2019-11-14T07:06:58-06:00 2018-12-31 990 2018-01-01 620545814 Morristown-Hamblen Hospital Association MORR 8653743140 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 JOHN T GEPPI EVP/CFO 8653743140 2019-10-03 168.85.177.4 2019-11-14 08:06:40 ES P 9FAA1952C08CFF6F9E2CB5A334C8BD7C4DA173D5 9FAA1952C08CFF6F9E2CB5A334C8BD7C4DA173D5 2018 2020-03-31 21:24:44Z Morristown-Hamblen Healthcare System James D VanderSteeg 100 Ft Sanders W Blvd Knoxville TN 37922 97114065 0 X www.morristownhamblen.com X 1952 TN Morristown-Hamblen Hospital Association operates a 167-bed acute care hospital located in Hamblen County, Tennessee. It is a member of the Covenant Health System. 18 16 854 69 126039 121684 75977 295917 106542746 95085159 54044 3798 504137 574793 107176904 95959667 7050 13593 0 0 30208524 32013951 0 0 0 70872135 55762265 101087709 87789809 6089195 8169858 57133635 67907412 9215266 8159654 47918369 59747758 X Morristown-Hamblen Hospital Association 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 86038897 13593 95110744 Beginning in 1895, Morristown-Hamblen Hospital Association doing business as Morristown-Hamblen Healthcare System ("Morristown-Hamblen") has provided more than 100 years of care within its community, serving an eight-county region in the Lakeway Area of East Tennessee. SERVICEMorristown-Hamblen includes six centers of excellence, around-the-clock emergency surgical services, cancer care, cardiology, and women's services. In 2018, The Joint Commission certified the hospital as an Advanced Primary Stroke Center and a certified Sleep Center. It was recognized with an "A" Hospital Safety Score by The Leapfrog Group and an Outstanding Achievement Award by VHA for achievements related to clinical effectiveness and overall performance. In 2018, the hospital saw 102,558 patients. Of these, 95,903 were outpatients and 6,655 were inpatients with an average length-of-stay of 4.17 days. The hospital is best known for its regional cancer center; heart, lung, and vascular center; women's center; surgery; and emergency departments. In 2018, it began construction of a new wound care center. PUTTING PATIENTS FIRSTThe hospital's Morristown Regional Cancer Center offers comprehensive cancer care that includes oncology, chemotherapy and radiation oncology, among other services. The radiation oncology department includes a highly specialized team of radiation therapists, a radiation oncologist, medical physicists and registered nurses. The program is the only provider of radiation therapy within a 45-mile radius of Morristown, Tennessee. The cancer center has a dedicated high-speed CT scanner for treatment simulation, the latest technology in treatment planning, and other state-of-the-art technology. The program offers treatments such as external beam radiation therapy, Intensity Modulated Radiation therapy, High-Dose Rate Brachytherapy, and low-dose CT scans for early detection of lung cancer. Morristown-Hamblen's Heart, Lung, and Vascular Center offers a complete continuum of care including prevention, diagnostic, interventional, and rehabilitative services for both inpatients and outpatients. Tests available include EKGs, Holter monitors, echocardiograms, and stress testing. Diagnostic and interventional exams are performed using advanced technologies in angioplasty, drug-eluting stents, intra-aortic balloon pumps, and closure devices. Cardio and pulmonary rehabilitation programs are designed to help people who have experienced cardiovascular events (e.g., heart attacks, angioplasty/stents, coronary artery bypass graft surgery, etc.) and pulmonary conditions (e.g., chronic obstructive pulmonary disease, emphysema, respiratory symptoms, etc.) recover faster and improve their quality of life. Both outpatient programs include exercise, education, counseling, and support for patients and their families. Morristown-Hamblen opened a new Women's Healthcare Center in 2018, offering care for women in all stages of life and includes specialties such as gynecology, pregnancy care, hormonal and menopause management, and gynecological surgery. The Center partners with the Hamblen County Foundation for Educational Excellence to provide "toolkits" with community resources and parenting guides to each new mother at the hospital.IMPROVING THE COMMUNITY'S QUALITY OF LIFE THROUGH BETTER HEALTHThe Meds to Beds program is a partnership between Morristown-Hamblen, College Park Pharmacy, and Covenant HomeCare. Studies show that 35 percent of patients do not get their medications filled at discharge, which exacerbates health issues for patients and increases the chances for readmission within 30 days. Patients who present with symptoms of a chronic illness are at high risk to develop other health problems solely due to a lack of medication compliance.The Meds to Beds program focuses on at-risk diagnoses of myocardial infarction, pneumonia, chronic heart failure, chronic obstructive pulmonary disease, and complicated Type II diabetes; however, the program is open to anyone that wants to participate. Patients receive increased education upon discharge, online consults from the patient at the hospital to the pharmacist, follow-up phone calls from the pharmacist and the hospital's quality department to review the medication plan, and ease of delivery and packaging of all medications. This program helps reduce readmission rates, which helps patients can lower risk for serious medical complications. COVENANT HEALTH SYSTEMMorristown-Hamblen 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 10,000 employees, affiliated physicians and volunteers, Covenant Health is the Knoxville area's largest employer and has been named by Forbes as a Best Employer four years in a row. 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.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.Morristown-Hamblen, 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. 86038897 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 65 0 1 854 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 18 16 0 0 1 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 1237 0 Willard Campbell MD Director 0.00 1.00 X 0 0 0 Michael Casey MD Director 0.00 1.00 X 0 1572 0 Ronni Chandler Director 0.00 1.00 X 0 0 0 Mitchell Dickson MD Director 0.00 1.00 X 0 1612 0 James Fitzsimmons Director/Chair 0.00 1.00 X X 0 1081 0 James Gibson Director 0.00 1.00 X 0 1081 0 Eddie Mannis Former Director (through March 2018) 0.00 1.00 X 0 0 0 Timothy Matthews Director 0.00 1.00 X 0 1438 0 Larry Mauldin Director 0.00 1.00 X 0 1429 0 Joseph Metcalf MD Director 0.00 1.00 X 0 14046 0 Linda Ogle Director 0.00 1.00 X 0 0 0 Roger Osborne 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 1563 0 Richard Swanson Director 0.00 1.00 X 0 0 0 David C Verble Director 0.00 1.00 X 0 0 0 Amber Wisner Director 0.00 1.00 X 0 1438 0 James D VanderSteeg President & CEO 0.00 50.00 X X 0 1578890 192255 John T Geppi EVP/CFO 0.00 50.00 X 0 951309 27744 Anthony L Spezia CEO - Emeritus 0.00 40.00 X 0 606147 15119 Gordon E Lintz President & CAO 50.00 0.00 X 0 380192 19723 Amy E Herndon VP - Financial Services 50.00 0.00 X 150057 0 19896 Wilma G Hart-Flynn VP - Chief Nursing Officer 50.00 0.00 X 197005 0 17164 Victoria E Adams Pharmacist 50.00 0.00 X 117394 0 25099 Robert J Drinnon Medical Physicist 50.00 0.00 X 174192 0 27625 Deborah J Clifton Director - Surgical Services 50.00 0.00 X 109226 0 17863 Iva D Starnes Radiation Oncology Dosimetetrist 50.00 0.00 X 107361 0 27646 Pamela S Western Pharmacist 50.00 0.00 X 126251 0 17138 Jacqueline H Hounshell Fmr VP-Finance; Curr LMC VP-Finance 0.00 50.00 X 0 153257 25467 Billy J Black MD Fmr HCE; Curr Perinatal Physician 0.00 40.00 X 0 239809 13358 981486 3936101 446097 11 1 1 0 Siemens Medical Solutions USA Inc 40 Liberty Blvd Malvern PA 19335 Maintenance & Support 643013 GE Healthcare 500 West Monroe St Floor 21 Chicago IL 60661 Maintenance & Support 630714 Sodexo Inc 9801 Washingtonian Blvd Gaithersburg MD 20878 Housekeeping Service 618011 Angelica Textile Services Inc 1105 Lakewood Pkwy Ste 210 Alpharetta GA 30009 Linen Service 446261 Airtech Service Co Inc 7140 Small Creek Way Powell TN 37849 HVAC Maintenance 331520 19 295917 100 295917 Net Patient Revenue 622110 94793841 94793841 Meaningful Use 900099 189617 189617 Rental Income - Exempt Affiliate 531120 101701 101701 95085159 7881 7881 258628 132589 126039 126039 126039 1017726 1021809 -4083 -4083 -4083 Cafeteria 722514 298244 298244 Gift Shop 453220 67959 67959 Vending 454210 29624 29624 52927 25585 27342 448754 95959667 95110744 126039 426967 12093 12093 1500 1500 384122 384122 26323993 25857737 466256 410432 404010 6422 2991725 2929577 62148 1903679 1845562 58117 8859264 8669892 189372 86474 86474 8674542 8602354 72188 180461 174952 5509 570687 507909 62778 2305517 2143580 161937 49518 44229 5289 33117 28224 4893 5034 5034 5633607 5633607 165244 162374 2870 Unrelated Business Inco 48546 48546 Supplies & Equipment 21180978 21180978 Bad Debt 6349369 6349369 Malpractice Reserve 810000 810000 809907 675916 133991 87789809 86038897 1750912 0 1400 1300 -519787 -79400 8541462 11534707 1502608 1329129 364769 325431 132877340 86984214 38359480 45893126 8819138 8819138 64565 83981 57133635 67907412 5943573 7426110 2988943 188945 282750 544599 9215266 8159654 X 47918369 59747758 47918369 59747758 57133635 67907412 X 8169858 -7636 3667167 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2541125 2541125 60602260 37087011 23515249 68807165 49733447 19073718 926790 163756 763034 45893126 Due to Affiliates, Net 125321 Due to Third Party Payors 337928 Long-term Deferred Compensation 81350 544599 X Part X, Line 2: Excerpt from the consolidated audited financial statements of Covenant Health (Covenant), parent company to Morristown-Hamblen Hospital Association: 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, 2018. As such, no interest or penalties were recognized in the consolidated financial statements related to unrecognized tax benefits. At December 31, 2018, tax returns for 2015 through 2018 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, 2018. 1 1 X 1 X 1 X 1 1 1 0 1 1 7607615 2922682 4684933 0.05750 24355801 21705467 2650334 0.03250 17165 18068 0 0.00000 31980581 24646217 7335267 0.09000 50065 50065 0.00060 1500 1500 0.00000 5396798 2240887 3155911 0.03880 33575 33575 0.00040 5481938 2240887 3241051 0.03980 37462519 26887104 10576318 0.12980 85 85 0.00000 2982 2982 0.00000 20037 20037 0.00020 414 414 0.00000 23518 23518 0.00020 1 6349369 1155585 18194387 15940100 2254287 X 1 1 1 1 Morristown-Hamblen Healthcare System 908 W Fourth North St Morristown TN 37814 www.morristownhamblen.com 00000073 X X X Morristown-Hamblen Hospital Association 1 0 0 1 X X X X X X X X 17 1 0 1 1 X See Part V, Page 8 X 1 17 1 See Part V, Page 8 0 1 X 200.000000000000 300.000000000000 X X 1 1 X X X 1 X https://www.morristownhamblen.com/financial-assistance/ X https://www.morristownhamblen.com/financial-assistance/ X https://www.morristownhamblen.com/financial-assistance/ X X X X X X 1 X 0 X X X 1 X 0 0 Morristown-Hamblen Hospital Association Part V, Section B, Line 5: Morristown-Hamblen Hospital Association, dba Morristown-Hamblen Healthcare System ("Morristown-Hamblen") was guided in the assessment process by representatives of several community organizations whose expertise and relationships helped the hospital access the general population as well as the most vulnerable residents of Hamblen County. Assessment partners were recruited from the broader public health system including staff from the local health department, United Way director, local school system, court system, public safety, senior programs, and social service organizations that serve the needs of the community's most vulnerable and at-risk population. The assessment process began with a half-day community health forum using an assessment tool "Forces of Change" by the Center for Disease Control. Thirty participants representing a diverse make up of stakeholders gave input into the significant issues facing Hamblen County. The Data Team members represented the health department, United Way, the Senior Citizens Center, the Hamblen County Health Council, Emergency Medical Services, Douglas Cherokee and Smoky Mountain Home Health and Hospice. These community leaders analyzed and distilled volumes of data into a short list of the most significant health issues affecting Hamblen County.Part V, Section B, Line 4:It was determined per audit that while the Community Health Needs Assessment ("CHNA") was prepared as of December 31, 2016, it was completed on May 8, 2017 with board approval. Morristown-Hamblen Hospital Association Part V, Section B, Line 6b: Morristown-Hamblen's CHNA was conducted with the following organizations and individuals: - Hamblen County Health Department - Hamblen County Health Council - Hispanic Outreach Leadership of the Lakeway Area - Helping Hands Clinic - Helen Ross McNabb Center - Smoky Mountain Home Health and Hospice - Hamblen County Mayor's Office - Hamblen County Jail - Boys and Girls Club - Coordinated School Health - Chamber of Commerce - Ministerial Association Temporary Shelter - Hamblen County Sheriff's Office - Hamblen County United Way - Hamblen County Housing Authority - Douglas Cherokee Economic Authority, Inc - ALPS Adult Day Services - Morristown Police Department - Department of Human Services Morristown-Hamblen Hospital Association Part V, Section B, Line 11: Of the significant findings identified in the CHNA, Morristown-Hamblen is focusing its resources on the following priorities: Prescription Drug AbuseMorristown-Hamblen leaders are active members of the local Prescription Drug Task Force which also includes local judicial and health department officials. The Task Force is currently developing solutions for prescription drug abuse in Hamblen County. Education was recently provided to community leaders on the significance of the issue through the Leadership Morristown program.Cancer and Heart DiseaseMorristown-Hamblen is focused on smoking cessation as a way to combat cancer and heart disease. The hospital provides quarterly "Freedom from Smoking" classes through the hospital's cardiopulmonary rehab program.Be Smart, Don't StartThis is a collaboration between the hospital, the health department and the Department of Education to reduce smoking among teens in Hamblen County. The campaign was launched in August of 2017 targeting middle and high school students. Students at school and at the local Boys and Girls Club signed a pledge and a banner was hung in the gym as a reminder of their commitment.ObesityTwice yearly Morristown-Hamblen participates with other Covenant Health organizations in a Biggest Winner employee health improvement program. Each program cycle includes up to 20 employees who focus on weight loss and improving personal health biometrics. Local greenways and trails are used for the exercise component. Pre- and post-testing are provided for participants to track their health improvements. In 2017, 8 employees joined the program and are continuing into 2018.Morristown-Hamblen implemented a Get on Trails program to encourage residents to exercise. Participants agree to walk 25 miles during a two month period, record their trails and distances, and redeem their hard work for an embroidered patch. Each subsequent year will earn a new patch. Morristown-Hamblen partnered with local Panther Creek State Park and publicized this program to its employees and to the community at large. In 2018, 20 participants completed the 26.2 mile program at Panther Creek State Park.Healthy Hamblen County CommissionMorristown-Hamblen participates in a series of community exercise events. Local patients and residents are able to participate in walk events and try multiple types of exercise and fitness opportunities. This program is on-going. Friday Fitness ClubMorristown-Hamblen initiated a Friday Fitness Club in the fall of 2018. This is a collaborative effort with the Hamblen County Parks and Recreation and state parks to sponsor a joint hike one Friday each month.CancerMorristown-Hamblen offers a Low-dose CT scan as a diagnostic screening to those at high risk for lung cancer. Physician education efforts are underway to educate primary care physicians on the benefits of this tool. Recently a program was provided at Cancer Committee with the purpose of increasing participation rates.Morristown-Hamblen participates in the Thompson Cares Breast Health Program. This is a continuing program which provides women with opportunities to receive screening mammograms regardless of their ability to pay. Mental HealthMorristown-Hamblen continues to collaborate with local mental health resources as needed and as services are available. The hospital does not provide mental health services. Morristown-Hamblen Hospital Association 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.morristownhamblen.com/community-health-needs-assessment/ Part V, Line 10a, Implementation Strategy Website https://www.morristownhamblen.com/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. 3 1 - Ambulatory Surgery Center 908 W Fourth North Street Morristown TN 37814 Outpatient Surgery Center 2 - Morristown Regional Diagnostic Center 901 W Fourth North Street Morristown TN 37814 Outpatient Diagnostic Center 3 - Morristown Sleep Disorder Center 924 W Fourth North Street Morristown TN 37814 Sleep Diagnostic Center Part I, Line 3c: In addition to the FPG (federal poverty guidelines), Morristown-Hamblen 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). Part I, Line 6a: Covenant Health, the parent company of Morristown-Hamblen 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 cost of providing in-patient behavioral health exceed the payments received by $546,897. The total also includes $2,609,015 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. 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 $6,349,369. Part II, Community Building Activities: Morristown-Hamblen 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 2018 were made to organizations meeting the community's needs by providing: - The basic needs of life including temporary shelter, food and clothing (Catholic Charities and Ladies of Charity) - Youth mentoring, development and after-school programs (Emerald Youth Foundation, Boys and Girls Club, The Change Center, Young Life, Williams Creek Youth Foundation and the Dollywood Foundation) - Business recruitment and marketing initiatives that boost economic development (East Tennessee Economic Development Agency and Knoxville Urban League) - Leadership development programs and workshops (Leadership Knoxville and Junior Achievement) - 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., East TN Technology Access Center, and Variety - The Children's Charity of Eastern Tennessee) - Improve access to health services (Interfaith Health Clinic, St. Mary's Legacy Clinic, and Knoxville Academy of Medicine) - Programs supporting patients and their families (Alzheimer's Tennessee, Cancer Support Community, Inc., and Random Acts of Flowers) 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: At regular intervals, the Vice President of Patient Account Services analyzes all self-pay accounts receivables to identify patients who may have been eligible for charity care during a particular period or year. Because this analysis does not yield a final determination of eligibility due to various factors including but not limited to charity applications still in process, failure of eligible patients to submit their charity application, and applications still under consideration, further analysis of the accounts comprising the self-pay accounts receivable is conducted. The accounts for which a patient was contacted to apply for charity care include an identifier; these charity-identified accounts are then categorized according to status. A ratio of the dollar amounts of those accounts whose charity application is in process or has been approved divided by the total self-pay accounts receivable is computed. This ratio is applied to the bad debt expense total to determine the estimated amount of the bad debt expense attributable to patients eligible for charity care according to the hospital's policy. Part III, Line 4: Note B to the 2018 Audited Consolidated Financial Statements of the Covenant Health system, of which Morristown-Hamblen 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: Morristown-Hamblen 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: Morristown-Hamblen 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 72% 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.Morristown-Hamblen 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 Morristown-Hamblen 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. Morristown-Hamblen 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. Morristown-Hamblen does not sell any accounts receivable accounts to outside firms. All accounts remain property of and under the policies set by Morristown-Hamblen. Morristown-Hamblen 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. Morristown-Hamblen obtains additional community information through the service of its employees with the Hamblen County Health Council, the Chamber of Commerce, and Rotary Clubs, and through its community health outreach in the local shopping mall. 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: Morristown-Hamblen informs patients and other persons who may be billed for patient care about its FAP by posting signs in highly visible areas of the hospital and including information about the FAP in patient booklets placed in all inpatient rooms. In addition, the FAP and application are available via the facility website and notice of the availability of financial assistance is communicated via patient billing statements. The following sign is posted in the main registration area:Financial Assistance: Covenant Health is committed to providing quality health services in a caring environment. It is the expressed philosophy of Covenant Health, and its member hospitals, that no one should be denied necessary medical care because of the inability to pay. In conjunction with this philosophy, staffs of Morristown-Hamblen Healthcare System 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, Morristown-Hamblen Healthcare System in compliance with Tennessee Code Annotated, Title 47, Chapter 18 and Title 68, will provide at a reduced rate, medically indicated services. A financial counselor is available to assist you with these matters by calling 423-492-5053, Monday through Friday between the hours of 8:00 a.m. and 4:00 p.m.Morristown-Hamblen employs full time financial counselors who meet with each uninsured patient. In addition, Morristown-Hamblen Hospital Association assists them with completion of a TennCare application and ensures the application is directed to the appropriate Department of Human Services.The FAP states that patients who are unable to pay and have exhausted all sources of payment assistance may be screened for potential charity care eligibility. According to the policy, the financial counselors initiate screening of the patient and/or guarantor by obtaining income and other financial information to determine eligibility for charity care or discounted services. Part VI, Line 4: Hamblen County, Tennessee, is the primary market area for Morristown-Hamblen. Hamblen County is a rural community with close proximity to the metropolitan Knoxville area. According to internal hospital data for 2018, 58% of the patient encounters (inpatient and outpatient) are residents of Hamblen County.According to 2018 data from the County Health Ranking report of the Robert Wood Johnson Foundation, the population of Hamblen County is 63,785. The population is evenly split between men and women. Persons 65 and older account for 18.2% of the population. Hamblen County has one of the largest Hispanic populations in East Tennessee at 11.9%. The median income of Hamblen County is $42,000 per household with 25% of the population living below the poverty level. Unemployment is at 5.2%.According to the 2018 County Health Rankings Report by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, Hamblen County residents have the following health indicators that are above the national benchmarks: Hamblen - TN - National Adult Smoking: 24% - 22% - 14% Adult Obesity: 32% - 32% - 26% Teen Birthrate: 48 - 36 - 15 of every 1,000 teenage girls Poor or Fair Health: 23% - 19% - 12% Physical Inactivity: 32% - 30% - 20% Drug Overdose Deaths: 33 - 22 - 10 per 100,000 population Part VI, Line 5: Morristown-Hamblen, in conjunction with its parent company, Covenant Health, is committed to providing quality health care services in a caring environment that fulfills the needs of patients, physicians, employers, employees, and the community.Covenant Health's Board of Directors serves as Morristown-Hamblen's board. The board is comprised of independent community leaders with diverse educational and professional backgrounds. The board sets policies and provides oversight of Morristown-Hamblen.Morristown-Hamblen maintains an open medical staff, with privileges available to all qualified physicians and healthcare professionals. Additionally, the hospital operates an active and accessible emergency department open to all persons, regardless of the ability to pay.The hospital uses any available surplus of receipts over disbursements to expand and modernize its facilities and to advance its medical training and education programs, both of which serve to improve patient care and serve the unmet needs of the community.Morristown-Hamblen provides numerous education and outreach efforts to the community, ranging from health screenings and fairs to presentations to area groups. The various programs and services are provided complimentary or at a minimum charge. These are offered throughout the year based upon activities and services which the hospital believes will serve a bona fide community need. In addition to health education programs and activities, the hospital participates in other community outreach and support programs, including various community activities to benefit civic organizations, local schools, and members of the community. The hospital values the relationships maintained with the community organizations and provides conference rooms for a variety of meetings, seminars, and educational programming at no charge to outside groups. Additionally, the hospital provides other in-kind services and staff support to many area support groups. In these and other respects, the hospital is organized and operated in a manner that promotes the health of the community and therefore fulfills charitable purposes within the meaning of Internal Revenue Code Section 501(c)(3). Part VI, Line 6: Morristown-Hamblen, 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 in 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. Morristown-Hamblen's 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, 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 Hamblen County Foundation for Educational Excellence 120 Evans Avenue Suite 216 Morristown TN 37816 621470855 501(c)3 7500 General support 1 0 Part I, Line 2: Grant funds are provided to charitable organizations for the purpose of enhancing and promoting health care in the local community. The organization has guidelines in place to review the eligibility of grantees, and all grants require written documentation and appropriate levels of approval. Funds are generally not tracked after being granted as the original eligibility and selection criteria have been met. X 1 1 0 1 0 0 0 0 0 0 0 James D VanderSteeg President & CEO 0 1023861 0 420000 0 135029 0 169408 0 22847 0 1771145 0 0 John T Geppi EVP/CFO 0 605182 0 251100 0 95027 0 10800 0 16944 0 979053 0 0 Anthony L Spezia CEO - Emeritus 0 49155 0 0 0 556992 0 10800 0 4319 0 621266 0 0 Gordon E Lintz President & CAO 0 257257 0 62100 0 60835 0 10800 0 8923 0 399915 0 0 Amy E Herndon VP - Financial Services 108099 0 17626 0 24332 0 3983 0 15913 0 169953 0 0 0 Wilma G Hart-Flynn VP - Chief Nursing Officer 176974 0 16826 0 3205 0 2317 0 14847 0 214169 0 0 0 Robert J Drinnon Medical Physicist 174109 0 0 0 83 0 5445 0 22180 0 201817 0 0 0 Jacqueline H Hounshell Fmr VP-Finance; Curr LMC VP-Finance 0 108152 0 14592 0 30513 0 5159 0 20308 0 178724 0 0 Billy J Black MD Fmr HCE; Curr Perinatal Physician 0 239136 0 0 0 673 0 0 0 13358 0 253167 0 0 Part I, Line 1a Tax gross-up payments related to deferred compensation are provided to certain executives and managers. Amounts are included in taxable compensation. Part I, Line 3 Covenant Health, the parent company of Morristown-Hamblen Hospital Association, 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 $158,608 are reported as deferred compensation on Schedule J, Part II, Column C. Contributions along with 2018 earnings of $19,018 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). Anthony L. Spezia retired as President and CEO in 2016 after serving Covenant Health for twenty years. Mr. Spezia was named CEO-Emeritus and continued serving the organization through early 2018 as a consultant. During 2018, Mr. Spezia received distributions from two NQDC plans resulting from contributions and associated earnings on contributions. Amounts vested in 2018 total $476,126 and are included in other reportable compensation on Schedule J, Part II, Column B(iii). Form 990, Part VI, Section A, line 4 In 2018, the Covenant Health system-wide bylaws were amended to provide that new directors who have not previously served on the board will be elected to an initial one-year term instead of three years (the previous standard). Amendments also grant authority to the compensation committee to negotiate and approve the CEO's compensation. The bylaws were also amended to authorize the board to establish special board committees which may be terminated by resolution of the board. The chairman of the board may establish special board committees to advise executive leadership, other board committees or the full board. Committees may be composed of elected or ex-officio board members. Also in 2018, Covenant Health adopted system-wide medical staff bylaws. The bylaws created two new committees: System Quality Committee and System Credentials and Clinical Standard Committee. The System Quality Committee consists of licensed physician voting board members, other appointed voting board members, Covenant Health's CEO, and the chiefs of staff of Covenant Health system hospitals. The committee shall review quality of patient care, perform other duties assigned in the system-wide medical staff documents, receive and review proposed amendments to the medical staff documents and make recommendations to the board, initiate quality-related investigations, and act as a Quality Improvement Committee as defined under Tennessee law. The System Credentials and Clinical Standard Committee consists of licensed physician voting board members and other appointed board members. Covenant Health's VP of Hospital Operations, Chief Medical Officer, and Chief Nursing Officer shall also serve as non-voting members of the committee. The committee shall develop and implement system-wide clinical standards, perform other duties as outlined in the medical staff documents, make determinations regarding routine credentialing matters and medical staff appointments/terminations, and act as a Quality Improvement Committee as defined under Tennessee law. Other 2018 amendments to the governing documents were not considered significant. Form 990, Part VI, Section A, line 6 Covenant Health is the sole member of Morristown-Hamblen Hospital Association. Form 990, Part VI, Section A, line 7a Covenant Health's board of directors also serves as the board of directors for Morristown-Hamblen Hospital Association. Form 990, Part VI, Section A, line 7b Governance decisions of Morristown-Hamblen Hospital Association 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, the parent company of the organization, distributes a board-approved Code of Conduct to all employees. The Code covers among other subjects, conflicts of interest. Additionally, managers are required to complete and sign a bi-annual management certification that addresses conflicts of interest. 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 key employees. These records are available to be queried prior to engaging in business transactions. The Chief 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. 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 Morristown-Hamblen Hospital Association, 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 Form 990. The process for Morristown-Hamblen Hospital Association'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 Gordon Lintz, 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 salary 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 Morristown-Hamblen Hospital Association 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 XI, line 9: Transfers of Capital 3,667,167. 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