2016-11-10T09:19:17-06:00 2015-12-31 990 2015-01-01 620790132 Cumberland Medical Center CUMB 8653746864 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 JOHN T GEPPI EVP/CFO 8653746872 2016-11-09 2015 2017-02-10 21:41:12Z James D Vandersteeg 100 Ft Sanders W Blvd Knoxville TN 37922 88745505 0 X 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 18 1017 136 1117959 0 86878 32040 98200620 86511756 545342 356373 2401187 1211765 101234027 88111934 12700 24640 0 0 48587967 33985019 0 0 0 54538292 51482728 103138959 85492387 -1904932 2619547 93367857 88784480 29850015 21833464 63517842 66951016 X See Schedule O.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 7419327 6223902 Inpatient Services: See Schedule O.Inpatient Services: Expenses - $7,419,327; Revenue - $6,223,902Cumberland Medical Center (CMC) is licensed for 189 beds. Fully accredited by the Joint Commission, CMC is an acute care hospital offering all private patient rooms as well as specialized services not usually found in the rural medical system. For seriously ill patients, advanced medical and surgical care is provided at CMC including telemetry monitored beds and an intensive care unit. Additionally, CMC offers an outpatient imaging center, same day surgery unit, cardiac and pulmonary rehab programs, a sleep disorder center, regional breast center (offering digital mammography), regional cancer center, durable medical equipment services division, and a hyperbaric medicine and wound center.In 2015, 5,170 patients were admitted for inpatient care resulting in 20,368 patient days or an average length of stay of 3.9 days. The physicians, staff, and volunteers of Cumberland Medical Center are dedicated to providing excellent quality care to every patient, every time. To complete the health team, there are 87 highly skilled physicians working with over 763 employees and 116 caring volunteers to deliver quality care to the residents of the Cumberland Plateau. Physicians on staff include the specialties of anesthesiology, cardiology, neurology, obstetrics, opthalmology, oncology, oral surgery, orthopedics, pediatrics, radiology, radiation oncology, urology, and vascular surgery. There are an additional 115 physicians that provide consulting and temporary staffing services as needed. 4302420 4838481 Surgical Services: See Schedule O.Surgical Services: Expenses - $4,302,420; Revenue - $4,838,481In 2015, surgeons at Cumberland Medical Center performed 8,141 surgical procedures across a range of specialty areas, including: general, gastroenterology, neurology and neurosurgery, urology and vascular surgery. Cumberland Medical Center's Surgery department consists of six major operating rooms, one cystoscopy room utilized primarily for urologic procedures, and a minor operating room utilized for outpatient procedures requiring a local anesthetic only. Four major operating rooms are equipped with state-of-the-art 1080p High Definition Endoscopic Video equipment, LED surgical lighting, and information routing. Surgical interventions are performed on an inpatient and outpatient basis with the majority of patients admitted through the Same Day Surgery Unit. Cumberland Medical Center's "Suite Operating Rooms" (i-Suite) are fully integrated, high-definition operating rooms. The i-Suite provides a new level of medical care while allowing the medical center to increase the productivity of its staff, reduce overall operative costs and most importantly, improve procedural efficiency which can boost patient outcomes. Cumberland Medical Center is the first healthcare facility in the state of Tennessee to implement the Stryker fully-integrated surgical suites with 1080p HD video. The i-Suite operating rooms serve as the centerpiece for CMC's technological advancement for both its patients and its staff. 2503387 7213412 Emergency Services: See Schedule O. Emergency Services: Expenses - $2,503,387; Revenue - $7,213,412In 2015, Cumberland Medical Center's (CMC) Emergency Department treated 32,890 patients. Emergency physicians are on duty 24 hours a day, 7 days a week. General and specialty surgeons provide round-the-clock coverage and treatment.Cumberland Medical Center's Emergency Department meets criteria to ensure trauma care capability and institutional performance. CMC provides hospital resources necessary for emergency care, along with the entire spectrum of care to address the needs of all injured patients. Cumberland County's Emergency Medical Service provides both emergency and inter-facility transportation for area patients. 68765757 24640 68247007 As a full-service acute care hospital, Cumberland Medical Center treats patients across a broad spectrum of medical specialties. 68765757 24640 68247007 82990891 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 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 78 0 1 1017 1 1 1 0 0 0 0 0 0 0 0 0 X 23 18 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 1 0 X X Nancy Beck 8653746864 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 X Ed Anderson Director 0.00 1.00 X 0 1435 0 Gerald Boyd Director 0.00 1.00 X 0 1316 0 Dr Willard Campbell Director 0.00 1.00 X 0 0 0 Dr Michael Casey Director 0.00 1.00 X 0 2275 0 Dr Mitchell Dickson Director 0.00 1.00 X 0 1919 0 Pamela P Fansler Director 0.00 1.00 X 0 0 0 Homer Fisher Director 0.00 1.00 X 0 0 0 James Fitzsimmons Director 0.00 1.00 X 0 1813 0 Jim Johnson Jr Director 0.00 1.00 X 0 1272 0 Amber Krupacs Director 0.00 1.00 X 0 1741 0 Eddie Manis Director 0.00 1.00 X 0 0 0 Timothy Matthews Director 0.00 1.00 X 0 1637 0 Larry Mauldin Chairman 0.00 1.00 X 0 1422 0 Dr Joseph Metcalf Director 0.00 1.00 X 0 0 0 George Miller Director 0.00 1.00 X 0 1270 0 Alvin Nance Director 0.00 1.00 X 0 1314 0 Linda Ogle Director 0.00 1.00 X 0 0 0 Roger Osborne Director 0.00 1.00 X 0 0 0 Carl Storms Director 0.00 1.00 X 0 1206 0 Joseph E Sutter Director 0.00 1.00 X 0 1490 0 Richard Swanson Director 0.00 1.00 X 0 1444 0 David C Verble Director 0.00 1.00 X 0 1428 0 Anthony L Spezia President & CEO 0.00 50.00 X X 0 1660333 230699 John T Geppi EVP/CFO 0.00 50.00 X 0 795717 27890 Jeremy Biggs President & CAO 50.00 0.00 X 0 311644 31593 Larry Moore VP-Financial Svcs. 40.00 0.00 X 205665 0 17871 Amanda Grubb Halford MD Chief Medical Officer 40.00 0.00 X 17603 243253 22162 Sivalingam Kanagasegar MD Physician 1.00 40.00 X 13846 486284 20472 Thomas A Allingham MD Physician 40.00 0.00 X 444986 0 7950 Elmer R Gibbs Physician 8.00 32.00 X 20747 364065 20940 Muhammad Q Mir Physician 1.00 40.00 X 16126 257980 21197 Elias Abou-Zeid Physician 10.00 40.00 X 14190 501956 21181 733163 4644214 421955 10 0 1 0 Rentenbach Constructors Inc 2400 Sutherland Ave Knoxville TN 37939 Construction Services 665161 Medstream Anesthesia PLLC 82 Patton Avenue Suite 510 Asheville NC 28801 Anesthesia services 582823 Cardinal Health 21377 Network Place Chicago IL 60673 Pharmacy Management 579006 Dr James Barnawell 421 South Main Street Crossville TN 38555 Pathologist Services 330000 DHP Management Services 170 Southport Drive Morrisville NC 27560 Orthopedic Medical Services 315404 20 25000 7040 32040 Medical Services 622110 86165304 86165304 Meaningful Use 900099 305619 305619 Laboratory UBI 621500 40833 40833 86511756 363923 363923 725035 626021 99014 99014 31755 67259 7550 -7550 -7550 -7550 Wellness Center 713940 1045371 1045371 Clinical Student Rotations 900099 27125 27125 Credentialing Fees 900099 19750 19750 20505 5004 15501 1112751 88111934 86522802 1117959 439133 24640 24640 506554 506554 28110402 27263554 846848 462219 451351 10868 2707683 2641927 65756 2198161 2110539 87622 2640072 2581868 58204 87562 87562 9500 9500 6957913 6836231 121682 215201 185075 30126 621241 507821 113420 1217579 1163485 54094 3076374 2990609 85765 77359 58930 18429 82762 76106 6656 941594 941594 5872108 5872108 497759 497759 Supplies & Equipment 12050368 11914390 135978 Bad Debts 6353076 6353076 Charity Care 5490456 5490456 Sponsorship 4233448 4233448 1058356 795924 262432 85492387 82990891 2501496 0 4395170 2659735 776738 0 9772939 7687685 1320038 1217809 925878 1222067 154023692 87992520 66164251 66031172 150513 154120 9452680 9452680 409650 359212 93367857 88784480 8940615 5858803 20909400 15974661 29850015 21833464 X 63368893 66951016 148949 0 63517842 66951016 93367857 88784480 X 2619547 821480 -7853 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2586250 2586250 82806632 35222205 47584427 62940679 49927941 13012738 5690131 2842374 2847757 66031172 Capital Lease Liability 62952 Due to Affiliates, Net 13445012 Due to Third Party Payors 363445 Long-term Deferred Compensation 1126 Long-term Reserve for Malpractice 500000 Long-term Reserve for Workers Comp 183441 Other Reserves 160000 Security Deposits 18353 SWAP Agreement Liability 1240332 15974661 X Part X, Line 2: Note B to the consolidated audited financial statements of Covenant Health, parent company to Cumberland Medical Center, reads in part: "Income Taxes: Covenant and certain of its subsidiaries or controlled entities are exempt from income taxes pursuant to Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for income taxes on qualifying activities has been made for these entities in the accompanying consolidated financial statements. However, certain entities and operations are subject to income taxes (See Note G). Note G reads in part: "Covenant had no unrecognized tax benefits at December 31, 2015 and 2014. As such, no interest or penalties were recognized in the Consolidated Statements of Operations and Changes in Net Assets related to unrecognized tax benefits. At December 31, 2015, tax returns for 2012 through 2015 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, 2015 or 2014." 1 1 X 1 X 1 X 1 1 1 0 1 1 5625336 5625336 0.06580 10008453 5133195 4875258 0.05700 15633789 5133195 10500594 0.12280 29220 520 28700 0.00030 42159 42159 0.00050 5507507 1524853 3982654 0.04660 16872 16872 0.00020 5595758 1525373 4070385 0.04760 21229547 6658568 14570979 0.17040 20 20 0.00000 5920 5920 0.00010 13601 13601 0.00020 330 330 0.00000 19871 19871 0.00030 0 6353076 1054611 31025824 29269961 1755863 X 1 1 1 None 1 1 CUMBERLAND MEDICAL CENTER INC 421 SOUTH MAIN ST CROSSVILLE TN 38555 00000020 X X X Cumberland Medical Center 1 0 1 1 X X X X X X X X X 12 1 0 1 1 X www.cmchealthcare.org X 1 12 1 www.cmchealthcare.org 0 0 1 X 200.000000000000 300.000000000000 X X 1 1 X X X 1 X X X X 1 X 0 X X X X 1 X 0 0 Cumberland Medical Center Part V, Section B, Line 5: Cumberland Medical Center obtained community input using multiple methods. Over 600 residents were surveyed to gather information about their personal health and well-being. Physicians in the community were surveyed using an on-line survey. Additionally, five major employers representing more than 1,000 employees were interviewed about their current health and wellness programs. Finally, a Community Summit was conducted with more than 75 community leaders and citizens. The audience was a mix of healthcare workers and lay persons. Cumberland Medical Center Part V, Section B, Line 6b: Several community and health care organizations formed a collaborative team to implement a five stage process focused on identifying and defining our local health issues, concerns and needs. The team worked together for five months to gather and analyze data, and provide direction for the full report. Participating organizations include: *City of Crossville/Cumberland County *Cumberland County Health Department *Fairfield Glade Community Club *Fairfield Glade Ladies Club *Lake Tansi Village *American Cancer Society *Cumberland County Sheriff's Office *Crossville Chronicle *Cumberland Community Health Coalition *University of Tennessee Regional Extension Center *Wyndridge Health and Rehabilitation Center *Crossville-Cumberland County Chamber of Commerce Cumberland Medical Center Part V, Section B, Line 2: In 2014 Cumberland Medical Center was acquired by Covenant Health, a nonprofit hospital system. Cumberland Medical Center Part V, Section B, Line 11: Based on input from the Hospital's Leadership and Community Summit, the following actions were agreed upon and form the foundation of Cumberland County's health initiatives: Obesity/ Exercise/ Lifestyle / Health Education *Support the Walks-a-lot initiative with the Cumberland County Health Department, Walgreens, and Big K *Perform weekly educational seminars at the Senior Fair Park Center and the CMC Wellness Center by the Medical Staff and Medical Students on healthy living, new procedures, cancer, heart healthy, preventative measures that promote good health, such as smoking cessation, healthy eating, and exercise *Promote community health fairs to provide education and health screenings Healthcare Affordability *Provide health fairs with affordable wellness screenings *Provide free sports physicals for students *Offer a sliding scale for those that are not employed, on a fixed income and/or do not have insurance through the Cumberland Physician GroupPhysicians / Access *Establish a walk-in clinic *Provide affordable care *Recruit more physicians to the areaDrug Abuse *Work with the sheriff's department on the Drug Take Back Program *Sponsor the Tansi Police Academy *Provide medical staff in-service on new prescription drug act Heart Health *Provide education to make the community aware of the signs of heart disease - Go Red for Women *Offer education programs to promote healthy eating, smoking cessation and exercise *Support the Cardiac Rehab Program Diabetes *Support the Diabetes Program available at CMC Wellness - staffed by an RN and a dietitian *Promote Health Fair education, screening and management *Identify patients through screenings and provide referrals to appropriate community assistance resourcesCancer *Promote early detection and prevention through Nursing Navigator, affordable mammograms and educational seminars *Suppport the Cancer Center with its efforts to provide smoking cessation classes *Partner with ACS / Relay for Life and Suzan G. Komen All needs identified in the CHNA are being addressed. Cumberland Medical Center Part V, Section B, Line 16i: Please see the explanation to Part VI, Line 3. Cumberland Medical Center Part V, Section B, Line 22d: Please see the explanation to Part III, Line 9b. 7 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 - Cumberland Physicians Group 133 Hayes St Crossville TN 38555 General and Specialty Physicians 4 - CMC Medical Equipment Services 591 South Main St Crossville TN 38555 Medical equipment and oxygen 5 - CMC Wound Center 421 South Main St Crossville TN 38555 Wound and hyperbaric treatment 6 - Cumberland Medical Center at FFG 130 Stonehenge Dr Crossville TN 38555 Wellness, physical therapy, x-ray and mammography 7 - CMC Wellness Complex 130 Woodmere Mall Crossville TN 38555 Wellness management Part I, Line 6a: Covenant Health, the parent company of Cumberland Medical Center and other affiliated acute care hospitals, prepares an annual Report to the Community on behalf of the entire system. Part I, Line 7: Amounts on Lines 7a-7c and certain program costs included 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: The subsidy of $1,654,831 is the difference between the cost of services provided in the hospital's physician offices, Wound Care Center, and Senior Perspectives and the payments received for those services. 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. The cost of providing these services exceeded the payments received by $1,617,756 during the reporting period.The wound care center provides hyperbaric and would treatment services. The cost of providing services exceeded revenue by $30,369.Senior perspectives provides behavioral health services to senior citizens. Revenue for these services exceeded the cost received by $276,793 during the reporting period. Part II, Community Building Activities: Cumberland Medical Center cares for the whole person and recognizes that improved social and economic conditions may lead to the improved health and well-being of the community. The hospital's community building activities and those of its parent organization, Covenant Health, address many of the root causes of health problems, such as poverty and homelessness, and help find solutions to 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. In 2014 contributions were made to organizations meeting the community's needs by providing: *Affordable, permanent housing and case management services to foster self-sufficiency - Habitat for Humanity *Literacy programs - Dollywood Foundation *The basic needs of life including temporary shelter, food and clothing - Catholic Charities, Ladies of Charity, United Way and others *Youth mentoring and development and after-school programs - Emerald Youth Foundation, Boys and Girls Club and Great Smoky Mountain Council, Boy Scouts of America *Business recruitment and marketing initiatives that boost economic development - Innovation Valley and East Tennessee Economic Development Agency *Leadership development programs and workshops - Leadership Knoxville *Assistance and special programs for at risk, physically challenged, abused and neglected children -Variety of Eastern Tennessee (local chapter of Variety-The Children's Charity) and East TN Tech Access Center, Inc. *Improve access to health services - Interfaith Health Clinic and Knoxville Academy of Medicine Part III, Line 4: Note B to the 2014 Audited Consolidated Financial Statements of the Covenant Health system, of which Cumberland Medical Center is a member, reads in part: "Patient accounts receivable are reported net of both an estimated allowance for uncollectible accounts and an estimated allowance for contractual adjustments. The contractual allowance represents the difference between established billing rates and estimated reimbursement from Medicare, TennCare and other third-party payment programs. The allowance for uncollectible accounts is estimated based upon the age of the patient accounts receivable, prior experience and any unusual circumstances (such as local, regional or national economic conditions) which affect the collectability of receivables, including management's assumptions about conditions it expects to exist and courses of action it expects to take. Covenant's policy does not require collateral or other security for patient accounts receivable and Covenant routinely accepts assignment of, or is otherwise entitled to receive, patient benefits payable under health insurance programs, plans or policies." Part III, Line 8: Medicare Shortfall: Cumberland Medical Center believes that all of the $2.8 million shortfall reported in Line 7 should be considered as community benefit. The IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in our community. This year, Medicare patients accounted for 58.4% of total patients' days (14,588 out of 24,966 total). The hospital provided care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. Costing Methodology: Cumberland Medical Center used a combination of sources in calculating Medicare allowable costs on Part III, Line 6 including its cost accounting system, general ledger accounting system, and facility-specific analyses and calculations. Part III, Line 9b: Self-pay patients automatically receive a minimum 35% discount on charges. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment assistance may qualify for charity care. A sliding scale is used for extending charity care utilizing the income levels reported under the federal poverty guidelines. Patients/guarantors with income that falls below 200% of the federal poverty guidelines receive 100% charity care. Patients/guarantors with income of 201-300% of the federal poverty guidelines receive 70% charity care.For catastrophic illness, exceptions to income and asset limitations may be made on a case-by-case basis. The amount considered for charity will be based upon the evaluation of the patient's/guarantor's ability to pay.Patients/guarantors who qualify for partial financial assistance are responsible for paying any balance remaining after the charity adjustment and third party payments. Once an account has been processed internally through routine collection channels, it may be assigned to an attorney or agency for collection. The patient/guarantor will be billed for all collection costs as may be applicable. Credit reports will be filed no earlier than 30 days following the assignment on all nonpaid balances. Part VI, Line 2: While the Community Health Needs Assessment is a formal means by which the health system assesses the needs of the community, there are many informal linkages that give the Covenant Health hospitals a sense of community issues and needs. Cumberland Medical Center 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. Part VI, Line 3: Cumberland Medical Center informs patients and other persons who may be billed for patient care about its financial assistance policies by posting signs in highly visible areas of the hospital and including information about the financial assistance policy in patient booklets placed in all inpatient rooms.The following sign is posted in the main registration area and Emergency Department registration entrance: Financial Assistance: Covenant Health is committed to providing quality health services in a caring environment. It is the expressed philosophy of Covenant Health, and its member hospitals, that no one should be denied necessary medical care because of the inability to pay. In conjunction with this philosophy, staffs of 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, 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 931.484.9511 or 931.459.7025, Monday through Friday between the hours of 8 a.m. and 5:00 p.m.Cumberland Medical Center employs full time financial counselors who meet with each uninsured patient. In addition, Cumberland Medical Center assists them with completion of a TennCare application and ensures the application is directed to the appropriate Department of Human Services.The Charity Care Policy states that patients who are unable to pay and have exhausted all sources of payment assistance may be screened for potential charity care eligibility. According to the policy, the financial counselors initiate screening of the patient and/or guarantor by obtaining income and other financial information to determine eligibility for charity care or discounted services. Part VI, Line 4: Cumberland County, Tennessee, is the primary market for Cumberland Medical Center. Cumberland is a rural community located on the Cumberland Plateau, approximately 60 miles from the metropolitan Knoxville area. Cumberland Medical Center is the only hospital in the county. The following statistics are taken from 2010 data of the U.S. Census Bureau. The population of Cumberland County numbers roughly 57,985 people and is predominantly female 51%. Persons over the age of 65 account for 28% of the population. Over 17% of the population lives below the poverty level, and the unemployment rate is at 8.8%. Healthcare and social assistance make up the 12.7% of the workforce and is the largest employer category in Cumberland County. The median household income is $37,188.According to the 2014 County Health Rankings Report of the Robert Wood Johnson Foundation/ University of Wisconsin Population Health Institute, Cumberland County residents have the following health indicators that are above the national benchmarks: Cumberland - TN - National Adult Smoking: 17% - 23% - 14% Adult Obesity: 29% - 32% - 25% Alcohol impaired driving deaths 31% - 28% - 14% Teen Birthrate: 65 - 49 - 29 of every 1,000 teenage girls Poor or Fair Health: 21% - 19% - 10% Physical Inactivity: 29% - 30% - 29% Part VI, Line 5: Cumberland Medical Center (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. It is comprised of independent community leaders with diverse educational and professional backgrounds. The board sets policies and provides oversight of CMC.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: Cumberland Medical Center (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. X 0 1 0 1 0 0 0 0 0 0 0 Anthony L Spezia President & CEO 0 1003236 0 503500 0 153597 0 214400 0 16299 0 1891032 0 0 John T Geppi EVP/CFO 0 496663 0 215000 0 84054 0 10400 0 17490 0 823607 0 0 Jeremy Biggs President & CAO 0 198277 0 60000 0 53367 0 9606 0 21987 0 343237 0 0 Larry Moore VP-Financial Svcs. 201276 0 0 0 4389 0 6179 0 11692 0 223536 0 0 0 Amanda Grubb Halford MD Chief Medical Officer 17603 242768 0 0 0 485 0 0 0 22162 17603 265415 0 0 Sivalingam Kanagasegar MD Physician 13846 228086 0 255559 0 2639 0 0 0 20472 13846 506756 0 0 Thomas A Allingham MD Physician 423463 0 0 0 21523 0 7950 0 0 0 452936 0 0 0 Elmer R Gibbs Physician 20747 292768 0 68218 0 3079 0 0 0 20940 20747 385005 0 0 Muhammad Q Mir Physician 16126 257338 0 0 0 642 0 0 0 21197 16126 279177 0 0 Elias Abou-Zeid Physician 14190 249334 0 252094 0 528 0 0 0 21181 14190 523137 0 0 Part I, Line 1a Tax gross-up payments related to deferred compensation are provided to certain executives and managers. These are treated as taxable compensation to the recipeints. Part I, Line 3 Covenant Health, the parent company of Cumberland Medical Center, used one or more of the methods listed in establishing the compensation of Anthony L. Spezia. Please see the statement to Core Part VI, Section B, Line 15a on Schedule O. Part I, Line 4b Anthony L. Spezia was a participant in two nonqualified deferred compensation plans, which will be referred to as Plan A and Plan B. In 2011 Mr. Spezia vested in Plan A, and the accumulated balance as of August 1, 2011 was included in his 2011 taxable income. An Amendment to Plan A was adopted effective August 1, 2011 which terminated further accruals (contributions) to the plan. However, the Amendment does allow the accrual of interest on undistributed amounts which will be subject to risk of forfeiture until such time as indicated in the Amendment. Interest earned by Plan A in 2015 amounted to $90,424 and is not required to be reported in Part II, as Mr. Spezia is not substantially vested in earnings accumulated after July 31, 2011. Plan B was established in 2011. Employer contributions to Plan B during 2015 totalled $204,000, which is reported in Column C of Schedule J, Part II. Interest earned by Plan B during 2015 of $57,620 is not required to be reported in compensation in Part II, as Mr. Spezia is not substantially vested in Plan B. Form 990, Part III, Line 1 2015 Report to the Community Covenant Health is a comprehensive, community-owned, not-for-profit health system serving 23 counties in East Tennessee. Nine acute care hospitals located in Knoxville and surrounding areas comprise the foundation of the health system. Additional outpatient and specialty care departments are located throughout the region providing diagnostic and surgery services, mental health and cancer treatments, and therapy and home health services. Over 10,000 employees and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than one million patients and families served each year. Covenant Health's mission is to serve its communities by improving health. It has invested well over a billion dollars in the local communities since 2000 - a commitment that no other healthcare organization in the region has approached. In the current challenging environment Covenant Health is nationally recognized as a top performer in many areas: patient care, quality, cost, information technology, finances, ethics and innovation. It reaffirms its long-standing commitment to the communities and its core strategies: * Provide the best care and outstanding customer service to every patient, every time. * Serve its communities as a not-for-profit health system. * Provide excellence in governance and leadership, effective strategic planning and wise use of resources. * Engage a work force with the appropriate skill sets. * Be the practice environment of choice for its physicians. * Optimize the value of being a unified health system. In 2015, Covenant Health ranked in the top 20 percent of a national study of health systems that measures quality and efficiency in areas such as adherence to clinical standards of care, patient safety and satisfaction, length of stay and other criteria. It received awards for clinical excellence from VHA, Inc., a national healthcare performance improvement alliance. Two of its hospitals - Fort Loudoun Medical Center and LeConte Medical Center - were among just six hospitals in the country to receive a VHA 2015 Excellence Award for Clinical Effectiveness for achieving exceptionally high levels of performance compared to national benchmarks. Fort Sanders Center for Bariatric Surgery Obesity has become a significant national health issue. Morbid obesity, defined as having a Body Mass Index (BMI) over 35 and being at risk for obesity-related health issues, is closely correlated with serious medical conditions including heart disease, high blood pressure and diabetes. Bariatric surgery often eliminates these conditions, along with the side effects that can result from the medications used to treat them. It is becoming a more viable option for people who need to lose at least 100 pounds and have found other weight-loss strategies to be unsuccessful. Bariatric surgeons, after helping more than 2000 patients over the past dozen years, created the Fort Sanders Center for Bariatric Surgery which has been designated as a Center of Excellence by the American Society of Metabolic and Bariatric Surgery. The atmosphere at the Center for Bariatric Surgery is one of support and encouragement. The relationship between physicians, staff and the patient is very open. It is important that the patient is completely informed when making a choice about surgery. A support group is available before and after surgery, and patients are strongly encouraged to take part. The Center for Bariatric Surgery offers two cutting edge solutions. Laparoscopic gastric bypass, usually done as a robotic procedure, creates a smaller stomach pouch and reroutes a portion of the small intestine. Sleeve gastrectomy removes a portion of the stomach and creates a narrower digestive tube. The safety of bariatric surgery has improved greatly over the past several years, and in most instances the patient goes home within 24 hours after surgery. Partners in Quality Care Covenant Health collaborates with physicians to carry out its mission of improving the quality of life through better health. Physicians partner with the health system in many ways including employment, as members of hospital medical staffs and Covenant's board of directors, and in committee leadership roles. Covenant Medical Group, Inc. (CMG) employs nearly 200 primary care and specialty physicians in about 100 practice locations. Covenant Health builds and maintains partnerships with physicians through joint ventures such as surgery centers and the development of service line strategies that focus on improving quality and cost of patient care. Nearly 1,500 physicians are affiliated with Covenant Health hospitals and member organizations as active or consulting members of the health system's medical staffs. These physicians may serve in leadership positions at their respective hospitals, and several also represent their organizations and communities through membership in Covenant Health's Board of Directors. Good Health is Good Business In addition to partnerships with physicians, Covenant Health works with businesses and insurance brokers to help control and lower healthcare costs. Working side by side with companies, Covenant Health helps to develop programs and services such as on-site clinics to engage employees in healthy behaviors and manage chronic diseases. With more than 30 years of experience providing biometric screenings and wellness programs in local communities, Covenant Health's professionals deliver on-site solutions for business clients. The program's goals are to improve employee health and positively affect an organization's healthcare investment. Form 990, Part III, Line 1 Covenant Health Named Among Nation's "Most Wired" The American Hospital Association's Health Forum and the College of Healthcare Information Management Executives (CHIME) named Covenant Health among the nation's "Most Wired" healthcare organizations in the 2015 "Most Wired" survey. The survey and benchmarking study is a leading industry barometer measuring information technology use among hospitals nationwide. The survey of more than 2,213 hospitals examined how healthcare organizations leverage IT to improve performance for value-based healthcare in areas such as infrastructure, business and administrative management, quality and safety, and clinical integration. The survey showed that hospitals are taking more aggressive privacy and security measures to protect and safeguard patient data. Most Wired hospitals are using IT to better facilitate information exchange across health care and other settings, and greater alignment between hospitals and physicians. Most Wired organizations are also implementing patient portals to get patients actively involved in their health and health care. Covenant Health is one of only four Tennessee healthcare organizations to be named to the Most Wired list. It is the 12th time that Covenant Health has been ranked among Most Wired. Best Practices for Babies' Healthy Start The Covenant hospitals are part of a statewide Healthy Tennessee Babies Are Worth the Wait initiative to increase awareness of the benefits of full-term delivery. Babies born too early are at risk for respiratory distress, jaundice, hypoglycemia and other conditions that need more medical care and put them at greater risk for death before their first birthdays. Waiting until 39 weeks to deliver allows for better growth and development of vital organs and is also better for the health and safety of the mother. In addition to patient and staff education programs, Covenant Health obstetrics departments adopted a policy prohibiting early elective deliveries before 39 weeks unless there is a clear medical risk to the mother or the baby. In 2011 about 12 percent of the hospitals' deliveries that occurred prior to 39 weeks gestation were considered elective. By second quarter of 2015, the number had dropped to zero. Covenant hospitals are also involved with the Tennessee Initiative for Perinatal Quality Care's breastfeeding project, which focuses on promoting and supporting breastfeeding in the delivery setting and after mothers return home. Caring for Women throughout Their Lives Covenant Health provides a full spectrum of health services for women of all ages. The health system's ten breast centers offer patients access to the latest technological advances in the prevention, early detection, diagnosis and treatment of breast cancer. A full range of diagnostic screenings, gynecological care, cancer care, and specialized treatment are offered to women in all ages and stages of life. The health system provides comprehensive heart and stroke care for women, and has developed educational and outreach programs to teach women about cardiovascular disease, risk factors, prevention, treatment and rehabilitation. Advanced Technology Keeps More Hearts Beating Covenant Health is committed to excellence in all areas of heart care - from heart disease prevention and diagnosis of heart conditions to advanced technology and treatments, emergency interventions, and cardiac rehabilitation programs for follow-up care. More than 50 affiliated cardiologists provide diagnostic testing and perform a variety of interventional procedures such as heart catheterization and techniques to clear blocked arteries and place stents to restore blood flow. Cardiologists also treat heart arrhythmias and often repair heart valves and holes in the chambers of the heart. Covenant Health is at the forefront of cardiac innovations that restore health and the ability to live life to the fullest. Covenant was the first health system in the region to offer Transcatheter Aortic Valve Replacement (TAVR), in which a minimally invasive procedure places a new valve into the heart. The procedure gives new hope to patients suffering from life-threatening aortic stenosis who are not candidates for open-heart surgery. In addition to TAVR, a full spectrum of advanced cardiac procedures are available at Covenant Health's "heart hospitals" - Fort Sanders Regional Medical Center, Methodist Medical Center of Oak Ridge and Parkwest Medical Center. For patients experiencing severe coronary disease like blocked arteries and aortic enlargement, care close to home may seem like a distant hope. Covenant's cardiac services offer complex surgeries and treatment that are often only available in larger cities. When Minutes Matter If a heart attack occurs, time is critical. The heart hospitals of Covenant Health have adopted the American College of Cardiology and American Heart Association recommended care standards for heart attack patients, specifically those identified as the "ST-Segment Elevation MI" (STEMI) population. These patients have the highest mortality (risk of death) and morbidity (risk of associated complications). They can be rapidly identified by having an electrocardiogram (EKG). The standards emphasize organizing regional systems of care and patient transfer procedures to provide faster access to advanced therapies that help facilitate rapid restoration of blood flow during a heart attack. The care team - from first responders and emergency departments to cardiologists and cath lab staff - collaborate to provide efficient and effective care. They evaluate the entire process and collaborate with anyone who has contact with this patient population to develop a standardized approach to efficiently get them to a cath lab. Every 30 minutes results in nearly an eight percent increase in risk of death, so patient outcomes are improved by having a systems approach to identification, notification, and rapid transfer. Several new processes have been developed, including: * Training EMS providers to identify STEMI patients quickly, and building relationships with emergency transporters to ensure efficient arrival at a center equipped to deal with STEMI patients. * Clinical members of Covenant Rapid Access, Covenant Health's patient transfer center, are available 24/7 to accept STEMI patients from outlying hospitals and immediately notify the cath lab team and interventional cardiologist. Rapid Access is the coordinating center for Covenant facilities. * Emergency transporters simultaneously notify both ED and cath lab teams of potential STEMI patients and transmit an EKG when available. This allows earlier activation of the cath lab team, with personnel available immediately when the patient arrives. * A regular review process provides feedback on outcomes and helps continually improve systems and processes. As a result of these efforts, Fort Sanders Regional Medical Center has exceeded state and national hospitals' performance in meeting standards for "First Medical Contact-to-Device" times. Mortality and readmission rates also declined. The STEMI team collaborates with hospitals and emergency responders in Claiborne, Sevier, and Jefferson counties, and as far away as Kentucky. Form 990, Part III, Line 1 Cardiac Rehabilitation Helps Pave the Road to Recovery The weeks immediately following a heart attack, angioplasty, or open heart surgery are critical for long-range rehabilitation. Several Covenant hospitals offer medically supervised Cardio-Pulmonary Rehabilitation programs that safely restore physical fitness and function for people who have recently had serious cardiac events. Through monitored exercise, education, counseling and healthy lifestyle changes, patients regain confidence in exercising their hearts, and they learn to make lifestyle changes to reduce the risk of further complications from heart disease. Cardiac rehabilitation offers effective treatment for heart attack, angina, post-infarction, angioplasty, post-coronary bypass, and patients considered to be high risk for coronary artery disease. The Region's Only Stroke Hospital Network When a stroke happens, timely treatment is critical. The Covenant Health network is well above the national average in delivering advanced diagnostics and treatment to halt the devastating effects of stroke. At the hub of the network are Fort Sanders Regional Medical Center, certified as a comprehensive stroke center by The Joint Commission, and the award-winning Patricia Neal Rehabilitation Center, accredited by the Commission on the Accreditation of Rehabilitation Facilities. Reaching Across Time and Distance Thanks to Fort Sanders Regional Medical Center's "tele-stroke" robot, East Tennessee stroke patients benefit from early consultation with the hospital's stroke experts, even if they are at a different hospital location. The InTouch R7 robot is a mobile communications platform that enables stroke patients to receive consults from Fort Sanders neurologists via its video screen "face." The robot allows neurologists to be available to patients in outlying areas 24 hours a day. Covenant Health has stationed robots in the emergency departments at Parkwest Medical Center in Knoxville, LeConte Medical Center in Sevierville and Morristown-Hamblen Hospital in Morristown. The telestroke network allows physicians in surrounding hospitals to use live Web video streaming to consult with neurologists as soon as a patient arrives at the community hospital. The neurologist can remotely review patient information and examine and talk with the patient, family members and local clinicians to help determine the best course of treatment, all at the patient's bedside. The interaction between neurologist and the patient via the robot helps the physician see facial expressions and get the patient to respond to the physician. Accurate, timely diagnosis is essential when stroke occurs. The clock starts with the onset of symptoms. As time ticks by, treatment options become more limited and patients can lose more and more functionality. With this tele-medicine tool, neurologists and specialists can advise surrounding emergency departments how to best treat their stroke patients or to have them transported to Fort Sanders Regional for advanced care. Rehabilitation After Stroke While prompt medical care can stop or minimize the effects of stroke, rehabilitation after a "brain attack" can help a patient recover abilities and reconnect with loved ones. At the Patricia Neal Rehabilitation Center, stroke patients are treated with a holistic team approach including the patient and family members. Physical Medicine and Rehabilitation physicians, physical therapists, occupational therapists, speech-language pathologists, rehab psychologists (behavioral medicine), nursing staff, case managers and recreation therapists make up the treatment team. Treatment is an active process with both patient and family involved in goal setting, therapy and education. Therapies include psychological and leisure/recreation evaluations, and training in range of motion, strengthening and conditioning exercises, self-care and daily living skills, and speech, language and swallowing. Other aspects include identification and management of risk factors to help prevent future strokes. The Patricia Neal Rehabilitation Center has received multiple awards including five top-honor Crystal Awards from Professional Research Consultants for overall patient satisfaction along with accolades for innovation, quality of care and successful outcomes. Leading the Fight Against Cancer Even though cancer affects many thousands of people, a cancer diagnosis can be a lonely experience. Covenant Health is committed to helping cancer patients fight the disease with excellent medical care and a multidisciplinary team of support. At the core of Covenant Health's cancer care is an elite team of physicians, armed with the most advanced cancer fighting tools available. Technology includes advanced imaging such as positron emission technology (PET) in Knoxville and mobile PET services in Sevierville, high-dose-rate brachytherapy and 3D radiation therapy. Fort Sanders Regional Medical Center offers Gamma Knife, a non-invasive radiosurgical device that targets tumors in a single visit. A variety of clinical trials, stem cell transplantation and genetic counseling are also available. Patients receiving cancer care at Covenant Health facilities receive individualized treatment plans, and have a multidisciplinary team of specialists and "navigators" to help with the treatment process. Support is also provided by social workers, nutrition counselors and other members of the cancer care team. The health system invested $7.6 million for equipment upgrades, expanded connectivity and growth of a highly regarded radiation therapy research program at six locations: Thompson Cancer Survival Centers in downtown and west Knoxville, Oak Ridge and Sevierville, at Morristown Regional Cancer Center, and at Cumberland Medical Center's radiation oncology program in Crossville. Thompson Oncology Group has 8 physician offices in 7 different counties. The group has been recognized by the Quality Oncology Practice Initiative Certification Program, an affiliate of the American Society of Clinical Oncology. The certification process includes each of the 8 Thompson Oncology Group locations and entails evaluation of treatment planning, staff training, patient education and safe chemotherapy administration. Form 990, Part III, Line 1 Connecting with Our Communities In addition to taking care of patients and families who receive direct services, Covenant Health is committed to making a positive impact in the health of the surrounding community. In all the communities Covenant Health serves, local initiatives and partnerships create opportunities to interact with people of all ages and encourage healthier lifestyles. * In March 2015 Covenant Health sponsored the Knoxville Marathon for the 11th year in a row. The race attracted over 7,750 people who competed in full and half marathons, a 5K, relays, hand cycling and push-rim wheelchair races. * Some of the funds raised through the Covenant Health Knoxville Marathon were contributed to Patricia Neal Rehabilitation Center's Innovative Recreation Cooperative (IRC). More than $5,000 was given to the IRC by a collaboration of groups and individuals who help disabled persons enjoy leisure/recreation activities such as skiing and cycling. * The Covenant Health Biggest Winner Weight Loss Challenge continued as a friendly competition that encourages East Tennesseans to get moving for a fit and healthy lifestyle. Team members trained together for five months, with the goal of crossing the finish line in Covenant Health Knoxville Marathon events, and challenging other East Tennesseans to change their lives for the better. * The Covenant Kids Run attracted nearly 1,000 children who participated in a "marathon of activities" over a period of several weeks, culminating in a run to Neyland Stadium the day before the Covenant Health Knoxville Marathon. * Covenant HomeCare Hospice helps children grieving the loss of a loved one through Katerpillar Kids Camp, a free event offered with the support of Variety - The Children's Charity. The camp helps children in grades 1-12 express their feelings of loss in a supportive environment. * Methodist Medical Center co-sponsored the third annual Baby's Best Fest, a day of family games and an ice cream social celebrating World Breastfeeding Month and supporting breastfeeding as the healthiest start for babies. * LeConte Medical Center partnered with Dollywood's Splash Country for the second year to host Water Safety Day. The day was held in conjunction with the "World's Largest Swimming Lesson," a national event promoting the importance of learning to swim. LeConte employees educated children about water safety; representatives from Thompson Cancer Survival Center talked about the need for sunscreen; and staff from the Patricia Neal Rehabilitation Center presented the Think First head and spinal cord injury prevention program and adaptive water sports. More than 600 children participated. * Cumberland Medical Center in Crossville co-sponsored numerous health fairs and community events throughout the year, and hosted free Mammogram Days for women who met specific screening criteria and did not have insurance coverage. * Parkwest Medical Center, LeConte Medical Center and Thompson Cancer Survival Center co-sponsored hiking programs led by Missy Kane, an Olympic Medalist from Tennessee and fitness expert. Missy led hikes in communities where Covenant Health hospitals are located and established walking clubs in Roane and Anderson counties in conjunction with Roane Medical Center and Methodist Medical Center. Form 990, Part VI, Section B, line 11 Covenant Health is a large, integrated health system which files fourteen Forms 990. Cumberland Medical Center is one of those fourteen entities. Annually, at the September Finance Committee meeting, one of the fourteen 990s is selected (a different entity each year) for distribution to each member of the Committee. Management then reviews in detail each of the Form 990 schedules and describes variances between entities, if any. The remaining thirteen Forms are made available for review by any committee member. The same presentation is made to the Covenant Health Board of Directors at the October meeting. All fourteen Forms 990 are then made available to all board members for their review throughout the month of October. Form 990, Part VI, Section B, line 12c Board members, officers and employees are required to adhere to rules and policies regarding conflicts of interest. Covenant Health, the parent company of the organization, distributes a board-approved Code of Conduct to all employees. The Code covers among other subjects, conflicts of interest. Additionally managers are required to complete and sign an annual management certification that addresses conflicts of interest. Board members' conflicts of interests are dealt within the corporate bylaws and board members are required to complete and sign a conflict of interest questionnaire on an annual basis. The Integrity Compliance Office maintains records that contain conflict of interest information obtained from board members, officers and employees. These records are available to be queried prior to engaging in business transactions. The Integrity Compliance Officer initially reviews all conflict of interest data. Based on this information, the officer determines what conflicts of interest exist at that point in time. Between times when surveys are collected board members are expected to disclose any new conflicts that have arisen that affect pending board decisions. As well, managers and other employees are expected to report conflicts to the Integrity Compliance Officer as they arise. Depending on the nature of the conflict and the circumstances surrounding the conflict and transaction, the Integrity Compliance Officer, Senior Leadership, or the Board of Directors may review the conflict of interest. Where appropriate these bodies may also consult legal counsel. Restrictions imposed on persons with a conflict of interest are determined on a case by case basis. For Covenant Health employees, the Integrity Compliance Officer, in conjunction with Executive Leadership determines how to appropriately handle the conflict. In any conflict involving a board member, such member is expected to excuse himself or herself from voting on matters that give rise to the conflict. Form 990, Part VI, Section B, line 15 Form 990, Part VI, Section B, Line 15a: Overall compensation policies for 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. Compensation policies for Anthony Spezia and John Geppi are reported on the 2015 Form 990 of Covenant Health, EIN 62-1646734. Form 990, Part VI, Section B, Line 15b: Base salary and annual bonus opportunities for Jeremy Biggs, 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 Larry Moore, Vice President of Financial Services, is based on targets established by an independent, nationally-recognized executive compensation consultant to ensure that total compensation for each executive is reasonable and within a fair market value range. Salary ranges are based upon comparison with similar jobs in similar size health systems across the nation. Base salaries and bonuses are approved by Executive Leadership predicated upon performance, and are reasonable and consistent with fair market value. Base salaries are initially targeted at midpoint and 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 VI, Section A, Line 9 Contact Addresses for Officers and Directors: Anthony L. Spezia Covenant Health 100 Fort Sanders West Blvd. Knoxville, TN 37922 John T. Geppi, Larry Mauldin and all Directors: Covenant Health 1420 Centerpoint Blvd., Bldg C. Knoxville, TN 37932 Jeremy Biggs Methodist Medical Center 990 Oak Ridge Turnpike Oak Ridge, TN 37830 All other persons listed in Part VII, Section A, inluding the Directors listed above, may be contacted at the organization's address, which is: Cumberland Medical Center 421 S. Main Street Crossville, TN 38555-5048 Form 990, Part XI, line 9: Change in value of Unrestricted Trusts 141,095. Change in value of restricted fund balance -148,948. Form 990, Part XII, Line 2c: The Audit Committee of the Board of Directors annually selects the external auditors for Covenant Health. There is a joint meeting of the Finance Committee and Audit Committee of the Board of Directors where the audit of the consolidated financial statements are presented. Cumberland Physician Group LLC 421 S Main St Crossville TN 385555048 371539508 Physician services TN 7241 197819 Cumberland Medical Center CMC Hospitalist Group LLC 421 S Main St Crossville TN 385555048 Hospitalist staffing services TN 228336 1485 Cumberland Medical Center Covenant Health 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 621646734 Supporting organization TN 501(c)(3) Line 11b, II N/A 0 Fort Sanders Regional Medical Center 1901 W Clinch Ave Knoxville TN 37916 620528340 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Parkwest Medical Center 9352 Park West Blvd Knoxville TN 37923 581897274 Acute care hospital and behavioral health services TN 501(c)(3) Line 3 Covenant Health 0 Methodist Medical Center 990 Oak Ridge Turnpike Oak Ridge TN 37830 620636239 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Morristown-Hamblen Hospital Association 908 W 4th N St Morristown TN 37814 620545814 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 LeConte Medical Center 742 Middle Creek Road Sevierville TN 37862 621114867 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Roane County Medical Center 8045 Roane Medical Center Dr Harriman TN 37748 680673354 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Fort Loudoun Medical Center 550 Fort Loudoun Medical Center Dr Lenoir City TN 37772 621373691 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Claiborne Medical Center 1850 Old Knoxville Rd Tazewell TN 378793625 464420358 Acute care hospital TN 501(c)(3) Line 3 Covenant Health 0 Thompson Cancer Survival Center 1915 White Ave Knoxville TN 37916 621250943 Cancer support center TN 501(c)(3) Line 3 Covenant Health 0 Thompson Oncology Group 1915 White Ave Knoxville TN 37916 621619239 Oncology services TN 501(c)(3) Line 3 Thompson Cancer Survival Center 0 Covenant Homecare 3001 Lake Brook Blvd Ste 101 Knoxville TN 37909 621623114 Home health services TN 501(c)(3) Line 9 Covenant Health 0 Fort Sanders Perinatal Center Trustees Tower 501 19th St Ste 304 Knoxville TN 37916 043760551 High risk obstetrical services TN 501(c)(3) Line 3 Fort Sanders Regional Medical Center 0 Fort Sanders Foundation 280 Fort Sanders West Blvd Ste 202 Knoxville TN 37922 621748601 Fundraising and patient outreach TN 501(c)(3) Line 11b, II Covenant Health 0 Thompson Cancer Survival Center Foundation 1915 White Ave Knoxville TN 37916 582130450 Fundraising and patient outreach TN 501(c)(3) Line 11b, II Covenant Health 0 Cumberland Medical Center Auxiliary Inc 421 S Main St Crossville TN 385555048 620988311 Support and promote services of hospital TN 501(c)(3) Line 9 N/A 0 Fort Sanders West OP Surgery Center LLC 210 Fort Sanders West Blvd Ste 200 Knoxville TN 37922 621366907 Outpatient surgery center TN N/A Fort Sanders West Associates 280 Fort Sanders West Blvd Ste 214 Knoxville TN 37922 621384171 Building ownership TN N/A KOSC Properties LLC 256 Fort Sanders West Blvd Ste 200 Knoxville TN 37922 262444076 Building ownership TN N/A Knoxville Orthopaedic Surgery Center LLC 256 Fort Sanders West Blvd Ste 200 Knoxville TN 37922 262437385 Orthopaedic surgery TN N/A KOC 260 Bldg LLC 260 Fort Sanders West Blvd Knoxville TN 37922 465228440 Land and building ownership TN N/A Endoscopy Center of Oak Ridge LLC 988 Oak Ridge Turnpike Ste 200 Oak Ridge TN 37830 621667358 Outpatient medical facility TN N/A Fortress Corporation 280 Fort Sanders West Blvd Ste 214 Knoxville TN 37922 621308885 Management company TN N/A C 0 Covenant Medical Group Inc 1400 Centerpoint Blvd Ste 100 Bldg Knoxville TN 37932 621282917 Physician practice management TN N/A C 1 Knoxville Heart Group 1819 Clinch Ave Ste 108 Knoxville TN 37916 271528941 Cardiology medical practice TN N/A C 0 East TN Cardiovascular Surgery Group Inc 9125 Cross Park Drive Ste 200 Knoxville TN 37923 621018541 Cardiovascular surgical practice TN N/A C 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 1 1 Covenant Medical Group Inc A 422998 FMV