2012-11-13T09:11:15-06:00 2011-12-31 990 2011-01-01 621697090 Morristown-Hamblen Hospital Foundation MORR 8653746864 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 JOHN T GEPPI 8653746872 2012-11-07 Self prepared 2011 2016-02-24 21:20:13Z George O Haggard Jr 908 W 4th North St Morristown TN 37814 526257 0 X http://www.mhhs1.org/foundation X 1997 TN To support the Morristown-Hamblen Healthcare System. See Form 990, Part III. 9 9 0 73 0 0 155476 466948 0 0 1586 604 14042 4320 171104 471872 0 4110 0 0 0 0 0 0 77524 60646 124240 60646 128350 110458 343522 1458790 1763514 163514 124716 1295276 1638798 X The purpose of the Morristown-Hamblen Hospital Foundation is to support the Morristown-Hamblen Healthcare System in promoting and advancing the well-being of our community by providing quality healthcare and health-related services. The Foundation provides philanthropic support to the Morristown-Hamblen Healthcare System through the generosity of individuals, corporations, and foundations in the community and supports the hospital's mission "to serve the community by improving the quality of life through better health." 0 0 4110 4110 466948 Morristown-Hamblen Hospital Foundation raised funds to provide for indigent patient care and services that were not funded by the health system, private insurance, or other reimbursement. The Foundation also has an active fundraising campaign underway for an 8-bed inpatient oncology unit at Morristown-Hamblen Healthcare System (MHHS). The objective is to raise two million dollars for the building project. During the current reporting period, $208,641 was raised toward the campaign. MHHS currently has an outpatient cancer center offering medical oncology, chemotherapy, radiation oncology and radiation therapy. The new unit will offer the highest level of cancer care for inpatients with specially trained clinical staff and will complete the continuum of care with the outpatient center. 4110 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 TN X X Tina Robertson 8653746864 1420 Centerpoint Blvd Bldg C Knoxville TN 379321960 X George O Haggard Jr 1.00 X X 0 0 0 Jack Maloney 1.00 X 0 0 0 Jennie Morris 1.00 X X 0 0 0 Harold Nichols 1.00 X 0 0 0 Shahin Assadnia MD 1.00 X 0 0 0 R Jack Fishman 1.00 X 0 0 0 Marjory Houston 1.00 X 0 0 0 Anthony Stapleton 1.00 X 0 0 0 Carl Storms 1.00 X 0 0 0 Pamela Snyder 14.00 X 0 105751 17813 0 105751 17813 0 0 0 0 Morristown-Hamblen Hospital Association 908 W 4th North St Morristown TN 37814 Staffing 108045 1 84648 293835 88465 14065 466948 604 604 30430 2101 28329 28329 28329 28275 84648 52284 -24009 -24009 471872 0 0 4924 1812 1812 2298 2298 2000 2000 108570 40558 68012 3362 3362 1333 421 912 282 56 226 3588 2012 1576 Miscellaneous Expense 2552 1169 1383 Meals and Entertainment 2053 2053 Dues and Licenses 500 500 128350 4110 46716 77524 859465 250 250000 1426308 34833 25967 3503 0 327000 16011 310989 310989 1458790 1763514 4631 251 147155 121155 11728 3310 163514 124716 X 1295276 1638798 1295276 1638798 1458790 1763514 343522 0 X X 0 1 1 X 0 X X X 0 0 0 M-H Hospital Association 620545814 3 1 1 1 788 1 788 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 197694 1936 5442 190316 0.00000 0.00000 1.00000 0 0 310989 310989 16011 16011 0 310989 Due to Affiliates 3310 3310 Description of Intended Use of Endowment Funds: Part V, Line 4: Endowments consist of temporarily restricted funds established by donor-restricted gifts for one of the following: Cancer Patient Fund, Oncology Capital Campaign Fund, Education Fund, or Heart, Lung, and Vascular Fund. Description of Uncertain Tax Positions Under FIN 48: Part X: Note G to the consolidated audited financial statements of Covenant Health, parent company of the consolidated group of which Morristown-Hamblen Hospital Foundation is a member, reads in part: At December 31, 2011, tax returns for 2008 through 2011 are subject to examination by the Internal Revenue Service. Covenant has no uncertain tax positions that would require financial statement recognition on disclosure under generally accepted accounting principles at December 31, 2011 or 2010. Golf Tournament 56785 50520 6265 6950 384 11400 Heart Gala Auction 56138 34128 22010 750 19279 1150 12371 112923 84648 28275 7700 19663 1150 23771 52284 -24009 Form 990, Part VI, Section A, line 6 Morristown-Hamblen Hospital Foundation has one member, Morristown-Hamblen Hospital Association (MHHA), a Tennessee nonprofit corporation. Form 990, Part VI, Section A, line 7a Per provisions in Article III, Section 3 of the Foundation's ByLaws, the Board of Directors of Morristown-Hamblen Hospital-Association shall nominate and elect members of the Foundation board of directors and fill vacancies on the board as often as vacancies occur, whether such vacancies are due to expansion, resignation, expiration of term, death or for any other reason and designate the term of service of each elected member of the board. Form 990, Part VI, Section A, line 7b Amendments to the ByLaws must be approved by a majority vote of the Board of Directors of the Foundation's sole member, Morristown-Hamblen Hospital Association. Form 990, Part VI, Section B, line 11 Morristown-Hamblen Hospital Foundation's 2011 Form 990 was presented to the Foundation's Board of Directors at its meeting in October 2012. Form 990, Part VI, Section B, line 12c Board members, officers and employees are required to adhere to rules and policies regarding conflicts of interest. Covenant Health, the parent company of Morristown-Hamblen Hospital Association, distributes a Board-approved employee handbook to all employees. The handbook 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. Form 990, Part VI, Section B, line 15a The base salary for Pamela Snyder, former Executive Director, was based on established targets to insure that total compensation was reasonable and within a fair market value range. Salary ranges for each executive position are based upon comparison with similar jobs in similar size health systems across the nation. Base salaries 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. Form 990, Part VI, Section C, line 19 Form 990, Part VI, Section C, Line 19: Morristown-Hamblen Hospital Foundation makes its governing documents and financial statements available to the public upon request. Hours Worked for Related Organizations: Form 990, Part VII, Section A, Col. (B) - Pamela Snyder is compensated by Morristown-Hamblen Hospital Association d/b/a Morristown Hamblen Healthcare System for her service to the system as a whole. Average hours per week devoted to the Morristown-Hamblen Hospital Foundation are reported on this return. Form 990, Part XII, Line 2c: The Finance Committee of the Covenant Health Board of Directors assumes responsibility for oversight of the audit of the consolidated financial statements and selection of an independent accountant. Covenant Health is the parent company of Morristown-Hamblen Hospital Association, the sole member of Morristown-Hamblen Hospital Foundation. Morristown-Hamblen Hospital Assocation dba M-H Healthcare System 908 West Fourth North Street Morristown TN 37814 620545814 Hospital Services TN 501(c)(3) Line 3 Covenant Health 0 Morristown Regional Cancer Center LLC 908 West Fourth North Street Morristown TN 37814 200916364 Cancer Treatment Facility TN 501(c)(3) Line 3 Morristown-Hamblen Hospital Association 0 Assoc of the Meridian Health Outpatient Surgery Ctr LLC 908 W 4th North St Morristown TN 37814 861167487 Healthcare Services TN N/A Morristown Hamblen Health Services Inc PO Box 1178 Morristown TN 37816 621588521 Inactive (dissolved 2/5/2011) TN N/A C 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 1