2014-11-11T09:30:09-06:00 2013-12-31 990 2013-01-01 581897274 Parkwest Medical Center PARK 8653746864 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 John T Geppi EVP/CFO 8653746872 2014-11-06 Self Prepared 2013 2015-11-30 17:44:51Z Anthony L Spezia 100 Ft Sanders W Blvd Knoxville TN 37922 339638090 0 X www.treatedwell.com X 1990 TN Parkwest Medical Center operates a full-service acute care hospital located in west Knoxville, Tennessee, and a psychiatric hospital in neighboring Blount County, with a combined total of 462 beds. It is a member of the Covenant Health system. 21 17 2487 172 775131 108850 673752 550800 330544134 323494985 31747 138 2750171 13179165 333999804 337225088 158490 181831 0 0 101964882 97586764 0 0 0 206408867 209859456 308532239 307628051 25467565 29597037 220740225 207417652 131346896 88427286 89393329 118990366 X Parkwest Medical Center provides quality healthcare, in alignment with Covenant Health's mission to serve the community by improving the quality of life through better health, regardless of the patient's ability to pay. 0 0 58732250 62682487 Cardiology. During 2013, Parkwest Medical Center performed 501 open heart surgeries. In addition, the cardiac cath lab performed 3,506 inpatient and 4,607 outpatient procedures for a total of 8,113 procedures.The Heart Hospital at Parkwest has been recognized by Thomson Reuters as one of the nation's top heart hospitals for almost a decade. 41641579 46154272 Orthopedics. During 2013, Parkwest Medical Center performed 3,079 orthopedic surgeries - 2,403 inpatient and 676 outpatient. Among these surgeries, 553 total hip replacements were done, as well as 1,240 total knee replacements. 30126640 23894989 Psychiatry. Peninsula, a division of Parkwest, is the region's largest provider of behavioral health services. Peninsula provides outpatient services in four counties and inpatient services at a 155 bed facility. The Parkwest Senior Behavioral Center provides an advanced level of care for older psychiatric patients.Parkwest's Senior Behavioral Center saw 542 admissions in 2013 resulting in 5,297 patient days. At the Peninsula campus, a division of Parkwest, admissions totaled 4,920, with 29,734 patient days. Outpatient visits totaled 145,789. 171033799 181831 194814676 As a full-service acute care hospital, Parkwest Medical CenterCenter treats patients across a broad spectrum of medical specialties. 171033799 181831 194814676 301534268 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 330 0 1 2487 1 1 1 0 0 0 0 0 0 0 0 0 X 21 17 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 1 0 X X Nancy Beck 8653746864 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 Anthony L Spezia President and CEO 0.00 50.00 X X 0 1543512 228486 Gerald Boyd Director 0.00 1.00 X 0 1445 0 Dr Richard Brinner Director 0.00 1.00 X 0 1576 0 Dr Mitchell Dickson Director 0.00 1.00 X 0 1873 0 Pamela P Fansler Director 0.00 1.00 X 0 0 0 James Fitzsimmons Director 0.00 1.00 X 0 1461 0 Kimberly Greene Director 0.00 1.00 X 0 0 0 Wayne Heatherly Director 0.00 1.00 X 0 1661 0 Jim Johnson Jr Director 0.00 1.00 X 0 1465 0 Karla Lane Director 0.00 1.00 X 0 0 0 Eddie Mannis Director 0.00 1.00 X 0 0 0 Larry Mauldin Chairman 0.00 1.00 X 0 1542 0 Dr Joseph Metcalf Director 0.00 3.00 X 0 26641 0 George Miller Director 0.00 1.00 X 0 1434 0 Alvin Nance Director 0.00 1.00 X 0 1464 0 Linda Ogle Director 0.00 1.00 X 0 0 0 Mitchell Steenrod Director 0.00 1.00 X 0 1311 0 Carl Storms Director 0.00 1.00 X 0 1453 0 Joseph E Sutter Director 0.00 1.00 X 0 1761 0 Richard Swanson Director 0.00 1.00 X 0 0 0 Joe Ben Turner Director 0.00 1.00 X 0 1636 0 David C Verble Director 0.00 1.00 X 0 1362 0 John T Geppi EVP/CFO 0.00 50.00 X 0 710276 25177 Larry R Lassiter President & CAO PWMC 50.00 0.00 X 0 385969 31105 Michael S Hamilton VP-Financial Services 37.00 13.00 X 160511 0 27490 John G Kupfner MD Physician - Behavioral 40.00 0.00 X 257564 0 34550 Bert E Simpson Physician - Behavioral 40.00 0.00 X 254178 0 18060 Navneet Taneja MD Physician - Behavioral 40.00 0.00 X 238699 0 33875 Donna G McKenzie Physician - Behavioral 40.00 0.00 X 235627 0 15731 Rajendra T Raman Physician - Behavioral 40.00 0.00 X 231899 0 38793 Jeffrey N Dice Former VP - Peninsula 50.00 0.00 X 130350 0 15462 Emlyn J Cobble VP - Chief Support Officer 50.00 0.00 X 149172 0 13224 Janice McKinley Former VP - Chief Nursing Officer 0.00 50.00 X 0 282303 16788 1658000 2970145 498741 41 1 1 0 GE Healthcare PO Box 402076 Atlanta GA 303842076 Equipment Maintenance/Service 2461858 Medic Regional Blood Center 1601 Ailor Ave Knoxville TN 37921 Blood Processing 1500796 Angelica Textile Services Inc PO Box 535122 Atlanta GA 303535122 Linen Service 1275814 Summit Medical Group PLLC 1225 E Weisgarber Rd Suite 200 Knoxville TN 37909 Hospitalist Fees 1269276 Bio Medical Applications of TN PO Box 101518 Atlanta GA 303921518 Dialysis Services 1027583 24 33894 411337 105569 300 550800 Medical Services 622110 322718226 322718226 Laboratory 621500 591563 591563 Pharmacy 621990 183568 183568 Rent - Exempt Affiliate 531120 1628 1628 323494985 -3106 -3106 3244 3244 2772971 2413002 359969 359969 359969 Pharmacy 900099 5734871 103925 5630946 Meaningful Use 900099 4355418 4355418 Cafeteria 722212 1852202 1852202 876705 363983 512722 12819196 337225088 327546424 775131 8352733 13200 13200 168631 168631 188001 188001 80467696 78741106 1726590 2493073 2441751 51322 8624988 8244225 380763 5813006 5655790 157216 21119909 20720031 399878 277170 277170 19640191 18650574 989617 571857 547174 24683 3112206 2534642 577564 5746801 4915765 831036 242320 224460 17860 243170 174498 68672 1902474 1902474 15574081 15574081 693519 676429 17090 Unrelated Business Inco 1000 1000 Medical Supplies 78551396 78551396 Charity Care 24889106 24889106 Bad Debts 18953142 18953142 18341114 17955793 385321 307628051 301534268 6093783 0 7845 7596 -888378 -2377185 26211073 27172619 5860053 5999909 924982 992266 382204343 220585786 170564095 161618557 199466 78271 17861089 13925619 220740225 207417652 24277171 21579670 419816 399872 50841541 26371729 1187604 665996 54620764 39410019 131346896 88427286 X 89393329 118990366 89393329 118990366 220740225 207417652 29597037 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 61422 871 62293 59011 2411 61422 56919 2092 59011 54689 2230 56919 51081 3608 946 946 54689 0.00000 1.00000 0.00000 0 1 1 19740902 19740902 23769606 158264889 69173370 112861125 3540430 3111985 428445 169469410 142974753 26494657 7419106 5325678 2093428 161618557 Assets Limited as to Use 12783567 Bond Issuance Costs, Net 75040 Deferred Compensation 360867 Other Receivables 706145 13925619 Due to Affiliates, Net 33319341 Long-term Deferred Compensation 360867 Long-term Reserve for Workers Comp 1500094 Due to Third Party Payors 4229717 39410019 X Part V, Line 4: Fort Sanders Foundation maintains a permanent endowment fund on behalf of Parkwest Medical Center. The Wayne Heatherly Excellence in Patient Care Endowment Fund was established to promote and encourage excellence in clinical quality and patient care by providing educational assistance to employees, recognizing and awarding nominated employees for their commitment to patient care excellence, and to help meet patient care needs. The principal of the permanent endowment will be kept intact in perpetuity and only the income generated will be distributed to provide support for Parkwest Medical Center. Part X, Line 2: Note B to the consolidated audited financial statements of Covenant Health, parent company to Parkwest Medical Center, reads in part: "Income Taxes: Covenant and certain of its subsidiaries or controlled entities are exempt from income taxes pursuant to Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for income taxes on qualifying activities has been made for these entities in the accompanying consolidated financial statements. However, certain entities and operations are subject to income taxes which are accounted for in accordance with Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 740, Income Taxes (See Note G)." Note G reads in part: "Covenant had no unrecognized tax benefits at December 31, 2013 and 2012. As such, no interest or penalties were recognized in the Consolidated Statements of Operations related to unrecognized tax benefits. At December 31, 2013, tax returns for 2010 through 2013 are subject to examination by the Internal Revenue Service. Covenant has no uncertain tax positions that would require financial statement recognition or disclosure under generally accepted accounting principles at December 31, 2013 or 2012." 1 1 X 1 X 1 X 1 1 1 0 1 1 14200801 4762565 9438236 0.03270 44774108 35956747 8817361 0.03050 528711 172841 355870 0.00120 59503620 40892153 18611467 0.06440 249706 2194 247512 0.00090 12669 12669 0.00000 15215964 9711782 5504182 0.01910 106943 106943 0.00040 15585282 9713976 5871306 0.02040 75088902 50606129 24482773 0.08480 19052 19052 0.00010 17861 17861 0.00010 207974 207974 0.00070 10317 10317 0.00000 923 923 0.00000 256127 256127 0.00090 0 18953142 4908864 83226279 83936816 -710537 X 1 1 1 None 2 1 Parkwest Medical Center 9352 Park West Blvd Knoxville TN 37923 www.treatedwell.com 00000042 X X X Behavioral Health A 2 Peninsula Hospital 2347 Jones Bend Road Louisville TN 37777 www.peninsulabehavioralhealth.org 00000042 X Behavioral Hospital A Facility Reporting Group - A 1 X X X X X X X 13 1 1 1 X www.treatedwell.com X X X X X X 1 0 1 1 200.000000000000 1 300.000000000000 1 X X X 1 1 X X 1 0 X X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Parkwest Medical Center, - Facility 2: Peninsula Hospital Facility 1 -- Parkwest Medical Center Part V, Section B, line 3: "Together! Healthy Knox" (T!HK) was launched by the Knox County Health Department in May 2010 and was designed to create a community approach to better health. The T!HK initiative is based on the Mobilizing for Action through Planning and Partnerships (MAPP) model for community health planning, which consists of specific steps meant to be repeated every three to five years. What began with a twenty partner Leadership Team grew to involve over seventy community and organizational partners. The assessment process, led by the Health Department, had broad participation from the public health community, including all Knox County hospitals. All four MAPP assessments were completed in 2011, and the T!HK Leadership Team determined the most critical issues to be addressed in Knox County. After nearly three years of data collection, analysis and meetings, the priority areas were announced to the broader community in a press conference on November 1, 2012. Three action teams formulated goals and strategies to address the three priority areas identified. Facility 1 -- Parkwest Medical Center Part V, Section B, line 4: Knox County hospitals who participated in the "Together! Healthy Knox" initiative included Parkwest Medical Center, Fort Sanders Regional Medical Center, East Tennessee Children's Hospital, and The University of Tennessee Medical Center. Facility 1 -- Parkwest Medical Center Part V, Section B, line 14g: Please see the explanation to Part VI, Line 3. Facility 1 -- Parkwest Medical Center Part V, Section B, line 20d: Please see the explanation to Part III, Line 9b. Facility 2 -- Peninsula Hospital Part V, Section B, line 3: "Together! Healthy Knox" (T!HK) was launched by the Knox County Health Department in May 2010 and was designed to create a community approach to better health. The T!HK initiative is based on the Mobilizing for Action through Planning and Partnerships (MAPP) model for community health planning, which consists of specific steps meant to be repeated every three to five years. What began with a twenty partner Leadership Team grew to involve over seventy community and organizational partners. The assessment process, led by the Health Department, had broad participation from the public health community, including all Knox County hospitals. All four MAPP assessments were completed in 2011, and the T!HK Leadership Team determined the most critical issues to be addressed in Knox County. After nearly three years of data collection, analysis and meetings, the priority areas were announced to the broader community in a press conference on November 1, 2012. Three action teams formulated goals and strategies to address the three priority areas identified. Facility 2 -- Peninsula Hospital Part V, Section B, line 4: Knox County hospitals who participated in the "Together! Healthy Knox" initiative included Parkwest Medical Center, Fort Sanders Regional Medical Center, East Tennessee Children's Hospital, and The University of Tennessee Medical Center. Facility 2 -- Peninsula Hospital Part V, Section B, line 14g: Please see the explanation to Part VI, Line 3. Facility 2 -- Peninsula Hospital Part V, Section B, line 20d: Please see the explanation to Part III, Line 9b. 11 Peninsula Outpatient Center - Knox 1451 Dowell Springs Blvd Knoxville TN 37919 Outpatient mental health facility Peninsula Outpatient Center - Blount 210 Simmons Street Maryville TN 37801 Outpatient mental health facility Parkwest Comprehensive Breast Center 9349 Park West Blvd 200 Knoxville TN 37923 Breast imaging center PWMC Boulevard Surgery Center 9300 Park West Blvd Knoxville TN 37923 Ambulatory surgery center Peninsula Knox Outpatient Pharmacy 1451 Dowell Springs Blvd Knoxville TN 37919 Pharmacy Peninsula Outpatient Center - Sevier 1104 Foxwood Drive Sevierville TN 37862 Outpatient mental health facility Therapy Center West 280 Fort Sanders West Blvd 201 Knoxville TN 37922 Physical, occupational & speech therapy Peninsula Outpatient Center - Loudon 423 Medical Park Drive Suite 400 Lenoir City TN 37772 Outpatient mental health facility CROPPROP 280 Fort Sanders West Blvd 205 Knoxville TN 37922 Cardiac & pulmonary rehabilitation Peninsula Lighthouse 1451 Dowell Springs Blvd Knoxville TN 37919 Outpatient alcohol & drug rehabilitation Weight Management Center 280 Fort Sanders West Blvd 200 Knoxville TN 37922 Weight management center Part I, Line 6a: Covenant Health, the parent company of Parkwest Medical Center and other affiliated acute care hospitals, prepares an annual Report to the Community on behalf of the entire system. Part I, Line 7: Amounts on Lines 7a-7c and certain program costs included in Line 7g are from the hospital's cost accounting system, which addresses all patient segments. Other community benefit expenses are at cost from the general ledger. Part I, Line 7g: The organization has included $4,478,161 in physician sponsorship fees in total subsidized health services. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 18,953,142. Part II, Community Building Activities: Parkwest Medical Center cares for the whole person and recognizes that improved social and economic conditions may lead to the improved health and well-being of the community. The hospital's community building activities and those of its parent organization, Covenant Health, address many of the root causes of health problems, such as poverty and homelessness, and help find solutions to alleviating the symptoms.An allocation of the Parent's community building expenditures has been made to each member hospital in proportion to the financial contribution of each to the health system. Covenant Health is not a hospital and does not file Schedule H with its Form 990. In 2013 contributions were made to organizations meeting the community's needs by providing:*Affordable, permanent housing and case management services to foster self-sufficiency - Knoxville's Community Development Corporation (KCDC) *Innovative education and literacy programs fostering success in school life - Great Schools Partnership and Dollywood Foundation *The basic needs of life including temporary shelter, food and clothing - Catholic Charities, Family Promise, Ladies of Charity, United Way and others *Youth mentoring and development and after-school programs - Emerald Youth Foundation and Great Smoky Mountain Council, Boy Scouts of America *Business recruitment and marketing initiatives that boost economic development - Innovation Valley *Leadership development programs and workshops - Leadership Knoxville *Assistance and special programs for at risk, physically challenged, abused and neglected children - Emory Valley Center and Variety of Eastern Tennessee (local chapter of Variety-The Children's Charity) 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. Part III, Line 3: In 2011, the hospital reviewed all self-pay accounts receivable to identify patients who might have qualified for financial assistance. As of year end, the hospital could not make a final determination as to some patients' qualification for financial assistance because not all requested financial information had been received but felt strongly that they were in need of some form of assistance. Notes in the patient records were examined to see if a charity care application had been sent to the patients or guarantors or if the accounts were being analyzed by a business office employee for approval for charity care. The percentage of patient accounts being analyzed as a percent of total self-pay accounts receivable has been applied to the current year total bad debt expense on Line 2 to arrive at the amount reported on Line 3. For the year ended 2013, the hospital sampled the self-pay accounts receivable to validate the percentage used in 2011 has remained the same. This sample concluded the percentage was still valid and therefore the same percentage has been used for the year ended 2013.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 2013 Audited Consolidated Financial Statements of the Covenant Health system, of which Parkwest Medical Center is a member, reads in part: "Patient accounts receivable are reported net of both an estimated allowance for uncollectible accounts and an estimated allowance for contractual adjustments. The contractual allowance represents the difference between established billing rates and estimated reimbursement from Medicare, TennCare and other third-party payment programs. The allowance for uncollectible accounts is estimated based upon the age of the patient accounts receivable, prior experience and any unusual circumstances (such as local, regional or national economic conditions) which affect the collectability of receivables, including management's assumptions about conditions it expects to exist and courses of action it expects to take. Covenant's policy does not require collateral or other security for patient accounts receivable and Covenant routinely accepts assignment of, or is otherwise entitled to receive, patient benefits payable under health insurance programs, plans or policies." Part III, Line 8: Medicare Shortfall: Parkwest Medical Center believes that all of the $700,000+ 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 33.5% of total patient days (34,744 out of 103,874 total). The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries.Costing Methodology: Parkwest Medical Center used a combination of sources in calculating Medicare allowable costs on Part III, Line 6 including its cost accounting system, general ledger accounting system, and facility-specific analyses and calculations. Part III, Line 9b: Self-pay patients of Parkwest Medical Center automatically receive a minimum 49% discount on charges. Self-pay patients of Peninsula Hospital receive a 30% discount. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment assistance may qualify for charity care. A sliding scale is used for extending charity care utilizing the income levels reported under the federal poverty guidelines. Patients/guarantors with income that falls below 200% of the federal poverty guidelines receive 100% charity care. Patients/guarantors with income of 201-300% of the federal poverty guidelines receive 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. Parkwest Medical Center obtains additional community information thru the service of its employees with the United Way of Greater Knoxville, local chambers of commerce and Rotary clubs, the Metropolitan Drug Commission, a local alternative high school, the Legacy Parks Foundation, and the Knoxville Area Coalition on Childhood Obesity. Part VI, Line 3: Parkwest Medical Center informs patients and other persons who may be billed for patient care about its financial assistance policies by posting signs in highly visible areas of the hospital and including information about the financial assistance policy in patient booklets placed in all inpatient rooms.The following sign is posted in the main registration area and at the Emergency Department registration entrance: Financial Assistance: Covenant Health is committed to providing quality health services in a caring environment. It is the expressed philosophy of Covenant Health, and its member hospitals, that no one should be denied necessary medical care because of the inability to pay. In conjunction with this philosophy, staffs of Parkwest Medical Center are available to assist you with your financial needs. If you are an uninsured person with no public or private source of payment for medical services, Parkwest Medical Center, in compliance with Tennessee Code Annotated, Title 47, Chapter 18 and Title 68, will provide at a reduced rate, medically indicated services. A financial counselor is available to assist you with these matters by calling 865-373-1244, Monday through Friday between the hours of 8 a.m. and 4:30 p.m.Signs are also posted at each registration desk and at Customer Service stating: Financial Assistance: It is Parkwest Medical Center's philosophy that no one shall be denied medically necessary services based on an inability to pay. Financial assistance applications for medically necessary services are available during the registration process or through our Financial Counselor's office. To apply for financial aid, please ask our registration staff or contact the Counselor's office at 865-373-1244. The Financial Counselor is available Monday - Friday, 8 a.m. - 4:30 p.m.Parkwest Medical Center employs full time financial counselors that meet with each uninsured patient. In addition, Parkwest 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: Parkwest Medical Center is located in the west area of Knoxville, Tennessee. Although located in metropolitan Knox County, Parkwest Medical Center receives many specialty referrals from outlying hospitals and physicians and serves patients from 16 diverse counties, a mix of urban, suburban and rural. According to internal hospital data for 2013, just over 46% of the inpatient discharges were Knox County residents. Loudon County provides Parkwest Medical Center with the second highest number of admissions compared to other counties in the region, slightly more than 13%. Parkwest Medical Center also provides mental health services to the region through its behavioral health division, Peninsula. Peninsula is East Tennessee's leading provider of behavioral healthcare services. Peninsula offers a complete range of mental health and alcohol/drug treatment programs. In addition to outpatient centers in Blount, Knox, Loudon and Sevier counties, care is also offered at Peninsula Hospital, a 155-bed inpatient facility which serves more than 5,000 patients annually.According to 2010 data from the U.S. Census Bureau, the collective population of the 16 counties is 1,176,033, of which 51.2% are female and 48.8% are male. The racial makeup of the population is 94% Caucasian, 4.6% black, and 1.4% other races. There are 22 hospitals in the 16-county area which, with one exception, are not-for-profit. The average income and percentage of the population with incomes below the federal poverty guideline within the 16 counties ranges from a low of $12,925 and 21% in Morgan County to a high of $21,875 and 14% in Knox County.According to the 2013 County Health Rankings Report by the Robert Wood Johnson Foundation/University of Wisconsin Population Health Institute, Knox County residents have the following health indicators that are above the national benchmarks: Knox - TN - National Adult Smoking: 19% - 23% - 13% Adult Obesity: 31% - 32% - 25% Excessive Drinking: 10% - 10% - 7% Teen Birthrate: 37 - 50 - 21 of every 1,000 teenage girls Poor or Fair Health: 16% - 19% - 10% Physical Inactivity: 28% - 30% - 21% Part VI, Line 5: Parkwest Medical Center ("Parkwest"), in conjunction with its parent company, Covenant Health, uses any available surplus of receipts over disbursements to expand and modernize the facility and to support the education of healthcare professionals, both of which serve to improve patient care and serve the unmet needs of the community.Covenant Health's Board of Directors serves as Parkwest's board. It is comprised of independent community leaders with diverse educational and professional backgrounds. The board sets policies and provides oversight of Parkwest.Parkwest maintains an open medical staff, with privileges available to all qualified physicians. Additionally, the hospital operates an active and accessible emergency department that accepts all patients regardless of ability to pay. Part VI, Line 6: Parkwest Medical Center, as a member of the Covenant Health system, benefits from the collaboration among all affiliated organizations to promote quality improvement, patient safety and efficient delivery of care for the communities served.As a system, Covenant assures that business processes are in place at each facility to measure and report quality, to increase the role of compliance, and to integrate risk management, utilization review, peer review, mandatory reporting and quality improvement into one cohesive function. In this way, the system is able to use analytic tools to help identify any systemic inability to satisfy the various requirements on the part of the facilities.Parkwest operates a 462-bed acute care hospital in Knoxville, Tennessee, and provides a full range of inpatient and outpatient hospital services. It has been named as one of the nation's top 100 cardiovascular hospitals seven times of the award's eight-year history and offers a full cardiovascular service line that includes coronary bypass surgery, diagnostic and interventional cardiac procedures. Patients may also receive treatment in one of Parkwest's specialty centers, which include: --The Senior Behavioral Center, a 16-bed unit for older psychiatric patients; --A Bariatric Surgery Center of Excellence; --A Joint Replacement Center; and --A surgical center utilizing the BrainSUITE system for brain, spine, ear, nose and throat surgery.Parkwest also operates Peninsula Hospital, a 155-bed psychiatric hospital located in Louisville, Tennessee. Peninsula has outpatient centers in Knox, Blount, Sevier and Loudon Counties. Peninsula is a valuable resource providing support for emergency rooms at the system's seven acute care hospitals. The affiliation makes for an accessible and efficient pathway for patients who require mental health services post-discharge.Parkwest and Peninsula patients benefit from the availability of and ease of access to Covenant Health affiliated entities for services not provided by the hospitals themselves. Transfer or referral to such services is expedited and coordinated to help create a seamless continuum of care. Specialized services such as inpatient rehabilitation, cancer treatment, home health and hospice services are provided by affiliated entities. The Covenant Health system also enhances the patient's access to care through the provision of outpatient services in a variety of settings located throughout the service area. These include diabetes, wound care, and ambulatory infusion centers.Fort Sanders Foundation seeks out community financial support for Parkwest Medical Center and Peninsula Hospital. Funds are used for indigent patient care, medical equipment, outreach programs, services and staff.Through this combination of resources and the collective development, implementation and monitoring of clinical protocols and other improvement initiatives, the affiliated entities of Covenant Health are able to deliver higher quality care in a more efficient manner than could be achieved working independently. 1 To help build affordable housing for low-income families. 0 0 Patient assistance with transportation, food, medicine, utilities and rent 1864 168631 Part I, Line 2: Donations are given at the discretion of Administration and Marketing departments for the purpose of enhancing and promoting healthcare within the community of East Tennessee. The organization maintains records of check requests authorizing gifts and donations. Recipients are trusted to use the funds for the purposes for which they were given. X 1 1 0 1 0 0 0 0 0 0 0 Anthony L Spezia President and CEO 0 955101 0 443088 0 145323 0 214000 0 14486 0 1771998 0 0 John T Geppi EVP/CFO 0 448213 0 184500 0 77563 0 10000 0 15177 0 735453 0 0 Larry R Lassiter President & CAO PWMC 0 293378 0 47080 0 45511 0 10000 0 21105 0 417074 0 0 Michael S Hamilton VP-Financial Services 144535 0 7000 0 8976 0 6469 0 21021 0 188001 0 0 0 John G Kupfner MD Physician - Behavioral 234584 0 6000 0 16980 0 14688 0 19862 0 292114 0 0 0 Bert E Simpson Physician - Behavioral 246114 0 6000 0 2064 0 0 0 18060 0 272238 0 0 0 Navneet Taneja MD Physician - Behavioral 229828 0 8000 0 871 0 14128 0 19747 0 272574 0 0 0 Donna G McKenzie Physician - Behavioral 226171 0 7500 0 1956 0 6082 0 9649 0 251358 0 0 0 Rajendra T Raman Physician - Behavioral 220212 0 10500 0 1187 0 15000 0 23793 0 270692 0 0 0 Jeffrey N Dice Former VP - Peninsula 83052 0 10000 0 37298 0 5566 0 9896 0 145812 0 0 0 Emlyn J Cobble VP - Chief Support Officer 132607 0 7000 0 9565 0 5777 0 7447 0 162396 0 0 0 Janice McKinley Former VP - Chief Nursing Officer 0 196777 0 57616 0 27910 0 10000 0 6788 0 299091 0 0 Part I, Line 1a Tax gross-up payments are provided to certain executives and managers. These are treated as taxable compensation to the recipient. Part I, Line 3 Covenant Health, the parent company of Parkwest Medical Center, used one or more of the methods listed in establishing the compensation of Anthony L. Spezia. Please see the statement to Core, Part VI, Section B, Line 15a on Schedule O. Part I, Line 4b Anthony L. 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 2013 amounted to $77,542 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 2013 totalled $204,000, which is reported in Col. C of Schedule J, Part II. Interest earned by Plan B during 2013 of $30,427 is not required to be reported in compensation in Part II, as Mr. Spezia is not substantially vested in Plan B. Form 990, Part III, Line 1 REPORT TO THE COMMUNITY Covenant Health was formed in 1996 with the mission to serve its communities by improving the quality of life through better health. The health system is nationally recognized as a top performer in many areas: patient care, quality performance, cost, integration, information technology, finances, ethics and innovation. Amid a challenging healthcare environment, Covenant Health has committed to these imperatives: * Serving the communities as a not-for-profit health system. * Leading in quality and service. * Outstanding governance and leadership. * An engaged work force with the right skill sets. * Being the practice environment of choice for physicians. * Reinvesting in the communities, providing programs, services, technologies and facilities that improve local healthcare services and patient care. Covenant Health has invested well over a billion dollars in its communities since 2000 - a commitment no other healthcare organization has approached. It has opened new hospitals, expanded services, and brought cutting-edge medical technology to the region. * Meeting the challenges of the healthcare environment through effective strategic planning and wise use of resources. * Providing excellent care to every patient, every time. Covenant Health's Board of Directors and its administration are challenged by a complex and changing healthcare environment. These challenges require strong collaboration and a common vision among all of Covenant Health's constituents: employees, physicians, board members, patients and the communities served by Covenant Health. Providing quality care and an excellent patient experience remain high priorities for the board, especially in a new era of reimbursement based on outcomes and patient satisfaction. Because of the focused commitment of Covenant's administration and caregivers, the health system performs well in these areas. Covenant Health is committed to maintaining its not-for-profit status while providing needed services to the communities. Despite the increasing shift of responsibilities for charity care to the hospitals, Covenant Health remains strong in delivering care that improves the quality of life at the lowest possible cost. It works closely with physicians to develop strategies for service lines and health system operations and has the financial strength to weather impending storms while investing in new technologies, people, and other opportunities as they arise. In the face of today's challenges, Covenant Health has a firm foundation on which to stand, balancing lessons learned with strengths gained from a disciplined execution of thoughtful strategies. The board has a clear vision of the importance of fulfilling the mission and is prepared to address challenges with determination, commitment, knowledge and community focus. Covenant Health Member Organizations Covenant Health Board members and administrative leaders serve their communities through strategic planning and successful operation of these member organizations: Hospitals and Other Healthcare Providers: Claiborne Medical Center (joined the system April 1, 2014) Cumberland Medical Center (joined the system February 1, 2014) Covenant Homecare and Hospice Fort Loudoun Medical Center (Fort Loudoun) Fort Sanders Perinatal Center (Perinatal Center) Fort Sanders Regional Medical Center (Fort Sanders Regional) LeConte Medical Center (LeConte) Methodist Medical Center (Methodist) Morristown-Hamblen Healthcare System (Morristown-Hamblen) Parkwest Medical Center (Parkwest) Peninsula Hospital, a Division of Parkwest Medical Center (Peninsula) Roane County Medical Center (Roane) Thompson Cancer Survival Center Thompson Oncology Group Knoxville Heart Group Outpatient and Specialty Care Departments and Joint Ventures: Hospital-based Therapy Centers Fort Sanders West Diagnostic Center Fort Sanders West Outpatient Surgery Center Morristown Regional Diagnostic Center Patricia Neal Rehabilitation Center Peninsula Outpatient Centers Thompson Cancer Survival Center hospital-based Infusion Centers Fort Sanders Sevier Nursing Home Foundations: Fort Sanders Foundation Methodist Medical Center Foundation Morristown-Hamblen Hospital Foundation Thompson Cancer Survival Center Foundation Other Programs and Services: Fortress Corporation Covenant Medical Management, Inc. Covenant Health is also a partner in joint ventures with physicians that provide surgical and other services. Recognized Excellence in Caring for Our Communities Covenant Health delivers quality care, with services designed to meet the specific needs of people in the communities it serves. Nine acute care hospitals located in Knoxville and surrounding areas comprise the foundation of the health system. The hospitals offer comprehensive care, including emergency care, specialty services, and a full range of diagnostics and treatment provided by board-certified medical staffs. Three Covenant Health hospitals - Fort Sanders Regional, Methodist, and Parkwest Medical Centers - were named among the top 10 hospitals in Tennessee in 2013 by U.S. News and World Report, recognizing excellence in both overall and specialty care. Covenant Health hospitals also have been recognized for clinical accomplishments by VHA, Inc., a cooperative of non-profit healthcare organizations. Form 990, Part III, Line 1 At the Forefront of Local Behavioral Health Care and Community Collaboration Following the closure of Lakeshore Mental Health Institute in 2012, patient volumes at Peninsula, a division of Parkwest Medical Center ("Peninsula") increased significantly. Efforts are made to keep patients in the community in order to provide a better continuum of care. While mental health resources are available in other Tennessee locations, outside transfers make a seamless transition and follow-up care more difficult. Therefore the staff at Peninsula continue to work on internal process improvements to be able to care for more patients. Outpatient treatment follows a 'best practice' model of care whereby new patients get immediate appointments with a nurse, therapist, physician or nurse practitioner. If a patient misses an appointment, it is rescheduled for the same day or the next. Patients have a better chance for success in treatment when there is no lag time. As a result of this approach, outpatient "no show" rates have decreased and outpatient satisfaction rates are in the 90th percentile. Other best practices include involving families or patient support systems in treatment plans and using a computerized call-back scheduling system so that phone calls are returned promptly. Peninsula staff members take a yearly refresher in Therapeutic Crisis Intervention to help behavioral staff recognize and verbally de-escalate situations that could otherwise turn into a crisis. Peninsula also works with police officers to help them recognize symptoms of mental illness among those they encounter as part of their work. Police officers may encounter someone with mental illness as often as once every shift. Peninsula also collaborates with other area mental health organizations and primary care physicians to enhance care and resources for behavioral health patients. The goal is to help people get the mental health services they need, rather than winding up in the Emergency Department, on the streets or in prison. The state of Tennessee provided funds for medications for indigent patients, transportation assistance and other outpatient programs. United Way provided a grant to assist patients transitioning to independent living. In addition to the 155-bed inpatient psychiatric hospital in Blount County, Peninsula also has outpatient facilities in Knox, Blount, Loudon, and Sevier counties. The provision of care may include hospitalization, therapy sessions, visits with psychiatrists, medication management, intensive outpatient programs and support groups. Covenant Health Hospitals Help Families Welcome New Babies More than 6,500 babies were born in a Covenant Health hospital in 2013. The health system offers a variety of birthing options and hospital amenities to help parents and families welcome their newborns. Families come in all shapes and sizes and so do expectations and beliefs about childbirth. Some mothers prefer minimum intervention. Others are comforted that pain relief is available during labor and delivery. Some mothers decide on an obstetrician before planning for their babies. Others choose the hospital first and then choose a qualified physician who delivers at that hospital. Covenant Health hospitals work to provide excellent care and comfort while accommodating patients' preferences for room-in or nursery care after delivery. Maternity suites at Covenant hospitals are spacious, beautifully decorated and designed to maximize comfort and provide immediate access to technology. Room options include private suites equipped with bassinets for rooming in and sleeper furniture for a family member. Some hospitals also have post-partum rooms available. Depending on the hospital, patients may have access to whirlpool tubs or entertainment units. All maternity units are secured with monitored entries and exits. Additional security devices and procedures are in place to monitor babies' safety. Covenant Hospitals Recognized for Reducing Early Elective Deliveries In addition to overall excellence in maternity and newborn care, five Covenant Health hospitals that offer obstetrics services have been recognized by the Tennessee Hospital Association (THA) for reducing the number of babies born electively between 37 and 39 weeks gestation. Fort Sanders Regional, Parkwest, LeConte, Methodist and Morristown-Hamblen medical centers each received recognition from the THA's Tennessee Center for Patient Safety for reducing elective early deliveries, thereby increasing babies' chances for better lifelong health. All five hospitals met the goal of decreasing early elective deliveries to five percent or less, and maintained the goal level for a minimum of six consecutive months. In 2011, about 12 percent of the hospitals' deliveries that occurred prior to 39 weeks gestation were considered elective. By 2014 the number had dropped to less than one percent. The Covenant hospitals are part of a statewide Healthy Tennessee Babies Are Worth the Wait initiative launched less than two years ago to increase awareness of the benefits of full-term delivery. Among other initiatives such as patient and staff education programs, Covenant Health obstetrics departments adopted a strict policy that prohibits early elective deliveries before 39 weeks unless there is a clear medical risk to the mother or the baby. The two-week wait dramatically increases the chances for good physical and developmental health for babies. Babies born too early are at risk for respiratory distress, jaundice, hypoglycemia and other conditions or complications 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 such as the brain, lungs and liver. Waiting is also better for the health and safety of the mother. Covenant Health is proud to lead this effort to decrease the number of infants delivered electively before 39 weeks. Two additional weeks may not seem like much time, but for an infant, it can mean the difference between complications leading to lifelong health issues and a healthy and robust start. Specialized Services for High-Risk Deliveries Specialized services are available in cases of a high-risk pregnancy. When a risk factor, either with the mother or unborn child, threatens a positive outcome it's important to know resources are available to discuss options and answer questions for concerned parents. Covenant Health hospitals plan and prepare for the unexpected with nurses trained in critical newborn care, access to neonatal intensive care services, and perinatologists at the Perinatal Center. At the Perinatal Center, perinatologists work with women of all reproductive ages and backgrounds to help them deliver a healthy baby - or babies. The referring physician, nurses, ultrasonographers, genetic counselors and support staff work together to help mothers during a difficult time and to deliver a healthy baby. Covenant Health has a comprehensive list of more than 50 physicians credentialed to provide care during pregnancy and while in the hospital. In addition, childbirth education classes are available to help parents prepare for their new arrival. Covenant Health Hospitals are Stroke Ready For a patient having a stroke, the care received immediately after it happens is critical. The hospitals of Covenant Health have been deemed "Stroke Ready" by the Healthcare Facilities Accreditation Program. This means Covenant hospitals are qualified to give patients the best initial care at the onset of a stroke. The hospitals of Covenant Health are working together to provide state-of-the-art emergency treatment and the most advanced stroke care in the region. The risk factors for stroke - high blood pressure, smoking, sedentary lifestyle and a Southern diet of deep-fried food - are high in this region. In 2013, Fort Sanders Regional's Comprehensive Stroke Center treated an average of 35-40 strokes per month. Stroke damage is often permanent and speed is vitally important to improving a patients' success at rehabilitation. A decade ago there were no local physicians that could perform procedures inside the arteries of the brain. Today, patients have access to highly qualified doctors and staff, and faster and more specialized procedures and care that significantly increase their chances of recovery. Recognized by The Joint Commission and the American Heart Association/American Stroke Association for its ability to care for stroke patients, Fort Sanders Regional is a referral center for complex stroke cases. In addition to the comprehensive Stroke Center, for patients recovering from the effects of a stroke, the nationally renowned Patricia Neal Rehabilitation Center offers a full spectrum of rehabilitation services. Form 990, Part III, Line 1 Excellence in Orthopedic Care The hospitals of Covenant Health offer comprehensive orthopedic care, including joint replacement surgery and follow-up rehabilitation services. Specialized Joint Replacement Centers are located at Parkwest, Methodist, Fort Sanders Regional and Morristown-Hamblen medical centers. The Joint Centers have teams of experienced orthopedic surgeons, nurses, clinicians and therapists who work together to provide care for hip or knee replacement patients. When patients schedule joint replacement surgery they receive personalized care and a team approach that focuses on creating positive outcomes from the surgery. Covenant Joint Center patients are prepared beforehand, guided through the process step by step, and given extraordinary care afterwards. The first step is an educational program, with an optional tour. Therapy following the surgery helps patients concentrate on developing strength in their new joints and regaining mobility. The Covenant Joint Centers' unique approach emphasizes patient education, family involvement and group support during rehabilitation. The expert team approach combined with a unique healing environment puts patients on the road to recovery faster and with fewer complications. Performing as Promised in Local Communities As a not-for-profit organization governed by a voluntary Board of Directors, Covenant Health reinvests excess revenues after expenses in improving patient care. Since 2000 Covenant Health has invested over $1 billion in facilities, technologies, programs and services. No other health system in East Tennessee in this decade has approached Covenant Health's investment in clinical and medical information technology, and new, renovated and expanded hospitals and services. Despite a challenging economic environment, Covenant Health's financial strength allows it to continue pursuing a strategy of excellence and a commitment to state-of-the-art facilities, medical technology and medical information systems. Achieving Quality Partnerships with Physicians Covenant Health collaborates with physicians to accomplish its mission of improving the quality of life through better health. Physicians partner with the health system in many ways including employment, as members of hospital medical staffs and Covenant's board of directors, in committee leadership roles, through joint ventures and in the development of service line strategies. Covenant Medical Group, Inc. (CMG) is the new name for the health system's employed physician practices. Formerly Covenant Medical Management, CMG has grown substantially over the past several years and has more than 140 physicians in more than 70 practice locations. CMG includes both primary care and specialty physicians, with significant growth among specialty physicians. Physicians often struggle with the complexity of running a medical practice in the current healthcare environment. A physician with a solo practice may struggle economically to make that practice work. Many physicians consider employment by hospitals and health systems as an effective way to continue providing medical care in their communities. Physicians who become part of CMG do so for more than just the economic aspect of practicing medicine, and often seek employment of Covenant Health for broader reasons. Physicians who become employed by Covenant Health often decide to do so based on confidence in the health system's leadership team, because of Covenant's strategic direction and performance, and because of the quality of care delivered. Other attributes that influence the decision include the health system's local governance and strong market position and relationships. Covenant Health builds and maintains partnerships with physicians through joint ventures such as surgery centers and the development of service line strategies that focus on improving quality and cost of patient care. Nearly 1500 physicians are affiliated with Covenant Health hospitals and member organizations as active or consulting members of the health system's medical staffs. Overall, Covenant Health's desire for alignment with both employed and non-employed physicians is driven by the need to fully evolve as a healthcare system in today's environment. The health system's goal is to work side by side with physicians to provide a seamless continuum of care and excellent outcomes for patients. Connecting to Meet the Need through Philanthropy Covenant Health's Office of Philanthropy coordinates the philanthropic contributions of individuals and businesses throughout East Tennessee and beyond in support of health care in our region. Fund raising efforts are led by volunteer boards and staff at four foundations: Fort Sanders Foundation (serving the needs of Fort Sanders Regional, Fort Loudoun, Parkwest, Roane, Peninsula, and the Patricia Neal Rehabilitation Center), Methodist Medical Center Foundation, Morristown- Hamblen Hospital Foundation, and Thompson Cancer Survival Center Foundation. The Dr. Robert F. Thomas Foundation is independent from Covenant Health but partners with LeConte to serve the needs of that hospital. During the past year the foundations of Covenant Health received contributions of approximately $3 million from generous individuals and businesses. These donors are partnering with Covenant Health to meet the challenges of providing the best health care possible for the communities served. Funds are used to provide new equipment and facilities at the hospitals, as well as for staff training, pastoral care and patient care programs. Covenant Health strives to go beyond excellent care and to find ways of improving health on all levels - physical, mental and spiritual. Pastoral care is a critical part of healing body, mind and spirit for many of the patients and their families. No patient is ever billed for the support and counseling offered by the hospital chaplains. In the health care environment, chaplains and volunteer spiritual counselors are seen as partners in the healing process, and their services are underwritten by many generous donors. Each year, the Fort Sanders Regional and Parkwest pastoral care departments host the Gammon-Heatherly Lecture Series which provides continuing education to area ministers and other caregivers. The annual event is provided through charitable gifts. The series aims to be thought-provoking and insightful and provides a good networking opportunity with clergy and laypersons from the community. In May 2013 a new Serenity Garden was dedicated at Roane County Medical Center. The garden offers a quiet spot for reflection and respite just outside the hospital's front entrance. It features specially engraved stone pavers recognizing generous community organizations, churches and individuals who supported the campaign for the new hospital and pastoral care services for patients and families. Together with many generous members of our community, the Foundations of Covenant Health are meeting important physical and spiritual needs on the path to improved health for all. Leadership Academy Welcomes Second Group of Participants for "Up Close" Healthcare Experience While the Office of Philanthropy staff coordinates community events and fund raisers, local community leadership and involvement is critical to fund raising success. To expand the number of informed volunteer leaders in the community, the Office of Philanthropy launched a new program, Covenant Answers: A Healthcare Leadership Academy. Inaugural Academy participants included representatives from the boards of Covenant Health, and Fort Sanders and Thompson Cancer Survival Center Foundations. Future Leadership Academy classes will include business and community representatives from throughout Covenant's service area. During a five-month period class members attend half-day sessions at five different Covenant hospitals. Classes include behind-the-scenes tours and hands-on access to the latest technologies and treatments. Participants have opportunities to discuss the challenges of the current healthcare environment with leading Covenant physicians and clinicians, and speak firsthand with patients whose recovery hinges on the excellent care provided at one of the Covenant hospitals. The first group of participants were given the chance to try their hands at using adaptive rehab equipment and maneuvering a surgical robot. Form 990, Part III, Line 1 Reaching Beyond Hospital Walls In addition to taking care of the 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 2013 approximately 7,000 people participated in the 9th anniversary of the Covenant Health Knoxville Marathon, which attracted local runners and hand cyclists, as well as competitors from throughout the U.S. and other countries. * The Covenant Health Biggest Winner Weight Loss Challenge continued as a friendly competition that encourages East Tennesseans to get off the couch and 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. Participants 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 The Patricia Neal Rehabilitation Center's Innovative Recreation 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 over 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, offered with the support of Variety-The Children's Charity. The camp is staffed by health system volunteers and helps children in grades 1-12 express their feelings in a supportive environment. Each year participating children make quilt squares, which are later used to create quilts representing each camp session. In 2013, several quilts were selected for display at the Oak Ridge Children's Museum. * Covenant Health hospitals are partnering with local organizations to perform assessments of health status and to identify the primary health issues affecting our region. Once assessments are complete, the hospitals will be developing local programs and communicating availability of existing services to help address some of these health issues. Community Benefit Report One of the most tangible expressions of the charitable purpose of Covenant Health is providing care to people in need. As a not-for-profit system, Covenant Health provides medically necessary services to people with limited resources. Covenant Health actively participates in the state's TennCare program, and collaborates with other area providers to identify and support efforts to make community healthcare resources available for those in need. Summary of System Community Benefit Totals for Uncompensated Care 2013 Charity Care . . . . . . . . . . . . . . . . . . $48.5 million TennCare* . . . . . . . . . . . . . . . . . . . $40.5 million Medicare* . . . . . . . . . . . . . . . . . . . . $71.1 million Total Uncompensated Care . . . . . . . . . . . $160.1 million Each hospital in the Covenant Health system reports its specific Uncompensated Care on its Form 990. *Care which costs more to provide than reimbursements from state and national programs cover. Covenant Health provides community benefit that far exceeds the value of its tax-exempt status. 2013 Summary of Additional Community Benefit Health Professions Education Continuing education; preparation of future healthcare professionals . $1,558,904 Subsidized Health Services Clinical services provided to meet community needs despite financial loss . . . . . . . . . . . . . . . $18,815,965 Donations, Medical Missions and Community Building Funds and in-kind services donated to the community, including funds to support charitable endeavors and address challenges such as poverty and homelessness, as well as mission trips to areas outside the U.S . $3,438,855 Total Contributions . . . . . . . . . $183,913,724 Form 990, Part VI, Section B, line 11 Covenant Health is a large integrated health system which files twelve Forms 990. Parkwest Medical Center is one of these twelve entities. Annually, at the September Finance Committee meeting, one of the twelve 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 eleven 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 twelve 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 Form 990, Part VI, Section B, Line 15a: Overall compensation policies for Parkwest Medical Center, Covenant Health (Parent Company), and affiliates are set by the Compensation Committee of the Board of Directors ("the Committee"), which is comprised of independent members of the Board. The Committee is guided in its decision-making process by an independent, nationally-recognized executive compensation consultant experienced in advising nonprofit hospital boards. Compensation policies for Anthony Spezia and John Geppi are reported on the 2013 Form 990 of Covenant Health, EIN 62-1646734. Form 990, Part VI, Section B, Line 15b: Base salary and annual bonus opportunities for Larry R. Lassiter, President and Chief Administrative Officer, are 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 for each executive is reasonable and within a fair market value range. Salary ranges are based upon the recommendations of the Consultant made after comparison with similar jobs in similar size health systems across the nation. Bonuses are recommended by the CEO and approved by the Committee conditioned upon receipt of a written opinion from the Consultant that total compensation for the executive is reasonable and consistent with fair market value. Base salaries are initially targeted at midpoint and vary according to the individual's experience, market conditions and competition. 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 S. Hamilton, Vice President of Financial Services, and Emlyn Cobble, Vice President and Chief Nursing officer, are based on established targets to ensure that total compensation is reasonable and within a fair market value range. Salary ranges are based upon comparison with similar jobs in similar size health systems across the nation. Base salaries and bonuses are approved by Executive Leadership predicated upon performance, and are reasonable and consistent with fair market value. Base salaries are initially targeted at midpoint and vary according to the individual's experience, market conditions and competition. Annual bonuses are designed to award 0-20% of base salary based upon system performance and accomplishment of certain targets established by Executive Leadership. Form 990, Part VI, Section C, line 19 Parkwest Medical Center files a Joint Annual Report containing financial information with the Tennessee Department of Health. Per its tax exempt bond provisions, Covenant Health, the parent company of the organization, is required to file quarterly and annual consolidated and obligated group financial statements and other documentation with various bond insurers and other agencies, including the Electronic Municipal Market Access (EMMA) service of the Municipal Securities Rulemaking Board (MSRB). Any member of such a repository has access to these financial statements. Form 990, Part VI, Section A, Line 9: Contact Addresses for Officers and Directors: Anthony L. Spezia Covenant Health 100 Ft Sanders West Blvd. Knoxville, TN 37922 John T. Geppi, Larry Mauldin, Janice McKinley and all Directors Covenant Health 1420 Centerpoint Blvd., Bldg. C Knoxville, TN 37932 Jeffrey N. Dice 140 Whispering Lake Drive Jonesborough, TN 37659 All other persons listed in Part VII, Section A may be contacted at the organization's address, which is: Parkwest Medical Center 9352 Parkwest Blvd. Knoxville, TN 37923 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. Covenant Health 1420 Centerpoint Blvd Bldg C Knoxville TN 37932 621646734 Supporting organization TN 501(c)(3) Line 11b, II N/A 0 LeConte Medical Center 742 Middle Creek Road Sevierville TN 37862 621114867 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Sanders Regional Medical Center 1901 W Clinch Avenue Knoxville TN 37916 620528340 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Methodist Medical Center 990 Oak Ridge Turnpike Oak Ridge TN 37830 620636239 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Roane County Medical Center dba Roane Medical Center 8045 Roane Medical Center Drive Harriman TN 37748 680673354 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Loudoun Medical Center 550 Fort Loudoun Medical Center Dr Lenoir City TN 37772 621373691 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Thompson Cancer Survival Center 1915 White Avenue Knoxville TN 37916 621250943 Cancer treatment facility TN 501(c)(3) Line 3 Covenant Health 0 Thompson Oncology Group 1915 White Avenue Knoxville TN 37916 621619239 Oncology services TN 501(c)(3) Line 3 Thompson Cancer Survival Center 0 Covenant Homecare 3001 Lake Brook Blvd Ste 101 Knoxville TN 37909 621623114 Home Health Services TN 501(c)(3) Line 9 Covenant Health 0 Fort Sanders Perinatal Center 501 19th St Trustees Tower Ste 304 Knoxville TN 37916 043760551 High risk obstetrical services TN 501(c)(3) Line 3 Fort Sanders Regional Medical Center 0 Fort Sanders Foundation 280 Fort Sanders West Blvd Ste 202 Knoxville TN 37922 621748601 Fundraising and Patient Outreach TN 501(c)(3) Line 11b, II Covenant Health 0 Morristown-Hamblen Hospital Assoc dba M-H Healthcare System 908 W 4th North St Morristown TN 37814 620545814 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Thompson Cancer Survival Center Foundation 1915 White Avenue Knoxville TN 37916 582130450 Fundraising and Patient Outreach TN 501(c)(3) Line 11b, II Covenant Health 0 501(c)(3) 0 KOSC Properties LLC 256 Fort Sanders West Blvd Ste 200 Knoxville TN 37922 262444076 Building ownership TN N/A Knoxville Orthopaedic Surgery Center LLC 256 Fort Sanders West Blvd Ste 200 Knoxville TN 37922 262437385 Orthopaedic surgery TN N/A 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 Ctr 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 Assoc of the Meridian Health OP Surgery Ctr LLC 908 W 4th North St Morristown TN 37814 861167487 Outpatient surgery center TN N/A Fortress Corporation 280 Fort Sanders West Blvd Suite 21 Knoxville TN 37922 621308885 Management company TN N/A C 0 Covenant Medical Group Inc 1400 Centerpoint Blvd Suite 100 Bld Knoxville TN 37932 621282917 Physician practice management TN N/A C 0 Knoxville Heart Group 1819 Clinch Avenue Suite 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 0 0 1 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1