2014-11-11T13:36:34-06:00 2013-12-31 990 2013-01-01 621250943 Thompson Cancer Survival Center THOM 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 19664233 0 X www.thompsoncancer.com X 1985 TN Thompson Cancer Survival Center is an outpatient treatment center for cancer patients, with facilities located in Knoxville, Tennessee, and surrounding counties. It is a member of the Covenant Health system. 21 17 118 29 217786 98634 1598679 1535473 20635586 18088539 5533 2427 17443 33517 22257241 19659956 77000 88976 0 0 6578716 6006582 0 0 0 10877481 9782884 17533197 15878442 4724044 3781514 42529088 46006146 1817101 1512645 40711987 44493501 X Thompson Cancer Survival Center provides quality healthcare, in alignment with Covenant Health's mission to serve the community by improving the quality of life through better health, regardless of a patient's ability to pay. 0 0 5272006 11515687 Radiation Oncology: The Radiation Oncology Department is dedicated to keeping up with the latest technology in order to give patients the best treatment available. Radiation services include TomoTherapy, High-dose Radiation, and Intense Modulated Radiation Therapy. Thompson's radiation services are provided in Downtown Knoxville, West Knoxville, and in Sevierville, TN. The Radiation Oncology locations combined served 2,046 patients in 2013, performing 21,822 treatments. 1733133 3398278 Positron Emission Tomography (PET): In 2013, Thompson served 921 patients at the PET West Knoxville location and 1077 patients at the PET Downtown Knoxville location. The Downtown location offers the latest in leading-edge PET technology: the Biograph 40 Truepoint PET/CT scanner. This technology combines the accuracy of the TruePoint system with a 40-slice CT scanner. Thompson's PET Imaging Centers at West and Downtown are both accredited in positron emission tomography by the American College of Radiology (ACR). This accreditation assures patients that their treatment meets the most rigid standards of excellence mandated by the ACR. PET mobile services in Sevierville, TN served 35 patients in 2013. The PET departments maintained a 90% or better customer service satisfaction rate among patients. 739840 534833 Breast Center: See Schedule OBreast Center Cancer Outreach: Expenses - $739,840; Revenue - $534,833Thompson Cancer Survival Center's Breast Center is one of a few select breast centers in Tennessee awarded a Breast Imaging Center of Excellence award by the American College of Radiology (ACR). Certified technologists performed approximately 8086 mammograms in 2013 using the latest in digital technology. The Outreach Program provided 371 mobile mammograms in the 18-county service area, with 193 of those at no charge to the medically needy or underserved. In 2013 the Outreach Program launched the Thompson Cares for Breast Health (TCBH) screening voucher program, replacing mobile mammography with the latest digital technology at eight Covenant Health Comprehensive Breast Centers serving the East Tennessee region. The program partnered with local non-profit agencies and clinics to offer accessible and affordable mammograms and breast cancer education to women most at risk for not getting screening mammograms. TCBH provided 518 screening mammograms, and of those, 59 individuals were called back for additional imaging due to detection of one cancer. The program continues to provide cancer screenings and education about early detection and prevention in the community. 6663856 88976 2435723 Other patient services provided by Thompson Cancer Survival Center are: a multi-disciplinary breast clinic, clinical trials, social services, genetic counseling, and a cancer registry; and a Fellowship Center, which provides lodging assistance and meals for out-of-town patients and their families during treatment at TCSC. 6663856 88976 2435723 14408835 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 53 0 1 118 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 & CEO 0.00 50.00 X X 0 1543512 228486 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 Gerald Boyd Director 0.00 1.00 X 0 1445 0 John T Geppi EVP/CFO 0.00 50.00 X 0 710276 25177 Mitzi Anderson VP Financial Services 25.00 25.00 X 102168 0 24529 Jeremy Biggs Interim CAO 25.00 25.00 X 0 210492 25566 Chester Ramsey Senior Medical Physicist 45.00 0.00 X 186675 0 31790 Joseph Bowling Medical Physicist 25.00 20.00 X 177109 0 22258 Daniel Chase Medical Physicist 45.00 0.00 X 171544 0 31362 Alexander Usynin Medical Physicist 45.00 0.00 X 125231 0 20881 Beverly A Henderlight VP - Chief Nursing Officer 25.00 20.00 X 110014 0 17544 Gordon Lintz Former President & CAO 0.00 50.00 X 0 308176 17692 872741 2820541 445285 7 1 1 0 Linde Healthcare Staffing Inc PO Box 915241 Dallas TX 75391 Physician Services 328155 TomoTherapy Incorporated 1240 Deming Way Madison WI 537171954 Service Contract 275000 GE Healthcare PO Box 96483 Chicago IL 60693 Equipment Maintenance/Service 162841 Staffing Solutions Inc PO Box 102332 Atlanta GA 303682332 Staffing Services 160971 Media Directions Advertising Inc 9724 Kingston Pike Ste 301 Knoxville TN 37922 Marketing Services 156713 6 1535473 5543 1535473 Medical Services 622110 16148591 16148591 Management Fees 900099 1010996 793210 217786 Rental Inc - Exempt Affiliate 531120 505051 505051 East TN Cancer Registry 900099 297715 297715 Clinical Trials 900099 126186 126186 18088539 2427 2427 6000 4277 1723 1723 1723 Property Insurance Claims 900099 18026 18026 Medical Records 900099 13441 13441 Meaningful Use 900099 327 327 31794 19659956 17884521 217786 22176 25405 25405 63571 63571 126697 126697 4721368 4280581 440787 209507 202579 6928 584071 561701 22370 364939 346902 18037 1827748 1670840 156908 24421 24421 1174999 1058111 116888 229672 26633 203039 1836136 1806733 29403 942415 896075 46340 17502 13154 4348 39381 30299 9082 2533402 2400411 132991 11743 11743 UBI Tax 42404 42404 Medical Supplies & Equi 430223 430223 Charity Care 317153 317153 Bad Debts 165977 165977 189708 100744 88964 15878442 14408835 1469607 0 675 675 -219625 -293308 1865312 1164908 735309 558917 46498229 38452560 10430611 8045669 29716806 36529285 42529088 46006146 1734154 1387198 82947 125447 1817101 1512645 X 40711987 44493501 40711987 44493501 42529088 46006146 3781514 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 19536231 14906622 4629609 26945419 23545938 3399481 16579 16579 8045669 Deferred Compensation 125447 Due from Affiliates, Net 36337810 Other Receivables 66028 36529285 Long-term Deferred Compensation 125447 125447 X Part X, Line 2: Note B to the consolidated audited financial statements of Covenant Health, parent company to Thompson Cancer Survival 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 The American Cancer Society 871 Weisgarber Rd Knoxville TN 37909 640329009 501(c)(3) 13250 Support services to cancer patients & families 1 0 Post hospital care assistance 668 63571 Cost Pharmaceuticals, utilities, transportation or miscellaneous need to facilitate patient recovery. Part I, Line 2: Funds to organizations are reviewed for how they support the Thompson Cancer Survival Center's objective of serving cancer patients. Individuals that need assistance submit a request for assistance. If the patient meets the criteria, payment is made on behalf of the patient for payment of pharmaceuticals, utilities, transportation, or a need that should be met to assist in the patient's healing or comfort. 0 1 0 0 0 0 0 0 0 Anthony L Spezia President & 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 Jeremy Biggs Interim CAO 0 164170 0 27000 0 19322 0 6783 0 18783 0 236058 0 0 Chester Ramsey Senior Medical Physicist 186311 0 0 0 364 0 11407 0 20383 0 218465 0 0 0 Joseph Bowling Medical Physicist 176983 0 0 0 126 0 10711 0 11547 0 199367 0 0 0 Daniel Chase Medical Physicist 164770 0 0 0 6774 0 10666 0 20696 0 202906 0 0 0 Gordon Lintz Former President & CAO 0 207264 0 55999 0 44913 0 10000 0 7692 0 325868 0 0 Part I, Line 3 Covenant Health, the parent company of Thompson Cancer Survival 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 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 $77,452 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 totaled $204,000, which is reported in Column 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 Form 990, Part VI, Section B, Line 11: Covenant Health is a large integrated health system which files twelve Forms 990. Thompson Cancer Survival 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 Thompson Cancer Survival 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, parent company of Thompson Cancer Survival Center. Form 990, Part VI, Section B, Line 15b: Base salary and annual bonus opportunities for Jeremy Biggs, Interim Chief Admininistrative 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 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 is reasonable and consistent with fair market value. Base salary is initially targeted at midpoint and varies 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 bonus opportunities for Mitzi Anderson, VP-Financial Services, 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 salary and bonuses are approved by Executive Leadership predicated upon performance and are reasonable and consistent with fair market value. Base salary is initially targeted at midpoint and varies 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 Thompson Cancer Survival 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 in addition to 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, 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 Jeremy Biggs Cumberland Medical Center P.O.Box 667 811 South Main Street Crossville, TN 38555 All other persons listed in Part VII, Section A may be contacted at the organization's address, which is: Thompson Cancer Survival Center 1915 White Ave Knoxville, TN 37916 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 379321960 621646734 Supporting organization TN 501(c)(3) Line 11b, II N/A 0 Covenant Homecare 3001 Lake Brook Blvd Suite 101 Knoxville TN 37909 621623114 Home health services TN 501(c)(3) Line 9 Covenant Health 0 Fort Loudoun Medical Center 550 Fort Loudoun Medical Center Dr Lenoir City TN 37772 621373691 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Sanders Regional Medical Center 1901 W Clinch Ave Knoxville TN 37916 620528340 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Sanders Foundation 280 Ft Sanders West Blvd Ste 202 Knoxville TN 37922 621748601 Fundraising & patient outreach TN 501(c)(3) Line 11b, II Covenant Health 0 Fort Sanders Perinatal Center 501 19th St Ste 304 Knoxville TN 37916 043760551 High risk obstetrical services TN 501(c)(3) Line 3 Fort Sanders Regional Medical Center 0 LeConte Medical Center 742 Middle Creek Road Sevierville TN 37862 621114867 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Methodist Medical Center 990 Oak Ridge Turnpike Oak Ridge TN 37830 620636239 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Morristown-Hamblen Hospital Assc 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 Parkwest Medical Center 9352 Park West Blvd Knoxville TN 37923 581897274 Acute care hospital & behavioral health services TN 501(c)(3) Line 3 Covenant Health 0 Roane County Medical Center dba Roane Medical Center 8045 Roane Medical Center Dr Harriman TN 37748 680673354 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Thompson Oncology Group 1915 White Ave Knoxville TN 37916 621619239 Oncology services TN 501(c)(3) Line 3 Thompson Cancer Survival Center 1 Thompson Cancer Survival Center Foundation 1915 White Ave Knoxville TN 37916 582130450 Fundraising & patient outreach TN 501(c)(3) Line 11b, II Covenant Health 0 Endoscopy Center of Oak Ridge LLC 988 Oak Ridge Turnpike Ste 200 Oak Ridge TN 378306919 621667358 Outpatient medical facility TN N/A Fort Sanders West Associates 280 Ft Sanders West Blvd Ste 214 Knoxville TN 37922 621384171 Building ownership 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 Associates of the Meridian Health OP Surgery Ctr LLC 908 W 4th North St Morristown TN 37814 861167487 Outpatient surgery center 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 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 BlvdBldg A Ste 100 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 Drive Ste 200 Knoxville TN 37923 621018541 Cardiovascular surgical practice TN N/A C 0 1 0 1 0 0 0 0 0 0 1 0 1 1 0 1 1 1 1 0 Thompson Oncology Group A 420476 cost Thompson Oncology Group Q 200764 cost Thompson Oncology Group R 100928 cost