2022-11-10T11:25:17-06:00 2021-12-31 990 2021-01-01 620790132 Cumberland Medical Center CUMB 8653743140 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 JOHN T GEPPI EVP/CFO 8653746872 2022-11-07 JOHN GEPPI 999009999 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z James D VanderSteeg 244 Ft Sanders W Blvd Knoxville TN 37922 102592380 0 X https://www.cmchealthcare.org/ X 1967 TN Cumberland Medical Center is a 189-bed full service, acute care hospital located in Crossville, TN. It is a member of the Covenant Health system. 23 21 836 96 170185 138719 2006593 7378093 89633389 92913362 77309 687599 1167952 1056608 92885243 102035662 15616 25070 0 0 38681547 40175833 0 0 0 50082109 53426312 88779272 93627215 4105971 8408447 100237442 90595447 22430779 16074696 77806663 74520751 X Cumberland 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 90951721 25070 92900437 Cumberland Medical Center ("Cumberland"), an acute-care hospital located on the Cumberland Plateau of Tennessee, has served the Cumberland community since 1950 and joined Covenant Health in 2014.SERVICECumberland offers specialized services not usually found in more rural areas, making health care resources more accessible to local residents. Currently licensed for 189 beds, Cumberland has more than 200 affiliated physicians working with nearly 700 employees and about 125 dedicated volunteers who deliver quality care to patients. Physician specialties include anesthesiology, cardiology, neurology, obstetrics, ophthalmology, oncology, orthopedics, pediatrics, radiology, radiation oncology and urology services.Cumberland served 118,592 patients in 2021. Of these, 113,556 were outpatients and 5,036 were inpatients with an average length-of-stay of 4.91 days. PUTTING PATIENTS FIRSTAdvanced medical and surgical care is provided at Cumberland, including telemetry-monitored beds and an intensive care unit. Additionally, Cumberland offers an outpatient diagnostics center, same-day surgery unit, cardiac and pulmonary rehab programs, a sleep disorders center, a breast center offering 3D mammography, a cancer center, and hyperbaric and wound care. The hospital also has a 12-bed maternity suite for labor and delivery. As a member of Covenant Health, Cumberland is part of the region's only stroke hospital network, which links Covenant Health's member hospitals in providing access to rapid diagnosis and treatment of stroke. Cumberland holds Advanced Primary Stroke Center certification from The Joint Commission. Cumberland has an in-house cardiac catheterization lab, inpatient dialysis services and an inpatient rehabilitation unit. A full-service laboratory, medical imaging department, physical therapy and cardiopulmonary services department are also available. Cumberland's surgery department includes six main operating rooms, four of which are equipped with high-definition endoscopic video equipment. Cumberland is accredited by The Joint Commission. It has also earned the Commission on Cancer's Accredited Cancer Program designation and is accredited by the American College of Radiology in Radiation Oncology, Positron Emission Tomography (PET) Imaging and Breast Imaging Center of Excellence. IMPROVING THE COMMUNITY'S QUALITY OF LIFE THROUGH BETTER HEALTHEmergency physicians are on duty 24 hours a day, seven days a week, while general and specialty surgeons provide around-the-clock coverage and treatment. A new emergency department was opened in 2016 that has allowed Cumberland to better serve patients with updated equipment and technology, new patient care rooms, and specialty cardiac and trauma rooms.Outreach programs were adapted to support social distancing to reduce potential spread of COVID-19 in 2021; however, the following milestones were accomplished:-Featured a variety of patient featured stories on topics and education surrounding breast health, diabetes, stroke, moving more, etc. -Supported a "Hike for Health" 12-week series of local one-mile paved trails-Partnered with the Cumberland County Playhouse to record a Breast Cancer Awareness video with potentially more than 20,000 online viewers COVENANT HEALTHCumberland Medical Center is a member of Covenant Health. Covenant Health is a comprehensive, community-owned health system dedicated to improving the health of the people it serves. Established in 1996 by the consolidation of Fort Sanders Health System, Knoxville, Tennessee, and MMC HealthCare System in Oak Ridge, Covenant Health is governed by a voluntary board of directors comprised of community leaders and medical professionals. With more than 11,000 employees, affiliated physicians and volunteers, Covenant Health is the Knoxville area's largest employer and has been named a Best Employer seven times by Forbes. Covenant Health includes nine acute care hospitals in East Tennessee: Methodist Medical Center of Oak Ridge, Fort Sanders Regional Medical Center and Parkwest Medical Center in Knoxville, Fort Loudoun Medical Center in Lenoir City, LeConte Medical Center in Sevierville, Morristown-Hamblen Healthcare System in Morristown, Roane Medical Center in Harriman, Claiborne Medical Center in Tazewell and Cumberland Medical Center in Crossville. It also includes Peninsula, a division of Parkwest Medical Center, a behavioral health hospital in Blount County, Tennessee. The health system also includes Covenant Medical Group, which includes more than 200 physicians and advanced practice clinicians in office locations throughout East Tennessee.Affiliated organizations include Thompson Cancer Survival Center, Thompson Oncology Group, Fortress Corporation and Subsidiaries, Covenant HomeCare, and Fort Sanders Perinatal Center. Philanthropic organizations include Fort Sanders Foundation and the Thompson Cancer Survival Center Foundation in Knoxville, Methodist Medical Center Foundation in Oak Ridge, Dr. Robert F. Thomas Foundation in Sevierville, and Morristown-Hamblen Hospital Foundation in Morristown. Funds raised by the foundations provide services, equipment and other resources for excellence in patient care.Cumberland Medical Center, as a member of Covenant Health, benefits from the collaboration among all affiliated organizations to promote quality improvement, patient safety and efficient delivery of care for the communities served. 90951721 1 0 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 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 39 0 1 836 1 1 1 0 0 0 0 0 0 0 0 0 X 23 21 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Amy DeLong 8653743140 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 Gerald Boyd Director 0.00 1.00 X 0 0 0 Willard Campbell MD Director 0.00 1.00 X 0 0 0 Michael Casey MD Director 0.00 1.00 X 0 0 0 Ronni Chandler Director 0.00 1.00 X 0 0 0 Mitchell Dickson MD Director 0.00 1.00 X 0 0 0 Stephanie Flood Director 0.00 1.00 X 0 0 0 James Fitzsimmons Director/Chair 0.00 1.00 X X 0 0 0 James Gibson Director 0.00 1.00 X 0 0 0 Edgar Gray Director 0.00 1.00 X 0 0 0 Leslye Hartsell Director 0.00 1.00 X 0 0 0 Timothy Matthews Director 0.00 1.00 X 0 0 0 Janice McKinley Director 0.00 1.00 X 0 0 0 Dave Miller Director 0.00 1.00 X 0 0 0 Bill Myers Director 0.00 1.00 X 0 0 0 Alvin Nance Director 0.00 1.00 X 0 0 0 Linda Ogle Director 0.00 1.00 X 0 0 0 King Purnell Director 0.00 1.00 X 0 0 0 Jorge Sanabria Director 0.00 1.00 X 0 0 0 Cosby Stone Director 0.00 1.00 X 0 0 0 Carl Storms Director 0.00 1.00 X 0 0 0 Joe Sutter Director 0.00 1.00 X 0 0 0 James Tramontana MD Director 0.00 1.00 X 0 0 0 James D VanderSteeg President & CEO 0.00 50.00 X X 0 2095841 237673 John T Geppi EVP/CFO 0.00 50.00 X 0 1061001 31342 David V Bunch President & CAO 50.00 0.00 X 0 385336 29598 April A VonAchen VP - Financial Services 50.00 0.00 X 156808 0 31276 Thomas A Allingham MD Physician/Chief of Staff 50.00 0.00 X 454878 0 9700 Jacqueline D Payne Clinical Nurse III 50.00 0.00 X 151018 0 4706 Jason L Chaston Clinical Nurse II 50.00 0.00 X 147983 0 24459 John W Grinder Pharmacist 50.00 0.00 X 143752 0 15986 Shana N Wyatt Chief Nursing Officer 50.00 0.00 X 135705 0 26522 Jeremy H Biggs Fmr CMC Pres/CAO; Curr MMC Pres/CAO 0.00 50.00 X 0 501772 37425 1190144 4043950 448687 17 1 1 0 SRS Telemedicine LLC 511 Union Street Ste 1800 Nashville TN 37219 Physician Fees 673061 Restorix Health 445 Hamilton Avenue Suite 800 White Plains NY 10601 Wound Care Management Fees 567713 Shared Medical Services Inc 209 Limestone Pass Cottage Grove WI 53527 Imaging Services 359455 Nurse Pro Plus LLC PO Box 549 Dellslow WV 26531 Staffing Services 355355 Kenneth Lister MD 8317 Neubert Springs Road Knoxville TN 37920 Physician Fees 195570 8 7377093 1000 7378093 Net Patient Revenue 622110 92892594 92892594 Laboratory 621500 20768 20768 92913362 687599 687599 751436 556718 194718 194718 149417 45301 Wellness Center 713940 419905 419905 Cafeteria 722514 376165 376165 Medical Records 561000 25225 25225 40595 7843 32752 861890 102035662 92900437 170185 1586947 X 19948 19948 5122 5122 188084 188084 33118082 31884411 1233671 433796 423080 10716 4271766 4146526 125240 2164105 2082110 81995 1850592 1802634 47958 15000609 14613608 387001 190971 173562 17409 516208 350760 165448 1229397 1214757 14640 2498606 2233099 265507 20444 18106 2338 44513 33383 11130 3324 3238 86 5290214 5289502 712 147425 145345 2080 Unrelated Business Inco 30000 30000 Medical Supplies 15097482 15097482 Bad Debt 8377484 8377484 Minor Equipment 2125507 2065708 59799 1003536 971856 31680 93627215 90951721 2675494 0 7902825 2963616 9339108 9520309 1007050 940359 1028654 1141982 167642096 108042766 59684292 59599330 289610 0 10323293 10082209 10662610 6347642 100237442 90595447 18893883 14125695 3536896 1949001 22430779 16074696 X 77806663 74520751 77806663 74520751 100237442 90595447 X 8408447 -289610 -11404749 X 0 1 X 1 1 1 X 149520 271 149791 148846 674 149520 147855 991 148846 143094 4000 761 147855 142604 2000 490 2000 143094 1.00000 0 0 2619122 2619122 90536194 47910196 42625998 3318470 1934677 1383793 70611103 58197893 12413210 557207 557207 59599330 Assets Limited as to Use 149791 Due From Affiliates, Net 4909659 Long-Term Deferred Compensation 108665 Other Receivables 1179527 6347642 Deferred Social Security Taxes 611711 Due to Third Party Payors 59047 Long-Term Deferred Compensation 108665 Long-Term Reserve for Workers Comp 529015 Operating and Finance Leases 630900 Security Deposits 9663 1949001 X Part V, Line 4: Cumberland Medical Center maintains three endowment funds for the purpose of supporting education of essential healthcare positions and provision of healthcare to children in need. The principal amount will be maintained in perpetuity and only the annual income generated will determine the number and amounts of expenditures each year. Part X, Line 2: Excerpt from the consolidated audited financial statements of Covenant Health (Covenant), parent company to Cumberland Medical Center: Covenant and certain of its subsidiaries or controlled entities are exempt from income taxes pursuant to Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for income taxes on qualifying activities has been made for these entities in the accompanying consolidated financial statements. However, certain entities and operations are subject to income taxes. Covenant had no unrecognized tax benefits at December 31, 2021 and 2020. As such, no interest or penalties were recognized in the consolidated financial statements related to unrecognized tax benefits. At December 31, 2021 and 2020, tax returns for 2018 through 2021 are subject to examination by the Internal Revenue Service. Covenant has no uncertain tax positions that would require financial statement recognition or disclosure under GAAP at December 31, 2021 and 2020. 1 1 X 1 X 1 X 1 1 1 0 1 1 2929185 2580 2926605 0.03430 8084578 6777852 1306726 0.01530 11013763 6780432 4233331 0.04960 54 54 0.00000 4812800 4812800 0.05650 16977 16977 0.00020 4829831 4829831 0.05670 15843594 6780432 9063162 0.10630 132 132 0.00000 22599 22599 0.00030 1144 1144 0.00000 23875 23875 0.00030 1 8377484 1005298 28485828 25601726 2884102 X 1 1 1 1 Cumberland Medical Center Inc 421 South Main St Crossville TN 38555 https://www.cmchealthcare.org 00000020 X X X Cumberland Medical Center 1 0 0 1 X X X X X X X X 19 1 0 1 1 X See Part V, Page 8 X 1 19 1 See Part V, Page 8 0 1 X 200.000000000000 300.000000000000 X X 1 1 X X X 1 X https://www.cmchealthcare.org/financial-assistance/ X https://www.cmchealthcare.org/financial-assistance/ X https://www.cmchealthcare.org/financial-assistance/ X X X X X X 1 X 0 X X X 1 X 0 0 Cumberland Medical Center Part V, Section B, Line 5: Cumberland Medical Center ("CMC") conducted its third Community Health Needs Assessment ("CHNA") in 2019. A Steering Committee was formed to guide the assessment process and included staff from the Cumberland County Health Department, United Fund, CMC, Cumberland County Emergency Medical Services, Cumberland County government, Crossville City Manager, Cumberland Heights, and Fairfield Glade Resident Services. Each of these community organizations serve the broader community and, in particular, the low-income, uninsured and chronically ill. The Steering Committee worked with the University of Tennessee-Knoxville Social Work Office of Research and Public Service ("UT-SWORPS") to devise a Cumberland County household survey and to host two focus groups of community leaders, each of which represented a part of the overall Cumberland County public health system. The household survey collected information from 623 Cumberland County residents. Participation in the survey was diverse and reflected the demographic profile of the county for the attributes of educational level, income, ethnicity and age. The primary research was analyzed and combined with county demographics, mortality, and secondary data for more than 60 health indicators. A Data Team was formed to analyze the data and determine the most significant findings from the assessment. The Data Team included Steering Committee members as well as representatives from the University of Tennessee/TN State University Extension Service, Coordinated School Health, Cumberland County Hospice, and Cumberland County Rising Anti-Drug Coalition. Cumberland Medical Center Part V, Section B, Line 6b: Though CMC's CHNA was issued as a stand-alone report, many non-hospital organizations assisted throughout the process. Research partners provided expertise on survey design, focus group facilitation, data collection, data sources, and analysis. UT-SWORPS was an integral contributor, as well as the Cumberland County Health Department and the Tennessee Department of Public Health (Nashville, TN).Additionally, focus groups were beneficial in discussing and identifying community needs in Cumberland County. Organizations and individuals participating in the focus groups included: - Cumberland County Health Department - Cumberland County United Fund- Cumberland County Schools - Cumberland County Hospice- Bread of Life Rescue Mission - Coordinated School Health- Plateau Pediatric Group - Crab Orchard Mayor- Local Pharmacist - Local Nurse Practitioner- Fairfield Glade Retirement Community- Wynd Ridge Health and Rehabilitation Center - Cumberland County Rising Anti-drug Coalition Cumberland Medical Center Part V, Section B, Line 11: At the conclusion of the 2019 assessment process, the Data Team identified a top ten list of health priorities and further refined this list into the top 5 most significant health issues. The top five identified community needs (in order of priority) are: Health Education for Chronic Diseases, Substance Abuse Disorder, Mental Health Access, ACES, and Health Care Providers for Specialty Services. CMC updated its 2019 Implementation Plan based on the identified needs and plans to address four of the five identified issues in the following ways:1. Health Education for Chronic Disease Conditions "Breast Cancer Awareness" Events - CMC launched an annual Breast Cancer Awareness Party that welcomes community members to hear guest speakers and receive educational information in support of annual mammogram screenings. Cancer Navigators - CMC now has two nurse navigators serving in the Breast and Cancer Centers to provide education to patients going through cancer treatment. Community Baby Shower - CMC participates in a community wide baby shower in partnership with the Health Department and Cumberland County Rising Anti-Drug Coalition. Expectant mothers are provided key information about their child's upcoming birth as well as vital community resource information to help those who are economically disadvantaged with resources, such as the Women, Infant, and Children program offered through the Health Department. COPD Support Group - CMC holds a free monthly support group for caregivers and patients with Chronic Obstructive Pulmonary Disease. Diabetes - CMC has expanded a Diabetes Center to help with metabolic associated conditions. The Cumberland Diabetes Center offers a free monthly support group for ongoing information and support. - For prevention and management of disease, CMC will hold regular hiking opportunities with Missy Kane, Covenant Health's health promotion coordinator, and the annual Cumberland County Hiking Marathon.Health Fairs - CMC has annual health education and screening fairs across the community. Events are held at local community and senior centers and local businesses.Patient Education - Signs and symptoms of Stroke and Heart Attack are provided to every inpatient upon discharge.2. Substance Abuse DisorderCumberland County Anti-Drug Coalition - CMC is committed to staying on the forefront of the latest trends affecting the community (such as vaping) by attending Cumberland County Rising Anti-Drug Coalition meetings and bridging information with hospital resources as opportunities arise.Opioid Light Protocol - CMC has adopted the Covenant Health protocol to reduce the amount of narcotics prescribed in our Emergency Department. Narcotics are reserved for acute pain, and other non-narcotic methods of pain control are offered to patients with more chronic pain. Patient Education - CMC teaches in-patients how to better manage pain with alternatives such as repositioning, ice packs, and pain scales (1-10). Prescription Drug Take Back - CMC continues to support Drug Take Back at Health Fairs and special events.3. Mental Health Access Covenant Health - As a member of Covenant Health, CMC will advocate and support the system's behavioral health services to assist area residents.Inpatient Education - CMC Case Management helps educate patients and families with resources available for those struggling with addiction. Mobile Crisis Services - CMC works with local and statewide agencies including the Tennessee Department of Mental Health & Substance Abuse Service's Mobile Crisis Services.Senior Perspectives - CMC supports Senior Perspectives in its effort to help caregivers and patients with Alzheimer's and Dementia. 4. Adverse Childhood Experiences (ACEs) ACEs is outside the scope of care provided by CMC because it is performed in a physician office setting as part of the patient's overall health management. 5. More Healthcare Providers for Specialty Services CMC is committed to supporting specialty services by: - Recruitment efforts for primary and specialty physicians, - Cultivated relationships with Covenant Health specialists not available in Cumberland County, and - Use of advancements for telehealth utilization (such as CMC's implementation of Tele-Nephrology in 2019) to help provide care to patients locally. Cumberland Medical Center Part V, Section B, Line 16j: All other ways in which the hospital widely publicizes the FAP are discussed in detail in Part VI, Line 3. Part V, Line 7a, CHNA website https://www.cmchealthcare.org/community-health-needs-assessment/ Part V, Line 10a, Implementation Strategy Website https://www.cmchealthcare.org/community-health-needs-assessment/ Part V, Line 20d, Presumptive Eligibility Determinations The hospital follows the eligibility procedures as detailed within the FAP and does not make presumptive eligibility determinations. 8 1 - CMC Outpatient Imaging Center 28 Hayes St Crossville TN 38555 Medical Imaging and PET Scan 2 - CMC Cancer Center 421 South Main St Crossville TN 38555 Oncology Radiation Therapy 3 - CMC Hyperbaric Medicine & Wound Ctr 124 Hayes St Crossville TN 38555 Wound and Hyperbaric Treatment 4 - CMC Specialty Surgery & Endoscopy Ctr 116 Brown Ave Crossville TN 38555 Outpatient Endoscopy Center 5 - CMC Physical Medicine & Rehabilitation 118 Brown Ave Suite 104 Crossville TN 38555 Physical Therapy and Occupational Therapy 6 - Sleep Disorder Center 49 Cleveland St Suite 200 Crossville TN 38555 Sleep Study Center 7 - CMC at Fairfield Glade 130 Stonehenge Dr Crossville TN 38555 Wellness, Physical Therapy, X-ray and Mammography 8 - Cumberland Physicians Group 133 Hayes St Crossville TN 38555 General and Specialty Physicians Part I, Line 3c: In addition to the Federal Poverty Guidelines ("FPG"), CMC utilizes an asset test as a factor in determining eligibility for free or discounted care. Ten percent (10%) of the patient/guarantor's net assets will be added to income for determination of total annual income. The guidelines for determining assets include, but are not limited to, primary dwelling (and attached land), automobiles, liquid assets, investments, farm land, business property, rental property, farm and/or business equipment including livestock and crops. All real property will be considered at fair market value. The values of both real and personal property will be reduced by any existing liabilities incurred by the applicant in obtaining the assets (net assets) with the exception of primary dwelling. The primary dwelling net asset will be the amount of equity above $100,000. Actual or potential third party liability to the patient, hospital or the guarantor by common law, contract, statute or otherwise, shall be considered an asset and must be listed on the Hospital Financial Assistance application. Part I, Line 6a: Covenant Health, the parent company of CMC and other affiliated acute care hospitals, prepares an annual Report to the Community on behalf of the entire system. Part I, Line 7: Amounts on Lines 7a-7c and certain program costs included on Line 7g are from the hospital's cost accounting system, which addresses all patient segments. Other community benefit expenses are at cost from the general ledger. Part I, Line 7g: Subsidized health services includes the difference between the cost of services and the payments received for those services. The total includes $4,812,800 in physician sponsorship fees. All subsidized health services included on line 7g are for services that would otherwise be unavailable in the community or be below the community's needs.The physician offices include family, internal medicine, OB/GYN, surgeons, and other specialty physicians. Although patients with Medicare or commercial insurance coverage are provided services, these physician offices were established to provide services for patients without insurance coverage or with Tenncare/Medicaid. Part I, Ln 7 Col(f): The Bad Debt expense included on Form 990, Part IX, Line 24a, but subtracted for purposes of calculating the percentage in this column is $8,377,484. Part II, Community Building Activities: CMC 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 alleviate 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. Contributions in 2021 were made to organizations meeting the community's needs by providing: - The basic needs of life including temporary shelter, food and clothing (Catholic Charities, Ladies of Charity, Knoxville Area Urban League and Knox County Community Action Committee) - Youth mentoring, development and after-school programs (Emerald Youth Foundation, Boys and Girls Club, Knox Education Foundation, Young Life, City Shepherds, First Tee of Greater Knoxville and Great Smoky Mountain Council) - Business recruitment and marketing initiatives that boost economic development (Legacy Parks Foundation and Pellissippi State Foundation) - Leadership development programs and workshops (Knoxville Area Urban League and Leadership Knoxville) - Assistance and special programs for at risk older adults, people with physical and mental challenges, and abused and neglected children (Senior Citizens Home Assist, Sertoma Center, Inc. and Senior Citizens Love) - Improve access to health services (East TN Children's Hospital, Interfaith Health Clinic, St. Mary's Legacy Clinic and Region II Emergency Medical Services) - Programs supporting patients and their families (Alzheimer's Tennessee, American Cancer Society, Angel Wings Memory Gowns, Random Acts of Flowers, Cancer Support Community, Juvenile Diabetes Research Foundation and Leukemia & Lymphoma Society) Part III, Line 2: Bad debt expense on Part III, Line 2 is the amount recorded in the organization's financial statements. Discounts and payments on patient accounts are netted against bad debt. The allowance for bad debt is determined based on management's assessment of factors including the age of the accounts, historical collections data, and industry standards. Part III, Line 3: The amount reported on Line 3 was estimated by multiplying self-pay bad debt by the percentage of the population living below the poverty level on a county-by-county basis. Cumberland uses the most recent data available from the U.S. Department of Agriculture Economic Research Service. Part III, Line 4: Note B to the 2021 Audited Consolidated Financial Statements of the Covenant Health system, of which CMC is a member, states: Patient accounts receivable are reported net of an estimated allowance for contractual adjustments and an allowance for implicit price concessions. Covenant's policy does not require collateral or other security for patient accounts receivable and Covenant routinely accepts assignment of, or is otherwise entitled to receive, patient benefits payable under health insurance programs, plans or policies. Part III, Line 8: Costing Methodology: CMC 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: CMC utilizes a look-back method to determine amounts generally billed ("AGB") to establish the maximum amount that will be charged to individuals eligible under the financial assistance policy ("FAP") for emergency or other medically necessary care. Self-pay patients automatically receive a 68% discount on charges based on the facility's calculated AGB. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment assistance may qualify for charity care. A sliding scale is used for extending charity care utilizing the income levels reported under the federal poverty guidelines. Patients/guarantors with income that falls below 200% of the federal poverty guidelines receive 100% charity care. Patients/guarantors with income of 201-300% of the federal poverty guidelines receive 90% charity care. For catastrophic illness, exceptions to income and asset limitations may be made on a case-by-case basis. The amount considered for charity will be based upon the evaluation of the patient's/guarantor's ability to pay.CMC makes reasonable efforts to determine a patient's eligibility under the facility FAP. All collection activity will be halted if a charity application is received and will remain on hold until a determination is made by CMC and communicated in writing to the responsible party. If the charity application is approved, all collection activities taken will be reversed and any amounts paid above the amount required will be refunded. Patients/guarantors who qualify for partial financial assistance are responsible for paying any balance remaining after the charity adjustment and third party payments. CMC will not engage in extraordinary collection actions ("ECA") before it makes reasonable efforts to determine whether an individual who has an unpaid bill is eligible for financial assistance. Reasonable efforts to determine whether the individual who has an unpaid bill is eligible for financial assistance include notification to the individual of the financial assistance policy, contacting individuals who have submitted incomplete financial assistance applications regarding how to complete the application, and allowing a reasonable time period to do so, and reviewing completed applications for financial assistance eligibility.CMC does not sell any accounts receivable accounts to outside firms. All accounts remain property of and under the policies set by CMC. CMC will not defer or deny medically necessary care because of nonpayment for previously provided care whether it was covered or not covered under the charity program. Part VI, Line 2: While the CHNA is a formal means by which the health system assesses the needs of the community, there are many informal networks that give the Covenant Health hospitals a sense of community issues and needs. CMC obtains additional community information through the service of its employees with the Chamber of Commerce, the local Health Council, Rotary Clubs, and local not-for-profit boards. Covenant Health, the parent organization, maintains community benefit professionals working year-round to ensure that all hospitals are assessing and addressing the needs of the communities served. Part VI, Line 3: The FAP states that patients who are unable to pay or have exhausted all sources of payment assistance may be considered for charity care. Signage about the policy is posted in highly visible areas of the hospital, such as lobbies and registration areas. Information about the FAP is posted in patient booklets provided to patients during the registration process and communicated via patient billing statements. In addition, the FAP and application are available on the facility website. CMC employs full time financial counselors to assist patients in applying for TennCare and screening for eligibility for financial assistance. Office hours and the phone number for the counselors are included on the signage. Wall signs informing patients about available financial assistance state the following: Covenant Health is committed to providing quality health services in a caring environment. It is the expressed philosophy of Covenant Health and its member hospitals that no one should be denied necessary medical care because of the inability to pay. In conjunction with this philosophy, counselors at Cumberland 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 Cumberland Medical Center will provide, at a reduced rate, medically indicated services. A financial counselor is available to assist you with these matters by calling 931-459-7281, Monday through Friday between the hours of 8 a.m.-5 p.m. Additional information regarding financial assistance is also available on our website at CMCHealthcare.org. Signage at the registration areas state the following:It is Cumberland Medical Center's philosophy that no one shall be denied medically necessary services based on an inability to pay. Financial assistance applications for medically necessary services are available during the registration process, through a financial counselor, or on our website at CMCHealthcare.org. A financial counselor is available to assist you with these matters by calling 931-459-7281, Monday through Friday between the hours of 8 a.m.-5 p.m. Part VI, Line 4: Cumberland County, Tennessee is located on the Cumberland Plateau and is home to the cities of Crossville, Crab Orchard and Pleasant Hill. Cumberland is a rural county located approximately 60 miles from the metropolitan Knoxville area. Cumberland County is the primary market for Cumberland Medical Center, the only hospital in the county. In 2021, 78.6% of the patient encounters (inpatient and outpatient) came from Cumberland county, the focus of the health assessment. The following statistics are taken from the 2021 County Health Rankings report of the Robert Wood Johnson Foundation. The population of Cumberland County is 60,520 people and is predominantly female, 51.2%. Persons over the age of 65 account for 31.2% of the population. The uninsured rate for adults is 15% and 5% for children. The unemployment rate is steadily improving and was at 4.5% in 2021. Healthcare and social assistance make up 21% (2019) of the workforce and is the largest employer category in Cumberland County. In 2021, the median household income was $49,100.In support of the significant findings from the 2019 CHNA, the following data points support the conclusions of the 2019 assessment:Health Education for Chronic Diseases - Of the top 9 leading causes of death in Cumberland County, 8 are largely preventable: diseases of the heart, cancers, respiratory diseases, accidents, stroke, diabetes, flu and pneumonia.Substance Abuse Disorder - In a county with a population of 60,520 residents, 16,631 patients are receiving opioids for pain. - In Cumberland County there were 1,372 prescriptions written for every 1000 residents. - Alcohol was involved in 23% of driving deaths in 2021. - 81% of the survey respondents listed adult substance abuse (drugs and alcohol) as the number one health issue in Cumberland County. - Youth substance abuse (alcohol and drugs) was identified as the second most important health issue in Cumberland County.Mental Health Access - Residents were more dissatisfied with efforts to address mental health access than any other issue in the community survey. - In Cumberland County there is a ratio 2,950 residents per each mental health provider. The Tennessee statewide ratio is 700:1.Healthcare Providers for Specialty Services - Due to a very low wage index rating in the CMC service area, reimbursements are lower. Physician recruitment and retention are significant challenges. - In 2019, the wage index for several areas in Tennessee, including Cumberland County, was increased, which should help with specialty recruitment. Part VI, Line 5: CMC, in conjunction with its parent company, Covenant Health, uses any available surplus of receipts over disbursements to expand and modernize the facility and to support the education of healthcare professionals, both of which serve to improve patient care and serve the unmet needs of the community.Covenant Health's Board of Directors serves as CMC's board. The board is comprised of independent community leaders with diverse educational and professional backgrounds. The board provides governance and oversight of Cumberland.CMC maintains an open medical staff, with privileges available to all qualified physicians. Additionally, the hospital operates an active and accessible emergency department that accepts all patients regardless of ability to pay. Part VI, Line 6: CMC, as a member of the Covenant Health system, benefits from the collaboration among all affiliated organizations to promote quality improvement, patient safety and efficient delivery of care for the communities served.As a system, Covenant assures that business processes are in place at each facility to measure and report quality; to increase the role of compliance; and to integrate risk management, utilization review, peer review, mandatory reporting and quality improvement into one cohesive function. In this way, the system is able to use analytic tools to help identify any systemic inability to satisfy the various requirements on the part of the facilities.CMC patients benefit from the availability of and ease of access to Covenant Health affiliated entities for services not provided by the hospital itself. Transfer or referral to such services is expedited and coordinated to help create a seamless continuum of care. A full range of community mental health and psychiatric hospital services are available within the system that help support the hospital's emergency room as well as provide an accessible and efficient pathway for those patients who require such services post discharge. Other specialized services such as inpatient rehabilitation, cardiac care, cancer treatment, home health and hospice services are provided by affiliated entities. The Covenant Health system also enhances the patient's access to care through the provision of outpatient services in a variety of settings located throughout the service area. These include a diabetes center, wound care center, bariatric surgery center, pulmonary rehabilitation programs and ambulatory infusion centers.Through this combination of resources and the collective development, implementation and monitoring of clinical protocols and other improvement initiatives, the affiliated entities of Covenant Health are able to deliver higher quality care in a more efficient manner than could be achieved working independently. 1 Fairfield Glade Community Club PO Box 2000 Crossville TN 38558 710425507 501(c)(4) 10000 0 Sponsorship 0 1 Patient Transportation 109 5122 Part I, Line 2: Grant funds are provided to charitable organizations for the purpose of enhancing and promoting health care and improving quality of life in the community. The organization has guidelines in place to review the eligibility of grantees, and all grants require written documentation and appropriate levels of approval. The organization also provides other post-hospital care assistance to eligible individuals. Funds are generally not tracked after being granted as the original eligibility and selection criteria have been met. 0 1 0 0 0 0 0 0 0 James D VanderSteeg President & CEO 0 1299832 0 625000 0 171009 0 210150 0 27523 0 2333514 0 0 John T Geppi EVP/CFO 0 657321 0 288143 0 115537 0 11400 0 19942 0 1092343 0 0 Jeremy H Biggs Fmr CMC Pres/CAO; Curr MMC Pres/CAO 0 343608 0 101528 0 56636 0 11400 0 26025 0 539197 0 0 Thomas A Allingham MD Physician/Chief of Staff 433110 0 0 0 21768 0 8700 0 1000 0 464578 0 0 0 David V Bunch President & CAO 0 284253 0 73272 0 27811 0 3650 0 25948 0 414934 0 0 April A VonAchen VP - Financial Services 126492 0 21165 0 9151 0 4741 0 26535 0 188084 0 0 0 Jason L Chaston Clinical Nurse II 147361 0 610 0 12 0 0 0 24459 0 172442 0 0 0 Shana N Wyatt Chief Nursing Officer 111746 0 16993 0 6966 0 425 0 26097 0 162227 0 0 0 John W Grinder Pharmacist 140522 0 910 0 2320 0 0 0 15986 0 159738 0 0 0 Jacqueline D Payne Clinical Nurse III 150316 0 610 0 92 0 4515 0 191 0 155724 0 0 0 Part I, Line 3 Covenant Health, the parent company of Cumberland Medical Center, used the following methods in establishing the compensation of President/CEO, James D. VanderSteeg: compensation committee, independent compensation consultant, written employment contract, compensation survey or study, and approval by the board or compensation committee. Additional detail is provided in response to Form 990, Part VI, Section B, Lines 15a and 15b within Schedule O. Part I, Line 4b Covenant Health maintains a nonqualified deferred compensation ("NQDC") plan intended to support retention of President and CEO, James D. VanderSteeg. Employer contributions of $198,750 are reported as deferred compensation on Schedule J, Part II, Column C. Contributions along with 2021 earnings of $54,440 are subject to a substantial risk of forfeiture. Amounts are combined with other compensation and considered for reasonableness. Compensation procedures are discussed in detail in Schedule O (Form 990, Part VI, Section B, Line 15a). Form 990, Part III, Line 4a IMPACT OF COVID-19 In March 2020, the outbreak of the coronavirus disease 2019 ("COVID-19") was declared a public health emergency published by the Department of Health and Human Services and declared a national pandemic by the World Health Organization. The COVID-19 pandemic had a major impact on the operations of all hospitals and affiliates included within the Covenant Health System during 2020 and 2021. In 2020, hospitals were learning how to respond to the virus and how to protect patients, staff and the community. Covenant Health hospitals were negatively impacted by reductions in elective surgeries, diagnostic procedures, and physical therapy. Additionally, non-COVID patient volumes were down at times in 2020, creating unique staffing issues. From July 2020 through February 2021 and from August 2021 through November 2021, the hospitals were challenged with an increased surge of COVID-19 cases within East Tennessee, which increased patient loads to sometimes maximum capacity. Knox County, Tennessee was labeled a coronavirus hot spot while all available hospital staff were working diligently to save lives and help reduce the spread of the virus in the community. Hospitals were adding beds and working to secure the needed equipment to serve COVID patients. In 2021, costs of medical supplies, including Personal Protective Equipment, continued to rise. Employment costs escalated as hospitals dealt with staff fatigue and turnover. Covenant Health created new incentives, such as retention bonuses, sign-on bonuses, and shift differentials; however, staffing levels were consistently less than demand and hospitals were forced to pay travel nurses at much higher rates. As a system, Covenant Health once again implemented a system-wide retention bonus plan for all employees and continued to seek ways to encourage healthcare workers across all hospitals. Government support, including the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act"), provided essential funding to hospitals and other healthcare entities. In 2020, CARES Act Provider Relief Funds and applicable state grants helped offset costs including the following: establishing a COVID unit at the hospitals, providing face shields for all patient-facing employees, adding screeners at all points of entry, adding COVID testing as an additional screen for patients exhibiting symptoms, subsidizing increased costs of PPE and lab supplies, coordinating and administering the COVID vaccine to employees and throughout the community, and subsidizing financial losses caused by significant declines in volumes due to cancelled and postponed procedures. In 2021, Federal and state grants (included as government grants in Form 990, Part VIII) continued to be used to subsidize the rising costs of retaining staff and providing quality care. While 2020 and 2021 were difficult and challenging years for healthcare organizations around the world, including Covenant Health, they were also years rich in learning and abundant blessings. A strong balance sheet and innovative ways to meet the challenges presented by the coronavirus, coupled with generosity from the community meant that each hospital could continue to deliver award-winning care throughout the East Tennessee community. Form 990, Part VI, Section A, line 2 Board members James Fitzsimmons and James Gibson have a business relationship as they serve as board members of portfolio companies owned by Liberty Hall Capital Partners, a taxable entity unrelated to Covenant Health and its affiliates. Form 990, Part VI, Section A, line 6 Covenant Health is the sole member of Cumberland Medical Center. Form 990, Part VI, Section A, line 7a Covenant Health's board of directors also serves as the board of directors for Cumberland Medical Center. Form 990, Part VI, Section A, line 7b Governance decisions of Cumberland Medical Center are subject to approval of the sole member, Covenant Health. Form 990, Part VI, Section B, line 11b The Covenant Health Board of Directors has delegated to its Finance Committee the full power and authority of the Board to receive, review, approve, authorize the filing of, address and resolve audit or review issues, and otherwise take all action required or appropriate relative to IRS Forms 990 and other applicable tax filings. Prior to filing Form 990, management reviews with the committee the returns, discusses any material variations in the Form 990 as compared to those to be filed by the organization's affiliates, and answers any questions. At the conclusion of review and discussion, the Finance Committee approves the Form 990. Form 990, Part VI, Section B, line 12c Board members, officers, and employees are required to adhere to rules and policies regarding conflicts of interest. Covenant Health distributes a board-approved Code of Conduct to all employees. The Code covers among other subjects, conflicts of interest and requires disclosure and resolution of employee conflicts of interest. Additionally, officers, employed physicians, and highly compensated employees are required to complete and sign an annual conflict of interest disclosure statement. Board members' conflicts of interests are addressed in the corporate bylaws, and board members are required to complete and sign a conflict of interest questionnaire on an annual basis. The Integrity-Compliance Office maintains records that contain conflict of interest information obtained from board members, officers, and employees. These records are available to be queried prior to engaging in business transactions. The Chief Compliance Officer reviews conflict of interest data. Based on this information, the officer determines what conflicts of interest exist at that point in time. Between times when surveys are collected, board members are expected to disclose any new conflicts that have arisen that affect pending board decisions. Officers and other employees are expected to report conflicts to the Chief Compliance Officer as they arise. Depending on the nature of the conflict and the circumstances surrounding the conflict and transaction, the Chief Compliance Officer, senior leadership, or the board of directors may review the conflict of interest. When appropriate, these parties may also consult legal counsel. Restrictions imposed on persons with a conflict of interest are determined on a case by case basis. For Covenant Health employees, the Chief Compliance Officer in conjunction with Covenant Health Executive Leadership determines how to appropriately manage the conflict. In any conflict involving a board member, such member is expected to recuse himself or herself from voting on matters related to the conflict. Form 990, Part VI, Section B, line 15 Overall compensation policies for Cumberland 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. The Covenant Health CEO is compensated by Covenant Health, and a detailed description of the compensation process is included on Covenant Health's 990. The process for Cumberland Medical Center's CEO is included in response to Part VI, Section B, Line 15b. Form 990, Part VI, Section B, Line 15b: Base salary and annual bonus opportunities for David Bunch, President and Chief Administrative Officer, are set by the Covenant Health CEO in consultation with the Senior 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 for the executive is reasonable and consistent with fair market value. Base salary is initially targeted at midpoint and may vary according to market conditions, performance, tenure, experience, special skills or qualifications, recruitment and retention challenges, and other relevant factors. Annual bonuses are designed to award 0-35% of base salary based upon system performance and accomplishment of certain targets established by the CEO. Base salaries and annual bonus opportunities for other officers and key employees are based on targets established by historical compensation consultant data and the Covenant Health Compensation department. Salary ranges are based upon comparison with similar jobs in similar size health systems across the nation. Base salaries and bonuses are approved by Executive Leadership predicated upon performance, and are reasonable and consistent with fair market value. Base salaries are initially targeted at midpoint and may vary according to market conditions, performance, tenure, experience, special skills or qualifications, recruitment and retention challenges, and other relevant factors. Annual bonuses are designed to award 0 - 20% of base salary based upon system performance and accomplishment of certain targets established by Executive Leadership. Form 990, Part VI, Section C, line 19 Cumberland Medical Center files a Joint Annual Report containing financial information with the Tennessee Department of Health. Per its tax-exempt bond provisions, Covenant Health, the parent company of the organization, is required to file quarterly and annual consolidated and obligated group financial statements and other documentation with various bond insurers and other agencies, including the Electronic Municipal Market Access (EMMA) service of the Municipal Securities Rulemaking Board (MSRB). Any member of such a repository has access to these financial statements. The organization's governing documents and conflict of interest policy are not made publicly available. Form 990, Part IX, line 11g Other Purchased Services: Program service expenses 9,916,989. Management and general expenses 387,001. Fundraising expenses 0. Total expenses 10,303,990. Sponsorship Fees: Program service expenses 4,696,619. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,696,619. Form 990, Part XI, line 9: Transfers of Capital -11,404,749. Cumberland Physician Group LLC 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 371539508 Physician services TN 0 57146 Cumberland Medical Center Covenant Health 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621646734 Supporting organization TN 501(c)(3) Line 12b, II N/A 0 Claiborne Medical Center 1420 Centerpoint Blvd Bldg C knoxville TN 379321960 464420358 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Covenant HomeCare 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621623114 Home health services TN 501(c)(3) Line 10 Covenant Health 0 Fort Loudoun Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621373691 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Sanders Regional Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 620528340 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Sanders Foundation 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621748601 Fundraising and patient outreach TN 501(c)(3) Line 12b, II Covenant Health 0 Fort Sanders Perinatal Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 043760551 High risk obstetrical services TN 501(c)(3) Line 3 Fort Sanders Regional Medical Center 0 LeConte Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621114867 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Methodist Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 620636239 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Morristown-Hamblen Hospital Association 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 620545814 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Parkwest Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 581897274 Acute care hospital and behavioral health services TN 501(c)(3) Line 3 Covenant Health 0 Roane County Medical Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 680673354 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Thompson Cancer Survival Center 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621250943 Cancer support center TN 501(c)(3) Line 3 Covenant Health 0 Thompson Oncology Group 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621619239 Oncology services TN 501(c)(3) Line 3 Thompson Cancer Survival Center 0 Thompson Cancer Survival Center Foundation 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 582130450 Fundraising and patient outreach TN 501(c)(3) Line 12b, II Covenant Health 0 Fort Sanders West Associates 280 Fort Sanders West Blvd Ste 214 Knoxville TN 37922 621384171 Building ownership TN N/A 0 0 Fortress Corporation 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621308885 Management company TN N/A C 0 Covenant Medical Group Inc 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621282917 Physician practice management TN N/A C 1 Knoxville Heart Group 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 271528941 Cardiology medical practice TN N/A C 0 East TN Cardiovascular Surgery Group Inc 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621018541 Cardiovascular surgical practice TN N/A C 0 VortexT Analytics 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 475296949 Computer programming services TN N/A C 0 TenHats LLC fka SH Data Centers LLC 550 Fort Summit Way Knoxville TN 37915 814563094 Data storage TN N/A C 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 1 1 Covenant Medical Group Inc A 437649 FMV