EAST TENNESSEE CHILDRENS HOSPITAL ASSOCIATION INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
EAST TENNESSEE CHILDRENS HOSPITAL ASSOCIATION INC (EIN 62-6002604)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201221369349301977
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-15T09:29:29-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PERSHING YOAKLEY & ASSOCIATES PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE CHEROKEE MILLS 2220 SUTHERLANDAddressLine1
CityKNOXVILLECity
StateTNState
ZIP Code379192363ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN626002604EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1EAST TENNESSEE CHILDREN'S HOSPITALBusinessNameLine1
Business Name Line2ASSOCIATION INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlEASTNameControl
Phone8655418154Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 15010AddressLine1
CityKNOXVILLECity
StateTNState
ZIP Code379015010ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameZANE GOODRICHName
TitleCHIEF FINANCIAL OFFICERTitle
Phone8655418154Phone
Date Signed2012-05-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDEBORAH O ERNSBERGERName
Phone8656730844Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKEITH D GOODWINNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 15010AddressLine1
CityKNOXVILLECity
StateTNState
ZIP Code379015010ZIPCode
FieldValueIRS element (for citing)
Gross Receipts161811560GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteHTTP://WWW.ETCH.COM/WebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1937YearFormation
State Legal DomicileTNStateLegalDomicile
Activity Or Mission DescriptionAT ETCH, CHILDREN ARE OUR ONLY CONCERN, PROVIDING THE BEST HEALTHCARE TO EVERY CHILD SERVED.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees2033TotalNbrEmployees
Total Nbr Volunteers14104TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4844759ContributionsGrantsPriorYear
Contributions Grants Current Year5392077ContributionsGrantsCurrentYear
Program Service Revenue Prior Year143270067ProgramServiceRevenuePriorYear
Program Service Revenue CY151244277ProgramServiceRevenueCY
Investment Income Prior Year462984InvestmentIncomePriorYear
Investment Income Current Year1377105InvestmentIncomeCurrentYear
Other Revenue Prior Year1730308OtherRevenuePriorYear
Other Revenue Current Year2182965OtherRevenueCurrentYear
Total Revenue Prior Year150308118TotalRevenuePriorYear
Total Revenue Current Year160196424TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year23000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY25320GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year80868252SalariesEtcPriorYear
Salaries Etc Current Year85478389SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year811984TotalFundrsngExpCurrentYear
Other Expense Prior Year61234572OtherExpensePriorYear
Other Expenses Current Year55215636OtherExpensesCurrentYear
Total Expenses Prior Year142125824TotalExpensesPriorYear
Total Expenses Current Year140719345TotalExpensesCurrentYear
Revenues Less Expenses Prior Year8182294RevenuesLessExpensesPriorYear
Revenues Less Expenses CY19477079RevenuesLessExpensesCY
Total Assets BOY216274757TotalAssetsBOY
Total Assets EOY240169746TotalAssetsEOY
Total Liabilities BOY86237345TotalLiabilitiesBOY
Total Liabilities EOY87511174TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY130037412NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY152658572NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionEAST TENNESSEE CHILDREN'S HOSPITAL ("ETCH") WILL IMPROVE THE HEALTH OF CHILDREN THROUGH EXCEPTIONAL COMPREHENSIVE FAMILY-CENTERED CARE, WELLNESS, AND EDUCATION. ETCH BELIEVES BECAUSE CHILDREN ARE SPECIAL, THEY DESERVE THE BEST POSSIBLE HEALTH CARE GIVEN IN A POSITIVE, CHILD/FAMILY CENTERED ATMOSPHERE OF FRIENDLINESS, COOPERATION, AND SUPPORT - REGARDLESS OF RACE, RELIGION, OR ABILITY TO PAY; THEIR MEDICAL NEEDS ARE CLOSELY RELATED TO THEIR EMOTIONAL AND INFORMATIONAL NEEDS; THEREFORE, THE TOTAL CHILD MUST BE CONSIDERED IN TREATING ANY ILLNESS OR INJURY; THEIR HEALTH CARE REQUIRES FAMILY INVOLVEMENT, SPECIAL UNDERSTANDING, SPECIAL EQUIPMENT, AND SPECIALLY TRAINED PERSONNEL WHO RECOGNIZE THAT CHILDREN ARE NOT MINIATURE ADULTS; THEIR HEALTH CARE CAN BEST BE PROVIDED BY A FACILITY WITH A WELL TRAINED MEDICAL AND HOSPITAL STAFF WHOSE ONLY INTERESTS AND CONCERNS ARE WITH THE TOTAL HEALTH AND WELL-BEING OF INFANTS, CHILDREN AND ADOLESCENTS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense120937315Expense
Grants25320Grants
Revenue153287202Revenue
DescriptionEAST TENNESSEE CHILDREN'S HOSPITAL ("ETCH") IS THE ONLY MEDICAL CENTER IN EAST TENNESSEE DEDICATED EXCLUSIVELY TO THE CARE OF CHILDREN. SINCE 1937, ETCH HAS PROVIDED EXCELLENT PEDIATRIC HEALTH CARE FOR CHILDREN FROM BIRTH TO 21 YEARS OF AGE. ETCH IS CERTIFIED BY THE STATE OF TENNESSEE AS THE ONLY COMPREHENSIVE REGIONAL PEDIATRIC CENTER IN EAST TENNESSEE. ETCH OFFERS MORE PEDIATRIC SUBSPECIALTIES THAN ANY OTHER HOSPITAL IN THE REGION, SERVING CHILDREN FROM EAST TENNESSEE, SOUTHWEST VIRGINIA, SOUTHEAST KENTUCKY AND WESTERN NORTH CAROLINA. THE SUBSPECIALTIES AVAILABLE AT ETCH INCLUDE: ADOLESCENT GYNECOLOGYADOLESCENT MEDICINENEONATOLOGYPEDIATRICSPEDIATRIC ALLERGY & IMMUNOLOGYPEDIATRIC ANESTHESIOLOGYPEDIATRIC CARDIOLOGY PEDIATRIC CRITICAL CAREPEDIATRIC DENTISTRY/PEDODONTICSPEDIATRIC DERMATOLOGYPEDIATRIC EMERGENCY MEDICINEPEDIATRIC ENDOCRINOLOGYPEDIATRIC GASTROENTEROLOGYPEDIATRIC HEMATOLOGY/ONCOLOGYPEDIATRIC INFECTIOUS DISEASESPEDIATRIC NEPHROLOGYPEDIATRIC NEUROLOGYPEDIATRIC NEUROSURGERYPEDIATRIC OPHTHALMOLOGYPEDIATRIC ORTHOPEDICSPEDIATRIC OTOLARYNGOLOGYPEDIATRIC PHYSIATRYPEDIATRIC PLASTIC/RECONSTRUCTIVE SURGERYPEDIATRIC PULMONOLOGYPEDIATRIC RADIOLOGYPEDIATRIC SURGERYPEDIATRIC UROLOGYPEDIATRIC PERINATOLOGYSLEEP MEDICINEIN ADDITION, ETCH PROVIDES THE FOLLOWING: MEDICAL/SURGICAL SERVICES:THE EMERGENCY DEPARTMENT IS STAFFED WITH LICENSED PHYSICIANS AND NURSING PERSONNEL TO PROVIDE TREATMENT FOR ALL TYPES OF EMERGENCIES 24 HOURS A DAY, SEVEN DAYS A WEEK. THE DEPARTMENT PROVIDES EVALUATION AND TREATMENT FOR PATIENTS UP TO 21 YEARS OF AGE WITH VARYING LEVELS OF ILLNESS AND INJURY, FROM MINOR TO LIFE THREATENING. THE HOSPITAL'S PEDIATRIC INTENSIVE CARE UNIT (PICU) PROVIDES SOPHISTICATED, 24-HOUR-A-DAY TREATMENT FOR CRITICALLY ILL AND INJURED CHILDREN. THE PICU IS STAFFED WITH DOCTORS AND NURSES SPECIFICALLY TRAINED AND EXPERIENCED IN THE CARE OF CRITICALLY ILL CHILDREN. PATIENTS IN THE PICU RECEIVE A HIGH LEVEL OF MONITORING AND/OR TREATMENT UNTIL THEY ARE WELL ENOUGH TO BE TRANSFERRED TO A REGULAR PATIENT ROOM OR DISCHARGED HOME.IN THE NEONATAL INTENSIVE CARE UNIT (NICU), TINY AND FRAGILE INFANTS BORN PREMATURELY OR FACING LIFE-THREATENING ILLNESSES RECEIVE TREATMENT FROM A TEAM OF BOARD-CERTIFIED NEONATOLOGISTS, WITH VALUABLE ASSISTANCE FROM SPECIALLY TRAINED NURSES, RESPIRATORY THERAPISTS, LACTATION CONSULTANTS AND OTHER MEDICAL PROFESSIONALS. THE NICU TREATS MORE THAN 600 NEWBORNS EACH YEAR, AND 97 PERCENT OF THE BABIES GO HOME. AS A REGIONAL REFERRAL CENTER FOR EAST TENNESSEE, ETCH OFFERS NEONATAL AND PEDIATRIC TRANSPORT FROM OUTLYING HOSPITALS IN LIFELINE, A MOBILE INTENSIVE CARE UNIT SPECIALLY DESIGNED TO MAINTAIN THE SAME QUALITY OF CARE DURING TRANSPORT AS PATIENTS RECEIVE IN THE HOSPITAL'S CRITICAL CARE UNITS. LIFELINE CARRIES ALMOST 1,000 SUPPLIES TO ADMINISTER CARE TO PATIENTS, FROM THE TINIEST PREMATURE INFANT TO AN ADULT-SIZE PEDIATRIC PATIENT, DURING TRANSPORT TO THE HOSPITAL. IN ADDITION TO THE SPECIAL EQUIPMENT, THE LIFELINE MEDICAL TEAM MAY INCLUDE A NEONATOLOGIST, NEONATAL NURSE PRACTITIONER, PEDIATRIC/NEONATAL RN, RESPIRATORY THERAPIST AND AN EMT, DEPENDING ON THE CONDITION OF THE PATIENT. THE HOSPITAL'S TWO LIFELINE VEHICLES TRAVEL TENS OF THOUSANDS OF MILES EACH YEAR TO DOZENS OF DIFFERENT HOSPITALS IN TENNESSEE AND SURROUNDING STATES, AND TRANSPORT HUNDREDS OF PEDIATRIC PATIENTS TO ETCH.ETCH MEETS A WIDE RANGE OF PEDIATRIC SURGICAL NEEDS, FROM COMMON OUTPATIENT PROCEDURES SUCH AS TONSILLECTOMIES TO MORE COMPLICATED PROCEDURES, SUCH AS RECONSTRUCTIVE SURGERY OR NEUROSURGERY. FIVE DEPARTMENTS COMPRISE ETCH'S SURGICAL SERVICES: OUTPATIENT SURGERY, SURGERY, POST-ANESTHESIA (THE OPERATING ROOMS) CARE UNIT ("WAKE UP" OR RECOVERY ROOM), INPATIENT SURGERY AND ANESTHESIA. THESE DEPARTMENTS WORK TOGETHER TO MAKE SURE EACH CHILD'S SURGERY AND RECOVERY IS AS QUICK AND PAINLESS AS POSSIBLE. THE DOCTORS, NURSES, ANESTHESIOLOGISTS AND OTHER SURGICAL STAFF ARE TRAINED IN PEDIATRIC MEDICINE. AT ANY GIVEN TIME AND FOR VARIOUS REASONS, A CHILD MAY NEED TO BE ADMITTED TO ETCH AS AN INPATIENT. DOCTORS AND NURSES CONTINUOUSLY MONITOR AND TREAT INPATIENTS ACCORDING TO THEIR INDIVIDUAL NEEDS. ALONG WITH PROVIDING COMPREHENSIVE MEDICAL AND NURSING CARE, ETCH IS DEDICATED TO MAKING A CHILD'S STAY IN THE HOSPITAL AS COMFORTABLE AS POSSIBLE. EACH ROOM HAS A TV/DVD PLAYER WITH ACCESS TO MOVIE CHANNELS, AND PLAY ROOMS ARE LOCATED ON EACH FLOOR. OTHER SERVICES SUCH AS CHILD LIFE, NUTRITION, PASTORAL CARE AND SOCIAL WORK PROVIDE FOR THE PHYSICAL AND EMOTIONAL NEEDS OF THE CHILD. THE RESPIRATORY CARE DEPARTMENT AT ETCH IS STAFFED WITH LICENSED AND ACCREDITED RESPIRATORY THERAPISTS WHOSE ROLES INCLUDE TREATING PATIENTS WITH LUNG AND/OR HEART DISEASES SUCH AS ASTHMA, PNEUMONIA, PREMATURE LUNGS AND CYSTIC FIBROSIS. TREATMENTS PROVIDED BY RESPIRATORY CARE PRACTITIONERS INCLUDE AEROSOL MEDICATIONS, DELIVERY OF OXYGEN AND OTHER MEDICAL GASES, VENTILATOR MANAGEMENT AND MANY OTHER PROCEDURES. RESPIRATORY CARE PRACTITIONERS HELP PATIENTS THROUGHOUT THE HOSPITAL, FROM THE EMERGENCY DEPARTMENT TO THE NICU. THEY ARE ALSO MEMBERS OF THE PEDIATRIC TRANSPORT TEAM THAT HELPS BRING SICK AND INJURED CHILDREN TO THE HOSPITAL FOR SPECIALIZED CARE. EDUCATION IS ALSO A KEY ROLE OF RESPIRATORY CARE PRACTITIONERS; THEY TEACH PATIENTS AND THEIR FAMILIES HOW TO CARE FOR CERTAIN CONDITIONS AT HOME. PATIENTS IN A VARIETY OF HOSPITAL DEPARTMENTS MAY BENEFIT FROM SEDATION DURING SOME PAINFUL TESTS AND PROCEDURES. IN ADDITION, YOUNG CHILDREN MAY NEED SEDATION TO REMAIN STILL DURING LONG TESTS, SUCH AS MRIS. TO MEET THESE NEEDS, ETCH OFFERS PASS ON PAIN, PROVIDED BY PEDIATRIC ANALGESIA AND SEDATION SPECIALISTS (PASS). WHILE THE HOSPITAL CANNOT ELIMINATE PAIN FOR SOME CHILDREN, IT IS OUR GOAL TO KEEP PAINFUL OR UNCOMFORTABLE SITUATIONS TO A MINIMUM. PASS ON PAIN IS A DEDICATED SERVICE THAT UTILIZES THE MOST CURRENT SEDATION TECHNIQUES TO HELP CHILDREN UNDERGOING LENGTHY OR PAINFUL PROCEDURES AT ETCH. A MULTISPECIALTY TEAM SEES EACH CHILD, INCLUDING A PEDIATRIC SEDATION PHYSICIAN AND PEDIATRIC NURSES WHO ARE SPECIFICALLY PREPARED TO WORK WITH CHILDRENS' SEDATION. DIAGNOSTIC SERVICES:THE CLINICAL LAB IS RESPONSIBLE FOR ALL DIAGNOSTIC TESTING, WHICH INCLUDES THE FOLLOWING AREAS: HEMATOLOGY, CHEMISTRY, MICROBIOLOGY, IMMUNOLOGY, SEROLOGY AND BLOOD BANK.NEUROLOGY LAB/SLEEP LAB -THE NEUROLOGY LAB OFFERS A VARIETY OF DIAGNOSTIC TESTS FOR PATIENTS DEALING WITH SEIZURES, HEARING PROBLEMS, SLEEP DISORDERS AND OTHER CONDITIONS INVOLVING THE BRAIN. THE MOST COMMON TESTS OFFERED IN THE NEUROLOGY LABORATORY ARE THE ELECTROENCEPHALOGRAM (EEG) FOR CHILDREN HAVING SEIZURES AND OTHER NEUROLOGICAL PROBLEMS, AND THE BRAINSTEM AUDITORY EVOKED RESPONSE (BAER) HEARING TEST, OFFERED MOST OFTEN TO INFANTS WHO FAIL NEWBORN HEARING SCREENINGS AND TODDLERS WHO ARE SPEECH DELAYED. CHILDREN'S SLEEP MEDICINE CENTER - THE CHILDREN'S SLEEP MEDICINE CENTER OFFERS SLEEP STUDY TESTING FOR CHILDREN WHO ARE HAVING PROBLEMS WITH SLEEP. THE SLEEP STUDIES TAKE PLACE OVERNIGHT, DURING THE CHILD'S REGULAR SLEEP CYCLE, TO FIND THE CAUSE OF SUCH PROBLEMS AS SLEEP TERRORS AND SLEEPWALKING.THE PULMONARY FUNCTION LAB, A VITAL PART OF THE RESPIRATORY CARE DEPARTMENT, PERFORMS TESTS TO DIAGNOSE LUNG AND HEART DISEASES. THE DEPARTMENT IS STAFFED BY SPECIALLY TRAINED RESPIRATORY CARE PRACTITIONERS. SERVICES PROVIDED INCLUDE SPIROMETRY TESTING, METABOLIC STUDIES, CARDIAC STRESS TESTING, LUNG VOLUMES AND THE CYSTIC FIBROSIS CLINIC. THE RADIOLOGY DEPARTMENT SERVES AS AN "IMAGING" CENTER FOR CHILDREN. THESE IMAGES INCLUDE X-RAY, ULTRASOUND, CT SCAN, NUCLEAR MEDICINE, MAGNETIC RESONANCE IMAGING (MRI), ECHOCARDIOGRAM AND FLUOROSCOPY.OUTPATIENT SERVICES:CHILDREN'S HOSPITAL HOME HEALTH CARE, WHICH IS A HOSPITAL-BASED HOME HEALTH AGENCY, SUPPORTS THE PHILOSOPHY, MISSION AND POLICIES OF ETCH AND IS DEDICATED TO MEETING THE NEEDS OF CHILDREN. HOME HEALTH PROVIDES FOLLOW-UP SUPPORTIVE CARE TO PATIENTS NEWBORN TO 21 YEARS OF AGE WHO DO NOT REQUIRE HOSPITALIZATION OR CONSTANT SKILLED SUPERVISION. HOME HEALTH IS LICENSED TO PROVIDE SERVICES IN 16 EAST TENNESSEE COUNTIES. ALL PATIENTS ARE ACCEPTED ON THE BASIS OF PHYSICIAN REFERRAL, THE ABILITY OF HOME HEALTH TO MEET THE PATIENT'S SPECIFIC NEEDS, AND WHEN THE PHYSICIAN, CHILD'S FAMILY AND THE HOME HEALTH STAFF AGREE THAT IN-HOME CARE WOULD BE AN APPROPRIATE AND EFFECTIVE MEANS OF TREATMENT. AVAILABLE SERVICES INCLUDE REGISTERED NURSING, RESPIRATORY THERAPY, HOME INFUSION, NUTRITIONAL SUPPORT, HOME MEDICAL EQUIPMENT, SUPPLIES, PHYSICAL THERAPY, SPEECH THERAPY AND OCCUPATIONAL THERAPY.Description
Total Program Service Expense120937315TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming1Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096105NumberFormsTransmittedWith1096
Number W2 G Included5NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2033NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledTNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ZANE D GOODRICHBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8655418154TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 15010AddressLine1
CityKNOXVILLECity
StateTNState
ZIP Code379015010ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
DENNIS B RAGSDALE
CHAIRMAN2.00X000
MICHAEL C CRABTREE
SECRETARY/TREASURER2.00X000
STEVEN D HARB
BOARD MEMBER2.00X000
DANNI B VARLAN
BOARD MEMBER2.00X000
LISE M CHRISTENSEN MD
BOARD MEMBER/CHIEF OF STAFF40.00X000
DEBBIE J CHRISTIANSEN MD
BOARD MEMBER2.00X000
DAWN FORD
BOARD MEMBER2.00X000
LEWIS W HARRIS MD
BOARD MEMBER2.00X000
DEE HASLAM
BOARD MEMBER2.00X000
A DAVID MARTIN
BOARD MEMBER2.00X000
WILLIAM F TERRY MD
VICE CHAIRMAN2.00X000
CHRISTOPHER A MILLER MD
BOARD MEMBER2.00X000
STEPHEN A SOUTH
BOARD MEMBER2.00X000
J LAURENS TULLOCK
BOARD MEMBER2.00X000
KEITH D GOODWIN
BOARD MEMBER/PRESIDENT40.00X473292069198X
LARRY MARTIN
BOARD MEMBER2.00X000
RUDOLPH MCKINLEY
VP OPERATIONS40.00259887060183X
LAURA PRESTON BARNES
VP PATIENT SERVICES40.00191655045206X
ZANE D GOODRICH
VP FINANCE40.00196475033243X
BRYAN PABST
VP PTRS IN PEDIATRICS40.00246144051873X
BRUCE ANDERSON
VP LEGAL SERVICES40.00213029027288X
SUE WILBURN
VP HUMAN RESOURCES40.00183159019524X
JOE CHILDS
VP MEDICAL SERVICES40.005621005437X
SUMEET SHARMA MD
PEDIATRIC CARDIOLOGIST40.00233684019081X
JEFFORY GLENN JENNINGS MD
PEDIATRIC CARDIOLOGIST40.00226454022615X
LASZLO HOPP MD
PEDIATRIC NEPHROLOGIST40.00249442016673X
MARTHA SPARROW MD
PEDIATRICIAN40.00208973010536X
JAMES R KERRIGAN MD
PEDIATRIC ENDOCRINOLOGIST40.0021981902530X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2958223TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation383387TotalOtherCompensation
Number Individuals GT100 K51NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CHILDREN'S ANESTHESIOLOGISTS PC
2018 W CLINCH AVENUEKNOXVILLETN37916PHYSICIAN SERVICES7936271
SOUTHEASTERN EMERGENCY PHYSICIANS
1900 NORTH WINSTON ROADKNOXVILLETN37919PHYSICIAN SERVICES6664349
CARDINAL HEALTH PHARMACY DIVISION
7000 CARDINAL PLACEDUBLINOH43017PHARMACY SERVICES3597267
OWENS & MINOR
3551 WORKMAN ROADKNOXVILLETN37950HEALTHCARE SERVICES3537389
GI FOR KIDS PLLC
2100 CLINCH AVE SUITE 510KNOXVILLETN37916PHYSICIAN SERVICES2581819
FieldValueIRS element (for citing)
Number Of Contractors GT100 K147NumberOfContractorsGT100K
Fundraising Events624256FundraisingEvents
Government Grants14449GovernmentGrants
All Other Contributions4753372AllOtherContributions
Noncash Contributions124349NoncashContributions
Total Contributions5392077TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT CARE REVENUE623990149155088149155088
OTHER HEALTHCARE SRVCS62130012217621221762
PASSTHROUGH REVENUE621110867427867427
FieldValueIRS element (for citing)
Total Program Service Revenue151244277TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1402916TotalRevenueColumn
Related Or Exempt Function Income1402916RelatedOrExemptFunctionIncome

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real643176Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real643176Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column643176TotalRevenueColumn
Related Or Exempt Function Income643176RelatedOrExemptFunctionIncome

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other25811Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-25811Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-25811TotalRevenueColumn
Related Or Exempt Function Income-25811RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Income Fundraising Events848577GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events624256CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses935323FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-86746TotalRevenueColumn
Exclusion-$86,746ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming29900GrossIncomeGaming
Gaming Direct Expenses7256GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column22644TotalRevenueColumn
Related Or Exempt Function Income22644RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Sales Of Inventory640690GrossSalesOfInventory
Cost Of Goods Sold646746CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-6056TotalRevenueColumn
Exclusion-$6,056ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA SALES7222101101476$1,101,476
MISCELLANEOUS900099508471$508,471
FieldValueIRS element (for citing)
Total Other Revenue1609947TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column160196424TotalRevenueColumn
Related Or Exempt Function Income153287202RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,517,145ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total25320Total
Program Services25320ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1964440Total
Program Services1670020ProgramServices
Management And General294420ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total64160865Total
Program Services53647113ProgramServices
Management And General9843437ManagementAndGeneral
Fundraising670315Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2689597Total
Program Services2277004ProgramServices
Management And General412593ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total11495433Total
Program Services9731995ProgramServices
Management And General1763438ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total5168054Total
Program Services4375257ProgramServices
Management And General792797ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total89736Total
Management And General89736ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total213312Total
Management And General213312ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total11727294Total
Program Services9389498ProgramServices
Management And General2328349ManagementAndGeneral
Fundraising9447Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2257209Total
Program Services2257209ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total392244Total
Program Services120203ProgramServices
Management And General266691ManagementAndGeneral
Fundraising5350Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total2275668Total
Program Services2275668ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6650390Total
Program Services5932168ProgramServices
Management And General716490ManagementAndGeneral
Fundraising1732Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1105285Total
Program Services51327ProgramServices
Management And General1053958ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
SUPPLIES206052771993910364743718737
EQUIPMENT RENTAL/MNT4078047404236335684
BAD DEBT39270453927045
OTHER96049793577124726
TELEPHONE337280144294192986

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total596352Total
Program Services195957ProgramServices
Management And General318718ManagementAndGeneral
Fundraising81677Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total140719345Total
Program Services120937315ProgramServices
Management And General18970046ManagementAndGeneral
Fundraising811984Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY16312244BOY
EOY23426717EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY28865135BOY
EOY30493532EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY31974486BOY
EOY34812041EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2610387BOY
EOY2486643EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1972381BOY
EOY1580248EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis153060652LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec74993830LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY77021695BOY
EOY78066822EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY57256332BOY
EOY68661429EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY383000EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY262097BOY
EOY259314EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY216274757BOY
EOY240169746EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY17810349BOY
EOY18446032EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY44674259BOY
EOY43681527EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY23752737BOY
EOY25383615EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY86237345BOY
EOY87511174EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY112412707BOY
EOY131710287EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3608325BOY
EOY4969630EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY14016380BOY
EOY15978655EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY130037412BOY
EOY152658572EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY216274757BOY
EOY240169746EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses19477079ReconcilationRevenueExpenses
Reconcilation Other Changes3144081ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance14016380BeginningOfYearBalance
Contributions1962275Contributions
End Of Year Balance15978655EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance13809173BeginningOfYearBalance
Contributions207207Contributions
End Of Year Balance14016380EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance13587048BeginningOfYearBalance
Contributions222625Contributions
Other Expenditures500OtherExpenditures
End Of Year Balance13809173EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis421201InvestmentCostOrOtherBasis
Other Cost Or Other Basis8532057OtherCostOrOtherBasis
Book Value8953258BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis90601135OtherCostOrOtherBasis
Depreciation41114294Depreciation
Book Value49486841BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis50150273OtherCostOrOtherBasis
Depreciation33879536Depreciation
Book Value16270737BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3355986OtherCostOrOtherBasis
Book Value3355986BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings78066822TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionINVESTMENT IN SUBSIDIARIESDescription
Amount$25,383,615Amount
FieldValueIRS element (for citing)
Total Of Amounts25383615TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationTHE HOSPITAL IS CLASSIFIED AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS RELATED TO THE 501(C)(3) ORGANIZATION. PRIMARY CARE AND CIK ARE TAXABLE ENTITIES AND ACCOUNT FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC 740, INCOME TAXES (NOTE M). THE HOSPITAL HAS NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2011 OR 2010.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1FANTASY OF TREESNameOfEvent1
Gross Receipts Event11041502GrossReceiptsEvent1
Charitable Contributions Event1334321CharitableContributionsEvent1
Gross Revenue Event1707181GrossRevenueEvent1
Rent Facility Costs Event159553RentFacilityCostsEvent1
Other Direct Expenses Event1555141OtherDirectExpensesEvent1
Name Of Event2CENTER STAGENameOfEvent2
Gross Receipts Event2360300GrossReceiptsEvent2
Charitable Contributions Event2267700CharitableContributionsEvent2
Gross Revenue Event292600GrossRevenueEvent2
Rent Facility Costs Event275545RentFacilityCostsEvent2
Other Direct Expenses Event2235539OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events71031GrossReceiptsOtherEvents
Charitable Contrib Other Events22235CharitableContribOtherEvents
Gross Revenue Other Events48796GrossRevenueOtherEvents
Other Direct Expenses Other Events9545OtherDirectExpensesOtherEvents
Gross Receipts Total1472833GrossReceiptsTotal
Charitable Contributions Total624256CharitableContributionsTotal
Gross Revenue Total Events848577GrossRevenueTotalEvents
Rent Facility Costs Total Events135098RentFacilityCostsTotalEvents
Other Direct Expenses Total Events800225OtherDirectExpensesTotalEvents
Direct Expense Summary Events935323DirectExpenseSummaryEvents
Net Income Summary-86746NetIncomeSummary

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Gross Revenue Other Gaming29900GrossRevenueOtherGaming
Non Cash Prizes Other Gaming6000NonCashPrizesOtherGaming
Other Direct Expenses Other Gaming1256OtherDirectExpensesOtherGaming
Volunteer Labor Other Gaming1VolunteerLaborOtherGaming
Volunteer Labor Prcnt Other Gaming1.00000VolunteerLaborPrcntOtherGaming
Gross Revenue Total Gaming29900GrossRevenueTotalGaming
Non Cash Prizes Total Gaming6000NonCashPrizesTotalGaming
Other Direct Expenses Total Gaming1256OtherDirectExpensesTotalGaming
Direct Expense Summary Gaming7256DirectExpenseSummaryGaming
Net Gaming Income Summary22644NetGamingIncomeSummary
FieldValueIRS element (for citing)
States Where Gaming ConductedTNStatesWhereGamingConducted
Licensed1Licensed
License Suspended Etc0LicenseSuspendedEtc
Gaming With Nonmembers1GamingWithNonmembers
Member Of Other Entity0MemberOfOtherEntity
Percentage Of Gaming Othr Facility1.00000PercentageOfGamingOthrFacility
Name Of Gaming Rec Keeper PersonZANE GOODRICHNameOfGamingRecKeeperPerson

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

FieldValueIRS element (for citing)
Address Line1PO BOX 15010AddressLine1
CityKNOXVILLECity
StateTNState
ZIP Code379015010ZIPCode
FieldValueIRS element (for citing)
Contract With3rd Party For Gam Rev0ContractWith3rdPartyForGamRev
Gaming Manager Name PersonELIZABETH THOMASGamingManagerNamePerson
Gaming Manager Services ProvidedELIZABETH THOMAS IS THE DIRECTOR OF VOLUNTEER SERVICES. THE VOLUNTEER SERVICES DEPARTMENT IS RESPONSIBLE FOR THE FANTASY OF TREES. THE RAFFLE TREE IS THE GAMING EVENT HELD WITHIN THE FANTASY OF TREES. VOLUNTEER SERVICES FOSTERS THE RELATIONSHIP WITH RAFFLE SPONSORS AND DECIDES WHERE/ HOW THE AREA IS DESIGNED ON THE FLOOR. VOLUNTEER SERVICES RECRUITS VOLUTEERS TO SELL RAFFLE TICKETS, LOCK THE DRUM, AND ARRANGE THE TICKET DRAWING AND DELIVERY.GamingManagerServicesProvided
Gaming Manager Is EmployeeXGamingManagerIsEmployee
Charitable Distrib Required1CharitableDistribRequired
Amount Distributed28734AmountDistributed

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense367824TotalCommunityBenefitExpense
Net Community Benefit Expense367824NetCommunityBenefitExpense
Percent Of Total Expense0.00270PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense85991796TotalCommunityBenefitExpense
Direct Offsetting Revenue71099687DirectOffsettingRevenue
Net Community Benefit Expense14892109NetCommunityBenefitExpense
Percent Of Total Expense0.10890PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense86359620TotalCommunityBenefitExpense
Direct Offsetting Revenue71099687DirectOffsettingRevenue
Net Community Benefit Expense15259933NetCommunityBenefitExpense
Percent Of Total Expense0.11160PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served216379PersonsServed
Total Community Benefit Expense470388TotalCommunityBenefitExpense
Direct Offsetting Revenue5330DirectOffsettingRevenue
Net Community Benefit Expense465058NetCommunityBenefitExpense
Percent Of Total Expense0.00340PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served6374PersonsServed
Total Community Benefit Expense877368TotalCommunityBenefitExpense
Direct Offsetting Revenue19475DirectOffsettingRevenue
Net Community Benefit Expense857893NetCommunityBenefitExpense
Percent Of Total Expense0.00630PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Persons Served500PersonsServed
Total Community Benefit Expense154087TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense154087NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served122806PersonsServed
Total Community Benefit Expense306861TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense306861NetCommunityBenefitExpense
Percent Of Total Expense0.00220PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served346059PersonsServed
Total Community Benefit Expense1808704TotalCommunityBenefitExpense
Direct Offsetting Revenue24805DirectOffsettingRevenue
Net Community Benefit Expense1783899NetCommunityBenefitExpense
Percent Of Total Expense0.01300PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served346059PersonsServed
Total Community Benefit Expense88168324TotalCommunityBenefitExpense
Direct Offsetting Revenue71124492DirectOffsettingRevenue
Net Community Benefit Expense17043832NetCommunityBenefitExpense
Percent Of Total Expense0.12460PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Persons Served2681PersonsServed
Total Community Building Expense94475TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense94475NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Persons Served2681PersonsServed
Total Community Building Expense94475TotalCommunityBuildingExpense
Net Community Building Expense94475NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$1,523,694BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare31921AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare110989CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-79068MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 CHILDREN'S WEST SURGERY CENTER LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityMEDICAL SURGERY CENTERDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.50000OrganizationProfitOrOwnership
Physicans Profit Or Ownership0.50000PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1EAST TENNESSEE CHILDREN'S HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1PO BOX 15010AddressLine1
CityKNOXVILLECity
StateTNState
ZIP Code379015010ZIPCode
FieldValueIRS element (for citing)
Childrens HospitalXChildrensHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1EAST TENNESSEE CHILDREN'S HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 7: A COST-TO-CHARGE RATIO, DERIVED FROM THE SCHEDULE H APPLICABLE WORKSHEETS, INCLUDING WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES, WAS USED TO DETERMINE CHARITY CARE. ACTUAL EXPENSE DATA IS ACCUMULATED WITHIN THE ETCH GENERAL LEDGER WHICH ADDRESSES ALL PATIENT SEGMENTS INCLUDING INPATIENT, OUTPATIENT, EMERGENCY ROOM, COMMERCIAL INSURANCE, GOVERNMENT INSURANCE, UNINSURED AND SELF-PAY. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO INDIGENT AND CHARITY CARE CHARGES TO ARRIVE AT COST. THE STATE OF TENNESSEE'S COVERKIDS PROGRAM PROVIDES COVERAGE FOR THE VAST MAJORITY OF CHILDREN WHO REQUIRE MEDICAL CARE BUT ARE UNINSURED. ETCH REPRESENTATIVES WORK EXTENSIVELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND AVAILABILITY OF STATE AID AND TO ASSIST THEM IN BECOMING ENROLLED IN THE PROGRAM. FOR THAT REASON, THE AMOUNT OF TRUE "CHARITY CARE" RENDERED BY ETCH IS CONSIDERABLY SMALLER THAN LEVELS EXPERIENCED BY COMMUNITY HOSPITALS OR OTHER FACILITIES SERVING THE ADULT POPULATION.
PART I, L7 COL(F): BAD DEBT EXPENSE OF $3,927,045 IS INCLUDED IN TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT EXCLUDED IN CALCULATING THE PERCENT OF TOTAL EXPENSES REPORTED IN COLUMN (F), ON PART I, LINE 7.
PART II: ETCH PROVIDES NUMEROUS BENEFITS TO THE PUBLIC TO PROMOTE THE HEALTH OF THE COMMUNITY:1. AN OPEN-DOOR POLICY. THIS IS OUR MOST IMPORTANT BENEFIT, AS STATED IN OUR STATEMENT OF PHILOSOPHY. WE OFFER MEDICAL SERVICES TO ALL CHILDREN, REGARDLESS OF THEIR PARENTS' ABILITY TO PAY. NOT ONLY THAT, BUT OUR SCOTT M. NISWONGER EMERGENCY DEPARTMENT IS OPEN 24 HOURS A DAY, MEANING THE DOOR IS ALWAYS OPEN!2. A DEDICATED PEDIATRIC FACILITY. ETCH TREATS PATIENTS FROM BIRTH THROUGH AGE 21. WE OFFER 28 PEDIATRIC SUBSPECIALTIES AND A FULL COMPLEMENT OF PEDIATRIC MEDICAL AND SURGICAL SERVICES. THIS MEANS FAMILIES SELDOM NEED TO TRAVEL TO NASHVILLE, ATLANTA OR EVEN FARTHER TO RECEIVE SPECIALIZED CARE FOR THEIR CHILDREN.3. HEALTHY KIDS COMMUNITY EDUCATION PROGRAM. THE HEALTHY KIDS PROGRAM FEATURES PARENTING CLASSES AND NEWSLETTERS ON A VARIETY OF TOPICS RANGING FROM SAFETY TO DEVELOPMENT TO HEALTH. CLASSES ARE PRIMARILY FOR PARENTS, GRANDPARENTS AND GUARDIANS, BUT SOME ARE ALSO DESIGNED FOR TEENS (SUCH AS THE SAFE SITTER BABYSITTING COURSE) AND CHILDREN. MOST CLASSES ARE FREE; IF A FEE IS CHARGED, IT IS ONLY TO COVER THE COST OF PURCHASED MATERIALS. HEALTHY KIDS NEWSLETTERS ARE PROVIDED FREE TO AREA SCHOOLS AND CHILD CARE CENTERS AS WELL AS TO PARENTS AND CAREGIVERS.4. COMMUNITY INVOLVEMENT. AS AN ADVOCATE FOR CHILDREN, ETCH PROVIDES STAFF, VOLUNTEERS, IN-KIND SERVICES (SUCH AS MEETING SPACE) AND/OR FINANCIAL SUPPORT TO MANY COMMUNITY ORGANIZATIONS WHOSE GOALS ARE TO IMPROVE THE LIVES OF CHILDREN, INCLUDING AMERICAN CANCER SOCIETY, COVERKIDS, CUREFINDERS, CYSTIC FIBROSIS FOUNDATION, DOWN SYNDROME AWARENESS GROUP, DREAM CONNECTION, GIRLS ON THE RUN, JUVENILE DIABETES RESEARCH FOUNDATION, KNOX COUNTY HEALTH DEPARTMENT, KNOX COUNTY SCHOOLS' PARTNERS IN EDUCATION, KNOXVILLE AREA PREGNANCY PREVENTION INITIATIVE, KNOXVILLE POLICE DEPARTMENT'S SAFETY CITY, KNOXVILLE POLICE DEPARTMENT'S THINK FAST ALCOHOL AWARENESS PROGRAM, LEUKEMIA AND LYMPHOMA SOCIETY, MARCH OF DIMES, A SECRET SAFE PLACE FOR NEWBORNS OF TENNESSEE, INC., MONTGOMERY VILLAGE, SMOKE-FREE KNOXVILLE, TENNDER CARE COALITION AND UNITED WAY. IN ADDITION, ETCH IS THE LEAD ORGANIZATION FOR SAFE KIDS OF THE GREATER KNOX AREA, A LOCAL CHAPTER OF THIS INTERNATIONAL NON-PROFIT DEDICATED TO PREVENTING UNINTENTIONAL INJURY IN CHILDREN AGES 14 AND UNDER. ETCH IS ALSO A PARTICIPATING MEDICAL FACILITY THAT WILL ACCEPT SURRENDERS OF NEWBORNS UNDER THE SAFE HAVEN LAW, WHICH ALLOWS MOTHERS OF NEWBORNS TO SURRENDER UNHARMED BABIES TO DESIGNATED MEDICAL FACILITIES WITHIN 72 HOURS OF THE BABY'S BIRTH, WITHOUT FEAR OF PROSECUTION. 5. PARTNERS IN EDUCATION. ETCH PARTICIPATES IN THE KNOX COUNTY SCHOOL SYSTEM'S PARTNERS IN EDUCATION PROGRAM. OUR "ADOPTED" SCHOOLS ARE KARNS ELEMENTARY SCHOOL, CEDAR BLUFF INTERMEDIATE SCHOOL AND FORT SANDERS EDUCATIONAL DEVELOPMENT CENTER. EACH SCHOOL YEAR, ETCH CONDUCTS PROGRAMS FOR THE STUDENTS AT EACH SCHOOL AND PROVIDES SPECIAL TREATS FOR THEIR TEACHERS. WE ALSO PROVIDE THE STUDENTS AN OPPORTUNITY TO CREATE ARTWORK TO HANG ON THE HOSPITAL'S WALLS OR AT OUR AFFILIATE SITES OR TO BE USED IN OUR PUBLICATIONS AND ON OUR WEB SITE. 6. HELLO HOSPITAL. THE CHILD LIFE DEPARTMENT AT ETCH AND DOZENS OF VOLUNTEERS PROVIDE THIS FREE PROGRAM TO KINDERGARTEN CLASSES IN ALL KNOX COUNTY ELEMENTARY SCHOOLS. "HELLO HOSPITAL" IS DESIGNED TO TEACH YOUNG CHILDREN ABOUT WHAT IT IS LIKE TO VISIT A HOSPITAL AND EASE SOME OF THEIR FEARS ABOUT THE EXPERIENCE.7. THE ETCH WEB SITE. THE ETCH WEB SITE PROVIDES FREE ACCESS TO A WIDE RANGE OF INFORMATION REGARDING KIDS AND THEIR HEALTH, INCLUDING THOUSANDS OF PEDIATRIC HEALTH ARTICLES AND "VIRTUAL VISITS," WHICH HELP TO TEACH KIDS (AND THEIR PARENTS) ABOUT WHAT TO EXPECT WHEN THEY VISIT THE HOSPITAL FOR A TEST, ADMISSION OR SURGERY.8. PROFESSIONAL EDUCATION. ETCH SUPPORTS HEALTH CARE EDUCATION BY OFFERING STUDENT INTERNSHIPS, EXTERNSHIPS, NURSING SCHOLARSHIPS AND TRAINING PROGRAMS FOR STUDENT NURSES, PRE-MED STUDENTS, SOCIAL WORK STUDENTS, CHILD DEVELOPMENT SPECIALISTS AND OTHERS PURSUING HEALTH CARE AS A CAREER. ALSO, ETCH WORKS JOINTLY WITH THE UNIVERSITY OF TENNESSEE MEDICAL CENTER AND UNIVERSITY OF TENNESSEE MEDICAL SCHOOL TO PROVIDE MEDICAL SCHOOL ROTATIONS IN FAMILY PRACTICE AND OTHER SPECIALTIES AT OUR FACILITY. ETCH ALSO IS THE PEDIATRIC CLINICAL TRAINING SITE FOR STUDENT NURSES, RESPIRATORY THERAPISTS, RADIOLOGY STUDENTS AND STUDENTS IN OTHER HEALTH CARE DISCIPLINES. FURTHERMORE, ETCH IS AN ACCREDITED CONTINUING MEDICAL EDUCATION PROVIDER IN TENNESSEE. AS A CME PROVIDER, ETCH CONDUCTS AND SPONSORS RELEVANT CME PROGRAMS FOR PHYSICIANS AND NURSE PRACTITIONERS WHO TREAT CHILDREN. 9. COMMUNITY EVENTS. ETCH TAKES PART IN A VARIETY OF HEALTH FAIRS AT LOCAL SCHOOLS AND COMMUNITY EVENTS TO PROVIDE HEALTH EDUCATION TO THE PUBLIC. AT THESE EVENTS WE PROVIDE FREE BROCHURES AND INFORMATION SHEETS ON MANY HEALTH TOPICS.10. SUMMER CAMPS. ETCH SPONSORS CAMPS FOR A NUMBER OF OUR PATIENTS WITH SPECIAL MEDICAL NEEDS WHO MIGHT BE UNABLE TO ATTEND A TRADITIONAL CAMP. THE CAMPS FOR OUR HEMATOLOGY/ONCOLOGY, DIABETES AND REHAB CENTER PATIENTS ARE STAFFED WITH HEALTH CARE PROFESSIONALS WHO PROVIDE SUPERVISION AND NEEDED MEDICAL CARE DURING THE CAMPING EXPERIENCE.
PART III, LINE 4: A COST-TO-CHARGE RATIO WAS ALSO USED TO DETERMINE BAD DEBT COST. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO THE BAD DEBT EXPENSE TO ARRIVE AT COST.ETCH'S FINANCIAL STATEMENTS READ AS FOLLOWS: "NET PATIENT SERVICE REVENUE IS REPORTED ON THE ACCRUAL BASIS IN THE PERIOD IN WHICH SERVICES ARE PROVIDED AT THE ESTIMATED NET REALIZABLE AMOUNTS, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH CERTAIN THIRD-PARTY PAYORS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED.PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF BOTH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS. THE CONTRACTUAL ALLOWANCE REPRESENTS THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND ESTIMATED REIMBURSEMENT FROM MEDICAID, TENNCARE AND OTHER THIRD PARTY PAYMENT PROGRAMS. CURRENT OPERATIONS ARE CHARGED WITH AN ESTIMATED PROVISION FOR BAD DEBTS BASED UPON HISTORICAL EXPERIENCE, AGING OF RECEIVABLES AND ANY UNUSUAL CIRCUMSTANCES WHICH AFFECT THE COLLECTABILITY OF RECEIVABLES. THE HOSPITAL'S POLICY DOES NOT REQUIRE COLLATERAL OR OTHER SECURITY FOR PATIENT ACCOUNTS RECEIVABLE. THE HOSPITAL ROUTINELY ACCEPTS ASSIGNMENT OF, OR IS OTHERWISE ENTITLED TO RECEIVE, PATIENT BENEFITS PAYABLE UNDER HEALTH INSURANCE PROGRAMS, PLANS OR POLICIES. RECEIPTS FROM THE STATE OF TENNESSEE UNDER THE TENNCARE ESSENTIAL ACCESS, DISPROPORTIONATE SHARE AND TRAUMA CARE PROGRAMS ARE RECOGNIZED AS NET PATIENT SERVICE REVENUE WHEN SUCH AMOUNTS CAN BE REASONABLY ESTIMATED.THE HOSPITAL PROVIDES HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNATED TO ENHANCE THE HEALTH OF CHILDREN IN THE COMMUNITY AND FOSTER MEDICAL EDUCATION AND RESEARCH. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS DESIGNED TO PROVIDE CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS WHO MEET CERTAIN CRITERIA FOR CHARITY CARE ARE PROVIDED HEALTH CARE WITHOUT CHARGE. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, CHARGES AT ESTABLISHED RATES ARE NOT REPORTED AS REVENUE."
PART III, LINE 8: A COST-TO-CHARGE RATIO WAS USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO MEDICARE CHARGES TO ARRIVE AT COST.THE SHORTFALL OF $79,068 AS REPORTED IN PART III, LINE 7, SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. ALSO, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS, AND THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS.
PART III, LINE 9B: UNDER ETCH'S POLICIES AND PROCEDURES, ETCH UNDERTAKES MEASURES TO COMMUNICATE WITH THE FAMILIES OF PATIENTS WITH SELF-PAY BALANCES. IN MANY CASES, ETCH AND FAMILIES WORK TOGETHER TO OBTAIN COVERAGE THROUGH THE STATE OF TENNESSEE'S COVERKIDS PROGRAM. IN CASES WHERE COVERKIDS COVERAGE IS NOT AVAILABLE, ETCH SEEKS TO OBTAIN INFORMATION NECESSARY TO DETERMINE THE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER ETCH'S CHARITY CARE PROGRAM. ONCE A PATIENT'S ELIGIBILITY FOR FREE OR DISCOUNTED CARE HAS BEEN DETERMINED, THE BALANCE ON THE PATIENT'S ACCOUNT IS ADJUSTED ACCORDINGLY. IN ADDITION, ETCH PERSONNEL WORK CLOSELY WITH FAMILIES TO DETERMINE THEIR ABILITY TO PAY THE ADJUSTED BALANCES, SUCH EFFORTS OFTEN RESULT IN PAYMENT PLANS INTENDED TO PERMIT THE GRADUAL PAYMENT OF AMOUNT DUE WITHOUT IMPOSING UNDUE FINANCIAL HARDSHIP ON FAMILIES ALREADY DEALING WITH THE CHALLENGES OF CHILDREN'S HEALTH ISSUES. UNFORTUNATELY, THERE REMAIN CIRCUMSTANCES WHERE PATIENTS CANNOT BE DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE DUE TO THE INACCESSIBILITY OF THE FAMILY, OR THE FAMILY'S INABILITY OR REFUSAL TO PROVIDE THE REQUIRED INFORMATION. IN SUCH CASES, ETCH FOLLOWS AN ESTABLISHED MULTI-STEP PROCESS CONSISTING OF MAILED NOTICES AND PHONE CALLS IN AN EFFORT TO REACH TO FAMILY AND PROVIDE THEM WITH INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE PROGRAM. ETCH'S COLLECTION PRACTICES APPLY TO ALL PATIENTS, CHARITY CARE AND NON-CHARITY CARE PATIENTS. ACCOUNTS ARE SENT TO COLLECTIONS (ETCH CONTRACTS WITH AN ORGANIZATION WITH SUBSTANTIAL EXPERIENCE IN COLLECTION OF PATIENT ACCOUNTS) ONLY AFTER ALL ESTABLISHED STEPS HAVE BEEN UNDERTAKEN, WITHOUT SUCCESS.
PART VI, LINE 2: CURRENTLY, THE ORGANIZATION RELIES ON ASSESSMENT DATA GATHERED FROM THE STATE OF TENNESSEE, KNOX COUNTY AND OTHER RESOURCES TO ASSESS THE NEEDS OF THE COMMUNITY. ETCH DOES NOT FORMALLY ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES BUT IS WORKING TO DEVELOP A FORMAL COMMUNITY NEEDS ASSESSMENT THAT WILL BE PERFORMED REGULARLY, COLLABORATING WITH LOCAL AGENCIES, SCHOOLS AND COMMUNITY GROUPS. ETCH IS PLANNING TO PARTNER WITH THE UNIVERSITY OF TENNESSEE SCHOOL OF SOCIAL WORK TO EXAMINE THE PEDIATRIC HEALTHCARE NEEDS OF EASTERN TENNESSEE AND THE SURROUNDING AREAS. THE RESULTS WILL HELP TO DETERMINE BOTH SHORT-TERM AND LONG-TERM PRIORITIES AS WELL AS STRATEGIES FOR IMPROVING PEDIATRIC HEALTH.
PART VI, LINE 3: ETCH RECOGNIZES THAT UNEXPECTED MEDICAL PROBLEMS CAN CREATE UNEXPECTED FINANCIAL PROBLEMS. ETCH IS AVAILABLE TO ASSIST PATIENTS' FAMILIES IN FINDING RESOURCES THAT HELP TO COVER MEDICAL EXPENSES. AS INDICATED ABOVE, ETCH WORKS CLOSELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND AND ENROLL IN MEDICAL ASSISTANCE PROGRAMS AVAILABLE THROUGH THE STATE OF TENNESSEE, AND WHERE APPROPRIATE, FEDERAL PROGRAMS. WHERE SUCH PROGRAMS ARE NOT AVAILABLE, HOWEVER, PATIENTS MAY BE ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER ETCH'S ESTABLISHED POLICIES AND PROCEDURES. THE AVAILABILITY OF FINANCIAL ASSISTANCE IS PUBLICIZED THROUGHOUT THE ETCH FACILITY AND THROUGH VARIOUS MEASURES, INCLUDING INFORMATION ON ETCH'S WEBSITE AND WRITTEN BROCHURES OR OTHER MATERIALS PROVIDED TO PATIENT'S FAMILIES. INFORMATION (IN BOTH ENGLISH AND SPANISH) IS MADE AVAILABLE AT ALL POINTS OF REGISTRATION (INTAKE AND DISCHARGE) AS WELL AS ON THE ETCH WEBSITE. THE MOST SIGNIFICANT EDUCATION, HOWEVER, OCCURS IN DIRECT DIALOGUE BETWEEN PATIENT FAMILIES AND ETCH'S TRAINED PATIENT ACCOUNT REPRESENTATIVES. ETCH MAKES EXTENSIVE EFFORTS TO PERMIT FACE-TO-FACE DIALOGUE, AS WELL AS COMMUNICATION VIA TELEPHONE AND OTHER MEANS, AS NECESSARY TO ENSURE THAT FAMILIES ARE PROVIDED WITH SUFFICIENT INFORMATION REGARDING FREE OR DISCOUNTED CARE, AS WELL AS THE BILLING AND COLLECTION PROCESS. ALL STAFF WITH PATIENT CONTACT ARE KNOWLEDGEABLE ABOUT THE CHARITY CARE POLICY (ADMITTING AND BILLING CLERKS, NURSING AND MEDICAL STAFF, SOCIAL WORKERS, ETC.).
PART VI, LINE 4: ETCH IS CERTIFIED BY THE STATE OF TENNESSEE AS THE ONLY COMPREHENSIVE REGIONAL PEDIATRIC CENTER IN EAST TENNESSEE. ETCH OFFERS MORE PEDIATRIC SUBSPECIALTIES THAN ANY OTHER HOSPITAL IN THE REGION, SERVING CHILDREN FROM EAST TENNESSEE, SOUTHWEST VIRGINIA, SOUTHEAST KENTUCKY AND WESTERN NORTH CAROLINA. ETCH'S PRIMARY SERVICE AREA INCLUDES: KNOX, BLOUNT, SEVIER, COCKE, JEFFERSON, HAMBLEN, GRAINGER, UNION, CLAIBORNE, ANDERSON, CAMPBELL, SCOTT, MORGAN, ROANE, LOUDON, AND MONROE COUNTIES. FENTRESS, CUMBERLAND, RHEA, MEIGS, MCMINN, HANCOCK, HAWKINS, GREENE, WASHINGTON AND SULLIVAN COUNTIES COMPRISE ETCH'S SECONDARY SERVICE AREA. ETCH IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS. ETCH IS A MEMBER OF CHILDREN'S HOSPITAL ALLIANCE OF TENNESSEE, HOSPITAL ALLIANCE OF TENNESSEE, THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS & RELATED INSTITUTIONS, AND TENNESSEE HOSPITAL ASSOCIATION.ETCH IS LOCATED WITHIN KNOX COUNTY, TENNESSEE. IN 2010 KNOX COUNTY HAD A POPULATION OF 432,226. CHILDREN UNDER THE AGE OF 18 MAKE UP 21.9% OF KNOX COUNTY'S POPULATION.
PART VI, LINE 6: ETCH'S PHILOSOPHY IS THAT BECAUSE CHILDREN ARE SPECIAL, THEY DESERVE THE BEST POSSIBLE HEALTH CARE GIVEN IN A POSITIVE, CHILD/FAMILY CENTERED ATMOSPHERE OF FRIENDLINESS AND COOPERATION REGARDLESS OF RACE, RELIGION, OR ABILITY TO PAY. ETCH IS COMMITTED TO CARING FOR VULNERABLE POPULATIONS SUCH AS CHILDREN WITH SPECIAL MEDICAL NEEDS, ADVOCATING FOR THE HEALTH AND SAFETY OF CHILDREN AS PART OF THE COMMON GOOD AND EFFECTIVELY STEWARDING COMMUNITY RESOURCES. ETCH OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS, WITHOUT REGARD TO THE ABILITY TO PAY. ETCH USES ANY SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND, OR IMPROVE ITS FACILITIES, AND ADVANCE ITS MEDICAL TRAINING, EDUCATION AND RESEARCH PROGRAMS. ETCH'S BOARD OF DIRECTORS CONSISTS PRIMARILY OF INDIVIDUALS REPRESENTING THE COMMUNITY. ETCH MAINTAINS AN OPEN MEDICAL STAFF, WITH MEMBERSHIP AND PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS AND HEALTHCARE PROFESSIONALS. IN THESE AND OTHER RESPECTS, ETCH IS ORGANIZED AND OPERATED IN A MANNER THAT PROMOTES THE HEALTH OF THE COMMUNITY AND THEREFORE FULFILLS CHARITABLE PURPOSES WITHIN THE MEANING OF INTERNAL REVENUE CODE SECTION 501(C)(3).ADDITIONALLY, PLEASE REFER TO THE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS AS PROVIDED IN SCHEDULE O FOR FURTHER DOCUMENTATION REGARDING ETCH'S COMMITMENT WITHIN ITS COMMUNITY.
PART VI, LINE 7: ETCH IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.
TNREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1MARCH OF DIMES FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11275 MAMARONECK AVENUEAddressLine1
CityWHITE PLAINSCity
StateNYState
ZIP Code10605ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient131846366EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant10000AmountOfCashGrant
Purpose Of GrantGENERAL SUPPORTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE ORGANIZATION HAS GUIDELINES IN PLACE THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY OF GRANTEES. ALL GRANTS REQUIRE WRITTEN DOCUMENTATION AND APPROPRIATE LEVELS OF APPROVAL.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KEITH D GOODWIN
44725102500001041063471057270542490000
RUDOLPH MCKINLEY
24884601000001041058455017280320070000
LAURA PRESTON BARNES
18061401000001041043326018800236861000
ZANE D GOODRICH
1857940100000681029408038350229718000
BRYAN PABST
21099403515000045007068660298017000
BRUCE ANDERSON
20042001000002609025848014400240317000
SUE WILBURN
1727070916701285016010035140202683000
SUMEET SHARMA MD
1278410105774069017688013930252765000
JEFFORY GLENN JENNINGS MD
1203530105774032702181508000249069000
LASZLO HOPP MD
2035500451180774010205064680266115000
MARTHA SPARROW MD
198382094190117208398021380219509000
JAMES R KERRIGAN MD
202788016406062500025300222349000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 1AHOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: IN SOME CASES AN EMPLOYMENT CONTRACT MAY PROVIDE FOR A TEMPORARY HOUSING ALLOWANCE. ALL SUCH CONTRACTS ARE IN WRITING AND A REAL ESTATE AGENT IS CONSULTED AS TO THE APPROPRIATE ALLOWANCE AMOUNT. AT THIS TIME ETCH HAS ONE SUCH CONTRACT.
PART I, LINE 4BSUPPLEMENTAL NONQUALIFIED PLAN KEITH GOODWIN $ 53,206 RUDOLPH MCKINLEY 43,018 BRUCE ANDERSON 17,374 ZANE GOODRICH 17,430 LAURA PRESTON BARNES 31,776 SUE WILBURN 16,010 SUMEET SHARMA 17,688 JEFFORY JENNINGS 21,815 BRUCE PABST 34,820
PART IIISUPPLEMENTAL NONQUALIFIED EXECUTIVE RETIREMENT PLAN: THE SUPPLEMENTAL EXECUTIVE 457(F) RETIREMENT PLAN IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES AND TO OFFER A COMPETITIVE TOTAL RETIREMENT BENEFIT. THESE BENEFITS ARE PART OF A RETIREMENT PROGRAM THAT PROVIDES RETIREMENT INCOME FOR THE EXECUTIVE'S TOTAL YEARS OF SERVICE WITH THE ORGANIZATION PURSUANT TO A WRITTEN PLAN AGREEMENT AS APPROVED BY INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THESE BENEFITS ARE AT RISK AND WILL NOT BE PAID UNLESS THE EXECUTIVE PROVIDES SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION IN ACCORDANCE WITH A VESTING SCHEDULE. NO PAYMENTS OF BENEFITS OCCURRED DURING THE CURRENT YEAR. AN ESTIMATE OF THE ANNUAL INCREASE IN ACTUARIAL VALUE IS REPORTED AS DEFERRED COMPENSATION IN PART VII AND IN SCHEDULE J, COLUMN (C) FOR THE APPLICABLE EXECUTIVES.SUPPLEMENTAL INFORMATION

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1THE HEALTH EDUCATIONAL AND HOUSING FACILITY BOARD OF KNOX COUNTY TENNESSEEBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN621220275IssuerEIN
CUSIP Number499523UD8CUSIPNumber
Date Issued2003-02-15DateIssued
Issue Price50000000IssuePrice
Description Of PurposeDEBT SERVICE AND FUTURE CAPITAL PROJECTSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds49754946TotalProceeds
Amount In Reserve Fund3301550AmountInReserveFund
Refunding Escrow6489075RefundingEscrow
Issuance Costs From Proceeds1965576IssuanceCostsFromProceeds
Working Capital Expenditures2727895WorkingCapitalExpenditures
Capital Expenditures35270850CapitalExpenditures
Year Of Subst Completion2006YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Counsel Routinely Engaged0BondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.01000PrcntgePrvtBusinessUseByOthers
Total Private Business Use0.01000TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed1Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
CHILD NEUROLOGY SERVICES PC
PROVIDER OF MEDICAL SERVICES TO ETCH400935CHRISTOPHER A. MILLER, M.D., MEMBER OF THE ETCH BOARD OF DIRECTORS, IS A SHAREHOLDER IN CHILD NEUROLOGY SERVICES, P.C.0
MARTIN & COMPANY INC
PROVIDER OF FINANCIAL SERVICES TO ETCH283956A. DAVID MARTIN, MEMBER OF THE ETCH BOARD OF DIRECTORS, IS THE PRESIDENT OF MARTIN & COMPANY, INC.0
NEUROSURGICAL ASSOCIATES PC
PROVIDER OR MEDICAL SERVICES TO ETCH330090LEWIS W. HARRIS, M.D., MEMBER OF THE ETCH BOARD OF DIRECTORS, IS A SHAREHOLDER IN NEUROSURGICAL ASSOCIATES, P.C.0

Schedule M IRS990ScheduleM

Works Of Art WorksOfArt

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990300NoncashContribsRptdF990
Method Of Determining RevenuesMARKET VALUEMethodOfDeterminingRevenues

Food Inventory FoodInventory

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions20NumberOfContributions
Noncash Contribs Rptd F99012855NoncashContribsRptdF990
Method Of Determining RevenuesMARKET VALUEMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)

Non Cash CheckboxNonCashCheckboxDescriptionDescriptionNumber Of ContributionsNumberOfContributionsNoncash Contribs Rptd F990NoncashContribsRptdF990Method Of Determining RevenuesMethodOfDeterminingRevenues
XAUCTION ITEMS7166205MARKET VALUE
XMISC SUPPLIES2825493MARKET VALUE
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11THE 2009 FORM 990 AND THE RELATED SCHEDULES ARE PREPARED BY AN UNRELATED, INDEPENDENT ACCOUNTING FIRM AND THEN SUBMITTED TO THE ETCH CFO FOR INTERNAL REVIEW. A DRAFT IS ALSO PROVIDED TO THE ETCH BOARD OF DIRECTORS FINANCE COMMITTEE FOR REVIEW. THE CFO IS AVAILABLE TO ANSWER ANY QUESTIONS RECEIVED FROM THE BOARD AND ADDRESS ANY SIGNIFICANT DISCLOSURES WITHIN THE FORM 990 AND RELATED SCHEDULES PRIOR TO FILING.
EACH MEMBER OF THE BOARD OF DIRECTORS IS ASKED TO REVIEW THE CONFLICT OF INTEREST POLICY AND PROVIDE DISCLOSURE OF ANY ACTIVITIES WHICH COULD CONSTITUTE A CONFLICT OF INTEREST OR POTENTIAL CONFLICT OF INTEREST. THESE CONFLICT OF INTEREST DISCLOSURES ARE REVIEWED BY ETCH'S GENERAL COUNSEL TO ASSURE COMPLIANCE WITH THIS POLICY. ADDITIONALLY, BOARD MEMBERS ARE ASKED TO RECUSE THEMSELVES ON ANY MATTERS OF INTEREST BEFORE THE BOARD IN WHICH A CONFLICT OF INTEREST MAY EXIST. ANY SUCH RECUSAL IS DOCUMENTED WITHIN THE MINUTES OF THE BOARD OR COMMITTEE.FORM 990, PART VI, SECTION B, LINE 12C
THE EXECUTIVE COMMITTEE OF THE ETCH BOARD OF DIRECTORS UTILIZES THE SERVICES OF INDEPENDENT, OUTSIDE COMPENSATION CONSULTANTS TO PROVIDE THE COMMITTEE WITH RELEVANT MARKET DATA FROM STATE AND NATIONAL SALARY SURVEYS FOR COMPARABLE MARKETS. WITH THIS DATA AND THE ADVICE OF OUTSIDE CONSULTANTS, THE ETCH BOARD OF DIRECTORS EXECUTIVE COMMITTEE MAKES RECOMMENDATIONS ON PAY AND BENEFITS FOR THE ETCH PRESIDENT/CEO. THE EXECUTIVE COMMITTEE COMPLETES THIS SAME PROCESS IN MAKING RECOMMENDATIONS FOR ETCH VICE PRESIDENTS.FORM 990, PART VI, SECTION B, LINE 15
ALL ETCH GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. ADDITIONALLY, FINANCIAL STATEMENTS ARE PROVIDED TO BONDHOLDERS, LOCAL HOSPITALS AND DONORS AND THE CONFLICT OF INTEREST POLICY IS POSTED ON ETCH'S INTRANET.FORM 990, PART VI, SECTION C, LINE 19
REIMBURSED COMPENSATIONBRYAN PABST AND MARTHA SPARROW ARE EMPLOYED AND RECEIVE A FORM W-2 FROM ETCH. HOWEVER, COMPENSATION FOR THESE INDIVIDUALS IS REIMBURSED BY ANOTHER ORGANIZATION.FORM 990, PART VII
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 4,068,799. EQUITY IN EARNINGS OF SUBSIDIARY -1,600,568. PASSTHRU REVENUE DIFFERENCE -39,887. TEMPORARILY RESTRICTED INVESTMENT INCOME 715,737. TOTAL TO FORM 990, PART XI, LINE 5: 3,144,081.FORM 990, PART XI, LINE 5:
CONTINUATION OF PROGRAM SERVICE ACCOMPLISHMENTSTHE CHILDREN'S HOSPITAL REHABILITATION CENTER WAS ESTABLISHED IN 1947 BY A GROUP OF PARENTS WHOSE CHILDREN HAD CEREBRAL PALSY, AND IT HAS BEEN AN ETCH DEPARTMENT SINCE 1995. THE CENTER PROVIDES REHAB EVALUATION AND TREATMENT SERVICES TO INPATIENTS AT ETCH AND THE CENTER, AS WELL AS HOME HEALTH REHAB THROUGH CHILDREN'S HOSPITAL HOME HEALTH CARE. PATIENTS RANGE FROM THOSE WITH MILD DEVELOPMENTAL DELAYS TO MULTIPLE HANDICAPPING CONDITIONS. ALL SERVICES ARE DESIGNED TO HELP CHILDREN REACH THEIR GREATEST INDEPENDENT FUNCTION AND DEVELOPMENTAL POTENTIAL. IN ADDITION TO OUTPATIENT PHYSICAL AND OCCUPATIONAL THERAPY AND SPEECH PATHOLOGY AT THE CENTER, OUTPATIENT SERVICES ALSO INCLUDE THE CHILDREN'S CORNER MEDICAL DAY TREATMENT PROGRAM, NUTRITION, PSYCHOLOGY, SUMMER DAY CAMP, TRANSPORTATION, PARENT TRAINING AND OUTPATIENT CLINICS AT ETCH. THE CENTER ALSO PROVIDES HIGH-RISK FOLLOW-UP AND SEATING CLINICS. THE CHILDREN'S HOSPITAL REHABILITATION CENTER IS A UNITED WAY AGENCY. ETCH ALSO PROVIDES COMPREHENSIVE CONSULTATION, EVALUATION, DIAGNOSTIC SERVICES AND TREATMENT FOR PEDIATRIC PATIENTS WITH ACUTE, CHRONIC AND/OR COMPLEX CONDITIONS THROUGH THE JAMES S. BUSH OUTPATIENT CARE CENTER. SEVERAL CLINICS FOR SPECIFIC CONDITIONS ARE OFFERED INCLUDING CRANIOFACIAL, CYSTIC FIBROSIS, DERMATOLOGY, DIABETES, GYNECOLOGY, HEMATOLOGY/ONCOLOGY, HIGH RISK, INFECTIOUS DISEASES, METABOLIC DISEASES, MULTISPECIALITY, RHEUMATOLOGY, SPECIAL ATTENTION AND SPASTICITY. A CLINIC VISIT MAY INCLUDE TREATMENT AND CONSULTATION WITH PHYSICIANS, NURSES AND STAFF FROM NUTRITION, SOCIAL WORK, CHILD LIFE, REHABILITATION OR RESPIRATORY CARE. ADDITIONAL SERVICES: THE SOCIAL WORK DEPARTMENT AT ETCH HELPS PATIENTS AND THEIR FAMILIES DEAL WITH EMOTIONAL STRESS CAUSED BY ILLNESS, INJURY OR THE HOSPITALIZATION ITSELF. SOCIAL WORK SERVICES INCLUDE INFORMATION AND REFERRAL; SHORT-TERM SUPPORTIVE COUNSELING FOR PATIENTS AND PARENTS; CRISIS INTERVENTION ASSISTANCE; DISCHARGE PLANNING; FINANCIAL ASSISTANCE; INFORMATION ON SUPPORT AND ADVOCACY GROUPS; AND ASSISTANCE WITH CONCRETE NEEDS, INCLUDING RONALD MCDONALD HOUSE REFERRALS. THE DEPARTMENT ALSO COORDINATES TRANSLATION OF MUCH OF THE HOSPITAL'S PRINTED MATERIAL INTO SPANISH TO GIVE THE HISPANIC POPULATION COMMUNICATION ACCESS WHEN MEDICAL SERVICES ARE PROVIDED. SOCIAL WORK ALSO PROVIDES SEVERAL INTERPRETATION SERVICES FOR ETCH. OPTIMAL PHONE INTERPRETERS IS A TELEPHONE SERVICE THAT PROVIDES INTERPRETERS IN MORE THAN 204 LANGUAGES AND DIALECTS. INTERPRETERS CAN BE ARRANGED FOR FACE-TO-FACE INTERACTIONS BETWEEN SPANISH-SPEAKING PATIENTS AND PARENTS AND THE PHYSICIAN AND/OR OTHER HOSPITAL STAFF MEMBER. SIGN LANGUAGE INTERPRETERS ARE ALSO AVAILABLE FOR HEARING IMPAIRED PATIENTS AND FAMILIES. HOSPITALIZATION, MEDICAL PROCEDURES, ILLNESS AND PAIN ARE OFTEN FEARFUL TIMES FOR PEOPLE OF ALL AGES. THE CHILD LIFE DEPARTMENT AT ETCH IS RESPONSIBLE FOR HELPING CHILDREN COPE WITH THEIR HOSPITALIZATION THROUGH EDUCATION, MEDICAL PLAY AND ACTIVITIES. THE CHILD LIFE STAFF ASSESSES THE CHILD'S FEARS AND NEEDS, EXPLAIN PROCEDURES IN LANGUAGE CHILDREN CAN UNDERSTAND AND USE DISTRACTIONS TO MAKE PROCEDURES, SUCH AS THE PLACEMENT OF AN IV LINE, LESS INTIMIDATING. THE CHILD LIFE STAFF MEMBERS HOLD DEGREES IN EDUCATION, CHILD DEVELOPMENT OR THERAPEUTIC RECREATION. THEY HAVE EXPERTISE IN DEALING WITH A CHILD'S CONCERNS AND REACTIONS TO THE HOSPITAL AND HIS OR HER ILLNESS. IN ADDITION TO ITS WORK WITHIN THE HOSPITAL, THE CHILD LIFE DEPARTMENT ALSO COORDINATES SEVERAL ACTIVITIES FOR CHILDREN IN THE COMMUNITY. PASTORAL CARE - CHAPLAINS ARE AVAILABLE 24 HOURS A DAY TO PROVIDE SPIRITUAL AND EMOTIONAL SUPPORT TO PATIENTS, FAMILIES AND STAFF AT ETCH. CHAPLAINS ALSO PROVIDE CONSULTATION CONCERNING ETHICAL ISSUES RELATED TO PATIENT CARE. FOOD AND NUTRITION SERVICES - ETCH'S CAFETERIA IS OPEN DAILY. VENDING MACHINES ON THE GROUND FLOOR NEAR THE DINING ROOM AND IN THE SCOTT M. NISWONGER EMERGENCY DEPARTMENT WAITING AREA PROVIDE SANDWICHES, SNACKS AND BEVERAGES 24 HOURS A DAY. FOR PATIENTS WITH NO DIETARY RESTRICTIONS, FOOD AND NUTRITION SERVICES OFFERS A SELECTIVE MENU OF IN-ROOM MEALS. ALSO, REGISTERED DIETITIANS PROVIDE CLINICAL NUTRITION SERVICES, AND MEDICAL NUTRITION THERAPY IS AVAILABLE TO INPATIENTS AND OUTPATIENTS WHO ATTEND SPECIALTY CLINICS OR WHO HAVE INDIVIDUAL APPOINTMENTS. THESE SERVICES INCLUDE NUTRITION ASSESSMENT, FEEDING RECOMMENDATIONS, INTAKE EVALUATION AND NUTRITION COUNSELING. ETCH'S HEALTHY KIDS PROGRAM IS A COMMUNITY EDUCATION INITIATIVE OF THE COMMUNITY RELATIONS DEPARTMENT. THE PROGRAM SERVES AS AN EDUCATION RESOURCE FOR PARENTS, GRANDPARENTS AND OTHER CARETAKERS BY OFFERING CLASSES, LITERATURE, A QUARTERLY NEWSLETTER AND OTHER OPPORTUNITIES FOR LEARNING HOW TO IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. ETCH IS THE LEAD ORGANIZATION FOR AN IMPORTANT AREA COALITION: SAFE KIDS OF THE GREATER KNOX AREA. THE MISSION OF THE LOCAL SAFE KIDS COALITION IS TO REDUCE UNINTENTIONAL INJURIES IN CHILDREN UP TO AGE 14 IN THE EAST TENNESSEE REGION BY PROMOTING AWARENESS AND IMPLEMENTING PREVENTION INITIATIVES. THE LOCAL SAFE KIDS IS PART OF SAFE KIDS WORLDWIDE, A NETWORK OF COALITIONS WHOSE PRIMARY PURPOSE IS TO PREVENT UNINTENTIONAL INJURIES IN CHILDREN BY PROVIDING CHILDREN AND ADULTS CARING FOR THEM WITH INFORMATION ABOUT HOW TO STAY SAFE. HOPP IS HEMATOLOGY/ONCOLOGY PATIENTS AND PARENTS, AN OFFICIAL SUPPORT GROUP OF ETCH THAT PROVIDES SUPPORT FOR FAMILIES DEALING WITH A CHILD WITH CANCER. FOR THE YEAR ENDED JUNE 30, 2011 ETCH HAD 35,942 TOTAL INPATIENT DAYS, 170,757 TOTAL OUTPATIENT VISITS AND 66,839 EMERGENCY DEPARTMENT VISITS.FORM 990, PART III, LINE 4A
WHISTLE BLOWER POLICYTHE ORGANIZATION DOES NOT PRESENTLY HAVE A FORMAL WRITTEN WHISTLE BLOWER POLICY; HOWEVER, ETCH DOES HAVE A NON-RETALIATION POLICY. THE ORGANIZATION IS CURRENTLY WORKING TO FORMALIZE A WHISTLE BLOWER POLICY.FORM 990, PART VI, SECTION B, LINE 13:

Schedule R IRS990ScheduleR

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S WEST SURGERY CENTER LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11020 CHILDRENS WAYAddressLine1
CityKNOXVILLECity
StateTNState
ZIP Code37922ZIPCode
FieldValueIRS element (for citing)
EIN621872553EIN
Primary ActivityMEDICAL SURGERY CENTERPrimaryActivity
Legal Domicile StateTNLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income867427ShareOfTotalIncome
Share Of EOY Assets845136ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S PRIMARY CARE CENTERBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 15010AddressLine1
CityKNOXVILLECity
StateTNState
ZIP Code37901ZIPCode
FieldValueIRS element (for citing)
EIN621573297EIN
Primary ActivityPEDIATRIC CLINIC HOLDING COMPANYPrimaryActivity
Legal Domicile StateTNLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Share Of Total Income23303704ShareOfTotalIncome
Share Of EOY Assets6454761ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S PRIMARY CARE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeDTransactionType
Amount Involved2646284AmountInvolved
Method Of Amt DeterminationCOSTMethodOfAmtDetermination

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