2011-11-11T09:02:24-06:00 2010-12-31 990 2010-01-01 680673354 Roane County Medical Center ROAN 8653746864 1410 Centerpoint Blvd No 401 Knoxville TN 379321985 JOHN T GEPPI 8653746872 2011-11-09 Self Prepared 2010 2016-02-24 21:20:13Z Roane Medical Center Anthony L Spezia 100 Ft Sanders W Blvd Knoxville TN 37922 33849869 0 X www.roanemedical.com X 2008 TN Roane Medical Center is a 105-bed full service, acute care hospital located in Harriman, Tennessee. It is a member of the Covenant Health System. 21 16 426 90 17955 16955 80968 37318 33528836 32922600 1655 1277 395843 449960 34007302 33411155 0 0 0 0 15908269 15224649 0 0 0 21133280 24563238 37041549 39787887 -3034247 -6376732 11582960 6339310 16377487 8327480 -4794527 -1988170 X See Schedule O.Roane Medical Center provides quality healthcare, in alignment with Covenant Health's mission to serve the community by improving the quality of life through better health, regardless of a patient's ability to pay. The Covenant Health System Report to the Community can be found at the conclusion of Schedule O. 0 0 13073633 15593454 Inpatient service is the largest program service at Roane Medical Center. There were 2,337 admissions in 2010, accounting for 8,312 patient days. The majority of admissions are for Respiratory and Circulatory diagnoses and are treated in either Intensive Care or Medical Surgical units. The goal is to provide the highest quality diagnostic and treatment services to the patients served. Patients admitted to Roane Medical Center live in Roane and surrounding counties. 13702690 11227258 Outpatient service is the second of the three largest programs with 28,625 visits in 2010. Outpatient services provided are Diagnostic X-ray, Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Nuclear Medicine, Ultrasound/ Vascular Procedures, Mammography, Bone Densitometry, Sleep Studies, Laboratory and Stress Tests. Other outpatient services provided are Cardiac Rehab; Physical, Occupational and Speech Therapies; and Dietary Consultation. Roane County Medical Center offers support to many community education efforts such as smoking cessation. The goal for outpatient services is to provide quality diagnostics and treatment to patients according to the physicians' orders. 8830086 5746607 Emergency diagnosis and treatment is the third program service provided to all patients without consideration of their ability to pay. Ten percent of the patients seen in the Emergency department are admitted for further observation or treatment at Roane Medical Center. The Emergency department treated 23,908 patients during 2010. The goal for outpatient service is to diagnose, treat or refer patients to the appropriate facility for care efficiently and in a timely manner. 2311687 422952 Additional services provided at Roane County Medical Center include geriatric psychiatric in-patient and out-patient services, occupational health and cardiac rehabilitation. 2311687 422952 37918096 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 36 0 1 426 1 1 1 0 0 0 0 0 0 0 0 0 X 21 16 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 1 0 X X Janice Bardill 8658824377 412 Devonia Street Harriman TN 37748 X Anthony L Spezia 0.00 X X 0 1406336 246381 Dr Richard Brinner 0.00 X 0 922 0 Harry M Call 0.00 X 0 1532 0 Dr Mitchell Dickson 0.00 X 0 1771 0 Pamela P Fansler 0.00 X 0 767 0 Homer Fisher 0.00 X 0 436 0 Dr William Hall 0.00 X 0 1274 0 Wayne Heatherly 0.00 X 0 1697 0 Jim Johnson Jr 0.00 X 0 1114 0 Karla Lane 0.00 X 0 950 0 Dr Randolph Lowry 0.00 X 0 1665 0 Larry Mauldin 0.00 X 0 1226 0 James Fitzsimmons 0.00 X 0 1876 0 George Miller 0.00 X 0 647 0 Alvin Nance 0.00 X 0 673 0 Linda N Ogle 0.00 X 0 0 0 Francis Olmstead Jr 0.00 X 0 2212 0 Mitchell Steenrod 0.00 X 0 1081 0 David C Verble 0.00 X 0 1434 0 Joseph E Sutter 0.00 X 0 1829 0 Joe Ben Turner 0.00 X 0 819 0 John T Geppi 0.00 X 0 675119 41480 James Gann 50.00 X 0 161645 19699 Janice Bardill 55.00 X 84606 0 16060 Dr Jules Mugemuzi 40.00 X 219177 0 1285 Dr Irina Schiopescu 40.00 X 179529 0 17191 Dr Suresh Nekuri 40.00 X 207539 0 32934 Dr Brian Hofung 40.00 X 187831 0 5934 878682 2267025 380964 4 0 1 0 Complete Rx 3100 South Gessner Ste 640 Houston TX 77063 Pharmacy Management 2124076 Staffing Solutions PO Box 934367 Atlanta GA 31193 Clerical Contract Labor 150365 Quest Diagnostics 12436 Collections Ctr Dr Chicago IL 60693 Reference Lab 141960 Vijay Jethandani 206 Rothesay Lane Knoxville TN 37909 Medical Director/ Contract Physician 140370 Airtech 7140 Small Creek Way Powell TN 37849 HVAC Service/Maintenance 139121 5 26240 11078 37318 Medical Services 622110 32922600 32922600 32922600 1277 1277 113688 140848 -27160 -27160 -27160 519240 297866 221374 17955 203419 Cafeteria 722212 181884 181884 Cardiac Rehab Fitness 622110 36735 36735 Physician Billing 541200 17272 17272 19855 13664 6191 255746 33411155 32990271 17955 365611 100665 100665 12445123 11817378 627745 363865 349093 14772 1336426 1274006 62420 978570 925339 53231 2591720 2291720 300000 10285 10285 4992 4992 3216656 2960936 255720 38037 3237 34800 1493119 1229861 263258 740310 717878 22432 2528 2175 353 17864 15066 2798 117636 117636 1005833 1003796 2037 74160 74160 UBI Tax 3727 3727 Bad Debts 4432994 4432994 Hospital Supplies 3295352 3292110 3242 Change in Accounting Pr 3088508 3088508 Charity Care Expense 2125054 2125054 2304463 2197149 107314 39787887 37918096 1869791 0 1486 1485 543617 679872 1637477 1622007 271617 309153 118982 120569 27642875 24052353 3794482 3590522 4088508 1126791 15702 11582960 6339310 5368206 5762482 365000 1879698 30854 10644281 654446 16377487 8327480 X -4794527 -1988170 -4794527 -1988170 11582960 6339310 X -6376732 9183089 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 255246 255246 2344575 1464031 880544 339547 78242 261305 24703507 22510080 2193427 3590522 Due to Third Party Payors 553765 Due to Affiliates, Net 65239 Current Portion of Long Term Debt 35442 654446 1 1 1 X 1 X 1 1 1 0 1 1 830016 341156 488860 0.01380 4963818 2916004 2047814 0.05790 5793834 3257160 2536674 0.07170 2337 2337 0.00010 629847 5618 624229 0.01770 9094 9094 0.00030 641278 5618 635660 0.01810 6435112 3262778 3172334 0.08980 380 380 0.00000 1450 1450 0.00000 1592 1592 0.00000 15 15 0.00000 75 75 0.00000 477 477 0.00000 3989 3989 0 1692074 470291 10195623 10057589 138034 X 1 1 1 None 1 1 Roane Medical Center

412 Devonia Street Harriman TN 37748

X X X Not Required 1 8 RMC Patricia Neal Outpatient Center

2497 S Roane Street Suite 100 Harriman TN 37748

Rehabilitation Therapy Center RMC Equipment and Supply

314 Devonia Street Harriman TN 37748

Durable Medical Equipment Store RMC Patricia Neal Outpatient Center

900 Waterford Street Suite 102 Kingston TN 37763

Rehabilitation Therapy Center RMC Sleep Lab

307 Devonia Street Harriman TN 37748

Sleep Diagnostic Center RMC Women's Center

307 Devonia Street Harriman TN 37748

Women's Imaging & Diagnostic Services RMC Industrial Medicine

814 North Kentucky Street Kingston TN 37763

Industrial Medicine/ Occupational Therapy Emory River Senior Behavioral Health

319 Devonia Street Harriman TN 37748

Outpatient Gero-psych. RMC Cardiopulmonary Rehab

415 Devonia Street Harriman TN 37748

Cardiopulmonary Rehab. Center Part I, Line 6a: Covenant Health, the parent company of Roane 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: Community benefit expense amounts on Lines 7a-7b were determined using Worksheets 1 and 3 contained in the IRS instructions to Schedule H. Other community benefit expenses are at cost from the general ledger. Part I, Line 7g: The organization has included $612,545 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 $ 4432994. Part II: Roane Medical Center supports the community building activities of its parent company, Covenant Health. 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.Community Building activities included cash and in-kind donations for the development of community health programs and partnerships. These activities include physical improvements and housing, economic development and support system enhancements like disaster readiness, mentoring programs, and youth asset development initiatives. Such programs address the root causes of health problems, such as poverty and homelessness due to lack of education and jobs.In 2010 the System provided Community Building support to many organizations, the most significant of which included: Catholic Charities of East Tennessee East TN Economic Development Agency Emerald Youth Foundation Great Schools Partnership Charitable Trust (for Knox Co. schools) Innovation Valley Technology Council Second Harvest Food Bank of East TN Variety Children's Charity of East TN Part III, Line 4: Note B to the 2010 Audited Consolidated Financial Statements of the Covenant Health system, of which Roane Medical Center is a member, reads: "Patient accounts receivable are reported net of both an estimated allowance for uncollectible accounts and an estimated allowance for contractual adjustments. The contractual adjustment represents the difference between established billing rates and estimated reimbursement from Medicare, TennCare and other third-party payment programs. Current operations for 2010 and 2009 include an estimated provision for bad debts, included in Supplies and Other in the Consolidated Statements of Operations and Changes in Net Assets. 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."To calculate bad debt expense on Part III, Line 2 at cost, bad debt expense per the general ledger was multiplied by the cost to charge ratio developed in Schedule H Instructions, Worksheet 2. This cost to charge ratio closely approximates the Medicare cost report cost to charge ratio.On Part III, line 3 the percentage of persons in Roane County living below the poverty level has been applied to bad debt expense to estimate the amount attributable to persons eligible for financial assistance but for whom a determination could not be made. Part III, Line 8: Costing Methodology: Roane Medical Center used a combination of sources in calculating Medicare allowable costs on Part III, Line 6 including its cost accounting system, general ledger accounting system, and facility-specific analyses and calculations. Part III, Line 9b: Self-pay patients automatically receive a minimum 30% discount on charges. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment assistance may qualify for charity care. A sliding scale is used for extending charity care utilizing the income levels reported under the federal poverty guidelines. Patients/guarantors with income that falls below 200% of the federal poverty guidelines receive 100% charity care. Patients/guarantors with income of 201-300% of the federal poverty guidelines, receive 70% charity care. For catastrophic illness, exceptions to income and asset limitations may be made on a case-by-case basis. The amount considered for charity will be based upon the evaluation of the patient's/guarantor's ability to pay. Part VI, Line 2: The hospital actively addresses a variety of identified needs in the community through its relationships with community based groups including the local health council, public health department, school systems, health coalitions, inter-agency council, and health-related not-for-profit organizations. Additionally, the East Tennessee 2-1-1 Information and Referral system is able to provide a profile of the health and social services most requested by the citizens of each county. This information serves as an ongoing assessment of basic health and human service needs and of what resources are lacking in each community. Part VI, Line 3: Roane Medical Center posts a sign that states: Financial Assistance: is Roane 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 through our Patient Accounts office. To apply for financial aid, please ask our registration staff or contact the Counselor's office at 882-4376. Patient Account Representatives are available Monday - Friday, 8 a.m. to 4:30 p.m.Roane Medical Center employs full time financial counselors in the Patient Accounts Department who meet with uninsured patients. In addition, Roane Medical Center's registration staff and social worker assist patients with TennCare enrollment.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 Patient Accounts Representatives 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: Roane County is the primary market area for Roane Medical Center, a nonprofit hospital which is affiliated with Covenant Health. It is the only hospital in the county, which is in close proximity to the metropolitan Knoxville area. According to internal hospital data for 2010, slightly more than 79% of the inpatient discharges were Roane County residents.The following statistics are taken from 2008 data of the U.S. Census Bureau. The 54,000 person population of Roane County is predominantly female (52%) and Caucasian (94%). The median age and income are 40 years old and $41,000 per household, respectively. The percentage of county residents over the age of 65 is 12%, and roughly 25% of the population is under the age of 18. The largest population segment is the 25-34 year age group, which makes up 30% of the county population. Nearly 16% of the population has incomes below the poverty level, and the unemployment rate is 9.1%. The dominant labor force is from the manufacturing sector (20.3%).According to a recently released study by the Robert Wood Johnson Foundation/ University of Wisconsin Population Health Institute, Roane County residents have the following health indicators that are above the national benchmarks: Roane - TN - National Adult Smoking: 18% - 24% - 15% Adult Obesity: 32% - 31% - 25% Excessive Drinking: 5% - 9% - 8% Teen Birthrate: 49 - 55 - 22 of every 1,000 teenage girls Poor or Fair Health: 27% - 19% - 10% Part VI, Line 6: Roane Medical Center (RMC), 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 RMC's board. It is comprised of independent community leaders with diverse educational and professional backgrounds. The board sets policies and provides oversight of RMC.RMC 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 7: Roane Medical Center is an integrated member of Covenant Health. Roane Medical Center patients are referred to the other Covenant Health facilities for specialty services not provided at Roane. The referral is expedited through the Rapid Response Center to which all Covenant facilities have access.Roane department managers attend systemwide compliance meetings where representatives of all Covenant Health hospitals are present. The compliance discussions center around charging and documentation standards as well as best practice in services provided. Tennessee Technical School and Roane State Community College students complete the clinical portion of their training at Roane Medical Center. X X 1 1 0 1 0 0 0 0 0 0 0 Anthony L Spezia 0 690560 0 652524 0 63252 0 216512 0 29869 0 1652717 0 156680 John T Geppi 0 367693 0 268268 0 39158 0 9800 0 31680 0 716599 0 0 James Gann 0 127229 0 8778 0 25638 0 6764 0 12935 0 181344 0 0 Janice Bardill 73274 0 0 0 11332 0 5311 0 10749 0 100666 0 0 0 Dr Jules Mugemuzi 191441 0 0 0 27736 0 0 0 1285 0 220462 0 0 0 Dr Irina Schiopescu 166155 0 0 0 13374 0 10869 0 6322 0 196720 0 0 0 Dr Suresh Nekuri 178172 0 0 0 29367 0 13149 0 19785 0 240473 0 0 0 Dr Brian Hofung 187745 0 0 0 86 0 0 0 5934 0 193765 0 0 0 Part I, Line 1a Tax indemnification and gross-up payments are provided to certain executives and managers. These are treated as taxable compensation to the recipient. Cell phone reimbursement, not treated as taxable compensation in 2010, was paid to physicians. Part I, Line 4b Anthony L. Spezia (compensated by Covenant Health, parent organization) $206,712 - current year contribution to 457(f) plan $213,161 - current year distribution from 457(f) plan, of which $156,680 was earned and reported in 2006. Supplemental Information Part III Part I, Line 3: Covenant Health, the parent company of Roane Medical Center, used one or more of the methods listed in line 3 in establishing the compensation of Anthony L. Spezia. Please see the statement to Core Part VI, Section B, Line 15a on Schedule O. Form 990, Part VI, Section B, line 11 A summary of Roane Medical Center's 2010 Form 990 was prepared and presented to the Covenant Health Finance Committee and Board of Directors at their 2011 September and October meetings, respectively. This entity is one member of a large, integrated healthcare system which files a total of twelve (12) Form 990s. Prior to filing, the Board of Directors and Finance Committee had access to the 990s of all Covenant Health facilities. 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 employee handbook to all employees. The handbook 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 Roane Medical Center, Covenant Health (Parent Company), and affiliates are set by the Compensation Committee of the Board of Directors, 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 2010 Form 990 of Covenant Health, EIN 62-1646734, parent company of Roane Medical Center. Form 990, Part VI, Section B, Line 15b: Base salaries and annual bonus opportunities for James Gann, President/CAO, and Janice Bardill, VP-Financial Services, ("Key Executives") are set by the Covenant Health CEO or Executive Vice President-Human Resources and/or Executive Vice President-Operations, 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 insure that total compensation for each executive is reasonable and within a fair market value range. Salary ranges for each executive position 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 each Key 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% for the CAOs and 0-20% for the VP-Financial Services of base salary based upon system performance and accomplishment of certain targets established by the CEO. Form 990, Part VI, Section C, line 19 Form 990, Part VI, Section C, Line 19: Per its tax-exempt bond provisions, the parent company, Covenant Health, 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 Nationally Recognized Municipal Securities Information Repositories. Any member of such a repository has access to these financial statements. In addition, Roane Medical Center files a Joint Annual Report containing financial information with the Tennessee Department of Health. Contact Addresses for Officers, Directors, Etc.: Form 990, Part VI, Line 9 & Part VII, Section A Anthony L. Spezia Covenant Health 100 Fort Sanders West Blvd. Knoxville, TN 37922 John T. Geppi, Francis Olmstead, and all Directors Covenant Health 1410 Centerpoint Blvd., Suite 401 Knoxville, TN 37932-1985 All other persons listed in Part VII, Section A may be contacted at the organization's address. Part VII, Section A, Column B: The President/CEO, EVP/CFO, and Board of Directors serve Covenant Health, EIN 62-1646734, parent company of an integrated health care delivery system, of which Roane Medical Center is a member, as a whole. The hours these individuals devoted to the system in 2010 are reported on Covenant Health's Form 990, Part VII. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Fund Balance Transfers 9,178,390. Transfer of funds from external sources 4,699. Total to Form 990, Part XI, Line 5: 9,183,089. Form 990, Part XII, Line 2c: The Finance Committee of the Board of Directors assumes responsiblity for oversight of the audit of the consolidated financial statements and selection of an independent accountant. Form 990, Part III, Line 1 - Report to the Community: Service to the people and communities of East Tennessee is the cornerstone of the mission of Covenant Health, hereinafter referred to as "the System," a community-owned health system which includes acute care hospitals, outpatient facilities and clinics, and numerous specialty services. The System's mission, "we serve the community by improving the quality of life through better health," has been the foundation of the services and programs offered by the System and its member organizations since it was formed through the consolidation of Fort Sanders Health System in Knoxville and MMC Healthcare System in Oak Ridge in 1996. The System is a community-owned healthcare system and provides comprehensive health services throughout East Tennessee. Headquartered in Knoxville, Tennessee, the System includes seven acute care hospitals with a total of more than 1,700 licensed beds, as well as numerous outpatient services and clinics. The System also includes specialty providers of behavioral, oncology, and rehabilitation services, along with home care, physician clinics, community wellness programs and managed care products and services. The System has more than 1,000 affiliated physicians and 9,000 employees. Covenant Health, a tax-exempt entity pursuant to section 501(c)(3) of the Internal Revenue Code, is the parent company and sole member of several controlled entities: Fort Loudoun Medical Center, Fort Sanders Regional Medical Center, LeConte Medical Center, Methodist Medical Center of Oak Ridge, Morristown-Hamblen Hospital Association, Parkwest Medical Center, Peninsula, a Division of Parkwest Medical Center, Roane Medical Center, Thompson Cancer Survival Center, Covenant HomeCare and Fort Sanders Perinatal Center. These entities were established to provide healthcare services primarily to East Tennesseans in the surrounding 16-county area. Operating as an integrated network of health services, Covenant Health and its affiliates seek to provide affordable, superior healthcare to patients through continued operation of both acute care and non-hospital programs. The history of the System demonstrates a clear and consistent charitable purpose: the provision of healthcare services to all residents of the community without regard to age, race, gender, creed, national origin, ability to pay, or physical or mental handicap. Beyond the services documented in this report are countless acts of generosity by employees that will never be completely captured and reported, nor will they be forgotten by those who benefited from them. One of the most tangible expressions of the System's charitable purpose is the provision of care to people unable to pay. The System embraces its purpose and strives to grow the types of services not provided by other area health care providers; examples of such services include but are not limited to services provided by Peninsula, a Division of Parkwest, which provides inpatient and outpatient behavioral health services, and the Hope Center, which provides comprehensive support services for patients with HIV/AIDS and other serious illnesses, and their families and caregivers. The System provides medically necessary services to all people, regardless of their ability to pay. Patients who fall below 300 percent of the federal poverty income guidelines for a 12-month period, who are unable to pay, and who have exhausted all sources of payment assistance may be eligible for charity care. According to policy, patients whose annual income falls between 0-200% of federal poverty guidelines receive 100% discount while those whose income is between 201-300% of the federal poverty guidelines receive a 70% discount. For those who do not fall below the guidelines but are facing difficult economic circumstances, ability to pay is determined on a case-by-case basis. In particular, cases involving serious illness and/or unusually high-cost care are individually evaluated, and expectation of payment by the System is adjusted to recognize the reasonable ability of the individual patient to pay for services received. For the year ending December 31, 2010, the System provided services under the previously stated policy which resulted in significant losses to the System. Both inpatients and outpatients were provided care under the aforementioned policy. No patient was refused necessary medical care on the basis of his or her ability to pay. In addition to the level of services identified above, the System is an active participant in the State of Tennessee TennCare program. The System is the area's largest TennCare provider of services to residents of East Tennessee. The TennCare program seeks to provide payment for healthcare services to individuals who meet certain financial and categorical requirements. Financial requirements include evaluation of both assets and income. TennCare program reimbursement rates are substantially below Medicare reimbursement rates. In addition to the provision of care without expectation of payment or the provision of care to TennCare-eligible people at rates substantially below charges, the System provided services to people covered under the federal Medicare program. Medicare recipients were the largest single payor classification of patients served by the System. The payment rate for inpatient services was on a per case rate, calculated based on the diagnostic-related group into which the patient was categorized, coupled with other factors related to area wage rates, capital costs and other variables. Outpatient services were reimbursed on a pre-determined case rate. Moreover, the System works diligently throughout the year to achieve its mission by supporting community health education and outreach programs. The System underwrites the cost of community screenings, health fairs, outreach programs for seniors, outdoor fitness programs, community exercise classes, support groups for new parents and other specific populations, smoking cessation classes, and local wellness education programs. Notable examples of these programs include: Covenant Health Check, a multi-county annual screening event, now in its 27th year, which has served more than 150,000 people; Body Works, a multi-location exercise program for adults; Passport, an organization promoting health and active lifestyles for adults 50 and older; Monthly Lunch'n Learns and Health Nights in Knox and surrounding counties; Covenant Health at the Mall, freestanding health information kiosks at two local malls; Community fitness events such as the Covenant Health Knoxville Marathon and a bike ride and foot race held in conjunction with Knoxville's Dogwood Arts Festival; Wellness programs, support groups, and outreach services sponsored by Covenant Health's member hospitals. The system also funds two "hospitality house" outreach programs, one at Fort Sanders Regional Medical Center in Knoxville, and one at Methodist Medical Center in Oak Ridge. These facilities provide temporary "homes away from home" for non-local patients and caregivers who are receiving ongoing medical treatment care at Covenant Health member organizations. The System is committed to education in order to prepare qualified nurses and other healthcare workers for the future, and to provide continuing education for current healthcare professionals. This support is shown in multiple ways, including support of Tennessee Wesleyan College - Fort Sanders Nursing, a baccalaureate level nursing education program offered under the auspices of Tennessee Wesleyan College in Athens, Tennessee, with classroom and clinical training opportunities offered in Knoxville and at various Covenant Health facilities. The System also provides clinical training rotations at its hospitals and member facilities for students in area nursing and ancillary health education programs. Additional program support and scholarships are given to students and to schools providing healthcare education throughout the area. Special programs are offered to high school and middle school students who are interested in careers in healthcare. Continuing education opportunities are provided for physicians, nurses, and other healthcare professionals on a variety of topics. During 2010, the System subsidized services related to sports medicine, services for women and children, and behavioral health assessments. Subsidized services are those services which are typically provided to meet an identified community need. If no longer offered, the services would either be unavailable in the area or fall to the responsibility of the government or another not-for-profit system to provide. The system also designated specific amounts as Physician subsidies to support the recruitment by the System and its affiliates of physicians and other health professionals for areas underserved or specialties not adequately served in the community. High populations of Tenncare patients and uninsured patients typically reside in these areas. The System supported the important work of many unaffiliated organizations and charities during 2010. While the principal community donation by the System was in the area of indigent care, donations within the context of the organization's established charitable contribution policy were also made to other causes. More than 50 organizations received charitable contributions from Covenant Health and/or its member organizations in 2010, including: American Cancer Society American Heart Association Catholic Charities East Tennessee Children's Hospital Great Schools Partnership Holston Home for Children Innovation Valley Knoxville Track Club (for sponsorship of Covenant Health Knoxville Marathon) Senior Services Contributions and Sponsorships Susan G. Komen Foundation University of Tennessee Variety Children's Charity of East Tennessee Wellness Community Donations also included support of medical mission trips to Guatemala and Haiti. Community Building activities included cash, in-kind donations, and budgeted expenditures for the development of community health programs and partnerships. These activities include physical improvements and housing, economic development and support system enhancements like disaster readiness, mentoring programs, and youth asset development initiatives. In 2010 the System provided Community Building support to many organizations, including but not limited to: Boys & Girls Club Emerald Youth Foundation Family Promise of Knoxville Interfaith Health Clinic Knoxville Academy of Medicine Project Access Roane Alliance Second Harvest Food Bank United Way Wee Course Classic In a separate but related donation category, in 2010 employees of the System also contributed financially to the System's United Way drive and Covenant Health's We Care campaign, which raises funds for charitable services provided by the System such as patient assistance with medication costs, chaplain's fund for employees in need, hospitality houses for patients from outside the area, and nursing scholarship programs. The volunteer programs at the System's acute care organizations are active and vital parts of the System's success. Volunteers donate time and service to Fort Loudoun Medical Center, Fort Sanders Regional Medical Center, LeConte Medical Center, Methodist Medical Center, Morristown-Hamblen Hospital Association, Parkwest Medical Center, Thompson Cancer Survival Center, and Covenant HomeCare. At the acute care facilities, volunteers include adults, college students and teenagers working in a variety of settings such as inpatient and outpatient facility departments, patient reception areas, gift shops, fellowship centers, etc. Funds raised by volunteers are donated for hospital equipment, supplies and special projects, as well as to meet charitable community needs. 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 Parkwest Medical Center 9352 Parkwest Blvd Knoxville TN 37923 581897274 Acute care hospital & behavioral health services 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 LeConte Medical Center 742 Middle Creek Rd Sevierville TN 37862 621114867 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Thompson Cancer Survival Center 1915 White Avenue Knoxville TN 37916 621373691 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 Ste 304 Knoxville TN 37916 043760551 High-risk obstetrical services TN 501(c)(3) Line 3 Fort Sanders Regional Medical Center 1 Covenant Health 1410 Centerpoint Blvd Suite 401 Knoxville TN 37932 621646734 Supporting Organization TN 501(c)(3) Line 11b, II N/A 0 Fort Loudoun Medical Center 550 Fort Loudoun Medical Ctr Dr Lenoir City TN 37772 621373691 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Sanders Foundation 280 Ft Sanders West Blvd Ste 100 Knoxville TN 37922 621748601 Fundraising and development TN 501(c)(3) Line 11a, I 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 Endoscopy Center of Oak Ridge LLC 988 Oak Ridge Turnpike Ste 220 Oak Ridge TN 37830 621667358 Outpatient Medical Facility TN N/A Fort Sanders Endoscopy Center LLC 100 Fort Sanders West Blvd Knoxville TN 37922 Inactive - dissolved October 2010 TN N/A Fort Sanders Outpatient Cardiac Catherization Center LLC 100 Fort Sanders West Blvd Knoxville TN 37922 Inactive - dissolved October 2010 TN N/A Fort Sanders West Associates 280 Fort Sanders West Blvd Ste 214 Knoxville TN 37922 621384171 Building Ownership TN N/A Fort Sanders West Outpatient Surgery Center LP 210 Fort Sanders West Blvd Ste 106 Knoxville TN 37922 621366907 Outpatient Surgery Center TN N/A Parkwest Endoscopy Center LLC 100 Fort Sanders West Blvd Knoxville TN 37922 Inactive - dissolved October 2010 TN N/A Associates of the Meridian Health Outpatient 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 Ste 214 Knoxville TN 37922 621308885 Management Company TN N/A C Covenant Medical Management 280 Fort Sanders West Blvd Ste 205 Knoxville TN 37922 621282917 Physician Practice Management TN N/A C KASC Acquisition Company Inc 1410 Centerpoint Blvd Suite 401 Knoxville TN 37932 263400984 Real Estate Holdings TN N/A C Knoxville Heart Group 1819 Clinch Avenue Suite 108 Knoxville TN 37916 271528941 Cardiology medical practice TN N/A C Morristown-Hamblen Health Services Inc 908 W 4th North St Morristown TN 37814 621588521 Inactive - dissolved 2/5/2011 TN N/A C 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0