CLAIBORNE MEDICAL CENTER: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- CLAIBORNE MEDICAL CENTER (EIN 46-4420358)
- Tax period
- 2014-04-01 to 2014-12-31
- Filed
- 2015-11-05
- IRS object ID
- 201503099349300130
- Schema version
- 2014v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-05T08:17:22-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 464420358 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Claiborne Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CLAI | BusinessNameControlTxt |
| Phone | 8653746864 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1420 Centerpoint Blvd Bldg C | AddressLine1Txt |
| City | Knoxville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 379321960 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN T GEPPI | PersonNm |
| Person Title | EVP/CFO | PersonTitleTxt |
| Phone | 8653746872 | PhoneNum |
| Signature | 2015-10-30 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Principal Officer | Anthony L Spezia | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 Ft Sanders W Blvd | AddressLine1Txt |
| City | Knoxville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37922 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $24,680,817 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.claibornehospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | Claiborne Medical Center is an 85-bed full service, acute care hospital located in Tazewell, TN. It also operates the Claiborne County Nursing Home which is licensed for 100 beds. It is a member of the Covenant Health system. | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 598 | TotalEmployeeCnt |
| Total Volunteers | 33 | TotalVolunteersCnt |
| Total Gross UBI | $4,898 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $3,508 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $60,660 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $23,650,674 | CYProgramServiceRevenueAmt |
| CY Investment Income | $1,372 | CYInvestmentIncomeAmt |
| CY Other Revenue | $932,395 | CYOtherRevenueAmt |
| CY Total Revenue | $24,645,101 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $3,448 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $11,742,734 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $13,543,290 | CYOtherExpensesAmt |
| CY Total Expenses | $25,289,472 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | -$644,371 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $15,451,494 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $6,633,660 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $8,817,834 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | See schedule O.Claiborne 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. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $11,135,849 | ExpenseAmt |
| Revenue | $14,867,688 | RevenueAmt |
| Desc | Inpatient Acute Care Services: See Schedule O.Inpatient Acute Care Services: Expenses - $11,135,849 Revenue: $14,867,688Claiborne Medical Center is an acute care hospital licensed for 85 beds which provides a variety of medical services to the citizens of Claiborne County and the surrounding area. Accredited by the Joint Commission of the Accreditation of Healthcare Organizations, the hospital is committed to improving the health of the community by providing high-quality and cost-effective health care services. The hospital features state-of-the-art technology including Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) scanners. The hospital admitted 1,175 patients resulting in 4,328 patient days or an average length of stay of 3.7 days during the period from April 1 through December 31, 2014. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,969,854 | ExpenseAmt |
| Revenue | $3,817,565 | RevenueAmt |
| Desc | Nursing Home Care: See Schedule O.Skilled & Intermediate Nursing Home Care: Expenses - $2,969,854 Revenue - $3,817,565 Claiborne Medical Center operates a 100-bed Nursing Home which provides intermediate and skilled nursing care to patients needing 24-hour, long-term care. Private and semi-private rooms are available, and staff provides the continuum of care for chronically and terminally ill patients. Skilled services are also provided to patients needing short-term rehabilitation. Patient care is provided under the direction of primary care physicians. Residents have access to the most current medical services and technology. Lab, radiology, respiratory therapy, pharmacy, and emergency services are available through the hospital. The nursing home provides a hydration program, restorative program, skin care management, and a rehabilitation department offering physical, occupational, and speech therapy. Mental health, dietary, podiatry, visual, dental, and audiology services are also provided to the residents. The Nursing Home admitted 107 patients during the period from April 1 through December 31, 2014. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $9,908,238 | ExpenseAmt |
| Grant | $3,448 | GrantAmt |
| Revenue | $5,661,578 | RevenueAmt |
| Desc | As a full-service, acute care medical center, Claiborne Medical Center treats patients across a broad spectrum of medical specialties in addition to those highlighted above. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $9,908,238 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $3,448 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $5,661,578 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $24,013,941 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 93 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 598 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (1) | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Nancy Beck | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8653746864 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1420 Centerpoint Blvd Bldg C | AddressLine1Txt |
| City | Knoxville | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 379321960 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Ed Anderson | ||||||||
| Director | 0.00 | 41.00 | Yes (X) | $0 | $154,867 | $1,512 | ||
| Gerald Boyd | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,034 | $0 | ||
| Dr Richard Brinner | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,134 | $0 | ||
| Dr Mitchell Dickson | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $829 | $0 | ||
| Pamela P Fansler | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| James Fitzsimmons | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,024 | $0 | ||
| Jim Johnson Jr | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,036 | $0 | ||
| Karla Lane | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $863 | $0 | ||
| Eddie Mannis | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Tim Matthews | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $969 | $0 | ||
| Larry Mauldin | ||||||||
| Chairman | 0.00 | 1.00 | Yes (X) | $0 | $941 | $0 | ||
| Dr Joseph Metcalf | ||||||||
| Director | 0.00 | 3.00 | Yes (X) | $0 | $16,799 | $0 | ||
| George Miller | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $641 | $0 | ||
| Alvin Nance | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $939 | $0 | ||
| Linda Ogle | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Mitchell Steenrod | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $641 | $0 | ||
| Carl Storms | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,173 | $0 | ||
| Joseph E Sutter | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,127 | $0 | ||
| Richard Swanson | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Joe Ben Turner | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| David Verble | ||||||||
| Director | 0.00 | 1.00 | Yes (X) | $0 | $1,063 | $0 | ||
| Anthony L Spezia | ||||||||
| President & CEO | 0.00 | 50.00 | Yes (X) | $0 | $1,603,983 | $229,665 | Yes (X) | |
| John T Geppi | ||||||||
| EVP/CFO | 0.00 | 50.00 | $0 | $752,660 | $26,356 | Yes (X) | ||
| Timothy Brown | ||||||||
| President & CAO | 50.00 | 0.00 | $0 | $159,950 | $10,506 | Yes (X) | ||
| Michael Tuten | ||||||||
| VP - Financial Services | 50.00 | 0.00 | $98,218 | $0 | $11,143 | Yes (X) | ||
| Anthony Rowe | ||||||||
| Pharmacist | 40.00 | 0.00 | $120,337 | $0 | $16,933 | Yes (X) | ||
| Kathy Kelley | ||||||||
| Pharmacist | 40.00 | 0.00 | $120,319 | $0 | $25,409 | Yes (X) | ||
| Robert Davis | ||||||||
| Physical Therapist | 40.00 | 0.00 | $100,763 | $0 | $19,741 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $439,637 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,701,673 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $341,265 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Cardinal Health | |||||
| PO Box 402574 | Atlanta | GA | 303842574 | Pharmacy services | $829,002 |
| Medhost of Tennessee Inc | |||||
| 2739 Momentum Place | Chicago | IL | 606895327 | Enterprise support | $576,167 |
| Apogee Medical Management | |||||
| 2525 E Camelback Rd | Phoenix | AZ | 850164219 | Physician services | $530,473 |
| Resource Anesthesia PC | |||||
| 12752 Kingston Pike Suite E201 | Knoxville | TN | 37934 | Anesthesia mgmt. & staffing | $258,121 |
| GE Healthcare | |||||
| PO Box 96483 | Chicago | IL | 60693 | Service maintenance contracts | $191,759 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $20,000 | GovernmentGrantsAmt |
| All Other Contributions | $40,660 | AllOtherContributionsAmt |
| Noncash Contributions | $10,660 | NoncashContributionsAmt |
| Total Contributions | $60,660 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Medical Services | 622110 | $19,709,359 | $19,709,359 |
| Nursing Home | 623000 | $3,817,565 | $3,817,565 |
| Ambulance Services | 621910 | $123,750 | $123,750 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $23,650,674 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,372 | TotalRevenueColumnAmt |
| Exclusion | $1,372 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $119,283 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $35,716 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $83,567 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $83,567 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $4,898 | UnrelatedBusinessRevenueAmt |
| Exclusion | $78,669 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Meaningful Use | 900099 | $696,157 | $696,157 | |
| Food Services | 722212 | $72,118 | $72,118 | |
| Miscellaneous | 900099 | $33,905 | $33,905 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,648 | TotalRevenueColumnAmt |
| Exclusion | $46,648 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $848,828 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,645,101 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,346,831 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $4,898 | UnrelatedBusinessRevenueAmt |
| Exclusion | $232,712 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,448 | TotalAmt |
| Program Services | $3,448 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,361 | TotalAmt |
| Management And General | $109,361 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,367,381 | TotalAmt |
| Program Services | $10,262,870 | ProgramServicesAmt |
| Management And General | $104,511 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,766 | TotalAmt |
| Program Services | $90,766 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $448,322 | TotalAmt |
| Program Services | $447,017 | ProgramServicesAmt |
| Management And General | $1,305 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $726,904 | TotalAmt |
| Program Services | $712,815 | ProgramServicesAmt |
| Management And General | $14,089 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,353 | TotalAmt |
| Management And General | $45,353 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,677,626 | TotalAmt |
| Program Services | $1,468,991 | ProgramServicesAmt |
| Management And General | $208,635 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,704 | TotalAmt |
| Program Services | $22,858 | ProgramServicesAmt |
| Management And General | $1,846 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,681 | TotalAmt |
| Program Services | $185,687 | ProgramServicesAmt |
| Management And General | $87,994 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $473,855 | TotalAmt |
| Program Services | $420,861 | ProgramServicesAmt |
| Management And General | $52,994 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,612 | TotalAmt |
| Program Services | $120,567 | ProgramServicesAmt |
| Management And General | $45 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,593 | TotalAmt |
| Program Services | $48,778 | ProgramServicesAmt |
| Management And General | $12,815 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,821 | TotalAmt |
| Program Services | $31,821 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $619,653 | TotalAmt |
| Program Services | $619,653 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,327 | TotalAmt |
| Program Services | $26,646 | ProgramServicesAmt |
| Management And General | $12,681 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Bad Debts | $4,078,123 | $4,078,123 | |
| Supplies & Equipment | $4,000,690 | $3,455,340 | $545,350 |
| Sponsorship | $1,074,071 | $1,074,071 | |
| Dues and Licenses | $399,844 | $341,338 | $58,506 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $622,337 | TotalAmt |
| Program Services | $602,291 | ProgramServicesAmt |
| Management And General | $20,046 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,289,472 | TotalAmt |
| Program Services | $24,013,941 | ProgramServicesAmt |
| Management And General | $1,275,531 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,285,501 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,821,937 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $606,757 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $131,258 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,651,078 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $571,310 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,079,768 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $5,075,822 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $450,451 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $15,451,494 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,690,712 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $86,795 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,856,153 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $6,633,660 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $8,817,834 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $8,817,834 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $15,451,494 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$644,371 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $9,462,205 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | EXPLANATION FOR FILING A SHORT YEAR RETURN | FormAndLineReferenceDesc |
| Explanation | Claiborne Medical Center assumed operation of the Claiborne County Hospital and Nursing Home on April 1, 2014. Prior to this date the hospital was a government operated hospital and not required to file the annual Form 990. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,620,000 | OtherCostOrOtherBasisAmt |
| Depreciation | $571,310 | DepreciationAmt |
| Book Value | $3,048,690 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $31,078 | OtherCostOrOtherBasisAmt |
| Book Value | $31,078 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,079,768 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Affiliates, Net | $3,819,784 |
| Due to Third Party Payors | $36,369 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,856,153 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | Note B to the consolidated audited financial statements of Covenant Health, parent company to Claiborne 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, 2014 and 2013. 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, 2014, tax returns for 2011 through 2014 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, 2014 or 2013." | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,401,077 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,337,528 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,063,549 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05010 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,401,077 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,337,528 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,063,549 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05010 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,110 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,110 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,598 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,598 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,708 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,708 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,408,785 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,337,528 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,071,257 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05040 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,078,123 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $933,890 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $5,093,644 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,424,452 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,330,808 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 None | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Claiborne Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1850 Old Knoxville Rd | AddressLine1Txt |
| City | Tazewell | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37879 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 00000014 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Claiborne Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Claiborne Medical Center | Part V, Section B, Line 5: Community input was gathered by the use of a survey developed with the input of consultants from the Debusk College of Medicine at Lincoln Memorial University. Almost 3,000 area community members completed the surveys. Surveys were distributed through the area schools, churches, the jail population and door to door. The survey was also available online. The Department of Social Work and the Debusk College of Osteopathic Medicine, Lincoln Memorial University were instrumental in tabulation of the gathered data. |
| Claiborne Medical Center | Part V, Section B, Line 7d: The completed CHNA was distributed to the Claiborne Medical Center Board of Directors, Lincoln Memorial University, Debusk College of Osteopathic Medicine at Lincoln Memorial University, and at different community meetings including a Claiborne County Health Council meeting. |
| Claiborne Medical Center | Part V, Section B, Line 2: Claiborne Medical Center was acquired by Covenant Health, a nonprofit hospital system on April 1, 2014. Prior to its acquisition the hospital was a governmental hospital exempt from federal income tax under Section 501(c)(3). As such, they were not required to file a Form 990 with the IRS for those years prior to acquisition by Covenant Health. |
| Claiborne Medical Center | Part V, Section B, Line 11: Claiborne Medical Center has adopted an implementation strategy to meet the community health needs identified and is focusing its resources on the following:Access to and Continuity of a Primary Care Home *Provide health screenings and information at community health fairs to facilitate early detection of disease *Continue recruitment of primary care physicians *Implement physician connectivity program to develop an effective referral system for primary care providers and determine physician needs in the community *Continue community flu shot program, providing low cost flu vaccinations for local business, industry, and community groups *Implement a breast cancer prevention program during the month of October providing breast health education along with making available extended hours for mammogram services during the evening and on Saturdays in order to accommodate working womenPromote Healthy Weight through Healthy Living *Provide free community education classes on healthy living topics *Continue partnership with the Claiborne Health Council to promote school walking trails program and healthy activities for families such as the annual Race for School Health and the "Kick Butts" tobacco prevention program *Support a community hiking program, and partner with Cumberland Gap National Park to implement a "Get on the Trails" hiking seriesAccess to Transportation for Medical Care *Collaborate with the Claiborne Health Council and Servolution to develop an effective referral system for transportation within the community *Continue to recruit specialists to see patients locally in the Claiborne Medical Center Outpatient Specialty Clinic, reducing the need for residents to drive long distances for medical careThe only identified need not addressed was "Access to and Continuity of Dental Care". This not a service that the hospital provides. However, the hospital will support the efforts of the Servolution free clinic, which provides free dental services to residents without insurance. |
| Claiborne Medical Center | Part V, Section B, Line 16i: Please see the explanation to Part VI, Line 3. |
| Claiborne Medical Center | Part V, Section B, Line 22d: Please see the explanation to Part III, Line 9b. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Claiborne County Nursing Home | ||||
| 1850 Old Knoxville Road | Tazewell | TN | 37879 | Skilled nursing facility |
| Tazewell Rehabilitation Center | ||||
| 1610 Tazewell Road Suite 100 | Tazewell | TN | 37879 | Outpatient therapy center |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a: | Covenant Health, the parent company of Claiborne 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 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 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 $ 4,078,123. |
| Part III, Line 2: | Bad debt expense on Line 2 is the amount recorded in the organization's financial statements. Discounts and payments on patient accounts are netted against bad debt expense. |
| Part III, Line 3: | The amount reported on Line 3 was estimated by multiplying self-pay bad debt by the percentage of the population living below the poverty level on a county-by-county basis. It is our belief that the amount of bad debt on Line 3 should be included as community benefit. As a tax-exempt hospital, we must provide necessary services regardless of the patient's ability to pay for the service provided. As a not-for-profit, patient care is provided to all, regardless of ability to pay for that care. Making quality patient care available to all in our community, regardless of economic means, qualifies bad debts as a community benefit. |
| Part III, Line 4: | Note B to the 2014 Audited Consolidated Financial Statements of the Covenant Health system, of which Cumberland 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: Claiborne Medical Center believes that all of the $1.3 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 42.9% of total patients' days (2,611 out of 6,093 total). The hospital provided care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries.Costing Methodology: Claiborne 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: | Self-pay patients automatically receive a minimum 39% discount on charges. 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 70% 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.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. The patient/guarantor will be billed for all collection costs as may be applicable. Credit reports will be filed no earlier than 30 days following the assignment on all nonpaid balances. |
| 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. Claiborne Medical Center obtains additional community information through the service of its employees with the local Claiborne County Health Council and, also, through its relationship with the professors and staff of Lincoln Memorial University and the Debusk College of Osteopathic Medicine. |
| Part VI, Line 3: | Claiborne Medical Center informs patients and other persons who may be billed for patient care about its financial assistance policies by posting a sign in the main registration area and including information about the financial assistance policy in patient booklets placed in all inpatient rooms.The following sign is posted at the main registration area: 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 Claiborne 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, Claiborne 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 423.526.2195, Monday through Friday between the hours of 8 a.m. and 4:30 p.m.Claiborne Medical Center employs full time financial counselors who meet with each uninsured patient. In addition, Claiborne Medical Center assists them with completion of a TennCare application and ensures the application is directed to the appropriate Department of Human Services.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. |
| Part VI, Line 4: | Claiborne County, Tennessee, is the primary market for Claiborne Medical Center. Claiborne is a rural community located approximately 50 miles from the metropolitan Knoxville area. Claiborne Medical Center is the only hospital in the county.The following statistics are taken from the 2010 data of the U.S. Census Bureau and the 2014 Tennessee County Health Rankings. The population of Claiborne County is 32,213 with nonwhite residents making up 3.1%. The percentage of the population 65 and older is 17.2%. Youth under 18 years of age make up 20.5% of the population and 34% of these live in poverty, 29% in single parent homes. The largest employers are manufacturers of furniture, healthcare supplies and manufactured homes. Unemployment was 10.4% in 2014.According to the 2014 County Health Rankings Report of the Robert Wood Johnson Foundation/University of Wisconsin Population Health Institute, Claiborne County residents have the following health indicators that are above national benchmarks: Claiborne TN NationalAdult Smoking 33% - 23% - 14%Adult Obesity 32% - 32% - 25%Physical Inactivity 37% - 31% - 21%Children in poverty 34% - 26% - 13%Reporting Fair or poor health 31% - 10% - 19% |
| Part VI, Line 5: | Claiborne Medical Center (CMC), 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 CMC's board. It is comprised of independent community leaders with diverse educational and professional backgrounds. The board sets policies and provides oversight of CMC.CMC 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: | Claiborne Medical Center (CMC), 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.CMC patients benefit from the availability of and ease of access to Covenant Health affiliated entities for services not provided by the hospital itself. Transfer or referral to such services is expedited and coordinated to help create a seamless continuum of care. A full range of community mental health and psychiatric hospital services are available within the system that help support the hospital's emergency room as well as provide an accessible and efficient pathway for those patients who require such services post discharge. Other specialized services such as inpatient rehabilitation, cardiac care, cancer treatment, home health and hospice services are provided by affiliated entities. The Covenant Health system also enhances the patient's access to care through the provision of outpatient services in a variety of settings located throughout the service area. These include a diabetes center, wound care center, bariatric surgery center, pulmonary rehabilitation programs and ambulatory infusion centers.Through this combination of resources and the collective development, implementation and monitoring of clinical protocols and other improvement initiatives, the affiliated entities of Covenant Health are able to deliver higher quality care in a more efficient manner than could be achieved working independently. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ed Anderson | ||||||||||||||
| Director | $0 | $82,102 | $0 | $0 | $0 | $72,765 | $0 | $1,512 | $0 | $0 | $0 | $156,379 | $0 | $0 |
| Anthony L Spezia | ||||||||||||||
| President & CEO | $0 | $983,682 | $0 | $469,288 | $0 | $151,013 | $0 | $214,200 | $0 | $15,465 | $0 | $1,833,648 | $0 | $0 |
| John T Geppi | ||||||||||||||
| EVP/CFO | $0 | $472,919 | $0 | $199,500 | $0 | $80,241 | $0 | $10,200 | $0 | $16,156 | $0 | $779,016 | $0 | $0 |
| Timothy Brown | ||||||||||||||
| President & CAO | $0 | $153,561 | $0 | $0 | $0 | $6,389 | $0 | $0 | $0 | $10,506 | $0 | $170,456 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | Covenant Health, the parent company of Claiborne Medical Center, used one or more of the methods listed in establishing the compensation of Anthony L. Spezia. Please see the statement to Core Part VI, Section B, Line 15a on Schedule O. |
| Part I, Lines 4a-b | Michael Tuten, Vice President - Financial Services, received severance of $8,946 in 2014. Anthony Spezia was a participant in two nonqualified deferred compensation plans, which will be 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 does allow the accrual of interest on undistributed amounts which will be subject to risk of forfeiture until such time as indicated in the Amendment. Interest earned by Plan A in 2014 amounted to $83,726 and is not required to be reported in Part II, as Mr. Spezia is not substantially vested in earnings accumulated after July 31, 2011. Plan B was established in 2011. Employer contributions to Plan B during 2014 totalled $204,000, which is reported in Col. C of Schedule J, Part II. Interest earned by Plan B during 2014 of $43,651 is not required to be reported in compensation in Part II, as Mr. Spezia is not substantially vested in Plan B. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 1 | REPORT TO THE COMMUNITY Covenant Health is a comprehensive, community-owned health system dedicated to improving the health of the people it serves. Established in 1996 by the consolidation of Fort Sanders Health System, Knoxville, Tennessee, and MMC HealthCare System in Oak Ridge, Covenant Health is governed by a voluntary board of directors made up of community leaders and medical professionals. Covenant Health includes nine acute care hospitals in East Tennessee: Claiborne Medical Center Cumberland Medical Center Fort Loudoun Medical Center Fort Sanders Regional Medical Center LeConte Medical Center Methodist Medical Center Morristown-Hamblen Healthcare System Parkwest Medical Center Roane County Medical Center Member organizations also include: Covenant HomeCare Peninsula Hospital The Patricia Neal Rehabilitation Center Thompson Cancer Survival Center Thompson Oncology Group Fortress Corporation Fort Sanders West Diagnostic Center Covenant Medical Group, Inc. Philanthropic affiliates include: Fort Sanders Foundation Methodist Medical Center Foundation Morristown-Hamblen Foundation Thompson Cancer Survival Center Foundation Approximately 10,000 people are employed by Covenant Health and its member organizations. Working together with nearly 1,500 affiliated physicians, these healthcare professionals deliver quality care to thousands of patients throughout East Tennessee. Kiosks for Patients' Convenience Covenant Health now has three types of kiosks available to help patients "check in" at registration, electronically sign documents, and to help family members find a patient's hospital location. The check-in kiosks are used over 5000 times per month by patients who sign in electronically, notifying registration staff of their arrival. A notable feature of the check-in kiosks is use of Covenant FastPass hand-scanning technology, which ensures positive patient identification and deters identity theft. Covenant also implemented electronic signature kiosks (eSign) at some facilities. These allow patients to review their personal and billing information and then sign registration paperwork on screen. The eSign service streamlines registration for patients with simple appointments and gives registration staff more time to spend with patients with more complex needs. For facility visitors, Covenant Wayfinding kiosks are used more than 2000 times per month to help family and friends locate patients being treated at Covenant facilities. A Legacy of Philanthropic Impact Since the first campaign of Fort Sanders Foundation to establish the Patricia Neal Rehabilitation Center (PNRC) in the late 1970s, the volunteer board members of Covenant Health's foundations have focused on raising funds to ensure the future of healthcare in its communities. The impact of the philanthropic efforts by individuals, businesses and foundations is substantial. Covenant's Office of Philanthropy coordinates fund raising efforts at four foundations: Fort Sanders Foundation, Methodist Medical Center Foundation, Morristown- Hamblen Hospital Foundation, and Thompson Cancer Survival Center Foundation. One strong example of philanthropic partnerships is the Will Rogers Institute and its 15-year history of support for the pulmonary rehabilitation programs of Covenant Health - in particular, the work of the Patricia Neal Rehabilitation Center. The Will Rogers Institute (WRI) is a national charitable organization dedicated to perpetuating the memory of one of America's best-loved entertainers. It supports cardiopulmonary research and treatment programs, neonatal care, and patient and community education on health/fitness topics. Each summer, movie theatres across the country participate in a fundraising campaign for WRI. Regal Entertainment Group, which supports the Patricia Neal Rehabilitation Center and its annual Golf Classic, helped develop the relationship between the Will Rogers Institute and Covenant Health many years ago. Over the past 15 years, WRI has granted more than $2 million to PNRC and the hospitals of Covenant Health. Grant funds support cardiopulmonary rehabilitation and health improvement initiatives at PNRC and other Covenant facilities, including a strong focus on smoking cessation and access to pulmonary rehabilitation care. Numerous pieces of therapy equipment, oxygen piping and monitoring systems, and pulmonary testing equipment have been provided for PRNC, the hospitals and outpatient pulmonary rehabilitation centers. The grant also funds a unique telemanagement program in which respiratory therapists make follow-up contact with all patients who have expressed an interest in smoking cessation while at a Covenant Health hospital. The therapists provide support, education and information on smoking cessation classes available in the area. At the end of 2014, the smoking cessation compliance rate for patients contacted by respiratory therapists via phone at 6 months post discharge stands at 41%. The grant also funded Covenant Health's development of a "Stop Smoking" app for Apple and Android phones. The app is offered free to the public as a tool to support efforts to break smoking addictions. The longstanding partnership with the Will Rogers Institute and Regal Entertainment Group has created a legacy for the future, not only for the Patricia Neal Rehabilitation Center and Covenant's pulmonary health initiatives, but for corporate and foundation funding of its health care mission throughout the region. |
| Form 990, Part III, Line 1 | Leadership Academy Participants Get Insider View of Healthcare For the third year, a selected group of business and community leaders from across the region have experienced an in-depth view of Covenant Health and the healthcare environment as participants in Covenant Answers: A Healthcare Leadership Academy. The Office of Philanthropy hosts the Academy each year in an effort to expand the cadre of healthcare-informed volunteer leaders in the community. Over a five-month period, class members attended an orientation with Covenant executive leadership and half-day sessions at five different Covenant hospitals. The sessions included behind-the-scenes tours and hands-on access to the latest technologies and treatments. Participants had opportunities to discuss the challenges of the current healthcare environment with Covenant physicians and clinicians, communicate via a tele-stroke robot with a physician in another state and visit with a patient who received a life-saving interventional stroke treatment. They also observed a TAVR heart valve replacement surgery and a Barrett's esophagus cancer laser procedure. A Healthy Start for Covenant's Smallest Patients When parents are expecting a new baby, they may read books, buy new furniture and baby clothes, and consult family and friends. As families prepare for their new arrivals, Covenant Health hospitals are ready and waiting with a variety of birthing options and hospital amenities to help welcome their smallest patients. More than 7,000 babies got their first glimpse of life from the security and comfort of a Covenant Health hospital in 2014. Maternity suites at Covenant hospitals are designed to maximize comfort and provide immediate access to technology. Room options may include private suites equipped with bassinets for "rooming in" and comfortable sleeper furniture for a family member. All maternity units are secured with monitored entries and exits. Additional security devices and procedures are in place to monitor babies' safety. More than 50 credentialed physicians provide care to Covenant Health patients during pregnancy and while in the hospital. Childbirth education classes are available to help parents prepare for their new arrival. Best Practices for Babies' Healthy Start Five Covenant Health hospitals that offer obstetrics services were recognized by the Tennessee Hospital Association for reducing the number of babies born electively between 37 and 39 weeks gestation during 2011-2014. Fort Sanders Regional Medical Center, Parkwest Medical Center, LeConte Medical Center, Methodist Medical Center and Morristown-Hamblen Healthcare System received recognition from THA's Tennessee Center for Patient Safety for reducing elective early deliveries, thereby increasing babies' chances for better lifelong health. The Covenant hospitals are part of a statewide Healthy Tennessee Babies Are Worth the Wait initiative to increase awareness of the benefits of full-term delivery. Babies born too early are at risk for respiratory distress, jaundice, hypoglycemia and other conditions that require more medical care and put them at greater risk for death before their first birthdays. Waiting until 39 weeks allows for better growth and development of vital organs and is also better for the health and safety of the mother. In addition to patient and staff education programs, Covenant Health obstetrics departments adopted a policy prohibiting early elective deliveries before 39 weeks unless there is a clear medical risk to the mother or the baby. For an infant, two additional weeks can mean the difference between complications leading to lifelong health issues and a healthy and robust start. In 2011 about 12 percent of the hospitals' deliveries that occurred prior to 39 weeks gestation were considered elective. By second quarter of 2015, the number had dropped to zero. Covenant hospitals with obstetrical services also collaborate with the Tennessee Department of Health's Safe Sleep program. Participating hospitals have agreed to develop and implement hospital safe sleep policies and provide education to staff and patients regarding safe sleep recommendations. LeConte Medical Center has received a bronze designation from the National Safe Sleep Hospital Certification Program for its leadership in best practices and education related to safe sleep. Covenant hospitals are also involved with the Tennessee Initiative for Perinatal Quality Care's breastfeeding project, which focuses on promoting and supporting breastfeeding in the delivery setting and after mothers return home. Caring for Women Throughout Their Lives Covenant Health provides a full spectrum of health services for women of all ages. The health system's nine breast centers, located conveniently throughout Covenant's service area, offer state-of-the-art digital mammography. Two locations, Parkwest Medical Center and Morristown-Hamblen Healthcare System, provide 3D mammography services. Covenant Health has additional technologies for the early detection of breast cancer, including breast ultrasound and MRI. The health system provides comprehensive heart and stroke care for women, and has developed educational and outreach programs to inform women about cardiovascular disease, risk factors, prevention, treatment and rehabilitation. A full range of diagnostic screenings, gynecological care, cancer care, and specialized treatment for conditions such as incontinence are offered to women in all ages and stages of life. A Heart for Excellence Covenant Health is committed to excellence in all areas of heart care - from heart disease prevention and diagnosis of heart conditions to advanced technology and treatments, emergency interventions, and cardiac rehabilitation programs for follow-up care. More than 50 affiliated cardiologists provide diagnostic testing and perform a variety of interventional procedures such as heart catheterization and techniques to clear blocked arteries and place stents to restore blood flow. Cardiologists also treat heart arrhythmias and often repair heart valves and holes in the chambers of the heart. Advanced Technology Keeps More Hearts Beating Covenant Health is at the forefront of cardiac innovations that restore health and the ability to live life to the fullest. Covenant was the first health system in the region to offer Transcatheter Aortic Valve Replacement (TAVR), in which a minimally invasive procedure places a new valve into the heart. The procedure gives new hope to patients suffering from life-threatening aortic stenosis who are not candidates for open-heart surgery. In addition to TAVR, a full spectrum of advanced cardiac procedures is available at Covenant Health's "heart hospitals" - Fort Sanders Regional Medical Center, Methodist Medical Center of Oak Ridge and Parkwest Medical Center. For patients experiencing severe coronary disease like blocked arteries and aortic enlargement, care close to home may seem like a distant hope. Covenant's cardiac services offer complex surgeries and treatments that are often only available in larger cities. When Minutes Matter If a heart attack occurs, time is critical. The heart hospitals of Covenant Health work together to make sure that patients receive the most appropriate care as quickly as possible. The American College of Cardiology and the American Heart Association have established recommended care standards for heart attack patients, specifically those identified as the "ST-Segment Elevation MI" (STEMI) population. These patients have the highest mortality (risk of death) and morbidity (risk of associated complications). They can be rapidly identified with an electrocardiogram (EKG). The standards emphasize organizing regional systems of care and patient transfer procedures to provide faster access to advanced therapies that help facilitate rapid restoration of blood flow during a heart attack. The care team - from first responders and emergency departments to cardiologists and cath lab staff - collaborate to provide efficient and effective care. They evaluate the entire process and collaborate with anyone who has contact with this patient population to develop a standardized approach to efficiently get them to a cath lab. Every 30 minutes results in nearly an eight percent increase in risk of death, so patient outcomes can be improved by having a systems approach to identification, notification, and rapid transfer. |
| Form 990, Part III, Line 1 | Several new Cardiac processes have been developed, including: * Training EMS providers to identify STEMI patients quickly, and building relationships with emergency transporters to ensure efficient arrival at a center equipped to deal with STEMI patients. * Clinical members of Covenant Rapid Access, Covenant Health's patient transfer center, are available 24/7 to accept STEMI patients from outlying hospitals and immediately notify the cath lab team and interventional cardiologist. "Rapid Access" is the coordinating center for Covenant facilities. * Emergency transporters can now simultaneously notify both ED and cath lab teams of potential STEMI patients and transmit an EKG when available. This allows earlier activation of the cath lab team, with personnel available immediately when the patient arrives. * A regular review process provides feedback on outcomes and helps continually improve systems and processes. As a result of these efforts, Fort Sanders Regional has exceeded state and national hospitals' performance in meeting standards for "First Medical Contact-to-Device" times. Mortality and readmission rates also declined. The STEMI team collaborates with hospitals and emergency responders in Claiborne, Sevier, and Jefferson counties, and as far away as Kentucky. Cardiac Rehab Helps Pave the Road to Recovery The weeks immediately following a heart attack, angioplasty, or open heart surgery are critical for long-range rehabilitation. Several Covenant hospitals offer medically supervised Cardio-Pulmonary Rehabilitation programs that safely restore physical fitness and function for people who have recently had serious cardiac events. Through monitored exercise, education, counseling and healthy lifestyle changes, patients regain confidence in exercising their hearts, and they learn to make lifestyle changes to reduce the risk of further complications from heart disease. Cardiac rehabilitation offers effective treatment for heart attack, angina, post-infarction, angioplasty, post-coronary bypass, and patients considered to be high risk for coronary artery disease. The Region's Only Stroke Hospital Network Covenant Health has the region's only stroke hospital network for delivering advanced diagnostics and treatment to halt the devastating effects of stroke. At the hub of the network are Fort Sanders Regional Medical Center, certified as a comprehensive stroke center by The Joint Commission, and the award-winning Patricia Neal Rehabilitation Center, accredited by the Commission on the Accreditation of Rehabilitation Facilities. Covenant Health's stroke hospital network offers advanced treatments and clinical trials that are unavailable in other areas of the region. Delivering Immediate and Excellent Care When a stroke happens, timely treatment is critical. The Comprehensive Stroke Center at Fort Sanders Regional Medical Center is well above the national average in delivering prompt treatment of life-saving medication. Clot-busting drugs are given to stroke patients to improve blood flow and minimize potential disabilities. The amount of time it takes for a patient to be brought into a hospital until the moment medications are intravenously administered is referred to as "door-to-needle time." The average door-to-needle time is a little more than an hour; the door-to-needle time at Fort Sanders Regional is 30 minutes, half an hour faster than the national average. The stroke center exists to provide the highest level of stroke care for complicated stroke cases, which includes finding out why the stroke occurred to prevent it from happening again. The Comprehensive Stroke Center at Fort Sanders Regional sees patients from throughout East Tennessee and beyond. To help patients reclaim as much ability and independence as possible, the Patricia Neal Rehabilitation Center provides inpatient and outpatient stroke care. Patients are treated by a holistic team that includes physiatrists (rehab physicians); physical, occupational and speech therapists; rehab psychologists; case managers and recreation therapists. Treatment includes goal setting and interdisciplinary in range of motion, strengthening and conditioning, along with self-care and activities of daily living. Leading the Fight Against Cancer Even though cancer affects many thousands of people, a cancer diagnosis can be a lonely experience. Covenant Health is committed to helping cancer patients fight the disease with excellent medical care and a multidisciplinary team of support. At the core of Covenant Health's cancer care is an elite team of physicians, armed with the most advanced cancer tools available. Technology includes advanced imaging such as positron emission technology (PET) in Knoxville and mobile PET services in Sevierville, TomoTherapy, high-dose-rate brachytherapy and 3D radiation therapy. Fort Sanders Regional Medical Center offers Gamma Knife, the area's only non-invasive radiosurgical device that targets tumors in a single visit. A variety of clinical trials, stem cell transplantation and genetic counseling are also available. The health system recently invested $7.6 million for equipment upgrades, expanded connectivity and growth of a highly regarded radiation therapy research program at six locations: Thompson Cancer Survival Centers in downtown and west Knoxville, Oak Ridge and Sevierville, at Morristown-Hamblen Hospital System, and at Cumberland Medical Center's radiation oncology program in Crossville. Patients receiving cancer care at Covenant Health facilities receive individualized treatment plans, and have a multidisciplinary team of specialists and "navigators" to help with the treatment process. Support is also provided by social workers, nutrition counselors, and other members of the cancer care team. Thompson Oncology Group has 10 physician offices in Sevierville, Knoxville, Blount County, Morristown and Oak Ridge. The group has been recognized by the Quality Oncology Practice Initiative Certification Program, an affiliate of the American Society of Clinical Oncology. The certification process includes each of the 10 Thompson Oncology Group locations and encompasses evaluation of treatment planning, staff training, patient education and safe chemotherapy administration. |
| Form 990, Part III, Line 1 | Connecting with Our Communities In addition to taking care of patients and families who receive direct services, Covenant Health is committed to making a positive impact in the health of the surrounding community. In all the communities Covenant Health serves, local initiatives and partnerships create opportunities to interact with people of all ages and encourage healthier lifestyles. * In April 2014 nearly 8,000 people participated in the 11th Covenant Health Knoxville Marathon, which attracted local runners and hand cyclists, as well as competitors from throughout the U.S. and other countries. Marathon events included 2- and 4-person relays, a 5K, half-marathon and full marathon. * The Covenant Health Biggest Winner Weight Loss Challenge continued as a friendly competition that encourages East Tennesseans to get moving for a fit and healthy lifestyle. Team members train together for five months, with the goal of crossing the finish line in Covenant Health Knoxville Marathon events, and challenge other East Tennesseans to start a health journey that will change their lives for the better. * Some of the funds raised through the Covenant Health Knoxville Marathon were contributed to Patricia Neal Rehabilitation Center's Innovative Recreation Cooperative. More than $5,000 was given to the Cooperative, a collaboration of groups and individuals who help disabled persons enjoy leisure and recreation activities such as water skiing and cycling. * The Covenant Kids Run attracted nearly 1,000 children who participated in a "marathon of activities" over a period of several weeks, culminating in a run to Neyland Stadium on the day before the Covenant Health Knoxville Marathon. * Covenant HomeCare Hospice helps children grieving the loss of a loved one through Katerpillar Kids Camp, a free event offered with the support of Variety - The Children's Charity. The camp helps children in grades 1-12 express their feelings of loss in a supportive environment. * Methodist Medical Center co-sponsored the annual Baby's Best Fest, a day of family games and an ice cream social celebrating World Breastfeeding Month and supporting breastfeeding as the healthiest start for babies. * LeConte Medical Center partnered with Dollywood's Splash Country to host Water Safety Day. The event provided health and safety information to local children and families, and was held in conjunction with the "World's Largest Swimming Lesson," a national event promoting the importance of learning to swim. At the event LeConte employees educated children about water safety, representatives from Thompson Cancer Survival Center talked about the importance of sunscreen, and staff from the Patricia Neal Rehabilitation Center were on hand to talk about the Think First head injury prevention program and adaptive water sports. More than 600 children participated. * Cumberland Medical Center in Crossville co-sponsored numerous health fairs and community events throughout the year, and hosted free Mammogram Days for women who had not received a mammogram in two years and were age 40 or older without insurance coverage. * Missy Kane, health promotions coordinator for Covenant Health, led hikes in communities where Covenant Health hospitals are located and established walking clubs in Roane and Anderson counties in conjunction with Roane Medical Center and Methodist Medical Center. Parkwest Medical Center, LeConte Medical Center and Thompson Cancer Survival Center have been co-sponsors of hiking programs led by Missy Kane. |
| Form 990, Part III, Line 2 | Claiborne Medical Center assumed operation of the Claiborne County Hospital and Nursing Home effective April 1, 2014. Prior to this date the hospital was a government operated hospital and not required to file the annual Form 990. |
| Form 990, Part III, line 2 | Claiborne Medical Center assumed operation of the Claiborne County Hospital and Nursing Home effective April 1, 2014. Prior to this date the hospital was a government operated hospital and not required to file the annual Form 990. |
| Form 990, Part VI, Section B, line 11 | Covenant Health is a large, integrated health system which files fourteen Forms 990. Claiborne Medical Center is one of those fourteen entities. Annually, at the September Finance Committee meeting, one of the fourteen 990s is selected (a different entity each year) for distribution to each member of the Committee. Management then reviews in detail each of the Form 990 schedules and describes variances between entities, if any. The remaining thirteen Forms are made available for review by any committee member. The same presentation is made to the Covenant Health Board of Directors at the October meeting. All fourteen Forms 990 are then made available to all Board members for their review throughout the month of October. |
| 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 an annual management certification that addresses conflicts of interest. Board members' conflicts of interests are dealt with 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 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 | Overall compensation policies for Claiborne 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 Anthony Spezia and John Geppi are reported on the 2014 Form 990 of Covenant Health, EIN 62-1646734. Form 990, Part VI, Section B, Line 15b: Base salary and annual bonus opportunities for Timothy Brown, President and Chief Administrative Officer, were set by the Covenant Health CEO or Executive 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 was 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 salaries for individual executives will vary based on performance, tenure, experience, special skills or qualifications, recruitment and retention challenges, and other relevant factors. It is anticipated that seasoned executives with sustained good performance will have salaries around the range midpoints. 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 salary and annual bonus opportunities for Michael Tuten, Vice-President of Financial Services, were evaluated and determined to be consistent with targets established by an independent, nationally-recognized executive compensation consultant to ensure that total compensation for the executive was reasonable and within a fair market value range. Salary range is based upon comparison with similar jobs in similar size health systems across the nation. Base salary and bonuses are approved by Executive Leadership predicated upon performance, and are reasonable and consistent with fair market value. Base salaries for individual executives will vary based on performance, tenure, experience, special skills or qualifications, recruitment and retention challenges, and other relevant factors. It is anticipated that seasoned executives with sustained good performance will have salaries around the range midpoints. 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 | Claiborne 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 VI, Section A, Line 9 | Contact addresses for officers, directors, etc. Anthony L. Spezia Covenant Health 100 Fort Sanders West Blvd. Knoxville, TN 37922 John T. Geppi, Larry Mauldin and all Directors Covenant Health 1420 Centerpoint Blvd, Bldg C Knoxville, TN 37932 Timothy Brown 8612 Washington Pike Corryton, TN 37721 Michael Tuten 193 Whistle Valley Rd New Tazewell, TN 37825 All other persons listed in Part VII, Section A may be contacted at the organization's address, which is: Claiborne Medical Center 1850 Old Knoxville Road Tazewell, TN 37879-3625 |
| Form 990, Part XI, line 9: | Ambulance service assets acquired from Claiborne County 93,330. Hospital assets acquired from Claiborne County 9,368,875. |
| Form 990, Part XII, Line 2c | The Finance Committee of the Board of Directors assumes responsibility for oversight of the audit of the consolidated financial statements and selection of an independent accountant. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Claiborne EMS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1809 Old Knoxville Rd | AddressLine1Txt |
| City | Tazewell | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 378793625 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320434218 | EIN |
| Primary Activities | Ambulance service | PrimaryActivitiesTxt |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Total Income | $2,552,036 | TotalIncomeAmt |
| End Of Year Assets | $2,708,968 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Claiborne Medical Center | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Covenant Health | |||||||||||
| 1420 Centerpoint Blvd Bldg C | Knoxville | TN | 379321960 | 621646734 | Supporting organization | TN | 501(c)(3) | Line 11b, II | N/A | 0 | |
| Covenant Homecare | |||||||||||
| 3001 Lake Brook Blvd Ste 101 | Knoxville | TN | 37909 | 621623114 | Home health services | TN | 501(c)(3) | Line 9 | 0 | Covenant Health | |
| Fort Loudoun Medical Center | |||||||||||
| 550 Fort Loudoun Medical Ctr Drive | Lenoir City | TN | 37772 | 621373691 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Fort Sanders Regional Medical Center | |||||||||||
| 1901 W Clinch Ave | Knoxville | TN | 37916 | 620528340 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Fort Sanders Foundation | |||||||||||
| 280 Ft Sanders West Blvd Ste 202 | Knoxville | TN | 37922 | 621748601 | Fundraising and patient outreach | TN | 501(c)(3) | Line 11b, II | 0 | Covenant Health | |
| Fort Sanders Perinatal Center | |||||||||||
| 501 19th St Suite 304 | Knoxville | TN | 37916 | 043760551 | High risk obstetrical services | TN | 501(c)(3) | Line 3 | 0 | Fort Sanders Regional Medical Center | |
| LeConte Medical Center | |||||||||||
| 742 Middle Creek Road | Sevierville | TN | 37862 | 621114867 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Morristown-Hamblen Hospital Assoc dba M-H Healthcare System | |||||||||||
| 908 W 4th North Street | Morristown | TN | 37814 | 620545814 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Parkwest Medical Center | |||||||||||
| 9352 Park West Blvd | Knoxville | TN | 37923 | 581897274 | Acute care hospital and behavioral health services | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Roane Co Medical Ctr dba Roane Medical Center | |||||||||||
| 8045 Roane Medical Center Dr | Harriman | TN | 37748 | 680673354 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Thompson Cancer Survival Center | |||||||||||
| 1915 White Ave | Knoxville | TN | 37916 | 621250943 | Cancer treatment facility | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Thompson Oncology Group | |||||||||||
| 1915 White Ave | Knoxville | TN | 37916 | 621619239 | Oncology services | TN | 501(c)(3) | Line 3 | 0 | Thompson Cancer Survival Center | |
| Thompson Cancer Survival Center Foundation | |||||||||||
| 1915 White Ave | Knoxville | TN | 37916 | 582130450 | Fundraising and patient outreach | TN | 501(c)(3) | Line 11b, II | 0 | Covenant Health | |
| Cumberland Medical Center | |||||||||||
| 421 S Main St | Crossville | TN | 385555048 | 620790132 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
| Methodist Medical Center | |||||||||||
| 990 Oak Ridge Turnpike | Oak Ridge | TN | 37830 | 620636239 | Acute care hospital | TN | 501(c)(3) | Line 3 | 0 | Covenant Health | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| Endoscopy Center of Oak Ridge LLC | |||||||
| 988 Oak Ridge Turnpike Ste 200 | Oak Ridge | TN | 37830 | 621667358 | Outpatient medical facility | 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 |
| KOSC Properties LLC | |||||||
| 256 Ft Sanders W Blvd Ste 200 | Knoxville | TN | 37922 | 262444076 | Building ownership | TN | N/A |
| Knoxville Orthopaedic Surgery Center LLC | |||||||
| 256 Ft Sanders W Blvd Ste 200 | Knoxville | TN | 37922 | 262437385 | Orthopaedic surgery | TN | N/A |
| KOC 260 Bldg LLC | |||||||
| 260 Fort Sanders West Blvd | Knoxville | TN | 37922 | 465228440 | Land & building ownership | TN | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Fortress Corporation | |||||||||
| 280 Ft 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 | 0 |
| 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 Dr Ste 200 | Knoxville | TN | 37923 | 621018541 | Cardiovascular surgical practice | TN | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Covenant Medical Group Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | A | TransactionTypeTxt |
| Involved | $6,276 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |