2025-11-12T09:32:04-06:00 2024-12-31 990 2024-01-01 621373691 Fort Loudoun Medical Center FORT 8653745329 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 Joseph C Dolan EVP/CFO 8655315421 2025-11-12 0 2024 2025-03-06 01:10:19Z Covenant Health Fort Loudoun James D VanderSteeg 244 Ft Sanders W Blvd Knoxville TN 37922 53844252 0 X www.covenanthealth.com/fort-loudoun/ X 1988 TN Fort Loudoun Medical Center is a 50-bed full service, acute care hospital located in Loudon County, Tennessee. It is a member of the Covenant Health system. 20 19 384 49 0 0 398 577483 47563802 52705479 11143 238932 275894 300019 47851237 53821913 15747 12000 0 0 16972294 18584123 0 0 0 26580134 29452061 43568175 48048184 4283062 5773729 24725176 27764028 4444823 4509560 20280353 23254468 X Fort Loudoun 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 a patient's ability to pay. 0 0 46989823 12000 52710865 Fort Loudoun Medical Center ("Loudoun") has been located in Lenoir City, Tennessee, since 2004, after serving the area from a previous location in Loudon County for many years.SERVICELoudoun is known for quality and safety and has earned accolades for top performance on core measures for inpatient care. The medical center is in the top 10 percent of hospitals nationwide in the prevention of hospital-acquired infections. The medical center is certified by The Joint Commission as an Advanced Primary Stroke Center. As part of Covenant Health's stroke hospital network, Fort Loudoun Medical Center provides rapid diagnosis and treatment of stroke. In 2024 Fort Loudoun received a Gold Plus Quality Achievement Award from the American Heart Association for its commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines.Loudoun was recognized by The Leapfrog Group in the spring and fall of 2024 with "A" grades for patient safety measures. In 2024, the hospital was also recognized with a 5-star overall hospital quality rating by Centers for Medicare and Medicaid Services. The Tennessee Hospital Association awarded Loudoun two Zero Harm Awards in 2024, recognizing zero healthcare-associated infections hospital-wide for CAUTIs (catheter-associated urinary tract infections) and in the Critical Care Unit for CLABSIs (central line-associated bloodstream infections). In 2024 the hospital saw 70,466 patients. Of these, 68,440 were outpatients and 2,026 were inpatients with an average length-of-stay of 4.09 days. PUTTING PATIENTS FIRSTLoudoun Descriptive Highlights - 87,000-square-foot facility, with an adjacent two-story medical office building - 50 beds - State-of-the-art imaging: X-Ray, CT, MRI, nuclear medicine and Low-Dose CT Lung Cancer screening. The hospital's Picture Archiving and Communications System (PACS) allows for digital capture, storage and transmission of medical images. - Emergency department with 12 private suites, open 24/7, 365 days a year - Surgical suites for endoscopy and gastrointestinal procedures; ear, nose and throat; gynecology; ophthalmology; orthopedic; podiatry; pulmonology, and general non-invasive procedures - Women's Imaging department offers mammography, ultrasound and bone density testing - Central registration area - Spacious private and semi-private rooms - Helipad for emergency transportation - Physicians representing various medical specialties provide a growing community with increased access to convenient, local care.IMPROVING THE COMMUNITY'S QUALITY OF LIFE THROUGH BETTER HEALTHThe hospital staff works with community partners such as the school system, local support groups, retirement communities, and senior centers to provide relevant education on topics such as recognizing the signs of a stroke, the importance of having a primary care physician, and other health-related topics. In addition, Loudoun hosts a monthly stroke support group. The medical center also offers a pulmonary rehabilitation program that addresses Chronic Obstructive Pulmonary Disease (COPD) and post-COVID syndrome. As part of improving the quality of life through better health, Loudoun is enhancing access to care through the construction of an advanced medical wing that will house additional patient rooms, an 11-bed Intensive Care/Intermediate Care unit, and respiratory and rehabilitation therapy. The project will also expand Emergency Department capacity to meet the needs of the growing community. Construction was underway throughout 2024, with an anticipated opening later in 2025. In 2024 staffing initiatives such as the implementation of Patient Care support Assistants and recruitment of RNs have improved the efficiency of emergency care for patients. The hospital also established an "Eyes of the Consumer" council composed of staff members, physicians and community members who make recommendations to improve hospital processes, including access to care. COVENANT HEALTH Loudoun is a member of Covenant Health. Covenant Health is a community-owned, clinically integrated healthcare enterprise dedicated to being the region's premier healthcare network through service, community, and innovation. Our mission is to improve the quality of life in our region through better health. Covenant Health provides patient-centered care that inspires clinical and service excellence and strives to be the first and best choice for the communities we serve. 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 composed of community leaders and medical professionals. With more than 11,000 employees, affiliated physicians and volunteers, Covenant Health is the Knoxville area's largest employer and has been named a top employer by Forbes and Becker's Hospital Review. Covenant Health serves a 25-county area and includes nine acute care hospitals in East Tennessee: Fort Sanders Regional Medical Center and Parkwest Medical Center in Knoxville, Methodist Medical Center of Oak Ridge, 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. Peninsula provides behavioral health services at an inpatient hospital in Blount County and at outpatient locations in Knox, Blount, Loudon, and Sevier counties. The health system includes Covenant Medical Group, which serves patients at more than 90 office and clinic locations. CMG providers include primary care physicians and specialists in areas such as cardiology, gastroenterology, neurology, surgery, and other medical specialties. Covenant Health employs nearly 450 physicians and advanced practice clinicians throughout East Tennessee. Affiliated organizations include Thompson Cancer Survival Center, Thompson Oncology Group, Fortress Corporation and Subsidiaries, Covenant HomeCare, and Fort Sanders Perinatal Center. Covenant Health also operates Thompson Proton Center and offers innovative services such as Advanced Care at Home. Philanthropic organizations include Covenant Health Foundation and 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 to enhance patient care.Loudoun, as a member of Covenant Health, benefits from collaboration among all affiliated organizations to promote quality, patient safety, and excellence in delivering care. 46989823 1 0 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 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 66 0 1 384 1 0 0 0 0 0 0 0 0 0 0 0 0 X 20 19 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Andrew McCreary 8653745329 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 Mitchell Dickson MD Director 0.00 1.00 X 0 0 0 Stephanie Flood Director 0.00 1.00 X 0 964 0 James Gibson Director 0.00 1.00 X 0 0 0 Edgar Gray Director 0.00 1.00 X 0 844 0 Leslye Hartsell Director 0.00 1.00 X 0 1124 0 Donald Hickman Director 0.00 1.00 X 0 675 0 Timothy Matthews Director 0.00 1.00 X 0 657 0 Janice McKinley Director 0.00 1.00 X 0 0 0 Cletus McMahon MD Director 0.00 1.00 X 0 0 0 Dave Miller Director 0.00 1.00 X 0 0 0 Bill Myers Director 0.00 1.00 X 0 0 0 Alvin Nance Director 0.00 1.00 X 0 648 0 Linda Ogle Director 0.00 1.00 X 0 0 0 King Purnell Director/Chair 0.00 1.00 X X 0 935 0 Jorge Sanabria Director 0.00 1.00 X 0 807 0 William Seale Director 0.00 1.00 X 0 1060 0 Cosby Stone Director 0.00 1.00 X 0 1113 0 Joe Sutter Director 0.00 1.00 X 0 881 0 James Tramontana MD Director 0.00 1.00 X 0 1086 0 James D VanderSteeg President & CEO 0.00 50.00 X X 0 2880556 362274 Joseph C Dolan EVP/CFO 0.00 50.00 X 0 861693 105608 M Scott Hamilton VP - Financial Services 10.00 40.00 X 0 251190 45231 Connie B Martin President & CAO 50.00 0.00 X 0 335406 37179 Brenda L Smith Clinical Nurse 50.00 0.00 X 148357 0 32216 Ashley N Touton Clinical Nurse 50.00 0.00 X 118638 0 18923 James E Pitt IV Pharmacist 50.00 0.00 X 115789 0 9900 Pamela G Free-Ollard Manager Rehab Services 50.00 0.00 X 114656 0 18727 Angela Knight Manager Imaging 50.00 0.00 X 114536 0 7098 611976 4339639 637156 10 0 1 0 The Christman Company 2400 Sutherland Ave Knoxville TN 37920 Contractor Services 3398491 Resource Anesthesia PC 12752 Kingston Pike Ste 202 Knoxville TN 37934 Physician Fees 315800 Quest Diagnostics PO Box 740736 Atlanta GA 303740736 Lab Services 220127 Linen King LLC 1521 West 36th Place Tulsa OK 74107 Linen Services 211012 Medic Regional Blood Center 1601 Ailor Ave Knoxville TN 37921 Blood Processing Fees 185443 8 398 577085 577483 Net Patient Revenue 622110 52705479 52705479 52705479 3076 3076 258195 22339 235856 235856 235856 Cafeteria 722514 160996 160996 Gift Shop 459420 133637 133637 Pharmacy 456110 5386 5386 300019 53821913 52710865 0 533565 X 1000 1000 11000 11000 15129995 14589543 540452 466430 451815 14615 1886525 1823223 63302 1101173 1066668 34505 5098720 5047874 50846 1542 1542 9159307 9138870 20437 2244 2144 100 373693 284410 89283 1292716 1156893 135823 5127 4722 405 9818 8989 829 4757 4757 2317647 2317647 48244 8794 39450 Medical Supplies 5164185 5164185 Bad Debt 4115997 4115997 Minor Equipment 1264718 1264718 Food and Dietary 317582 317582 275764 208992 66772 48048184 46989823 1058361 0 1700 1700 -110487 -197489 6140415 6110577 295713 442659 2086274 85331 58261616 37301528 15891975 20960088 419586 361162 24725176 27764028 3063599 3290986 136195 1381224 1082379 4444823 4509560 X 20280353 23254468 20280353 23254468 24725176 27764028 X 5773729 -2799614 X 0 1 X 1 1 1 X 2914985 2914985 19135626 12022181 7113445 56576 36987 19589 31714322 25242360 6471962 4440107 4440107 20960088 Due to Affiliates, Net 236818 Long-Term Deferred Compensation 79192 Long-Term Reserve for Workers Comp 50000 Operating and Finance Leases 17258 Third Party Settlements 699111 1082379 X Part X, Line 2: Excerpt from the consolidated audited financial statements of Covenant Health (Covenant), parent company to Fort Loudoun 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, 2024 and 2023. As such, no interest or penalties were recognized in the consolidated financial statements related to unrecognized tax benefits. At December 31, 2024 and 2023, tax returns for 2021 through 2024 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, 2024 and 2023. 1 1 X 1 X 1 X 1 1 1 0 1 1 1924586 1924586 0.04010 6311848 5567790 744058 0.01550 10474 20134 0 0.00000 8246908 5587924 2668644 0.05560 21884 21884 0.00050 1152 1152 0.00000 4789061 4789061 0.09970 4192 4192 0.00010 4816289 4816289 0.10030 13063197 5587924 7484933 0.15590 39 39 0.00000 3222 3222 0.00010 835 835 0.00000 2209 2209 0.00000 338 338 0.00000 6643 6643 0.00010 1 4115997 491038 8648761 7670632 978129 X 1 1 1 1 Fort Loudoun Medical Center 550 Fort Loudoun Medical Center Drive Lenoir City TN 37772 www.covenanthealth.com/fort-loudoun 00000084 X X X Fort Loudoun Medical Center 1 0 0 1 X X X X X X X X 23 1 0 1 1 X See Part V, Page 8 X 1 23 1 See Part V, Page 8 0 1 X 200.000000000000 300.000000000000 X X 1 1 X X X 1 X https://www.covenanthealth.com/patients-visitors/financial-assistance/ X https://www.covenanthealth.com/patients-visitors/financial-assistance/ X https://www.covenanthealth.com/patients-visitors/financial-assistance/ X X X X X X 1 X 0 X X X 1 X 0 0 Fort Loudoun Medical Center Part V, Section B, Line 5: Fort Loudoun Medical Center ("Fort Loudoun") conducted its fourth Community Health Needs Assessment ("CHNA") in 2023. A Steering Committee was formed to guide the assessment process and included the Loudon County Health Department, Fort Loudoun, Loudon County Health Council, and the Prevention Alliance of Loudon County. Each of these community organizations serve the broader community and, in particular, the low-income, uninsured, and chronically ill. The Steering Committee worked with the University of Tennessee-Knoxville Social Work Office of Research and Public Service ("UT-SWORPS") to devise a Loudon County household survey and to host four focus groups of community leaders, each of which represented a part of the overall Loudon County public health system. The household survey collected information from 336 Loudon County residents. Participation in the survey was diverse and reflected the demographic profile of the county for the attributes of educational level, income, ethnicity and age. The primary research was analyzed and combined with county demographics, mortality, and secondary data for more than 60 health indicators. A Data Team was formed to begin the analysis of the data and determine the most significant findings from the assessment. The Data Team included members of the Steering Committee as well as representatives from the Tennessee Department of Public Health, Office on Aging, Prevention Alliance of Loudon County, and several community leaders. Fort Loudoun Medical Center Part V, Section B, Line 6b: Though Fort Loudoun's CHNA was issued as a stand-alone report, many non-hospital organizations assisted with the report. Research partners provided expertise on survey design, focus group facilitation, data collection, data sources, and analysis. UT-SWORPS was an integral participant, as well as the Loudon County Health Department and the Loudon County Health Council.Additionally, focus groups were beneficial in discussing and identifying community needs in Loudon County. Organizations and individuals participating in the focus groups include:- Loudon Co. Coordinated School Health - Priority Ambulance - Prevention Alliance of Loudon County - EMS of Loudon County- Loudon County Schools - Lenoir City Government - Fort Loudoun Medical Center - Loudon County Government- Loudon County Health Dept - Lenoir City Parks and Recreation- Tellico Recreation Center - United Way of Loudon County - Loudon Senior Center - Loudon Co. Road Superintendent - Office on Aging - 911 Fort Loudoun Medical Center Part V, Section B, Line 11: For 2023, the Steering Committee elected to use the same secondary health indicators that were used in the 2020 assessment. The indicators were updated to include the most current data points available. Additionally, COVID-19 statistics were included that did not exist in 2020. Updated demographics, leading causes of death, community survey results, focus group analysis and secondary data for dozens of health indicators was used by the Data Team to determine the most significant health priorities for the 2023 health assessment cycle.The Data Team used a methodology to determine whether the 2020 CHNA significant issues should be continued, modified or replaced. New issues that may have emerged since the 2020 CHNA also were discussed for potential inclusion. Largely due to COVID-19, the Data Team consensus was to continue the four health priorities of the 2020 CHNA and add a fifth health priority: improving access to healthcare. Data Team members felt each priority area of the 2020 assessment had worsened. Communities were faced with increased uncertainty and stress, many community resources were paused, and healthcare organizations were pushed to a breaking point. Overall, the demand for health and human resources far outweighed the supply. The 2023 most significant health priorities for Loudon County are as follows: Substance Abuse Disorders, Mental Health Access, Chronic Disease Management, Smoking and Vaping, and Improving Access to Healthcare. Fort Loudoun updated its 2023 Implementation Plan based on the identified needs and plans to address all of the identified issues in the following ways:1. Substance Abuse DisorderPeninsula Drug Treatment Program:- Peninsula, a department of Parkwest Medical Center, provides an outpatient Opioid Treatment Center- Covenant Health's partnership with Acadia to open East Tennessee Behavioral Health provides another option for treatment.- Fort Loudoun participates in tracking of referrals to ensure patients receive the most appropriate and most timely transfer from the Emergency Department. Opioid Light Program:- Fort Loudoun's Emergency Department is participating in a Covenant Health system-wide initiative to curb the use of hospital prescribed opioids. Physicians are prescribing non-opioid drugs when indicated for pain management, both during treatment and upon discharge from the hospital. - Fort Loudoun will work in conjunction with other community resources, including the McNabb Center, Loudon County Health Department and the Prevention Alliance of Loudon County to address opioid-related issues. 2. Mental Health AccessBehavioral Health Services Expansion:- Psychiatric consult service is now being provided for patients in the Emergency Department and for inpatients at Fort Loudoun via tele-video through Peninsula Behavioral Health as well as remote mobile crisis.- Fort Loudoun has access to Covenant Health's Emergency Department Diversion Program for patients with psychiatric and emotional needs. A team of behavioral specialists conduct a behavioral assessment for each patient to determine the correct treatment plan. This program includes a psychiatric consult service via tele-video through Peninsula Behavioral as well as remote Mobile Crisis. The Emergency Department Diversion program assists in placement to an inpatient facility if deemed appropriate and will follow up for Outpatient treatment if patient is discharged from the Emergency Department. - Peninsula Outpatient has an office located on the campus of Fort Loudoun.- Covenant Health's partnership with Acadia to open East Tennessee Behavioral Health provides another option for treatment and patient transfer. - Fort Loudoun participates in tracking of referrals to ensure patients receive the most appropriate and most timely transfer from the Emergency Department. 3.Chronic Disease ManagementPulmonary Outreach Programs:- Fort Loudoun is offering a grant-funded pulmonary rehab program that addresses Chronic Obstructive Pulmonary Disease and Post-COVID Syndrome. Information is given to medical providers for community members who would benefit from the program.Community Stroke Education:- Fort Loudoun will continue to promote and implement a community-wide stroke education program in Loudon County to improve and ensure awareness of stroke, stroke symptoms and the need for rapid treatment.- Fort Loudoun launched a stroke support group in 2023, which is another opportunity to continue both patient and family education, as well as connect patients with appropriate services. - Fort Loudoun implemented an Educational Series in 2023 that delivers content to nearby communities.Expanded Parkinson's Disease Therapeutic Services:- Fort Loudoun Outpatient Rehabilitation Clinic plans to secure Big and Loud certification for selected therapists to expand therapy to patients with Parkinson's disease.4. Smoking and VapingVaping Impact Program:-Fort Loudoun collaborated with Fort Loudoun Primary Care to launch smoking cessation education for Emergency Department patients. Fort Loudoun Primary Care providers offer appointments to assess patients for potential medical management during smoking cessation.Smoking Cessation Education:-Fort Loudoun, in partnership with the Prevention Alliance of Loudon County, is co-developing education and prevention videos and other content for use in Loudon County Schools to reduce the incidence of vaping among students.Low Dose CT Lung Cancer Screening:-Fort Loudoun introduced Low Dose CT Lung Cancer Screening in 2022, which allows qualifying patients to receive annual screening. Low Dose CT screening identifies lung cancer earlier when it is more treatable.5. Improve Access to Healthcare- Fort Loudoun will be adding an advanced medicine wing that will house additional patient rooms, an 11-bed Intensive Care/Immediate Care unit, respiratory and rehabilitation therapy. This will enable all private rooms, resulting in more Loudon County patients choosing Loudoun for their care because they do not have the potential to be in a double-occupancy patient room. - The relocation of the existing Critical Care Unit (which will transition into the 11-bed ICU/IMC) will vacate space that will allow expanded Emergency Department capacity.- Creative initiatives, e.g. Patient Care Support Assistants, coupled with successful recruitment of Registered Nurses has reduced the number of boarded patients in the Emergency Department, thereby reducing the likelihood patients seek care further away. Improved efficiency has already resulted in additional patients being treated in our Emergency Department. - Fort Loudoun is implanting an Eyes of the Consumer council, comprised of hospital staff, physicians, and selected community members to develop recommendations to improve processes, including access to care. - Fort Loudoun partnered with both Fort Loudoun Primary Care and an external agency to assist with transitions of care and ensure assessment and monitoring once discharged. Fort Loudoun Medical Center Part V, Section B, Line 16j: All other ways in which the hospital widely publicizes the FAP are discussed in detail in Part VI, Line 3. Part V, Line 7a, CHNA website https://www.covenanthealth.com/fort-loudoun/chna/ Part V, Line 10a, Implementation Strategy Website https://www.covenanthealth.com/fort-loudoun/chna/ Part V, Line 20d, Presumptive Eligibility Determinations The hospital follows the eligibility procedures as detailed within the FAP and does not make presumptive eligibility determinations. 3 1 - Ft Loudoun Therapy Center - Lenoir City 423 Medical Park Drive Suite 300 Lenoir City TN 37772 Physical Rehabilitation & Therapy Center 2 - Ft Loudoun Cardiopulmonary Rehab Ctr 423 Medical Park Drive Suite 500 Lenoir City TN 37772 Cardiac Rehab Therapy Center 3 - Fort Loudoun Therapy Center - Loudon 1127 Grove Street Loudon TN 37774 Physical Rehabilitation & Therapy Center Part I, Line 3c: In addition to the Federal Poverty Guidelines ("FPG"), Fort Loudoun utilizes an asset test as a factor in determining eligibility for free or discounted care. Ten percent (10%) of the patient/guarantor's net assets will be added to income for determination of total annual income. The guidelines for determining assets include, but are not limited to, primary dwelling (and attached land), automobiles, liquid assets, investments, farm land, business property, rental property, farm and/or business equipment including livestock and crops. All real property will be considered at fair market value. The values of both real and personal property will be reduced by any existing liabilities incurred by the applicant in obtaining the assets (net assets) with the exception of primary dwelling. The primary dwelling net asset will be the amount of equity above $100,000. Actual or potential liability to the patient, hospital or the guarantor by common law, contract, statute or otherwise, shall be considered an asset and must be listed on the Hospital Financial Assistance application. Part I, Line 6a: Covenant Health, the parent company of Fort Loudoun 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 $4,789,061 in physician sponsorship fees 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 $4,115,997. Part II, Community Building Activities: Fort Loudoun 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 access to care, tobacco use, and conditions such as diabetes and obesity, and help develop collaborative responses with other community organizations.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 2024 were made to organizations meeting the community's needs by providing: - The basic needs of life, including temporary shelter, food, clothing, and safety (Ladies of Charity, Seymour Volunteer Fire Department, YWCA Knoxville, Salvation Army, Clinch River Habitat for Humanity) - Youth mentoring, development and after-school programs (Emerald Youth Foundation, Boys and Girls Club, First Tee of Greater Knoxville, Great Smoky Mountain Council) - Business recruitment, education marketing and community initiatives that boost economic development and quality of life (Knoxville Technology Council, Pellissippi State Foundation, Tennessee Wesleyan University, University of Tennessee College of Nursing) - Leadership development programs and workshops (Knoxville Area Urban League, Leadership Knoxville) - Assistance and special programs for at-risk older adults, children and adults with physical or developmental challenges, and children who have experienced abuse, neglect or trauma (Knoxville-Knox County Community Action Committee, Senior Citizens Home Assistance Services, Sertoma Center, Friends of Tennessee's Babies with Special Needs, New Hope Children's Advocacy Center, Street Hope Tennessee, Variety Children's Charity of East Tennessee) - Improve access to health services (East TN Children's Hospital, McNabb Center, Metropolitan Drug Commission, Interfaith Health Center, Knoxville Academy of Medicine, Region II Emergency Medical Services, Renew Clinic) - Programs supporting patients and families (Alzheimer's Tennessee, American Heart Association, Angel Wings Memory Gowns, Cancer Support Community East Tennessee, East TN Veterans Memorial Association, Honor Air Knoxville, Knox County Imagination Library, Random Acts of Flowers, Spark, Survivor Fitness) 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 Revenue Cycle 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 2024 Audited Consolidated Financial Statements of the Covenant Health system, of which Fort Loudoun 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 receives payments for services rendered from federal and state agencies, managed care health plans, commercial insurance companies, employers and patients. Covenant recognizes that revenues and receivables from government agencies are significant to operations, but does not believe there are significant credit risks associated with these government agencies. Covenant does not believe there are any other significant concentrations of revenues from any particular payer that would subject Covenant to any significant credit risks in the collection of accounts receivable. 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: Costing Methodology: Fort Loudoun 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: Fort Loudoun 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 69% 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.Fort Loudoun 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 Fort Loudoun 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. Fort Loudoun 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. Fort Loudoun does not sell any accounts receivable accounts to outside firms. All accounts remain property of and under the policies set by Fort Loudoun. Fort Loudoun 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. Fort Loudoun obtains additional community information through the service of its employees with the local health council, United Way of Loudon County, Chamber of Commerce, and Rotary Clubs. Covenant Health, the parent organization, maintains community benefit professionals working year-round to ensure that all hospitals are assessing and addressing the needs of the communities served. Part VI, Line 3: The FAP states that patients who are unable to pay or have exhausted all sources of payment assistance may be considered for charity care. Signage about the policy is posted in highly visible areas of the hospital, such as lobbies and registration areas. Information about the FAP is posted in patient booklets provided to patients during the registration process and communicated via patient billing statements. In addition, the FAP and application are available on the facility website. Fort Loudoun employs full time financial counselors to assist patients in applying for TennCare and screening for eligibility for financial assistance. Office hours and the phone number for the counselors are included on the signage. Wall signs informing patients about available financial assistance state the following: Covenant Health is committed to providing quality health services in a caring environment. It is the expressed philosophy of Covenant Health and its member hospitals that no one should be denied necessary medical care because of the inability to pay. In conjunction with this philosophy, counselors at Fort Loudoun 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 Fort Loudoun Medical Center will provide, at a reduced rate, medically indicated services. A financial counselor is available to assist you with these matters by calling 865-271-6219 or 865-271-6223, Monday through Friday between the hours of 8:30 a.m.-5:00 p.m. Additional information regarding financial assistance is also available on our website at FtLoudoun.com. Signage at the registration areas state the following:It is Fort Loudoun Medical Center's philosophy that no one shall be denied medically necessary services based on an inability to pay. Financial assistance applications for medically necessary services are available during the registration process, through a financial counselor, or on our website at FtLoudoun.com. A financial counselor is available to assist you with these matters by calling 865-271-6219 or 865-271-6223, Monday through Friday between the hours of 8:30 a.m.-5 p.m. Part VI, Line 4: Loudon County, Tennessee, is the primary market for Fort Loudoun. Loudon is a rural community within close proximity to the metropolitan Knoxville area. Loudoun is the only hospital in the county. According to internal hospital data for 2024, 76.5% of inpatient and 69.6% of outpatient encounters were Loudon County residents. The following statistics are taken from the 2024 County Health Rankings data, Robert Wood Johnson Foundation. The population of Loudon County is 58,181. Persons over the age of 65 account for 27.9% of the population. The racial makeup of the population is 86.1% white persons, non-Hispanic, 9.9% Hispanic, and less than three percent of other races. In 2024, 12% of the adults were uninsured as were 6% of the children. The median income of Loudon County is $79,700 per household. Unemployment is at 3.2%.According to the 2024 County Health Rankings Report of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, Loudon County residents have the following health indicators that are above the national benchmarks: Loudon - TN - National Adult Smoking: 19% - 20% - 15% Adult Obesity: 34% - 36% - 34% Teen Birthrate: 25 - 24 - 17 of every 1,000 teenage girls Poor or Fair Health: 17% - 18% - 14% Physical Inactivity: 27% - 27% - 23% Drug Overdose Deaths: 46 - 43 - 27 per 100,000 population Part VI, Line 5: Fort Loudoun, 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 voluntary Board of Directors serves as Fort Loudoun's board. The board is comprised of independent community leaders with diverse educational and professional backgrounds. The board provides governance and oversight of Loudoun.Fort Loudoun 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: Fort Loudoun, 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.Fort Loudoun 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.Covenant Health Foundation seeks out community financial support for Loudoun and other Covenant Health hospitals. 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 Scholarships 11 11000 Part I, Line 2: Grant funds are provided to charitable organizations for the purpose of enhancing and promoting health care and improving quality of life in the community. The organization has guidelines in place to review the eligibility of grantees, and all grants require written documentation and appropriate levels of approval. Funds are generally not tracked after being granted as the original entity and selection criteria have been met. Part III, Line 1 Scholarship assistance is both merit-based and needs-based, and funds are contingent upon ongoing satisfactory academic progress. 1 0 1 0 0 0 0 0 0 0 James D VanderSteeg President & CEO 0 1578849 0 1078259 0 223448 0 335103 0 27171 0 3242830 0 0 Joseph C Dolan EVP/CFO 0 697828 0 138667 0 25198 0 72802 0 32806 0 967301 0 0 Connie B Martin President & CAO 0 210655 0 57500 0 67251 0 11925 0 25254 0 372585 0 0 M Scott Hamilton VP - Financial Services 0 202796 0 32000 0 16394 0 9794 0 35437 0 296421 0 0 Brenda L Smith Clinical Nurse 147993 0 0 0 364 0 9018 0 23198 0 180573 0 0 0 Part I, Line 3 Covenant Health, the parent company of Fort Loudoun 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, Line 4b Covenant Health maintains a nonqualified deferred compensation ("NQDC") plan intended to support retention of President and CEO, James D. VanderSteeg, and EVP and CFO, Joseph C. Dolan. Employer contributions of $321,903 for James D. VanderSteeg and $72,802 for Joseph C. Dolan are reported as deferred compensation on Schedule J, Part II, Column C. Contributions along with 2024 earnings of $114,551 for James D. VanderSteeg and $4,468 for Joseph C. Dolan 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). Please note that the amounts included in Part II, Column C as contributions to the NQDC plan for James D. VanderSteeg and other executive leaders are deferred but NOT received during the filing year. We report compensation in both the year earned and the year paid, as required by IRS guidelines; however, wages appear overstated due to dual reporting of compensation earned in one year and distributed in a subsequent year. Form 990, Part VI, Section A, line 6 Covenant Health is the sole member of Loudoun. Form 990, Part VI, Section A, line 7a Covenant Health's board of directors also serves as the board of directors for Loudoun. Form 990, Part VI, Section A, line 7b Governance decisions of Loudoun 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 makes available a board-approved Code of Conduct to all employees. The Code covers among other subjects, conflicts of interest, and requires disclosure and resolution of employee conflicts of interest. Additionally, officers, employed physicians, and highly compensated employees are required to complete and sign an annual conflict of interest disclosure statement. Board members' conflicts of interests are addressed in the corporate bylaws, and board members are required to complete and sign a conflict of interest questionnaire on an annual basis. The Integrity-Compliance Office maintains records that contain conflict of interest information obtained from board members, officers, and employees. These records are available to be queried prior to engaging in business transactions. The Chief Compliance Officer reviews conflict of interest data. Based on this information, the officer determines what conflicts of interest exist at that point in time. Between times when surveys are collected, board members are expected to disclose any new conflicts that have arisen that affect pending board decisions. Officers and other employees are expected to report conflicts to the Chief Compliance Officer as they arise. Depending on the nature of the conflict and the circumstances surrounding the conflict and transaction, the Chief Compliance Officer, senior leadership, or the board of directors may review the conflict of interest. When appropriate, these parties may also consult legal counsel. Restrictions imposed on persons with a conflict of interest are determined on a case by case basis. For Covenant Health employees, the Chief Compliance Officer in conjunction with the Covenant Health Executive Leadership Team 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 Loudoun, Covenant Health (Parent Company), and affiliates are set by the Covenant Health Chief Executive Officer (CEO) in consultation with appropriate Executive Vice Presidents and the Senior Vice President-Human Resources, after review by and discussion with the executive compensation consultant ("the Consultant") to ensure that total compensation for each executive is reasonable and within a fair market value range. The Covenant Health CEO is compensated by Covenant Health, and a detailed description of the compensation process is included on Covenant Health's Form 990. The process for Fort Loudoun'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 Connie Martin, President and Chief Administrative Officer, are set by the Covenant Health CEO in consultation with appropriate Executive Vice Presidents and the Senior Vice President-Human Resources, after review by and discussion with the executive compensation consultant ("the Consultant") to ensure that total compensation is reasonable and within a fair market value range. Salary ranges are based upon the recommendations of the Consultant made after comparison with similar jobs in similar size health systems across the nation. Bonuses are recommended by the CEO and reviewed with the Committee conditioned upon receipt of a written opinion from the Consultant that total compensation for the executive is reasonable and consistent with fair market value. Base salary for the CAO is initially targeted at the 25th percentile and may vary according to market conditions, performance, tenure, experience, special skills or qualifications, recruitment and retention challenges, and other relevant factors. Annual bonuses are designed to award 0-35% of base salary based upon system performance and accomplishment of certain targets established by the CEO. Base salaries and annual bonus opportunities for other officers and key employees are based on targets established by historical compensation consultant data and the Covenant Health Compensation department. Salary ranges are based upon comparison with similar jobs in similar size health systems across the nation. Base salaries and bonuses are approved by Executive Leadership predicated upon performance, and are reasonable and consistent with fair market value. Base salaries are initially targeted at midpoint and may vary according to market conditions, performance, tenure, experience, special skills or qualifications, recruitment and retention challenges, and other relevant factors. Annual bonuses are designed to award 0 - 20% of base salary based upon system performance and accomplishment of certain targets established by Executive Leadership. Form 990, Part VI, Section C, line 19 Loudoun 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 1,343,804. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,343,804. Other Purchased Services: Program service expenses 3,314,462. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,314,462. Sponsorship Fees: Program service expenses 4,480,604. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,480,604. Other Purchased Services: Program service expenses 0. Management and general expenses 20,437. Fundraising expenses 0. Total expenses 20,437. Form 990, Part XI, line 9: Transfers of Capital -2,799,614. 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