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        <BusinessNameLine1>Fort Sanders Regional Medical Center</BusinessNameLine1>
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        <AddressLine1>1420 Centerpoint Blvd Bldg C</AddressLine1>
        <City>Knoxville</City>
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      <Name>JOHN T GEPPI</Name>
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      <NameOfPrincipalOfficerPerson>Anthony L Spezia</NameOfPrincipalOfficerPerson>
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        <City>Knoxville</City>
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      <ActivityOrMissionDescription>FSRMC provides quality hospital and other health services in the Knoxville metro area. (see Sch. O)Fort Sanders Regional Medical Center is located in the Fort Sanders community of downtown Knoxville, Tennessee, and is a member of the Covenant Health system. It serves as a regional referral center, where other hospitals send their most difficult cases. Fort Sanders Regional includes a full-service acute care hospital with 517 beds serving many specialty areas, the 24-bed Fort Sanders Transitional Care Unit, the Patricia Neal Rehabilitation Center, and specialized outpatient centers. In early 2011, Fort Sanders Regional opened its Gamma Knife Center, which houses the first advanced system in Tennessee and is one of only 30 in the United States.</ActivityOrMissionDescription>
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      <MissionDescription>Fort Sanders Regional 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.</MissionDescription>
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      <Description>Orthopedics, Neurology and Rehabilitation:The Ortho/Neuro/Rehab program at Fort Sanders Regional Medical Center is a comprehensive program of inpatient and outpatient services designed to restore optimal function and independence to individuals who are impaired due to orthopedic or neurological illness or injury. More information about these services is on Schedule O.Orthopedics, Neurology and Rehabilitation: Expenses - $73,594,647; Revenue - $59,297,186.From hip, knee and shoulder replacement to other commonly performed orthopedic procedures like hand, foot and ankle and spine and back surgery, Fort Sanders Regional (FSR) possesses a commitment to service excellence and to improving the patient experience in every way. These commitments are reflected in the comprehensive care provided orthopedic surgery patients, including:* In-depth education that fully prepares patients for surgery and recovery;* Infection prevention protocols that minimize infection risks;* Experienced, specialized surgeons and operating room teams that use state-of-the-art techniques;* A dedicated inpatient orthopedic nursing unit staffed by expert nurses and caregivers who know how to help patients recover from orthopedic surgery; and* A wide array of rehabilitation and therapy services, inpatient and outpatient, to help patients return to an active lifestyle.At the FSR Joint and Spine Center, patients undergoing knee or hip replacement surgeries are not treated as "sick" but as healthy adults undergoing a procedure that will allow them to return to an active life. The goal is to get patients out of bed and moving as quickly as possible. This is accomplished through education, surgical expertise and intense physical therapy. Patients are provided information about joint replacement and are challenged to take the lead in their recovery. Patients go through the program with a family member, who is designated as the patient's "Coach" and is taught how to assist the patient at home.Outpatient rehabilitation services are provided on the hospital campus and at a network of community based outpatient therapy centers. These centers offer a wide variety of therapy services, many of which are unique in the community. They include: * Physical, occupational and speech therapy, * Wound care, * Aquatic therapy, * Lymphedema treatment, * Low-vision and adaptive driving programs, * Certified hand therapy, * Vestibular rehabilitation, and * Functional capacity evaluations.In 2012 the hospital recorded 10,393 Wound Care Center patient visits and 62,047 Outpatient Physical Therapy visits.Conditions and diseases of the brain, spinal cord and nervous system can affect how people walk, talk, comprehend and function. FSR's neurologists specialize in the diagnosis and treatment of epilepsy, tumors, stroke, Alzheimer's disease, dementia, Parkinson's disease and multiple sclerosis. As a Neuro-Spine Center of Excellence, FSR has made the commitment to offer the latest advancements in neurology, neurosurgery, spine surgery, and neuro-interventional radiology. Whether a patient needs medical, surgical or neuro-radiological intervention, the goal is to provide the most appropriate care to optimize patient outcome. In 2012 there were 281 Interventional neuro-radiology cases - made up of 195 Aneurysm coilings, 66 IVC Filter placements, and 20 stroke treatments.At the Fort Sanders Sleep Disorders Center, the area's first accredited sleep center, neurologists work with patients who suffer from a host of sleep/wake disorders including sleep apnea, insomnia, narcolepsy, and restless leg syndrome. The Center treated 778 patients in 2012.Fort Sanders' neurosurgeons provide surgical intervention for brain tumors, aneurysms and hemorrhages, as well as a host of spine conditions. They also provide surgical relief for issues caused by nerve and muscle diseases, carpal tunnel syndrome, chronic back pain and conditions resistant to medical management, like Parkinson's disease.An example of the hospital's commitment to state-of-the-art technology is the StealthStation Treon, which helps guide FSR's neurosurgeons through a variety of operations, including neurological and spinal procedures. This innovative 3D-imaging system uses global positioning technology to give physicians real time views inside the body, without radiation. This innovative technology allows less invasive operations and helps avoid brain and nerve damage.Strokes are the third leading cause of death in the United States and affect more than 795,000 Americans each year. As a Stroke Center of Excellence, the care provided by FSR and Patricia Neal Rehabilitation Center physicians and staff utilizes state-of-the-art diagnostic, treatment and rehabilitation modalities. The hospital holds a Primary Stroke Center certification from the Joint Commission (one of only a handful in the state of Tennessee) as well three separate stroke accreditations from the Commission on the Accreditation of Rehabilitation Facilities (CARF). In 2012, FSR's aggregate score related to strokes was 98.47%, and it had 379 Ischemic and 66 Hemorrhagic stroke patient admissions.FSR was the first facility in the area to combine CT and bi-plane angiography with a full-time neuro-interventional radiologist to provide our region with new, minimally-invasive options for treating stroke, aneurysms, and other vascular diseases in the brain. With this system, neuro-interventional radiology procedures can be performed that would have previously required surgery and an extended hospital stay or would not have been options for some patients.Bi-plane technology improves imaging and resolution creating comprehensive 3D views of the blood vessels in the brain. Having a more precise picture of an abnormality makes it easier to diagnose and repair. A team of specialized technologists and nurses work to assist the performing radiologist with each procedure. All technologists are certified by the American Association of Radiological Technologists. Micro-catheters are inserted through the groin and then guided to the area of treatment to administer medications, coil aneurysms or retrieve clots. These new procedures often involve very short hospital stays, all while keeping radiation exposure to a safe minimum and avoiding major surgery.The Patricia Neal Rehabilitation Center (PNRC) is East Tennessee's recognized leader in helping stroke, spinal cord, brain injury, orthopedic and cancer patients rebuild their lives through the delivery of optimal rehabilitation services. Opened in 1978 as an integral part of the Ortho/Neuro/Rehab program at FSR, the PNRC offers a comprehensive team approach to care. Physical, occupational, recreational, behavioral medicine and speech language therapists work with nurses and physiatrists - doctors whose specialty is physical medicine and rehabilitation. This team develops the best individual care plan to return patients to their recovery potential as quickly as possible. Rehabilitation nurses and other specialists also educate patients, teaching them self-care skills to function as well as possible upon returning home. The Center holds 15 separate accreditations from the Commission on the Accreditation of Rehabilitation Facilities (CARF) and provides a comprehensive array of inpatient rehabilitation services that would otherwise be unavailable in the community.FSR is committed to maintaining access to unique services such as those at the PNRC. Through donations and other community support, the hospital, through the Fort Sanders Foundation, provides scholarships to allow patients with limited resources access to the rehab center's services.The Patricia Neal Innovative Recreation Cooperative (IRC) was created in 1994 to meet the needs of individuals who have suffered a life-changing illness or injury. The program was designed to be part of the continuum of care in the rehabilitation process. Its scope is to host clinics under an umbrella of education and awareness: education to teach leisure skills to enhance quality of life in a safe environment and awareness to heighten the understanding of disabilities to the community. In its existence, the IRC has seen over 7,000 participants and volunteers. The goal is to remove all the barriers to develop each individual's right to self-directed leisure for a healthier lifestyle. This program is supported by community donations, grants and a hospital subsidy.Older adults are a significant portion of the patient population in Ortho/Neuro/Rehab. FSR is committed to special health care for older adults and was the first NICHE-certified (Nurses Improving Care for Health System Elders) facility in the East Tennessee region. Care is provided to help prevent complications such as skin breakdowns, falls/injuries, pain, acute confusion, and the loss of strength and mobility.</Description>
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        <Description>Oncology Services: Fort Sanders Regional Medical Center features extensive inpatient and outpatient oncology care provided by exceptional oncologists who practice throughout the Knoxville area. In 2012 FSR had 1,477 admissions to the Oncology unit with 8,667 patient days. More information about oncology services is on Schedule O.Oncology Services: Expenses - $64,566,476; Revenue - $50,287,733.The Oncology Center of Excellence at Fort Sanders offers a comprehensive approach to patient care which minimizes patient disruption and maximizes clinical quality and efficiency. Cancer patients and their families can be assured their loved ones will receive the most complete and exceptional oncology care available. Safety is the number one priority in the Oncology Center of Excellence. Due to the nature and potency of the medications used in this area, strict safety processes are performed by doctors, pharmacists and certified nurses who work as a team to double and triple check these medications for accuracy. Chemotherapy-trained nurses work with oncologists to make sure each patient receives the correct chemotherapy drug, in the right dosage cycle, every time. Within the Oncology Center of Excellence, many of the nurses are also oncology certified at a national level. They have dedicated more than 1,000 hours caring for cancer patients and have successfully completed a national certification examination demonstrating their specialized knowledge in this field. Staff attends special lectures and conferences hosted by local and national medical oncologists and radiation oncologists to keep up with the newest innovative treatments available.Fort Sanders' emphasis on oncology knowledge and expertise isnt just limited to nurses. Each staff member on the oncology unit is also uniquely trained in the care of cancer patients. The oncology team includes a dedicated oncologic pharmacist, dietitian, social worker, and RN case manager. This team communicates regularly to ensure excellent patient care from admission to discharge. From dietitians, to pharmacists and radiologists, to housekeeping staff, Fort Sanders has done a lot of work to provide oncology education to every employee who may come in contact with patients. By completing this 360-degree education, Fort Sanders provides better patient care. The Oncology Center of Excellence at Fort Sanders Regional holds the prestigious Certificate of Approval from the Commission on Cancer. The Commission on Cancer Certification is awarded only to facilities with oncology programs committed to providing the best comprehensive cancer care. The Oncology Nursing Unit also serves as the inpatient component of the Stem Cell Center which is based at the Thompson Cancer Survival Center. This Stem Cell treatment center in conjunction with our Oncology Nursing Unit has accomplished accreditation by the Foundation of Accreditation for Cellular Therapy, also known as FACT.Surgical oncology is the branch of surgery which focuses on the surgical management of cancer. The Medical Staff at Fort Sanders Regional Medical Center includes general surgical oncologists as well as thoracic surgical oncologists, gynecologic oncologists and other sub-specialists that specialize in treating cancer patients. Outcomes in surgical cancer care are positively associated to surgeon volume -- i.e. the more cancer cases a surgeon treats, the more proficient he becomes, thus improving overall outcomes and survival rates. In 2012 FSR had 205 surgical oncology cases.Due to the close proximity of Fort Sanders Regional Medical Center to Thompson Cancer Survival Center, the surgeons and staff at Fort Sanders Regional work closely with the cancer center's multidisciplinary treatment teams in the collaboration of care and treatment plans for patients with chest and breast cancer. A team of cancer specialists in differing areas of expertise, including surgeons, gather and evaluate each patient's case to determine possible treatment options. Each specialist then meets individually with the patient to go over treatment choices and answer questions. As part of outpatient Oncology care, Fort Sanders Regional has opened four outpatient Infusion Centers in the area providing many of the chemotherapy medications for cancer patients. There were 61,303 infusion visits to the infusion centers in 2012.Fort Sanders Regional Medical Center, through the Patricia Neal Rehabilitation Center is the only place in East Tennessee, and one of a handful in the country, who offers a cancer rehabilitation program. The cancer program combines many of the rehabilitation techniques currently used for patients with brain and spinal cord injuries and strokes because the impairments cancer patients experience can be very similar to those of traumatic injuries. The health-care team includes:* Each patient's personal physician * Medical, radiation and surgical oncologists * Physiatrists doctors whose specialty is physical medicine and rehabilitation * Rehabilitation nurses * Physical, occupational and recreational therapists * Psychologists * Speech language pathologists * Pharmacists * Dietitians * Case managers At Patricia Neal, the cancer rehab team creates a special care plan for each patient with the goal of helping patients regain as much ability and independence as possible. The center treats many of the impairments that can result from cancer, cancer surgery, radiation therapy, chemotherapy and other treatments, such as:* Fatigue * Muscle wasting * Weakness * Pain * Skin breakdown * Impaired mobility * Anxiety * Depression * Adjustment problems * Overall deconditioning * Lymphedema swelling * Weight loss * Communication difficulty * Impaired thinking or memory loss Patricia Neal has a positive, encouraging atmosphere and is known for outstanding resources, from a rooftop therapy park to a computer life-skills lab. The center also offers:* Fully-equipped therapy gyms * Special adaptive equipment programs * Animal therapy * Support groups * Community outings * Family and caregiver training * Tools to improve communication * Adaptive driving programs* Balance programs * An adaptive living apartment to ease the transition back to everyday life</Description>
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        <Description>Cardiovascular Services:From diagnosis to rehabilitation, Fort Sanders Regional's award-winning Heart Center has the most comprehensive cardiac services available. Our advanced diagnostics, interventional technologies, cardiovascular surgery, and clinical trials are tailored to meet each patients cardiac needs. More information about cardiology services is on Schedule O. Cardiovascular Services: Expenses - $39,156,792; Revenue - $28,164,512.The team of cardiologists, cardiovascular surgeons, nurses, and technologists has the right treatment and the right people to give heart patients the best possible care. Cardiopulmonary rehabilitation is an integral part of the healing process for many cardiac patients. Fort Sanders Regional's program is designed to help patients regain their strength and stamina. Fort Sanders Regional Medical Center's Cardiology Department is the recipient of the 2012 American College of Cardiology Foundations NCDR ACTION Registry 2012 GWTG Platinum Performance Achievement Award. FSRMC is one of just 164 hospitals nationwide to receive this designation. The award recognizes the hospital's commitment and success in implementing a higher standard of care for heart attack patients. Honored hospitals have maintained a rate of performance of 90% or better for eight consecutive quarters, ending quarter four in 2011. Coronary artery disease is the term used to identify the presence of atherosclerosis in the arteries that carry blood to the heart muscle. Atherosclerosis is a buildup up of fatty substances on the inner walls of blood vessels which can block or restrict blood flow. Atherosclerosis is a major risk factor of heart attacks. For some patients, medications are the best course of action. For others, surgical intervention may be necessary. Before a plan of treatment is chosen, a definitive diagnosis is needed.Even the most complex cardiovascular problems can now be treated in Knoxville. Covenant Health is debuting "valve centers" at Fort Sanders Regional Medical Center and its sister hospitals. Covenant Health is also the first health system in East Tennessee and only one of 140 nationwide to offer TAVR, a breakthrough procedure for replacing heart valves. State-of-the-Art Cardiac DiagnosticsYou may have heard the phrase "time is muscle." This refers to heart attack survivability. When blood flow does not reach heart tissue and muscle, it dies. The faster someone can receive medical care, the better their chances for recovery. That is why a fast, accurate diagnosis of a heart condition is so important. State-of-the-art diagnostic tools available at Fort Sanders Regional include:* The area's first Lightspeed 64-slice VCT Scanner captures an incredibly precise image of the heart in just five heartbeats. * Vivid 7 echocardiography uses ultrasound to produce a moving cardiac image in real time. * Nuclear stress tests find difficult-to-detect problems in the heart's outer covering. * Electrocardiograms provide reliable diagnostics and stress tests performed right in the hospital assure immediate care if a problem is discovered. The Latest MedicinesPhysicians at Fort Sanders Regional participate in clinical trials of new medicines for a wide range of heart conditions. Three potentially life-saving medicines for unstable angina and heart attacks are currently being tested. A new trial is investigating a drug to prevent heart attacks and strokes in acute coronary syndrome patients. Minimally-Invasive TreatmentGreat strides have been made in minimally-invasive procedures for heart-related issues. Minimally-invasive procedures allow physicians to implant valves and repair holes in the heart wall without a major incision.* The new Innova 2100-IQ all-digital cath lab gives cardiologists unprecedented image clarity to better view hard-to-see blood vessels, with less radiation exposure for patients and physicians. * Radiofrequency ablation controls rapid heartbeats with radio waves. * Drug-eluting stents open blocked arteries and help prevent a recurrence of the blockage. Cardiovascular SurgeryCardiovascular surgery includes surgical procedures to correct abnormalities within the heart and/or great vessels. Some of the more common procedures are coronary artery bypass, valve repair or replacement, correction of congenital heart defects and repair of aortic aneurysms.Coronary Artery Bypass Surgery Coronary Artery Bypass Surgery, also referred to as CABG, is a treatment option for coronary artery disease. Based on the size, number, and locations of artery blockages, your doctor may decide that bypass surgery is the best treatment. Valve Repair and Replacement Heart valves work like gates which open to let blood move forward and close to allow the heart chamber to fill with more blood. Problems occur when a valve does not open wide enough (stenosis) or close tight enough (regurgitation). When these problems occur, the heart cannot pump enough blood forward which causes problems over time like shortness of breath or heart failure. Your doctor may suggest that you have the valve repaired or replaced. Aortic Aneurysm Repair The aorta is the large artery which carries blood from the heart to the major organs and other areas. This artery can develop a weakening in the wall of the vessel. If this occurs your doctor may suggest that you have it repaired. Robotically-Assisted SurgeryThe daVinci robotics system gives surgeons the capability to perform select heart procedures without opening the patient's chest and patients usually experience fewer side effects and faster recovery times. Cardiac RehabilitationLeaving the hospital is just the first step in recovering from a heart attack, heart surgery or angioplasty. Heart patients often need to strengthen weakened heart muscles and learn heart-healthy practices. Fort Sanders Regional's complete Cardiac Rehabilitation Outpatient Program (CROP) combines education, exercise, counseling, and more to help heart patients regain their functional capacity and reduce the possibility of future heart problems. Information for Heart Failure Patients - Fort Sanders Regional has developed a resource booklet for patients who are being treated for heart failure. This booklet includes details about heart failure, how it is diagnosed and treated, and lifestyle information for those seeking to be as healthy and active as possible while dealing with heart failure. The booklet also contains tracking sheets to record information that will be helpful for you and your healthcare provider, as well as a list of related resources and services within Covenant Health.</Description>
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        <Description>As a full-service acute care hospital and regional referral center, Fort Sanders Regional Medical Center treats patients across a broad spectrum of medical specialties in addition to those highlighted above.</Description>
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      <OtherWebsite>X</OtherWebsite>
      <UponRequest>X</UponRequest>
      <TheBooksAreInCareOf>
        <NameBusiness>
          <BusinessNameLine1>Nancy Beck</BusinessNameLine1>
        </NameBusiness>
        <TelephoneNumber>8653746864</TelephoneNumber>
        <AddressUS>
          <AddressLine1>1420 Centerpoint Blvd Bldg C</AddressLine1>
          <City>Knoxville</City>
          <State>TN</State>
          <ZIPCode>379321960</ZIPCode>
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      </TheBooksAreInCareOf>
      <Form990PartVIISectionA>
        <NamePerson>Anthony L Spezia</NamePerson>
        <Title>President &amp; CEO</Title>
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        <AverageHoursPerWeekRelated>50.00</AverageHoursPerWeekRelated>
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        <Officer>X</Officer>
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        <OtherCompensation>230374</OtherCompensation>
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      <Form990PartVIISectionA>
        <NamePerson>Gerald Boyd</NamePerson>
        <Title>Director</Title>
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        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
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      <Form990PartVIISectionA>
        <NamePerson>Dr Richard Brinner</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>0.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
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        <OtherCompensation>0</OtherCompensation>
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      <Form990PartVIISectionA>
        <NamePerson>Dr Mitchell Dickson</NamePerson>
        <Title>Director</Title>
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        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
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      <Form990PartVIISectionA>
        <NamePerson>Pamela P Fansler</NamePerson>
        <Title>Director</Title>
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      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>James Fitzsimmons</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>0.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
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      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Kimberly Greene</NamePerson>
        <Title>Director</Title>
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      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Wayne Heatherly</NamePerson>
        <Title>Director</Title>
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        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
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      </Form990PartVIISectionA>
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        <NamePerson>Jim Johnson Jr</NamePerson>
        <Title>Director</Title>
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        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
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      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Karla Lane</NamePerson>
        <Title>Director</Title>
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        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
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        <ReportableCompFromRelatedOrgs>924</ReportableCompFromRelatedOrgs>
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      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Eddie Mannis</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>0.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
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      <Form990PartVIISectionA>
        <NamePerson>Larry Mauldin</NamePerson>
        <Title>Chairman</Title>
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      <Form990PartVIISectionA>
        <NamePerson>Dr Joseph Metcalf</NamePerson>
        <Title>Director</Title>
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        <AverageHoursPerWeekRelated>3.00</AverageHoursPerWeekRelated>
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        <ReportableCompFromRelatedOrgs>15603</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>George Miller</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>0.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
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        <ReportableCompFromRelatedOrgs>978</ReportableCompFromRelatedOrgs>
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      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Alvin Nance</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>0.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
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        <ReportableCompFromRelatedOrgs>966</ReportableCompFromRelatedOrgs>
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      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Linda Ogle</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>0.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
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        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Mitchell Steenrod</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>0.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
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        <ReportableCompFromRelatedOrgs>805</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
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        <NamePerson>Carl Storms</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>0.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
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        <ReportableCompFromRelatedOrgs>1641</ReportableCompFromRelatedOrgs>
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      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Joseph E Sutter</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>0.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>1313</ReportableCompFromRelatedOrgs>
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      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Richard Swanson</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>0.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
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        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Joe Ben Turner</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>0.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>783</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>David C Verble</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>0.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>1.00</AverageHoursPerWeekRelated>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>958</ReportableCompFromRelatedOrgs>
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      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>John T Geppi</NamePerson>
        <Title>EVP/CFO</Title>
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        <AverageHoursPerWeekRelated>50.00</AverageHoursPerWeekRelated>
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        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>673095</ReportableCompFromRelatedOrgs>
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        <NamePerson>Keith Altshuler</NamePerson>
        <Title>Pres. &amp; CAO - FSRMC</Title>
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        <Officer>X</Officer>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>349933</ReportableCompFromRelatedOrgs>
        <OtherCompensation>30339</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Ronnie S Beeler</NamePerson>
        <Title>VP-Financial Services</Title>
        <AverageHoursPerWeek>30.00</AverageHoursPerWeek>
        <AverageHoursPerWeekRelated>10.00</AverageHoursPerWeekRelated>
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        <ReportableCompFromOrganization>176459</ReportableCompFromOrganization>
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        <OtherCompensation>29666</OtherCompensation>
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      <Form990PartVIISectionA>
        <NamePerson>Jennifer L Hanson</NamePerson>
        <Title>VP-Chief Nursing Officer</Title>
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        <OtherCompensation>8638</OtherCompensation>
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        <NamePerson>Mary E Dillon MD</NamePerson>
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        <OtherCompensation>3769</OtherCompensation>
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        <NamePerson>Christopher Norris</NamePerson>
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        <ReportableCompFromOrganization>144023</ReportableCompFromOrganization>
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        <OtherCompensation>25891</OtherCompensation>
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        <NamePerson>Marianne Oliveira</NamePerson>
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        <ReportableCompFromOrganization>135142</ReportableCompFromOrganization>
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        <NamePerson>Gary Bush</NamePerson>
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        <OtherCompensation>6832</OtherCompensation>
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        <NamePerson>Nancy Granger</NamePerson>
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        <ReportableCompFromOrganization>132846</ReportableCompFromOrganization>
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        <OtherCompensation>26326</OtherCompensation>
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        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>GE Healthcare</BusinessNameLine1>
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        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>PO Box 402076</AddressLine1>
            <City>Atlanta</City>
            <State>GA</State>
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        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Medic Regional Blood Center</BusinessNameLine1>
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          <AddressUS>
            <AddressLine1>1601 Ailor Avenue</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
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        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Angelica Textile Services Inc</BusinessNameLine1>
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        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>PO Box 535122</AddressLine1>
            <City>Atlanta</City>
            <State>GA</State>
            <ZIPCode>30353</ZIPCode>
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        <DescriptionOfServices>Linen Service</DescriptionOfServices>
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      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Summit Medical Group</BusinessNameLine1>
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          <AddressUS>
            <AddressLine1>1225 E Weisgarber Rd Ste 200</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37909</ZIPCode>
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        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Sodexo Inc and Affiliates</BusinessNameLine1>
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        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>PO Box 536922</AddressLine1>
            <City>Atlanta</City>
            <State>GA</State>
            <ZIPCode>303536922</ZIPCode>
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        <DescriptionOfServices>Housekeeping Services</DescriptionOfServices>
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      <GovernmentGrants>101657</GovernmentGrants>
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        <BusinessCode>622110</BusinessCode>
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        <Description>Laboratory</Description>
        <BusinessCode>621500</BusinessCode>
        <TotalRevenueColumn>2535507</TotalRevenueColumn>
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      <ProgramServiceRevenue>
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        <BusinessCode>531120</BusinessCode>
        <TotalRevenueColumn>777291</TotalRevenueColumn>
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        <Real>4174650</Real>
        <Personal>46953</Personal>
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      <LessRentalExpenses>
        <Real>4005100</Real>
        <Personal>74174</Personal>
      </LessRentalExpenses>
      <RentalIncomeOrLoss>
        <Real>169550</Real>
        <Personal>-27221</Personal>
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      <NetRentalIncomeOrLoss>
        <TotalRevenueColumn>142329</TotalRevenueColumn>
        <UnrelatedBusinessRevenue>-31786</UnrelatedBusinessRevenue>
        <ExclusionAmount>174115</ExclusionAmount>
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        <Other>100</Other>
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      <LessCostOthBasisSalesExpenses>
        <Other>9663</Other>
      </LessCostOthBasisSalesExpenses>
      <GainOrLoss>
        <Other>-9563</Other>
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        <TotalRevenueColumn>-9563</TotalRevenueColumn>
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        <BusinessCode>900099</BusinessCode>
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      <MiscellaneousRevenue>
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        <RelatedOrExemptFunctionIncome>782347</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>830000</UnrelatedBusinessRevenue>
        <ExclusionAmount>1097297</ExclusionAmount>
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      <TotalOtherRevenue>10531055</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>335539804</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>323606832</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>3348739</UnrelatedBusinessRevenue>
        <ExclusionAmount>7863107</ExclusionAmount>
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      <GrantsToDomesticOrgs>
        <Total>318292</Total>
        <ProgramServices>318292</ProgramServices>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>35610</Total>
        <ProgramServices>35610</ProgramServices>
      </GrantsToDomesticIndividuals>
      <CompCurrentOfficersDirectors>
        <Total>431135</Total>
        <ManagementAndGeneral>431135</ManagementAndGeneral>
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        <Total>76145487</Total>
        <ProgramServices>75392092</ProgramServices>
        <ManagementAndGeneral>753395</ManagementAndGeneral>
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        <ManagementAndGeneral>28662</ManagementAndGeneral>
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      <OtherEmployeeBenefits>
        <Total>10148483</Total>
        <ProgramServices>10032699</ProgramServices>
        <ManagementAndGeneral>115784</ManagementAndGeneral>
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      <PayrollTaxes>
        <Total>5503460</Total>
        <ProgramServices>5424559</ProgramServices>
        <ManagementAndGeneral>78901</ManagementAndGeneral>
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      <FeesForServicesManagement>
        <Total>20417724</Total>
        <ProgramServices>19655487</ProgramServices>
        <ManagementAndGeneral>762237</ManagementAndGeneral>
      </FeesForServicesManagement>
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        <ManagementAndGeneral>96126</ManagementAndGeneral>
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        <ManagementAndGeneral>32280</ManagementAndGeneral>
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        <ManagementAndGeneral>90260</ManagementAndGeneral>
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        <ManagementAndGeneral>219480</ManagementAndGeneral>
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        <Identifier>Description of Intended Use of Endowment Funds:</Identifier>
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        <Explanation>Fort Sanders Foundation mantains two permanent endowments for the purpose of providing a permanent source of income for the following programs at Fort Sanders Regional Medical Center: The Pastoral Care Fund and the Caroline Can! Fund. The principal of the endowments will be kept intact in perpetuity. Only the income generated will be distributed to FSRMC to provide support for the aforementioned programs.</Explanation>
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          <Name>
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          </Name>
          <Address>
            <AddressLine1>1901 Clinch Avenue</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37916</ZIPCode>
          </Address>
          <FacilityType>Rehabilitation Unit</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Fort Sanders Wound Care Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2001 Laurel Avenue Suite G-6</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37916</ZIPCode>
          </Address>
          <FacilityType>Wound Care</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FSR Infusion Services Lenoir City</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>576 Fort Loudoun Med Ctr Dr Ste 204</AddressLine1>
            <City>Lenoir City</City>
            <State>TN</State>
            <ZIPCode>37772</ZIPCode>
          </Address>
          <FacilityType>Pharmacy - Infusion Services</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Fort Sanders West Diagnostic Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>MOB-3 Ste 210 Ft Sanders West Blvd</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37922</ZIPCode>
          </Address>
          <FacilityType>Diagnostic Center</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Fort Sanders Regional Infusion Svcs</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1901 Clinch Avenue</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37916</ZIPCode>
          </Address>
          <FacilityType>Pharmacy - Infusion Services</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FSR Gamma Knife Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1915 White Avenue 1st Floor</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37916</ZIPCode>
          </Address>
          <FacilityType>Gamma Knife Center</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FSRMC Transitional Care Unit</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1901 Clinch Avenue</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37916</ZIPCode>
          </Address>
          <FacilityType>Skilled Nursing Facility</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FS Neurodiagnostics &amp; Sleep Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>Ft Sanders POB Ste 303 501 20th St</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37916</ZIPCode>
          </Address>
          <FacilityType>Neurodiagnostics and Sleep Center</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Fort Sanders Regional Breast Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1915 White Avenue</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37916</ZIPCode>
          </Address>
          <FacilityType>Breast Center (Diagnostics)</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Fort Sanders Regional Laser Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1915 White Avenue</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37916</ZIPCode>
          </Address>
          <FacilityType>Center for Barrett's Esophagus</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FSR Therapy Center - Downtown</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2001 Laurel Avenue Ste 504</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37916</ZIPCode>
          </Address>
          <FacilityType>Physical Rehabilitation Therapy Center</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Diabetes Center Outreach Program</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>MOB-2 Ste 205 220 FSW Blvd</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37922</ZIPCode>
          </Address>
          <FacilityType>Diabetes Center</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FSR Cardiopulmonary Rehab</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>Ft Sanders POB Ste 301 501 20th St</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37916</ZIPCode>
          </Address>
          <FacilityType>Cardiopulmonary Rehab Therapy Center</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FSR Therapy Center - Halls</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>6679 Maynardville Hwy</AddressLine1>
            <City>Knoxville</City>
            <State>TN</State>
            <ZIPCode>37918</ZIPCode>
          </Address>
          <FacilityType>Physical Rehabilitation Therapy Center</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FSR Therapy Center - Powell</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>3515 Emory Road Suite P-9</AddressLine1>
            <City>Powell</City>
            <State>TN</State>
            <ZIPCode>37849</ZIPCode>
          </Address>
          <FacilityType>Physical Rehabilitation Therapy Center</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, Line 6a: Covenant Health, the parent company of Fort Sanders Regional Medical Center and other affiliated acute care hospitals, prepares an annual Report to the Community on behalf of the entire system.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, Line 7g: The organization has included $1,887,910 in physician sponsorship fees in total subsidized health services.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 23773009.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part II: Fort Sanders Regional 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 finding 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 2012 contributions were made to organizations meeting the community's needs by providing: *Affordable, permanent housing and case management services to foster self-sufficiency - Knoxville's Community Development Corporation (KCDC) *Residential and foster care for children, special education services, and support services to reunite families and keep them together - Holston Home for Children *The basic needs of life including temporary shelter, food and clothing - Catholic Charities, Family Promise, Ladies of Charity, and others *Youth mentoring and development and after-school programs - Emerald Youth Foundation and Boy Scouts of America *Business recruitment and marketing initiatives that boost economic development - East Tennessee Economic Development Agency (ETEDA) and Innovation Valley *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)</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part III, Line 4: Part III, Line 2: Bad debt expense on Line 2 is the amount recorded in the organization's financial statements. Discounts and payments on patient accounts are netted against bad debt.Part III, Line 3: In 2011, the hospital reviewed all self-pay accounts receivable to identify patients who might have qualified for financial assistance. As of year end, the hospital could not make a final determination as to their qualification for financial assistance due to all information not yet being received but felt strongly that the patient was in need of some form of assistance. Notes in the patient record were examined to see if a charity care application had been sent to the patient or guarantor or if the account was being analyzed by a business office employee for approval for charity care. The percentage of patient accounts being analyzed as a percent of total self-pay accounts receivable has been applied to the current year total bad debt expense on Line 2 to arrive at the amount reported on Line 3.It is our belief that the amount of bad debt on Line 3 should be included as community benefit. As a tax-exempt hospital, we must provide necessary services regardless of the patient's ability to pay for the service provided. As a not-for-profit, patient care is provided to all, regardless of ability to pay for that care. Making quality patient care available to all in our community, regardless of economic means, qualifies bad debts as a community benefit.Part III, Line 4: Note B to the 2012 Audited Consolidated Financial Statements of the Covenant Health system, of which Fort Sanders Regional 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."</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part III, Line 8: Costing Methodology: Fort Sanders Regional 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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part III, Line 9b: Self-pay patients automatically receive a minimum 47% 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 through routine collection channels internally, it may be assigned to an attorney/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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Fort Sanders Regional Medical Center</Identifier>
        <Explanation>Part V, Section B, Line 14g: Please see the explanation to Part VI, Line 3.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Fort Sanders Regional Medical Center</Identifier>
        <Explanation>Part V, Section B, Line 20d: Please see the explanation to Part III, Line 9b.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 2: Covenant Health, on behalf of its affiliated hospitals, is engaged in conducting community health needs assessments. Covenant has chosen to complete the assessment process in partnership with the local health department, free health clinics, community based health councils, United Way and chambers of commerce.The assessment is utilizing a variety of data collection methods to ensure that at risk populations have a voice in the process. Qualitative research is being conducted using focus groups of community leaders, key informant interviews, and household surveys of 500-600 per county. In working with area health departments, a variety of health statistics have been gathered including demographics, social-cultural indicators, morbidity and mortality data, health rankings, KIDS COUNT data, health professional needs per population, and behavioral risk factor data.Upon completion of data collection, a community based data synthesis team will begin to meet, discuss, and prioritize the significant findings. Each hospital will proceed with the assessment's significant findings and translate that into an action plan to address the identified needs.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 3: Part VI, Line 3: Fort Sanders Regional Medical Center informs patients and other persons who may be billed for services 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 provided to inpatients during the registration process.The following sign is posted in the main registration area, main lobby area and in the Emergency Department registration lobby 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, staff of Fort Sanders Regional Medical Center is 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, Fort Sanders Regional 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 865.541.1112, Monday through Friday between the hours of 8 a.m. and 4:30 p.m.Signs are also posted at each registration desk stating: Financial Assistance: It is Fort Sanders Regional Medical Center's philosophy that no one shall be denied medically necessary services based on an inability to pay. Financial assistance applications for medically necessary services are available during the registration process or through our Financial Counselor's office.To apply for financial aid, please ask our registration staff or contact the Counselor's office at 541-1112. The Financial Counselor is available Monday - Friday, 8 a.m. - 4:30 p.m.Fort Sanders Regional Medical Center employs a full time financial counselor and has a contract employee from First Source Solutions that meets with each uninsured patient. In addition, Fort Sanders Regional Medical Center assists 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 counselor initiates screening of the patient and/or guarantor by obtaining income and other financial information to determine eligibility for charity care or discounted services.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 4: Fort Sanders Regional Medical Center is located in downtown Knoxville, Tennessee. Although located in metropolitan Knox County, Fort Sanders Regional Medical Center receives many specialty referrals from outlying hospitals and physicians and serves patients from 16 diverse counties, a mix of urban, suburban and rural. According to internal hospital data for 2012, more than 56% of the inpatients discharged were Knox County residents. Sevier County provides Fort Sanders Regional with the second highest number of admissions compared to other counties in the region, slightly more than 9% of the total.According to 2010 data of the U.S. Census Bureau, the collective population of the 16-county region is 1,176,033, of which 51.2% are female and 48.8% are male. The racial makeup of the population is 94% Caucasian, 4.6% black, and 1.4% other races. There are 22 hospitals in the 16-county area which, with one exception, are tax exempt. The average household income and percentage of the population with incomes below the federal poverty guideline within the 16 counties ranges from a low of $28,563 and 27% in Cocke County to a high of $47.277 and 13.7% in Knox County.According to a recently released study by the Robert Wood Johnson Foundation/ University of Wisconsin Population Health Institute, Knox County residents have the following health indicators that are above the national benchmarks: Knox - TN - National Adult Smoking: 19% - 23% - 13% Adult Obesity: 31% - 32% - 25% Excessive Drinking: 10% - 10% - 7% Teen Birthrate: 37 - 50 - 21 of every 1,000 teenage girls Poor or Fair Health: 16% - 19% - 10% Physical Inactivity: 28% - 30% - 21%</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 5: Fort Sanders Regional Medical Center (FSRMC), 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 FSRMC's board. It is comprised of independent community leaders with diverse educational and professional backgrounds. The board sets policies and provides oversight of FSRMC.FSRMC 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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 6: Fort Sanders Regional Medical Center, 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. Fort Sanders Regional, as a regional referral hospital, provides a wide range of acute care services, many of which are unique in the Covenant system. These services are therefore more easily accessible by other affiliated hospitals and health care organizations through transfer or referral helping to create a seamless continuum of care. The hospital, through its Patricia Neal Rehabilitation Center division, is the only acute inpatient rehabilitation facility in the Covenant system and the largest such provider in the service area. Programming includes specialized services for stroke, brain injury, spinal cord injury and other difficult patient populations with the primary goal of returning the patient home with the greatest gain in functional ability possible. Fort Sanders Regional also provides hospital-based skilled nursing care which serves as either a bridge back home or as an important step along the continuum of care to other long term care resources.In 2011 Fort Sanders Regional opened its Gamma Knife Center located at Thompson Cancer Survival Center, an affiliated cancer treatment center. The Gamma Knife Center features the newest and most advanced Leksell Gamma Knife Perfexion, a non-invasive radiosurgical tool used to treat brain tumors and other disorders. Patients undergoing Gamma Knife procedures benefit from reduced treatment times and minimized surgical complications. Fort Sanders Regional also provides other important services unique to the Covenant system including high risk obstetrical services and home infusion. It's outpatient diabetes center serves a large community-based population with educational, dietary and other supportive medical services that would otherwise be unavailable or difficult to access. Co-located with the diabetes center, the Coumadin clinic serves to educate another vulnerable population as well as to monitor the therapeutic effectiveness of this drug. These services, the diabetes center and the Coumadin clinic, are important to preventing unnecessary hospitalizations through the provision of effective community-based care. Fort Sanders Regional also provides other extensive outpatient services through its ambulatory infusion centers, physical therapy centers, a wound care center, and its cardiac and pulmonary rehabilitation programs. Fort Sanders Regional's patients benefit from the availability of and ease of access to Covenant 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 which 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. Home health and hospice services are also an important part of the continuum of care for a large portion of the hospital's patient population. 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.The Fort Sanders Foundation seeks out community support for Fort Sanders Regional and other Covenant Health hospitals through a variety of fund raising mechanisms. For example, the Fort Sanders Foundation helps to arrange sponsorship for significant fund raising activities of the Patricia Neal Rehabilitation Center division of the hospital including an annual golf tournament that has become the largest, single day fundraising event in the state of Tennessee. The proceeds of these events help fund needed equipment and facilities for the center as well as to provide access to the center's services for uninsured or underinsured individuals who are in need of intensive rehabilitation but may otherwise be denied such services due to the lack of resources. The Foundation also provides temporary residential services through the Fellowship Center for patients of the hospital and their families that travel to Knoxville to receive needed care but are unable to afford the costs involved.The Fort Sanders Nursing Department at Tennessee Wesleyan College is an important affiliate of Fort Sanders Regional. The school provides a baccalaureate nursing education, helping to alleviate a shortage of registered nurses to serve a growing and aging population. It is a continuation of a nursing education tradition of the hospital that began more than eighty years ago. The hospital provides a substantial financial contribution to support the program. Training qualified nursing professionals to serve the current or future needs of the community is an important hospital mission.Fort Sanders Regional is integrated with its community in a number of ways including its active participation in the development of a Fort Sanders Neighborhood District Long Range Plan. Fort Sanders is a densely populated urban neighborhood in the City of Knoxville. With its proximity to downtown and with the location of two regional referral hospitals (East Tennessee Children's Hospital being the other) and the flagship campus of the University of Tennessee in its boundaries, it provides an ideal location for convenient access for residents and as a gateway to visitors. With these assets, it is imperative that the city and neighborhood leaders work together in order to coordinate quality growth while maintaining the rich character and history that give Fort Sanders its unique identity.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.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <RecordsMaintained>1</RecordsMaintained>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Thompson Cancer Survival Center</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>1915 White Avenue</AddressLine1>
          <City>Knoxville</City>
          <State>TN</State>
          <ZIPCode>37916</ZIPCode>
        </AddressUS>
        <EINOfRecipient>621250943</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>75192</AmountOfCashGrant>
        <PurposeOfGrant>Financial support of Fellowship Center</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Fort Sanders Foundation</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>280 Fort Sanders West Blvd Suite</AddressLine1>
          <AddressLine2>100</AddressLine2>
          <City>Knoxville</City>
          <State>TN</State>
          <ZIPCode>37922</ZIPCode>
        </AddressUS>
        <EINOfRecipient>621748601</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>202060</AmountOfCashGrant>
        <PurposeOfGrant>Fellowship Center maintenance and food fund</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Joni and Friends Ministry Knoxville</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>1540 Robinson Road</AddressLine1>
          <City>Knoxville</City>
          <State>TN</State>
          <ZIPCode>37923</ZIPCode>
        </AddressUS>
        <EINOfRecipient>621458199</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>7500</AmountOfCashGrant>
        <PurposeOfGrant>Support &amp; ministry to the disabled</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>American Heart Association</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>4708 Papermill Road</AddressLine1>
          <City>Knoxville</City>
          <State>TN</State>
          <ZIPCode>37909</ZIPCode>
        </AddressUS>
        <EINOfRecipient>135613797</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>24890</AmountOfCashGrant>
        <PurposeOfGrant>Support for cardiovascular disease education and research</PurposeOfGrant>
      </RecipientTable>
      <TotalNbrOf501C3AndGovtGrants>4</TotalNbrOf501C3AndGovtGrants>
      <TotalNbrOfOtherOrganizations>0</TotalNbrOfOtherOrganizations>
      <Form990ScheduleIPartIII>
        <TypeOfGrant>Provided indigent patients with medications to facilitate discharge or to prevent readmission.</TypeOfGrant>
        <NumberOfRecipients>413</NumberOfRecipients>
        <AmountOfNonCashAssistance>29404</AmountOfNonCashAssistance>
        <MethodOfValuation>Cost</MethodOfValuation>
        <DescriptionOfNonCashAssistance>Prescription medications</DescriptionOfNonCashAssistance>
      </Form990ScheduleIPartIII>
      <Form990ScheduleIPartIII>
        <TypeOfGrant>Paid rental to supplier for LifeVest wearable defibrillator for patient</TypeOfGrant>
        <NumberOfRecipients>1</NumberOfRecipients>
        <AmountOfCashGrant>2900</AmountOfCashGrant>
      </Form990ScheduleIPartIII>
      <Form990ScheduleIPartIII>
        <TypeOfGrant>Paid nursing home bill for specific patient</TypeOfGrant>
        <NumberOfRecipients>1</NumberOfRecipients>
        <AmountOfCashGrant>1090</AmountOfCashGrant>
      </Form990ScheduleIPartIII>
      <Form990ScheduleIPartIII>
        <TypeOfGrant>Paid mortuary for burial expenses for a deceased patient</TypeOfGrant>
        <NumberOfRecipients>1</NumberOfRecipients>
        <AmountOfCashGrant>700</AmountOfCashGrant>
      </Form990ScheduleIPartIII>
      <Form990ScheduleIPartIII>
        <TypeOfGrant>Provided indigent PTCA/Stent patients at discharge with antiplatelet medication to prevent stent thrombosis.</TypeOfGrant>
        <NumberOfRecipients>1</NumberOfRecipients>
        <AmountOfNonCashAssistance>1516</AmountOfNonCashAssistance>
        <MethodOfValuation>Cost</MethodOfValuation>
        <DescriptionOfNonCashAssistance>Prescription medications</DescriptionOfNonCashAssistance>
      </Form990ScheduleIPartIII>
      <Form990ScheduleIPartIV>
        <Identifier>Procedure for Monitoring Grants in the U.S.:</Identifier>
        <ReturnReference>Part I, Line 2:</ReturnReference>
        <Explanation>Schedule I, Part I, Line 2: The hospital provides for the post-hospitalization transportation and medication needs of its patients when there is a demonstrated need as attested to by a social services worker. The determination is made by Case Management based on the judgment of the social services worker after working with the patient and the patient's family. Assistance is approved on a case-by-case basis by Case Management, and this approval is verified upon approval of any invoices to be paid.</Explanation>
      </Form990ScheduleIPartIV>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePayment>1</SeverancePayment>
      <SupplementalNonqualRetirePlan>1</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>0</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>0</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>0</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>0</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>0</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>0</AnyNonFixedPayments>
      <InitialContractException>0</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>Anthony L Spezia</NamePerson>
        <Title>President &amp; CEO</Title>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>941953</CompBasedOnRelatedOrgs>
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        <ReturnReference>Part I, Line 3</ReturnReference>
        <Explanation>Covenant Health, the parent company of Fort Sanders Regional 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.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <ReturnReference>Part I, Lines 4a-b</ReturnReference>
        <Explanation>Part I, Line 4a: Gary Bush's reportable compensation includes $44,575 for severance. 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 2012 amounted to $71,781.22 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 2012 totaled $204,000, which is reported in Column C of Schedule J, Part II. Interest earned by Plan B during 2012 of $17,909.59 is not required to be reported in compensation in Part II, as Mr. Spezia is not substantially vested in Plan B.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <Identifier>Organization Mission Statement</Identifier>
        <ReturnReference>Form 990, Part III, Line 1</ReturnReference>
        <Explanation>In 1996, Fort Sanders Health System and MMC Healthcare System of Oak Ridge consolidated to form Covenant Health, with a mission of serving its communities by improving the quality of life through better health. Covenant Health is a nationally recognized top health system in many areas: patient care, quality performance, cost, integration, information technology, finances, ethics and innovation. To meet the challenges and implications of healthcare reform, Covenant Health has committed to these imperatives: * Serving the community as a not-for-profit health system. * Leading in quality and service. * Outstanding governance and leadership. * An engaged work force with the right skill sets. * Being the practice environment of choice for physicians. * Reinvesting in communities, providing programs, services, technologies and facilities that improve local healthcare services and patient care. Covenant Health has invested more than a billion dollars in its communities since 2000 - a commitment no other healthcare organization has approached. Covenant Health has opened new hospitals, expanded services, and brought cutting-edge medical technology to the region. * Meeting the challenges of the healthcare environment through effective strategic planning and wise use of resources. * Providing excellent care to every patient, every time. This commitment to excellence will help the system accomplish its mission of improving the quality of life through better health. In order to deliver on the promise of excellence in today's healthcare environment, preparation is critical. Covenant Health's Board of Directors ("the Board") is committed to advancing its understanding of health care. The Board is continually learning about hospitals' operational challenges and how the current environment affects physicians and their practices. The healthcare universe is constantly shifting. The Board members are volunteers, but have a passion for Covenant Health's mission, and a desire to expand its knowledge in preparation for leading the organization. Dedication to a shared goal is essential. Very few community endeavors are as important as making high-quality health care available to its citizens. Our patients and their families are at vulnerable points in their lives, and the Board believes it is a privilege to meet their healthcare needs. Experience is a valuable asset. Covenant Health has a legacy of delivering high-quality care, which will help to weather the storms of change, including transitioning to value-based reimbursement. COVENANT HEALTH MEMBER ORGANIZATIONS AND SERVICES Covenant Health Board members and administrative leaders serve their communities through strategic planning and successful operation of these member organizations: Hospitals and Other Healthcare Providers: Covenant Homecare and Hospice Fort Loudoun Medical Center Fort Sanders Perinatal Center Fort Sanders Regional Medical Center LeConte Medical Center Methodist Medical Center of Oak Ridge Morristown-Hamblen Healthcare System Parkwest Medical Center Peninsula Hospital, a Division of Parkwest Medical Center Roane County Medical Center Thompson Cancer Survival Center Thompson Oncology Group Knoxville Heart Group Outpatient and Specialty Care Departments, and Joint Ventures: Fort Sanders West Diagnostic Center Fort Sanders West Outpatient Surgery Center Patricia Neal Rehabilitation Center Peninsula Outpatient Centers Fort Sanders Sevier Nursing Home Foundations: Fort Sanders Foundation Methodist Medical Center Foundation Morristown-Hamblen Hospital Foundation Thompson Cancer Survival Center Foundation BRINGING QUALITY CARE TO LOCAL COMMUNITIES Covenant Health delivers quality care, with services designed to meet the specific needs of people in the communities it serves. Seven acute care hospitals located in Knoxville and surrounding areas comprise the foundation of the health system. The hospitals offer comprehensive care, including emergency care, specialty services, and a full range of diagnostics and treatment, provided by board-certified medical staffs. Three Covenant Health hospitals - Fort Sanders Regional, Methodist, and Parkwest Medical Centers, were named among the top 10 hospitals in Tennessee in 2013 by U.S. News and World Report, recognizing excellence in both overall and specialty care. Several hospitals have been recognized for clinical accomplishments by VHA, Inc., a cooperative of non-profit healthcare organizations. In 2013, the community celebrated the opening of the new 50-bed Roane County Medical Center in Harriman. The new hospital brings expanded medical services and sophisticated technology to the people of Roane County. In addition to comprehensive hospital services, Covenant Health provides: * Innovative cancer care and technologies to deliver radiation therapy and other cancer treatment in Knox, Sevier, Anderson and Hamblen counties. * Nationally recognized care for patients suffering from physical disabilities, stroke and traumatic brain injury at Fort Sanders Regional Medical Center's Patricia Neal Rehabilitation Center. * Affiliated physician clinics throughout the region which offers convenient access to primary and specialty care. * Rehabilitation services including physical therapy, speech therapy, sports medicine, and specialized therapy such as hand therapy and vestibular (balance) rehabilitation. RACING AGAINST TIME AND DISTANCE IN STROKE CARE With Fort Sanders Regional Medical Center's "tele-stroke" robot, East Tennessee stroke patients can benefit from early consultation with the hospital's stroke experts - regardless of where patients are located across the region. Fort Sanders Regional Medical Center ("Fort Sanders") introduced robots to the region in 2012. 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 neurologist's availability to patients in outlying areas 24 hours a day. Covenant Health stationed its first two robots in the emergency departments at Parkwest Medical Center in Knoxville and LeConte Medical Center in Sevierville. The telestroke network allows physicians in surrounding hospitals to use live Web video streaming to consult with Fort Sanders Stroke Center 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. A STROKE CENTER OF EXCELLENCE Fort Sanders is a Stroke Center of Excellence, and the only facility in the region to hold both a Comprehensive Stroke Center certification from the Joint Commission and three separate stroke accreditations from the Commission on the Accreditation of Rehabilitation Facilities. Fort Sanders has a team of experts available to treat patients 24 hours a day, seven days a week. The stroke team includes emergency room physicians, neurologists, neurosurgeons, neurointerventional radiologists, nurses and therapists who quickly diagnose patients and use the most technically advanced methods available to remove clots, repair broken arteries that cause strokes, and restore blood flow to the brain.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Explanation>TAVR - CHARTING NEW DIRECTIONS IN HEART CARE In 2012, Parkwest Medical Center ("Parkwest") performed its first transcatheter aortic valve replacement (TAVR) procedure. Parkwest is the first hospital in the area to offer TAVR as a minimally invasive procedure to help men and women with the progressive, life-threatening condition known as aortic stenosis. Within the first year, the TAVR team of physicians from Parkwest and Fort Sanders Regional Medical Centers performed surgery for nearly 60 people who were deemed inoperable for traditional open-heart surgery. The patients received new heart valves via a catheter tube inserted either into the femoral artery or through the rib cage. Recovery is markedly shorter than traditional open-heart surgery. In most cases the patients were discharged from the hospital within three to six days. An important aspect of TAVR is its multi-disciplinary approach. The TAVR team includes physicians specializing in cardiovascular and cardiothoracic surgery, interventional cardiology, and cardiac anesthesiology, as well as nurses and technicians with specialized training. The operating room used for TAVR procedures at Parkwest is also multi-disciplinary in design. The $2.6 million hybrid operating room combines the resources of a cardiac catheterization lab and an operating room, including the imaging equipment needed for minimally invasive procedures. ACHIEVING QUALITY THROUGH PARTNERSHIPS WITH PHYSICIANS Overall, Covenant Health's desire for alignment is driven by the need to fully evolve as a healthcare system. In pursuing its goal of outstanding quality and seamless continuum of care, Covenant Medical Management, Inc. (CMM), a for-profit entity in the Covenant Health system, has developed models with physicians that include both employment and joint ventures. CMM provides practice management services and support to over 120 primary care and specialty physicians in more than 60 practices in East Tennessee. CMM recently added Southern Medical Group and Family Care Specialists to its employed physician groups that include: * Cardiology Associates of East Tennessee * Crossville Medical Group * Fort Sanders Women's Specialists * Tennessee Brain and Spine CMM also acquired a new, separate corporation, East Tennessee Cardiovascular Surgery Group, in 2012. Prior to joining the Covenant Health system, the surgeons in this practice served as the primary cardiac surgeons for Fort Sanders Regional, Methodist, and Parkwest Medical Centers and worked in the system's Valve Centers and TAVR program. BEHAVIORAL HEALTH - A COMMITMENT TO ESSENTIAL SERVICES In 2012, Peninsula, a division of Parkwest Medical Center, faced an unprecedented challenge: Lakeshore, a state-funded mental health institute, would be closing its doors for good, and the majority of patients would funnel into Peninsula Hospital. The closing was a strategic move by the state Department of Mental Health to follow the national trend of moving behavioral health toward community-based care and away from state-funded care. With a multi-professional team made up of experienced people from across the continuum of mental health care, Peninsula laid out a plan to accommodate the influx of hospital admissions, reduce costs, and improve the quality of care for mental health patients. The team was challenged by not only having more patients, but patients with serious and complex mental disorders. Changes in staffing and processes helped create a smooth admission process and improvement of service. On average, Peninsula serves about a dozen more inpatients per day since Lakeshore closed. Even with the additional volume, Peninsula has been able to increase its customer satisfaction score and maintain or improve its performance in safety quality measures. Many of the changes which resulted in taking the patients from Lakeshore translated to better service. For example, a process was developed to assess and enroll the patients in CoverRX, the state-funded program for prescription coverage. Patients have benefited by increased collaborative efforts within the community such as regular meetings with a community providers group including representatives from local law enforcement, hospital emergency departments, mobile crisis, and a state mental health facility. The group works on the continuum of services for behavioral health patients in the area. Peninsula participates in the Crisis Intervention Training (CIT) for officers from the surrounding areas' police and sheriff's offices. The training facilitates understanding about mental illness, and when that happens, patients benefit. A partnership with the State of Tennessee brought improvements to the community based care of mental health patients, such as transportation and medications. As a result, more outpatients are keeping their first appointments, and there are a lower number of readmissions. In addition to the 155-bed inpatient psychiatric hospital in Blount County, Peninsula also has outpatient facilities in Knox, Blount, Loudon, and Sevier counties. SETTING THE STANDARD FOR TECHNOLOGY The recently enacted American Recovery and Reinvestment Act includes incentives and penalties designed to accelerate our nation's adoption and "meaningful use" of electronic health records, ("EHRs"). The implementation of meaningful use initiatives is changing the way healthcare is delivered not only at Covenant Health, but also across Tennessee, and throughout the U.S. With widespread adoption, EHRs can: * make a patient's current health information available in a single, secure, shared record, * provide real-time decision support designed to hardwire best practices and reduce care variability, * reduce paperwork, duplicate testing and other inefficiencies. Meaningful Use provides the technology infrastructure and electronic applications to connect care settings, reduce costs, improve efficiency and standardize quality. From 2015 forward, for every year that meaningful use requirements are not met, providers will receive penalties in the form of reduced reimbursement. At Covenant Health, interdisciplinary and multidisciplinary operational teams have been involved in developing and implementing applications and processes related to the main components of Meaningful Use: * E-prescription writing, and computerized patient order entry, * Interoperability, or exchanging key clinical information among providers and patients, * Automated quality reporting. Through Meaningful Use initiatives Covenant Health will transform the way it delivers care by improving patient outcomes, clinical quality, patient safety and organizational effectiveness. Covenant Health has installed a record number of applications related to Meaningful Use. Seven initiatives ranging from admission databases and medication reconciliation (important for patient safety) to computerized patient order entry and physician practice management software took place in 2012 and continued in 2013. The successful installation of multiple applications in a one-year period is unprecedented in the IT world. Quality assurance processes are in place to ensure delivery of the best applications and processes for patient care, clinical quality, and patient safety. "MOST WIRED"</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Explanation>Hospitals &amp; Health Networks magazine, the journal of the American Hospital Association, has named Covenant Health among the nation's Most Wired healthcare organizations in the 15th annual Most Wired Survey and Benchmarking Study. It is the 10th time that Covenant Health has been named to the Most Wired list. Although Covenant has been named among the nation's Most Wired many times, the health systems that made the list in recent years have had to meet the demands of a more stringent analytic structure. The Most Wired survey includes questions about IT initiatives that support Meaningful Use requirements. It measures IT achievements in four focus sections: infrastructure, business and administrative management, clinical quality and safety (hospital inpatient/outpatient) and clinical integration (ambulatory/physician/community). Participating organizations must meet specific criteria for each section in order to be named "Most Wired." Most Wired surveys were completed by 659 healthcare organizations representing 1,713 hospitals, or roughly 30 percent of all U.S. hospitals. PHILANTHROPY TURNS CHALLENGE INTO OPPORTUNITY The Covenant Health Office of Philanthropy coordinates the philanthropic contributions of individuals and businesses throughout East Tennessee and beyond in support of health care in the region. Fund raising efforts are led by volunteer boards and staff at four foundations: Fort Sanders Foundation, Methodist Medical Center Foundation, Morristown- Hamblen Hospital Foundation, and Thompson Cancer Survival Center Foundation. When Fort Sanders Health Systems created its first fund raising office, Fort Sanders Foundation, in the mid-1970s to raise funds to support Fort Sanders Regional Medical Center, it was a progressive move for a health care provider. Fund raising was not a need, but more in the category of 'nice to have.' This status has changed in today's era of healthcare reform. Financial resources have tightened and hospitals look to the community for charitable contributions that are now very much in the 'need to have' category if they are to continue to meet the healthcare needs of the people of East Tennessee. During the past year these foundations received contributions of approximately $3.7 million to help provide new equipment and facilities at the hospitals, staff training and patient care programs. While the Office of Philanthropy staff coordinates community events and fund raisers, local community leadership and involvement is critical to fund raising success. In an effort to expand the cadre of informed volunteer leaders in the community, the Office of Philanthropy launched a new education program this year, Covenant Answers: A Healthcare Leadership Academy. Inaugural Academy participants included representatives from the boards of Covenant Health, and Fort Sanders and TCSC foundations. Future Leadership Academy classes will include business and community representatives from throughout Covenant Health's service area. Over a five-month period, class members attended half-day sessions at five Covenant hospitals, which included behind-the-scenes tours and hands-on access to the latest technologies and treatments. Participants discussed the challenges of the current health care environment with Covenant physicians and clinicians, heard firsthand from patients whose recovery hinged on the excellent care provided at our hospitals, and even tried their hands at using adaptive rehab equipment and maneuvering a surgical robot. IMPROVING HEALTH BEYOND HOSPITAL WALLS One of the greatest challenges facing a healthcare organization is not only caring for the patients and families who receive direct services, but making a positive impact in the health of the surrounding community. That is the mission of Covenant Health: reaching beyond hospital walls to improve the quality of life through better health. 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 Knoxville more than 7,000 people participated in the annual Covenant Health Knoxville Marathon, which attracted local runners and hand cyclists, as well as competitors from throughout the U.S. and other countries. * The Covenant Health Biggest Winner Weight Loss Challenge is a friendly competition that encourages East Tennesseans to get off the couch and get moving for a fit and healthy lifestyle. Team members train together for five months, with the goal of crossing the finish line in Covenant Health Knoxville Marathon events. Participants challenge other East Tennesseans to start a health journey that will change their lives for the better. * Some of the funds raised through the Covenant Health Knoxville Marathon were contributed to The Patricia Neal Rehabilitation Center's Innovative Recreation Cooperative, a collaboration of groups and individuals who help disabled persons enjoy leisure and recreation activities such as water skiing and cycling. * The Covenant Kids Run attracted over 1,000 children who participated in a "marathon" of activities over a period of several weeks, culminating in a run to Neyland Stadium on the day before the Covenant Health Knoxville Marathon. * Covenant Health was the fitness sponsor of the Dogwood Arts Festival, held annually in April. Fitness activities included several outdoor walks, "Bikes and Blooms" bike rides on local Dogwood trails, and a Dogwood Mile run and Kids Race held in downtown Knoxville. * Covenant HomeCare Hospice helps children grieving the loss of a loved one through Katerpillar Kids Camp, offered with the support of Variety-The Children's Charity. The camp is staffed by health system volunteers and helps children in grades 1-12 express their feelings in a supportive environment while enjoying camp activities. * Morristown-Hamblen's Wellness of Women is dedicated to improving the lives of area women and their families. The program sponsors events such as an annual Girls Night Out, which offers free health screenings and encourages women to have fun while learning to stay healthy. UNCOMPENSATED CARE One of the most tangible expressions of the charitable purpose of Covenant Health is providing care to people in need. As a not-for-profit system, Covenant Health provides medically necessary services to people with limited resources. Covenant Health actively participates in the state's TennCare program, and collaborates with other area providers to identify and support efforts to make community healthcare resources available for those in need. The Community Benefit totals for uncompensated care are included on the Forms 990 for the individual Covenant Health hospitals.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section A, line 5</ReturnReference>
        <Explanation>A surgery technician was linked to a national investigation involving selling surgical equipment and supplies to the gray market. The individual was apprehended, his employment terminated, and the government has seized all his assets. The exact amount of the theft cannot be determined but is estimated to be about $2 million.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section B, line 11</ReturnReference>
        <Explanation>Covenant Health is a large integrated health system which files twelve Forms 990. Fort Sanders Regional Medical Center is one of these twelve entities. Annually, at the September Finance Committee meeting, one of the twelve 990s is selected (a different entity each year) for distribution to each member of the Committee. Management then reviews in detail each of the Form 990 schedules and describes variances between entities, if any. The remaining eleven Forms are made available for review by any committee member. The same presentation is made to the Covenant Health Board of Directors at the October meeting. All twelve Form 990s are then made available to all Board members for their review throughout the month of October.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section B, line 12c</ReturnReference>
        <Explanation>Board members, officers and employees are required to adhere to rules and policies regarding conflicts of interest. Covenant Health, the parent company of the organization, distributes a Board-approved Code of Conduct to all employees. The Code covers among other subjects, conflicts of interest. Additionally, managers are required to complete and sign an annual management certification that addresses conflicts of interest. Board members' conflicts of interests are dealt with in the corporate bylaws, and Board members are required to complete and sign a conflict of interest questionnaire on an annual basis. The Integrity Compliance Office maintains records that contain conflict of interest information obtained from Board members, officers and employees. These records are available to be queried prior to engaging in business transactions. The Integrity Compliance Officer initially reviews all conflict of interest data. Based on this information, the officer determines what conflicts of interest exist at that point in time. Between times when surveys are collected Board members are expected to disclose any new conflicts that have arisen that affect pending Board decisions. As well, managers and other employees are expected to report conflicts to the Integrity Compliance Officer as they arise. Depending on the nature of the conflict and the circumstances surrounding the conflict and transaction, the Integrity Compliance Officer, Senior Leadership, or the Board of Directors may review the conflict of interest. Where appropriate these bodies may also consult legal counsel. Restrictions imposed on persons with a conflict of interest are determined on a case by case basis. For Covenant Health employees, the Integrity Compliance Officer in conjunction with Executive Leadership determines how to appropriately handle the conflict. In any conflict involving a Board member, such member is expected to excuse himself or herself from voting on matters that give rise to the conflict.</Explanation>
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      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section B, line 15</ReturnReference>
        <Explanation>Form 990, Part VI, Section B, Line 15a: Overall compensation policies for Fort Sanders Regional Medical Center, Covenant Health (Parent Company), and affiliates are set by the Compensation Committee of the Board of Directors, which is comprised of independent members of the Board. The Committee is guided in its decision-making process by an independent, nationally-recognized executive compensation consultant experienced in advising nonprofit hospital boards. Compensation policies for Anthony Spezia and John Geppi are reported on the 2012 Form 990 of Covenant Health, EIN 62-1646734, parent company of Fort Sanders Regional Medical Center. Form 990, Part VI, Section B, Line 15b: Base salary and annual bonus opportunities for Keith Altshuler, President/CAO, are set by the Covenant Health CEO or Executive Vice President-Human Resources, subject to approval of the Compensation Committee of the Covenant Health Board of Directors ("the Committee"), after review by and discussion with the executive compensation consultant ("the consultant") to ensure that total compensation is reasonable and within a fair market value range. Salary ranges are based upon the recommendations of the consultant made after comparison with similar jobs in similar size health systems across the nation. Bonuses are recommended by the CEO and approved by the Committee conditioned upon receipt of a written opinion from the consultant that total compensation for the President/CAO is reasonable and consistent with fair market value. Base salaries are initially targeted at midpoint and vary according to the individual's experience, market conditions and competition. Annual bonuses are designed to award 0-35% of base salary based upon system performance and accomplishment of certain targets established by the CEO. Base salary and annual bonus opportunities for Ronnie Beeler, VP-Financial Services, are based on established targets to insure that total compensation is reasonable and within a fair market value range. Salary ranges are based upon comparison with similar jobs in similar size health systems across the nation. Base 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 vary according to the individual's experience, market conditions and competition. Annual bonuses are designed to award 0-20% of base salary based upon system performance and accomplishment of certain targets established by Executive Leadership.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section C, line 19</ReturnReference>
        <Explanation>Form 990, Part VI, Section C, Line 19: Per its tax-exempt bond provisions, the parent company, Covenant Health, is required to file quarterly and annual consolidated and obligated group financial statements in addition to other documentation, with various bond insurers and other agencies, including the Electronic Municipal Market Access, EMMA, website. Any member of such a repository has access to these financial statements. In addition, Fort Sanders Regional Medical Center files a Joint Annual Report containing financial information with the Tennessee Department of Health.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Contact Addresses for Officers, Directors, Etc.:</Identifier>
        <ReturnReference>Form 990, Part VI, Section A, Line 9</ReturnReference>
        <Explanation>Anthony L. Spezia Covenant Health 100 Ft Sanders West Blvd. Knoxville, TN 37922 John T. Geppi, Larry Mauldin, and all Directors Covenant Health 1420 Centerpoint Blvd., Bldg. C Knoxville, TN 37932 Gary Bush 5046 Ridgemont Drive Knoxville, TN 37918-4525 All other persons listed in Part VII, Section A may be contacted at the organization's address, which is: Fort Sanders Regional Medical Center 1901 Clinch Avenue Knoxville, TN 37916</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Changes in Net Assets or Fund Balances:</Identifier>
        <ReturnReference>Form 990, Part XI, line 9:</ReturnReference>
        <Explanation>Intracompany Eliminations -74,946. Forgiveness of Affiliate Payables 6,505.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part XII, Line 2c:</ReturnReference>
        <Explanation>The Finance Committee of the Board of Directors assumes responsibility for oversight of the audit of the consolidated financial statements and selection of an independent accountant.</Explanation>
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        <NameOfOtherOrganization>
          <BusinessNameLine1>Fort Sanders Perinatal Center</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>A</TransactionType>
        <AmountInvolved>706239</AmountInvolved>
        <MethodOfAmtDetermination>Cost</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Fort Sanders Perinatal Center</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>46446</AmountInvolved>
        <MethodOfAmtDetermination>Cost</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Fort Sanders Perinatal Center</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>M</TransactionType>
        <AmountInvolved>136241</AmountInvolved>
        <MethodOfAmtDetermination>Cost</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Fort Sanders Perinatal Center</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>N</TransactionType>
        <AmountInvolved>289622</AmountInvolved>
        <MethodOfAmtDetermination>Cost</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Fort Sanders Perinatal Center</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>Q</TransactionType>
        <AmountInvolved>165941</AmountInvolved>
        <MethodOfAmtDetermination>Cost</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Knoxville Heart Group</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>A</TransactionType>
        <AmountInvolved>246829</AmountInvolved>
        <MethodOfAmtDetermination>Cost</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Knoxville Heart Group</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>N</TransactionType>
        <AmountInvolved>69499</AmountInvolved>
        <MethodOfAmtDetermination>Cost</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>