a comprehensive, community-owned, not-for-profit health system serving 23 counties in East Tennessee. Nine acute care hospitals located in Knoxville and surrounding areas comprise the foundation of the health system. Additional outpatient and specialty care departments are located throughout the region providing diagnostic and surgery services, mental health and cancer treatments, and therapy and home health services. Over 10,000 employees and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than one million patients and families served each year. Member organizations: Hospitals Claiborne Medical Center Cumberland Medical Center Fort Loudoun Medical Center Fort Sanders Regional Medical Center LeConte Medical Center Methodist Medical Center of Oak Ridge Morristown-Hamblen Healthcare System Parkwest Medical Center Peninsula Hospital, a division of Parkwest Medical Center Roane County Medical Center Outpatient and Specialty Care Covenant HomeCare and Hospice Covenant and Methodist Therapy Centers Fort Sanders West Diagnostic Center Fort Sanders West Outpatient Surgery Center Morristown Regional Diagnostic Center Patricia Neal Rehabilitation Center Peninsula Outpatient Centers Thompson Cancer Survival Centers Covenant Breast Centers Covenant Joint Centers Covenant Sleep Centers Claiborne Nursing Home Fort Sanders Sevier Nursing Home Physician Services Covenant Medical Group, Inc. Other Programs and Services Fortress Corporation Fort Sanders Health and Fitness Center Nanny's Nursery Covenant Staffing Services Tennessee Wesleyan University - Fort Sanders Nursing Foundations Fort Sanders Foundation Methodist Medical Center Foundation Morristown-Hamblen Hospital Foundation Thompson Cancer Survival Center Foundation Patient Care Summary Population of 23-County Service Area 1,427,213 (2010 Census) 2014 2015 2016 Patient Care Summary 67,235 68,193 68,320 (Excludes nursing home) Inpatient Surgeries 16,908 16,585 17,426 Outpatient Surgeries 29,644 29,265 29,480 ED Visits 317,575 328,360 327,724 Outpatient Visits 1,040,593 1,061,082 1,091,009 Physician Office Visits 499,881 548,210 580,660 Leadership Jim VanderSteeg, Covenant Health's President and CEO, remains committed to the mission of improving the quality of life through better health and a vision of being the region's premier healthcare network through clinical and service excellence. Everyone associated with the health system knows and is committed to the following Pledge of Excellence: * The patient always comes first. Our patients are the reason Covenant Health exists, and it is both a privilege and a high calling to care for them. * We are committed to excellence. Our patients and our coworkers in all areas of the organization deserve nothing less. * First and best choice - Covenant Health will strive to be the organization that our communities instinctively seek out when they need health care. We will continually work to be the best in every aspect of the care we provide. Jim VanderSteeg and the executive leadership team have stated: * We will lead courageously, being proactive in delivering excellent care and meeting the challenges of today's healthcare environment. * We will be honest in our business dealings and in our interactions with co-workers, patients,and the communities we serve. * We will use our resources wisely as we deploy medical services and technology in our local communities. * We will collaborate to create a workplace culture where people know they are valued and how they connect to the mission and vision of Covenant Health. * We will encourage innovative thinking and creative ideas from all employees in order to make Covenant Health the best it can be. Awards Several Covenant Health hospitals received top recognitions from national organizations in 2017: * Cumberland Medical Center in Crossville was named the Upper Cumberland's only "Top 100 Rural & Community Hospital" by iVantage Health Analytics and The Chartis Center for Rural Health. It is one of only two hospitals in Tennessee to earn the 2017 designation. * For the second year in a row, Fort Sanders Regional Medical Center in Knoxville has been named to a national list of "100 Hospitals and Health Systems with Great Oncology Programs" by Becker's Hospital Review. The Becker's editorial team selected hospitals and health systems that lead the way in oncology expertise, outcomes, research and treatment options. * LeConte Medical Center in Sevierville was named among "100 Great Community Hospitals" by Becker's Hospital Review, also for the second year in a row. Hospitals on the list are recognized for quality, patient satisfaction and overall excellence, and play a key role in their communities as the centerpiece for health care. * The transition program at Peninsula, the behavioral health division of Parkwest Medical Center, has been recognized as a Program of Excellence by the Tennessee Association of Mental Health Organizations, and has achieved the lowest readmission rate to Peninsula Hospital compared to the past two years. * Claiborne Health and Rehabilitation Center, affiliated with Claiborne Medical Center in Tazewell, earned a 2017 Bronze National Quality Award from the American Health Care Association and National Center for Assisted Living. The award honors the facility's commitment to improving quality of care for seniors and persons with disabilities. Claiborne Health and Rehabilitation Center was one of 520 long-term facilities in 46 states and one of 10 nursing homes and two assisted living facilities in Tennessee to receive the award. * Fort Sanders Sevier Nursing Home, affiliated with LeConte Medical Center in Sevierville, was named a 2017 Best Nursing Home by U.S. News and World Report. To be included in the list, the nursing home had to earn at least four stars (out of five) on the Centers for Medicare and Medicaid Services "Nursing Home Compare" rating for the 10 months of federal reports ending in August 2017, and had to earn a 4.5 or higher for at least five of those months. Form 990, Part III, Line 1 Achievements Covenant HomeCare has been recognized as the first home health agency in Tennessee and the third in the nation to reach Milestone 5, the highest level of a five-step Home Health Quality Improvement initiative aimed at preventing heart attack and strokes. The HHQI Cardiovascular Health Improvement initiative is an ongoing effort to reduce the incidence of heart attack and stroke among home health patients through a series of best practice interventions. It tracks data on aspirin and tobacco usage, blood pressure and cholesterol levels among home health patients with ischemic vascular disease. Covenant HomeCare offers skilled nursing, certified nursing assistants, physical therapy, speech therapy, occupational therapy and medical social services. It is the area's largest non-profit home health and hospice provider and serves more than 4,700 patients annually in 17 counties through branches in Knoxville, Oak Ridge and Morristown. Covenant HomeCare and Hospice scored 100% on CMS (Centers for Medicare and Medicaid) quality measures for patient care, including evaluation and treatment for symptoms such as pain and shortness of breath, and patients' treatment preferences related to hospice care. Stroke Care Covenant Health has the region's only stroke hospital network for delivering advanced diagnostics and treatment to halt the devastating effects of stroke. Residents in any of the 23 counties served have increased rates of survival due to a hub-and-spoke model for stroke treatment. At the hub of the network are Fort Sanders Regional Medical Center and Patricia Neal Rehabilitation Center. An emergency department physician at any of the Covenant Health hospitals can confer with colleagues and administer the clot-busting drug tPA (tissue plasminogen activator) before transporting the patient to Fort Sanders Regional. * Fort Sanders Regional Medical Center is an accredited Comprehensive Stroke Center, offering both advanced stroke treatment and the stroke rehab services of the Patricia Neal Rehabilitation Center. * Other Covenant Health member hospitals are certified as advanced primary centers for stroke care, or are preparing to be certified as "stroke ready" facilities. * Eighty-three percent of patients with stroke symptoms see an emergency physician within 15 minutes of arrival at Covenant Health hospitals, compared to a national average of 67%. * Seventy-one percent of patients who have a neurological intervention for stroke at Fort Sanders Regional do not need a wheelchair when they are discharged from the hospital. * Fort Sanders Regional Medical Center exceeds the national average of patients who are able to go directly home after stroke treatment. Cancer Care The Covenant Health breast centers offer Digital 3D mammography - also known as tomosynthesis which allows cancer to be detected much earlier. It's a newer technology and especially helpful for women with dense breast tissue because it allows a more detailed look at the breast tissue. With 6 locations across the 23 county service area, patients have access to this new technology close to home. At Covenant Health's breast center locations, patients receive their screening mammography results within 24 hours. When cancer is caught in its earliest stages, patients can undergo a shorter duration of radiation therapy. Covenant Health radiation oncology locations offer partial breast radiation which takes only five days, compared to the traditional whole breast radiation course of four to six weeks. In 2015 Covenant Health began implementing a low dose CT (LDCT) program for lung cancer screening. Now in maturity, the program led to the detection of 20 new cases of lung cancer in 2017. With this LDCT program, patients can receive treatment for earlier stages of lung cancer, improving the chance of sustainability. Cardiac Care Covenant Health's heart hospitals began collaborating in 2012 to offer Transcatheter Aortic Valve Replacement (TAVR). Much has changed in the TAVR world since then. Smaller catheters and surgical instruments have opened new pathways to the heart and opened the procedure to a wider range of candidates. No longer limited to elderly "inoperable" patients, TAVR is now available to younger patients and those deemed "high or intermediate risk." In addition, this therapy and technology are offered locally so patients do not have to travel far. * Covenant Health was the first to bring the life-saving TAVR procedure to our region. * Covenant Health cares for more hearts than any other area health system. * Covenant Health's average door-to-balloon time for STEMI (heart attack) patients is 52 minutes, 42% faster than the national goal. * Covenant Health has more cardiac rehab locations than any other area health system. Spine and Neuro Care Fort Sanders Regional is one of three centers for Covenant Health's spine surgery network, which also has locations at Methodist and Parkwest Medical Centers. The network uses a multidisciplinary team approach that includes neurosurgeons, orthopedic surgeons, nurses, and physical therapists. Surgeons have access to the latest technology and methods for inpatient and outpatient surgeries, including minimally invasive techniques that result in faster recoveries, less postoperative pain, and fewer complications. For patients needing spinal fusion, a neurosurgeon can perform a minimally invasive surgical procedure called Transforaminal Lumbar Interbody Fusion (TLIF) a spinal fusion technique used to treat spondylolisthesis, degenerative disc disease or recurrent disc herniations. * Covenant Health's spine centers perform more than 2,300 elective spine surgeries each year. * The spine centers treat conditions such as spinal cord injuries, herniated or ruptured discs, degenerative disc disease, spine tumors, sciatica, and others. * Ninety-two percent of elective spine surgery patients are able to go directly home after surgery. Form 990, Part III, Line 1 Expansion and Renovation In 2017 Parkwest Medical Center began a $99 million expansion and renovation project to accommodate both patient care improvements and growth on Parkwest's main campus in west Knoxville. Highlights of the project include: * A new patient care tower to better serve the hospital's inpatients and observation patients within specialized units. * Additional operating rooms and an expansion of surgical support space within the existing main surgery area of the hospital. * A dedicated entrance for surgical patients. * Creation of a clinical observation unit to help staff and physicians better serve medical and surgical observation patients who do not need to be admitted as inpatients. * Relocation of the helipad closer to the Emergency Care Center. The new location will allow quicker access for Covenant Health patients across the region who are airlifted to Parkwest for emergency medical care. Physician Relationships Nearly 1,500 physicians are affiliated with Covenant Health hospitals and organizations as members of the health system's medical staffs. These physicians serve in leadership positions at their respective hospitals, and several represent their organizations and communities through membership in Covenant Health's Board of Directors. Covenant Medical Group, Inc,(CMG) comprises the health system's largest group of employed physicians. CMG includes primary care and specialty physicians in more than 100 practice locations. CMG also builds and maintains partnerships with physicians through joint ventures such as surgery centers and the development of service line strategies that focus on improving the quality of patient care. Physician and hospital agendas are aligned so that the first priority is always the patient. The health system's goal is to work side by side with physicians to provide a seamless continuum of care and excellent outcomes. Preparing Future Healthcare Professionals In 2017 Covenant Health welcomed a new group of medical students as part of the health system's partnership with DeBusk College of Osteopathic Medicine at Lincoln Memorial University in Harrogate, Tennessee. It is the second year for the medical student program, which provides clinical experiences at Covenant Health hospitals for aspiring physicians and mid-level providers. Thirty-seven students took part in an orientation highlighted by a traditional "white coat ceremony" in which each student received a personalized white coat to wear during their clinical training at Covenant Health hospitals. Three of Covenant Health's member hospitals - Cumberland Medical Center, Methodist Medical Center and Morristown-Hamblen Healthcare System - serve as core rotation sites for the program. Under the direct supervision of physicians, the medical students interview and examine patients, review clinical information, make hospital rounds, participate in interdisciplinary team meetings, practice appropriate documentation and perform procedures. Covenant Health and LMU-DCOM by the numbers: * Each core rotation site (Cumberland Medical Center, Methodist Medical Center and Morristown-Hamblen Healthcare System) hosts 12 LMU-DCOM medical students for their 3rd and 4th year clinical rotations. * During the 2016-17 clinical year, additional LMU-DCOM students completed electives at seven other Covenant Health locations. * The program depends on approximately 150 physicians throughout Covenant Health who serve as preceptors (teachers). * About 160 LMU medical students have rotated through Covenant Health facilities during the past two years. Healthcare Education at Covenant Health * Covenant Health provided clinical experiences for more than 1,000 students in fall 2017. Students represented 10 colleges and medical specialty areas including nursing, pharmacy, rehabilitation and others. * Sixteen universities routinely place students at Covenant Health facilities for clinical training. * Covenant Health partners with Tennessee Wesleyan University - Fort Sanders Nursing Department to offer a bachelor of science in nursing degree and an RN-to-BSN program. * Covenant Health offers a nurse residency program for recent nursing graduates, and supports advanced certification and continuing education for nurses, and other healthcare professionals. Community Outreach With local community assessment data identifying obesity as a significant health issue throughout East Tennessee, Covenant Health offers a variety of community opportunities to encourage physical activity among all ages. More than 8,000 runners took part in the 13th annual Covenant Health Knoxville Marathon. The two-day event included a Kids Run and 5k race on Saturday evening and a half-marathon, four-person relay and full marathon on Sunday. The 2017 event also included a Fittest Company Challenge and a Corporate Challenge Team of individuals representing area businesses who trained together in pursuit of healthier lifestyles while preparing for marathon events. More than 2,000 children in grades 1-8 participated in the Covenant Kids Run, which included a kick-off event at Zoo Knoxville in January and each child logging "a marathon's worth" of activity during the months leading up to a final one-mile group run. Covenant Health began the second year of the "Dogwood Patch" program in 2017, part of its health and fitness sponsorship of the Dogwood Arts Festival. The health system offered a limited-edition patch for anyone who completed 25 miles on featured Dogwood trails between April 1 and May 31. More than 400 people qualified to receive a patch in 2017. In Hamblen County, Covenant Health and Panther Creek State Park began a fall "Redbud Patch" program, offering a limited-edition patch for walkers who completed 26.2 miles of trails in the park. Several group hikes were held, including an after-turkey-dinner walk on the day after Thanksgiving. The program ended with a New Year's Day group hike on Jan. 1, 2018. The health system sponsored additional group hikes and walking events throughout the year in all counties where Covenant Health hospitals are located. Support for Community Programs As Knoxville's largest employer and a business organization with a significant presence in East Tennessee, Covenant Health is a committed corporate citizen and supports numerous charitable and community organizations in categories such as: * Health-related organizations * Community needs and outreach programs * Children, youth and education programs, including major sponsorship of The Change Center initiative for safe recreation, community activities and job training activities in Knoxville's center city * Economic development * Community leadership development * Arts,recreation and quality of life In addition, Covenant Health and its affiliated Foundations have supported community programs related to cancer outreach services (including mammography screenings), HIV/AIDS, leisure/recreation activities for persons with disabilities, and fitness activities for all ages. Philanthropy Covenant Health has a strong foundation, thanks to generous individuals and businesses across East Tennessee. The fifth class of business and community leaders participated in the Office of Philanthropy's annual Covenant Health Leadership Academy. They got a behind-the-scenes look at health care with tours of Covenant Health facilities, conversations with caregivers and administrators, and opportunities to observe surgical procedures and advanced technology. Several Academy graduates have joined Covenant Health fund raising event committees and Foundation boards, and are connecting Covenant facilities and programs with new philanthropic resources in the community. Covenant's Office of Philanthropy coordinates fund raising efforts at four foundations: * Fort Sanders Foundation (serving the needs of Fort Sanders Regional, Fort Loudoun, Parkwest, Roane,and Cumberland Medical Centers; Peninsula, and the Patricia Neal Rehabilitation Center) * Methodist Medical Center Foundation * Morristown- Hamblen Hospital Foundation * Thompson Cancer Survival Center Foundation Form 990, Part VI, Section B, line 11b The Parkwest Medical Center 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. The Finance Committee met in regular session in September, 2018, at which meeting executive management reviewed with the committee Form 990 and material information to be included in the form, discussed any material variations in the Form 990 as compared to those to be filed by the organization's affiliates, and answered questions of the committee regarding the Form 990. At the conclusion of review and discussion, the Finance Committee unanimously approved 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 dealt within the corporate bylaws, and board members are required to complete and sign a conflict of interest questionnaire on an annual basis. The Integrity Compliance Office maintains records that contain conflict of interest information obtained from board members, officers and employees. These records are available to be queried prior to engaging in business transactions. The Integrity 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. As well, managers and other employees are expected to report conflicts to the Integrity Compliance Officer as they arise. Depending on the nature of the conflict and the circumstances surrounding the conflict and transaction, the Integrity Compliance Officer, Senior Leadership, or the Board of Directors may review the conflict of interest. Where appropriate these bodies may also consult legal counsel. Restrictions imposed on persons with a conflict of interest are determined on a case by case basis. For Covenant Health employees, the Integrity Compliance Officer in conjunction with Executive Leadership determines how to appropriately handle the conflict. In any conflict involving a board member, such member is expected to excuse himself or herself from voting on matters that give rise to the conflict. Form 990, Part VI, Section B, line 15 Form 990, Part VI, Section B, Line 15a: Overall compensation policies for Parkwest Medical Center, Covenant Health (Parent Company), and affiliates are set by the 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. Compensation policies for James VanderSteeg and John Geppi are reported on the 2017 Form 990 of Covenant Health, EIN 62-1646734. Form 990, Part VI, Section B, Line 15b: Base salary and annual bonus opportunities for Neil Heatherly, 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 Michael S. Hamilton, Vice President of Financial Services, Emlyn Cobble, Vice President and Chief Support Officer, and Lynn Cagle, Chief Nursing Officer, are based on targets established by historical compensation consultant data and the Covenant Compensation department. Salary ranges are based upon comparison with similar jobs in similar size health systems across the nation. Base salaries and bonuses are approved by Executive Leadership predicated upon performance, and are reasonable and consistent with fair market value. Base salaries are initially targeted at midpoint and may vary according to market conditions, performance, tenure, experience, special skills or qualifications, recruitment and retention challenges, and other relevant factors. Annual bonuses are designed to award 0 - 20% of base salary based upon system performance and accomplishment of certain targets established by Executive Leadership. Form 990, Part VI, Section C, line 19 Parkwest Medical Center files a Joint Annual Report containing financial information with the Tennessee Department of Health. Per its tax exempt bond provisions, Covenant Health, the parent company of the organization, is required to file quarterly and annual consolidated and obligated group financial statements and other documentation with various bond insurers and other agencies, including the Electronic Municipal Market Access (EMMA) service of the Municipal Securities Rulemaking Board (MSRB). Any member of such a repository has access to these financial statements. The organization's governing documents and conflict of interest policy are not made publicly available. Form 990, Part XI, line 9: Contributed Capital, Affiliate -28,924,992. Form 990, Part XII, Line 2c: The Audit Committee of the Board of Directors annually selects the external auditors for Covenant Health. There is a joint meeting of the Finance Committee and Audit Committee of the Board of Directors where the audit of the consolidated financial statements are presented. Covenant Health 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621646734 Supporting organization TN 501(c)(3) Line 12b, II N/A 0 Claiborne Medical Center 1850 Old Knoxville Rd Tazewell TN 378793625 464420358 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Covenant Homecare 3001 Lake Brook Blvd Ste 101 Knoxville TN 37909 621623114 Home health services TN 501(c)(3) Line 10 Covenant Health 0 Cumberland Medical Center 421 S Main St Crossville TN 385555048 620790132 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Loudoun Medical Center 550 Fort Loudoun Medical Center Dr Lenoir City TN 37772 621373691 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Sanders Regional Medical Center 1901 W Clinch Ave Knoxville TN 37916 620528340 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Sanders Foundation 280 Fort Sanders West Blvd Ste 202 Knoxville TN 37922 621748601 Fundraising and patient outreach TN 501(c)(3) Line 12b, II Covenant Health 0 Fort Sanders Perinatal Center Trustees Tower 501 19th St Ste 304 Knoxville TN 37916 043760551 High risk obstetrical services TN 501(c)(3) Line 3 Fort Sanders Regional Medical Center 0 LeConte Medical Center 742 Middle Creek Rd Sevierville TN 37862 621114867 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Methodist Medical Center 990 Oak Ridge Turnpike Oak Ridge TN 37830 620636239 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Morristown-Hamblen Hospital Association 908 W 4th N St Morristown TN 37814 620545814 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Roane County Medical Center 8045 Roane Medical Center Dr Harriman TN 37748 680673354 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Thompson Cancer Survival Center 1915 White Ave Knoxville TN 37916 621250943 Cancer support center TN 501(c)(3) Line 3 Covenant Health 0 Thompson Oncology Group 1915 White Ave Knoxville TN 37916 621619239 Oncology services TN 501(c)(3) Line 3 Thompson Cancer Survival Center 0 Thompson Cancer Survival Center Foundation 1915 White Ave Knoxville TN 37916 582130450 Fundraising and patient outreach TN 501(c)(3) Line 12b, II Covenant Health 0 KOSC Properties LLC 256 Fort Sanders West Blvd Ste 200 Knoxville TN 37922 262444076 Building ownership TN N/A Knoxville Orthopaedic Surgery Center LLC 256 Fort Sanders West Blvd Ste 200 Knoxville TN 37922 262437385 Orthopaedic surgery TN N/A Fort Sanders West OP Surgery Center LLC 210 Fort Sanders West Blvd Ste 200 Knoxville TN 37922 621366907 Outpatient surgery center TN N/A Fort Sanders West Associates 280 Fort Sanders West Blvd Ste 214 Knoxville TN 37922 621384171 Building ownership TN N/A KOC 260 Bldg LLC 260 Fort Sanders West Blvd Knoxville TN 37922 465228440 Land and building ownership TN N/A CovenantUSP Surgery Centers LLC 15305 Dallas Parkway Ste 1600 Addison TX 75001 364828197 Holding company TN N/A Canterfield of Oak RidgeLLP 140 Bus Terminal Rd Oak Ridge TN 37830 274129674 Assisted living community GA N/A Fortress Corporation 280 Fort Sanders West Blvd Ste 214 Knoxville TN 37922 621308885 Management company TN N/A C 0 Covenant Medical Group Inc 1400 Centerpoint Blvd Ste 100 Bldg Knoxville TN 37932 621282917 Physician practice management TN N/A C 1 Knoxville Heart Group 1819 Clinch Ave Ste 108 Knoxville TN 37916 271528941 Cardiology medical practice TN N/A C 0 East TN Cardiovascular Surgery Group Inc 9125 Cross Park Drive Ste 200 Knoxville TN 37923 621018541 Cardiovascular surgical practice TN N/A C 1 1 0 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 Covenant Medical Group Inc A 508877 FMV East TN Cardiovascular Surgery Group Inc A 555 FMV