2011-11-11T09:02:24-06:00 2010-12-31 990 2010-01-01 581897274 Parkwest Medical Center PARK 8653746864 1410 Centerpoint Blvd No 401 Knoxville TN 379321985 John T Geppi 8655315412 2011-11-09 Self-prepared 2010 2016-03-07 17:11:31Z Anthony L Spezia 100 Fort Sanders West Blvd Knoxville TN 37922 320101752 0 X www.treatedwell.com X 1990 TN Parkwest Medical Center is a 462-bed full service acute care and psychiatric hospital located in west Knoxville, Tennessee. It is a member of the Covenant Health system. 21 16 2632 167 287929 18977 1362297 1212709 298893440 312816939 -48557 -888970 2939624 3424705 303146804 316565383 158447 110749 0 0 110238794 102080779 0 0 0 182505761 191807958 292903002 293999486 10243802 22565897 220917608 226439630 208873275 187561288 12044333 38878342 X Parkwest 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. Please see The Report to the Community for the Covenant Health organizations, which describes the substantial benefit provided by the system, at the end of this schedule. 0 0 51429870 59395006 Cardiology. See Schedule O for additional details. Cardiology: Expenses - $51,429,870; Revenue - $59,395,006During 2010, Parkwest Medical Center performed 416 open heart surgeries. In addition, the cardiac cath lab performed 11,255 inpatient and 15,727 outpatient procedures for a total of 27,398 procedures.The Heart Hospital at Parkwest has been recognized by Thomson Reuters as one of the nation's top heart hospitals for almost a decade. 43657542 46111683 General/Urology/Vascular. See Schedule O for more details.General/Urology/Vascular: Expenses - $43,657,542; Revenue - $46,111,683In 2010, Parkwest's General/Urology/Vascular surgery program performed 16,086 cases, including both inpatient and outpatient surgeries. 30165890 23654787 Psychiatry. See Schedule O for more details.Psychiatry: Expenses - $30,165,890; Revenue - $23,654,787Parkwest's Senior Behavioral Center saw 513 admissions in 2010 resulting in 4,150 patient days. At the Peninsula campus, a division of Parkwest, admissions totaled 4,690 admissions with 27,402 patient days. Outpatient visits totaled 155,346.Peninsula, a division of Parkwest, is the region's largest provider of behavioral health services. Peninsula provides outpatient services in four counties and inpatient services at a 155 bed facility. The Parkwest Senior Behavioral Center provides an advanced level of care for older psychiatric patients. 161764623 110749 183659760 As a full-service acute care hospital, Parkwest Medical CenterCenter treats patients across a broad spectrum of medical specialties. 161764623 110749 183659760 287017925 1 1 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 202 0 1 2632 1 1 1 0 0 0 0 0 0 0 0 0 X 21 16 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 1 0 TN X X Michael S Hamilton 8653731005 9352 PARK WEST BLVD KNOXVILLE TN 37923 Dr Richard Brinner 0.00 X 0 922 0 Harry M Call 0.00 X 0 1532 0 Dr Mitchell Dickson 0.00 X 0 1771 0 Pamela P Fansler 0.00 X 0 767 0 Dr William Hall 0.00 X 0 1274 0 Wayne Heatherly 0.00 X 0 1697 0 Karla Lane 0.00 X 0 950 0 Dr Randolph Lowry 0.00 X 0 1665 0 Larry Mauldin 0.00 X 0 1226 0 James Fitzsimmons 0.00 X 0 1876 0 George Miller 0.00 X 0 647 0 Alvin Nance 0.00 X 0 673 0 Linda N Ogle 0.00 X 0 0 0 Francis Olmstead Jr 0.00 X 0 2212 0 Mitchell Steenrod 0.00 X 0 1081 0 Jim Johnson Jr 0.00 X 0 1114 0 Joseph E Sutter 0.00 X 0 1829 0 Homer Fisher 0.00 X 0 436 0 Joe Ben Turner 0.00 X 0 819 0 David C Verble 0.00 X 0 1434 0 Anthony L Spezia 0.00 X X 0 1406336 246381 John T Geppi 0.00 X 0 675119 41480 Larry R Lassiter 50.00 X 0 382939 36147 Michael S Hamilton 50.00 X 156159 0 39259 Janice McKinley 50.00 X 207965 0 31505 Emlyn J Cobble 50.00 X 143762 0 25337 Safia Sabri 40.00 X 245860 0 15751 Manju Khanna 40.00 X 240907 0 32799 Kris D Houser 40.00 X 237041 0 25697 Shyam P Vuyyuru 40.00 X 227892 0 32122 Karthi S Namasivayam 40.00 X 183477 0 18680 1643063 2488319 545158 31 0 1 0 Covenant Medical Management 280 Fort Sanders West Blvd Ste 205 Knoxville TN 37922 Physician Services 2884204 GE Medical Systems 96483 PO Box 96483 Chicago IL 60693 Consolidated Service Contract 1701376 Medic Regional Blood Center 1601 Ailor Ave Knoxville TN 37921 Blood Processing 1574587 Dialysis Assoc West Stark 11305 Station West Drive Knoxville TN 37922 Dialysis Services 1203952 Angelica Textile Services Inc PO Box 535122 Atlanta GA 30353 Linen Services 1201477 34 463015 619153 130541 1212709 Medical Services 622110 312723866 312723866 Laboratory 621500 85273 85273 Rental Inc.-Affiliate 531120 7800 7800 312816939 52696 52696 9665 9665 2431774 1594238 837536 837536 837536 990800 1942131 -951331 -951331 -951331 Cafeteria 722212 1855604 1855604 Gift Shop 453220 371453 371453 Support Services 900099 228868 202656 26212 131244 79905 51339 2587169 316565383 312821236 287929 2243509 18275 18275 92474 92474 603987 603987 82673727 81301986 1371741 2555591 2481907 73684 10201176 9843222 357954 6046298 5883085 163213 18427661 17855387 572274 317230 317230 34500 34500 20628199 19595736 1032463 740065 716876 23189 3353736 2572138 781598 5073387 4835947 237440 218512 210713 7799 197972 139481 58491 4515935 4515935 18493248 18493248 908865 160415 748450 Unrelated business inco 10600 10600 Hospital Supplies 71125819 71125819 Charity Care 19446257 19446257 Bad Debts 13883023 13883023 Hospital Equipment 5948879 5948879 8484070 7897122 586948 293999486 287017925 6981561 0 99320 7845 -1935685 -2265988 30427444 26985837 5026865 5283568 479375 798858 356842688 178968767 167262151 177873921 2374495 441856 17183643 17313733 220917608 226439630 20663830 25526121 285503 302257 94181468 80530685 1155845 624229 92586629 80577996 208873275 187561288 X 12044333 38878342 12044333 38878342 220917608 226439630 X 22565897 4268112 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 54689 2230 56919 51081 3608 946 946 54689 47482 3599 1913 1913 51081 1.00000 0 1 1 10340753 10340753 168734477 51948427 116786050 3509803 2720714 789089 168553550 120709250 47844300 5704105 3590376 2113729 177873921 Assets limited as to use 16047749 Bond Issuance Costs, Net 354854 Deferred Compensation 337645 Other Receivables 573485 17313733 Due to Affiliates 75726214 Long-term Deferred Compensation 337645 Long-term Reserve for Workers Comp 1952712 Due to Third Party Payors 2561425 80577996 Description of Intended Use of Endowment Funds: Part V, Line 4: Fort Sanders Foundation maintains a permanent endowment fund on behalf of Parkwest Medical Center. The Wayne Heatherly Excellence in Patient Care Endowment Fund was established for the purpose to promote and encourage excellence in clinical quality and patient care by providing educational assistance to employees, recognizing and awarding nominated employees for their commitment to patient care excellence, and to help meet patient care needs. The principal of the permanent endowment will be kept intact in perpetuity and only the income generated will be distributed to provide support for Parkwest Medical Center. 1 1 X 1 X 1 X 1 1 1 0 1 1 13041859 4725087 8316772 0.02970 63519337 45195817 18323520 0.06540 657124 171480 485644 0.00170 77218320 50092384 27125936 0.09680 101307 1785 99522 0.00040 91726 0 91726 0.00030 5605843 0 5605843 0.02000 96121 0 96121 0.00030 5894997 1785 5893212 0.02100 83113317 50094169 33019148 0.11780 44328 0 44328 0.00020 49300 0 49300 0.00020 46677 0 46677 0.00020 524 0 524 0.00000 5758 0 5758 0.00000 146587 146587 0.00060 0 1472476 560719 78889652 77224251 1665401 X 1 1 2 1 Parkwest Medical Center

9352 Park West Blvd Knoxville TN 37923

X X X Behavioral Health 2 Peninsula Hospital

2347 Jones Bend Road Louisville TN 37777

X Behavioral Hospital Not Required 1 10 Peninsula Outpatient Center - Knox

1451 Dowell Springs Road Knoxville TN 37919

Outpatient mental health services Peninsula Outpatient Center - Blount

210 Simmons Street Maryville TN 37801

Outpatient mental health services Parkwest Comprehensive Breast Center

9349 Park West Blvd 200 Knoxville TN 37923

Breast imaging PWMC Boulevard Surgery Center

9300 Park West Blvd Knoxville TN 37923

Ambulatory surgery Peninsula Outpatient Center - Sevier

124 N Henderson Ave Bldg A Sevierville TN 37862

Outpatient mental health services Therapy Center West

280 Fort Sanders West Blvd 201 Knoxville TN 37922

Physical, occupational & speech therapy Peninsula Outpatient Center - Loudon

423 Medical Park Drive Suite 400 Lenoir City TN 37772

Outpatient mental health services Peninsula Lighthouse

1451 Dowell Springs Road Knoxville TN 37919

Outpatient alcohol & drug rehabilitation CROPPROP

280 Fort Sanders West Blvd 205 Knoxville TN 37922

Cardiac & pulmonary rehabilitation Weight Management Center

280 Fort Sanders West Blvd 200 Knoxville TN 37922

Weight management center Part I, Line 6a: Covenant Health, the parent company of Parkwest Medical Center and other affiliated acute care hospitals, prepares an annual Report to the Community on behalf of the entire system. Part I, Line 7: Amounts on Lines 7a-7c are from the hospital's cost accounting system, which addresses all patient segments. Other community benefit expenses are at historical cost from the general ledger. Part I, Line 7g: The organization has included $3,064,242 in physician sponsorship fees in total subsidized health services. 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 $ 13883023. Part II: Parkwest Medical Center's community building activities provide the hospital with opportunities to address the root causes of health problems by offering its expertise and resources. In 2010 Parkwest donated money, supplies & volunteer staff hours to build a Habitat for Humanity house. As part of the build, Parkwest made a $30,000 cash donation to the project as well as utilized 115 volunteers who contributed 570 volunteer hours (all done off shift). In addition to the staff hours, Parkwest provided all of the food for the build days, totaling $1,425.Parkwest provided opportunities for students from local high schools to explore health care careers through job shadowing programs. In 2010 twenty-three students from three area high schools "shadowed" staff of the respiratory department for a total of 204 hours. Thirty students learned about jobs in various other departments, including the laboratory, labor and delivery, and radiology. In addition Parkwest Medical Center supports the community building activities of its parent company, Covenant Health. 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.Community Building activities included cash and in-kind donations for the development of community health programs and partnerships. These activities include physical improvements and housing, economic development and support system enhancements like disaster readiness, mentoring programs, and youth asset development initiatives. Such programs address the root causes of health problems, such as poverty and homelessness due to lack of education and jobs.In 2010 the System provided Community Building support to many organizations, the most significant of which included: Catholic Charities of East Tennessee East TN Economic Development Agency Emerald Youth Foundation Great Schools Partnership Charitable Trust (for Knox Co. schools) Innovation Valley Technology Council Second Harvest Food Bank of East TN Variety Children's Charity of East TN Part III, Line 4: Note B to the 2010 Audited Consolidated Financial Statements of the Covenant Health system, of which Parkwest Medical Center is a member, reads:"Patient accounts receivable are reported net of both an estimated allowance for uncollectible accounts and an estimated allowance for contractual adjustments. The contractual adjustment represents the difference between established billing rates and estimated reimbursement from Medicare, TennCare and other third-party payment programs. Current operations for 2010 and 2009 include an estimated provision for bad debts, included in Supplies and Other in the Consolidated Statements of Operations and Changes in Net Assets. 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."Bad debt expense at cost on Line 2 was obtained from the hospital's cost accounting system from a listing of all accounts written off to bad debt.In the previous year, the hospital reviewed all patient accounts in bad debt status to identify persons who might have qualified for financial assistance. Notes in the patient record were reviewed to see if a patient or guarantor was sent a charity care application based on statements that they could not afford to pay all that they owed. The hospital could not make a final determination as to their qualification for financial assistance due to missing or incomplete information (i.e. charity care application was not returned to the hospital business office or supporting documentation was not provided) but felt strongly that the patients were in need of some form of assistance. The percentage of total bad debt at cost applicable to patients identified through this review process has been applied to the current year total bad debt at cost on Line 2 to arrive at the amount reported on Line 3. Part III, Line 8: Costing Methodology: Parkwest Medical Center used a combination of sources in calculating Medicare allowable costs on Part III, Line 6 including its cost accounting system, general ledger accounting system, and facility-specific analyses and calculations. Part III, Line 9b: Self-pay patients of Parkwest Medical Center automatically receive a minimum 48% discount on charges. Self-pay patients of Peninsula Hospital receive a 30% discount. 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. Part VI, Line 2: The hospital actively addresses a variety of identified needs in the community through its relationships with community based groups including the local health council, public health department, school systems, health coalitions, inter-agency council, and health-related not-for-profit organizations. Additionally, the East Tennessee 2-1-1 Information and Referral system is able to provide a profile of the health and social services most requested by the citizens of each county. This information serves as an ongoing assessment of basic health and human service needs and of what resources are lacking in each community. Part VI, Line 3: Parkwest Medical Center posts a sign in each registration station that state: Financial Assistance: Covenant Health is committed to providing quality health services in a caring environment. It is the expressed philosophy of Covenant Health and its member hospitals that no one should be denied necessary medical care because of the inability to pay. In conjunction with this philosophy, staffs of Parkwest Medical Center are available to assist you with your financial needs. If you are an uninsured person with no public or private source of payment for medical services, Parkwest 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)373-1244, Monday through Friday between the hours of 8:00 a.m. and 4:00 p.m.Peninsula posts a similar sign in its registration stations, substituting "Peninsula, a division of Parkwest Medical Center" for "Parkwest Medical Center."Both Parkwest Medical Center and Peninsula employ full time financial counselors who meet with uninsured patients. In addition, both hospitals contract with First Source Solutions USA, LLC and have a representative on-site who screens patients for eligibility, assists them with TennCare and disability enrollment, and ensures enrollment in the appropriate programs.The Charity Care Policy, which applies to both hospitals, states that patients who are unable to pay and have exhausted all sources of payment assistance may be screened for potential charity care eligibility. According to the policy, the financial counselors initiate screening of the patient and/or guarantor by obtaining income and other financial information to determine eligibility for charity care or discounted services. Part VI, Line 4: Parkwest Medical Center is located in the west area of Knoxville, Tennessee. Although located in metropolitan Knox County, Parkwest 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 2010, slightly more than 42% of the inpatient discharges were Knox County residents. Loudon County provides Parkwest Medical Center with the second highest number of admissions compared to other counties in the region, nearly 14%.Parkwest Medical Center also provides mental health services to the region through its behavioral health division, Peninsula. Peninsula is East Tennessee's leading provider of behavioral healthcare services. Peninsula offers a complete range of mental health and alcohol/drug treatment programs. In addition to outpatient centers in Blount, Knox, Loudon and Sevier counties, care is also offered at Peninsula Hospital, a 155-bed inpatient facility which serves more than 5,000 patients annually.According to 2008 data from the U.S. Census Bureau, the collective population of the 16 counties is 1,157,473, 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 not-for-profit. The average income and percentage of the population with incomes below the federal poverty guideline within the 16 counties ranges from a low of $12,925 and 21% in Morgan County to a high of $21,875 and 14% 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: 21% - 24% - 15% Adult Obesity: 29% - 31% - 25% Excessive Drinking: 11% - 9% - 8% Teen Birthrate: 39 - 55 - 22 of every 1,000 teenage girls Poor or Fair Health: 16% - 19% - 10% Part VI, Line 6: Parkwest Medical Center ("Parkwest"), 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 Parkwest's board. It is comprised of independent community leaders with diverse educational and professional backgrounds. The board sets policies and provides oversight of Parkwest.Parkwest maintains an open medical staff, with privileges available to all qualified physicians. Additionally, the hospital operates an active and accessible emergency department that accepts all patients regardless of ability to pay. Part VI, Line 7: Parkwest Medical Center is a member of Covenant Health. Headquartered in Knoxville, Covenant is a non-profit system providing comprehensive services throughout East Tennessee. Covenant is a community-owned organization committed to improving the health of the people it serves. The organization is governed by a voluntary board of directors composed of community leaders and medical professionals.Covenant includes seven acute care hospitals: Parkwest Medical Center and Fort Sanders Regional in Knoxville, Methodist Medical Center of Oak Ridge, Fort Loudoun Medical Center in Lenoir City, LeConte Medical Center in Sevierville, Roane Medical Center in Roane County and Morristown-Hamblen in Morristown. It also includes Peninsula Hospital, a psychiatric hospital in Blount County. In addition to the hospitals, Covenant's primary member organizations include Peninsula (a division of Parkwest Medical Center), Patricia Neal Rehabilitation Center, Thompson Cancer Survival Center, Thompson Cancer Survival Center at Methodist, Fortress Corporation, Fort Sanders West Diagnostic Center, Fort Sanders West Outpatient Surgery Center, Nanny's Nursery, Fort Sanders Health and Fitness Center, Covenant Medical Management and Covenant HomeCare.Covenant Health operates the Fort Sanders Nursing Department, a baccalaureate nursing education program at Tennessee Wesleyan College, in Athens, Tenn.Its philanthropic affiliates include the Fort Sanders Foundation and Thompson Cancer Survival Center Foundation in Knoxville, Methodist Medical Center Foundation in Oak Ridge, Dr. Robert F. Thomas Foundation in Sevierville, and Morristown-Hamblen Hospital Foundation in Morristown. Funds raised by the foundations provide services, equipment and other resources for excellence in patient care.The system performs the needs assessments for its hospitals. Utilizing this needs assessment, Covenant Health coordinates community benefits programs for the system through planning, developing, implementing and funding programs that address community needs. Parkwest participates in these programs. Parkwest's community involvement includes the American Heart Association, Habitat for Humanity and the Medic Regional Blood Center. Parkwest has a Green initiative as part of its strategic plan to become more environmentally aware. The initiative has garnered both local and state-wide accolades.On behalf of the system, Covenant also funds the majority of the cash contributions to unrelated organizations that promote community health and wellness.Approximately 10,000 people are employed by Covenant and its member organizations. Working together with approximately 1,000 affiliated physicians, these healthcare professionals deliver quality care to thousands of patients throughout East Tennessee. 1 X Patient Assistance 538 92474 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Donations are given at the discretion of Administration and Marketing departments for the purpose of enhancing and promoting health care within the community of East Tennessee. The organization maintains records of check requests authorizing gifts and donations. X 1 1 0 1 0 0 0 0 0 0 0 Anthony L Spezia 0 690560 0 652524 0 63252 0 216512 0 29869 0 1652717 0 156680 John T Geppi 0 367693 0 268268 0 39158 0 9800 0 31680 0 716599 0 0 Larry R Lassiter 0 257399 0 96325 0 29215 0 9800 0 26347 0 419086 0 0 Michael S Hamilton 130899 0 9987 0 15273 0 13238 0 26021 0 195418 0 0 0 Janice McKinley 169808 0 13243 0 24914 0 16920 0 14585 0 239470 0 0 0 Emlyn J Cobble 120260 0 8849 0 14653 0 11778 0 13559 0 169099 0 0 0 Safia Sabri 222067 0 7970 0 15823 0 14683 0 1068 0 261611 0 0 0 Manju Khanna 211971 0 8000 0 20936 0 14368 0 18431 0 273706 0 0 0 Kris D Houser 205006 0 6500 0 25535 0 0 0 25697 0 262738 0 0 0 Shyam P Vuyyuru 205747 0 7500 0 14645 0 13968 0 18154 0 260014 0 0 0 Karthi S Namasivayam 162245 0 6000 0 15232 0 11108 0 7572 0 202157 0 0 0 Part I, Line 1a Part I, Line 1a: Tax indemnification and gross-up payments are provided to certain executives and managers. These are treated as taxable compensation to the recipient. Part I, Line 4b Part I, Line 4b: Anthony L. Spezia (compensated by Covenant Health, parent organization) $206,712 - current year contribution to 457(f) plan. $213,161 - current year distribution from 457(f) plan, of which $156,680 was earned and reported in 2006. Supplemental Information Part III Part I, Line 3: Covenant Health, the parent company of Parkwest 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. Form 990, Part VI, Section B, line 11 A summary of Parkwest Medical Center's 2010 Form 990 was prepared and presented to the Covenant Health Finance Committee and Board of Directors at their 2011 September and October meetings, respectively. This entity is one member of a large integrated healthcare system which files a total of twelve (12) Form 990s. Prior to filing, the Board of Directors and Finance Committee had access to the 990s of all Covenant Health facilities. Form 990, Part VI, Section B, line 12c Board members, officers and employees are required to adhere to rules and policies regarding conflicts of interest. Covenant Health, the parent company of the organization, distributes a board approved 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 15 Form 990, Part VI, Section B, Line 15a: Overall Compensation policies for Parkwest 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 Committe 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 2010 Form 990 of Covenant Health, EIN 62-1646734, parent company of Parkwest Medical Center. Form 990, Part VI, Section B, Line 15b: Base salaries and annual bonus opportunities for Larry R. Lassiter, President/CAO, and Michael S. Hamilton, VP-Financial Services, ("Key Executives") are set by the Covenant Health CEO or Executive Vice President-Human Resources and/or Executive Vice President-Operations, 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 insure that total compensation for each executive is reasonable and within a fair market value range. Salary ranges for each executive position 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 each Key Executive 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% for the CAOs and 0-20% for the VP-Financial Services of base salary based upon system performance and accomplishment of certain targets established by the CEO. 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 Nationally Recognized Municipal Securities Information Repositories. Any member of such a repository has access to these financial statements. In addition, Parkwest Medical Center files a Joint Annual Report containing financial information with the Tennessee Department of Health. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 25,269. Bioterrorism Grant Released 31,132. Contribution to Net Assets 4,211,711. Total to Form 990, Part XI, Line 5: 4,268,112. Form 990, Part XII, Line 2C: 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. Contact Addresses for Officers, Directors, Etc: Form 990, Part VI, Line 9 and Part VII Anthony L. Spezia Covenant Health 100 Ft Sanders West Blvd. Knoxville, TN 37922 John T. Geppi, Francis Olmstead, and all Directors Covenant Health 1410 Centerpoint Blvd., Suite 401 Knoxville, TN 37932 All other persons listed in Part VII, Section A may be contacted at the organization's address. Form 990, Part VII, Section A, Column B: The President/CEO, EVP/CFO, and Board of Directors serve Covenant Health, EIN 62-1646734, parent company of an integrated health care delivery system, of which Parkwest Medical Center is a member, as a whole. The hours these individuals devoted to the system in 2010 are reported on Covenant Health's Form 990, Part VII. Form 990, Part III, Line 1 - Report to the Community: Service to the people and communities of East Tennessee is the cornerstone of the mission of Covenant Health, hereinafter referred to as "the System," a community-owned health system which includes acute care hospitals, outpatient facilities and clinics, and numerous specialty services. The System's mission, "we serve the community by improving the quality of life through better health," has been the foundation of the services and programs offered by the System and its member organizations since it was formed through the consolidation of Fort Sanders Health System in Knoxville and MMC Healthcare System in Oak Ridge in 1996. The System is a community-owned healthcare system and provides comprehensive health services throughout East Tennessee. Headquartered in Knoxville, Tennessee, the System includes seven acute care hospitals with a total of more than 1,700 licensed beds, as well as numerous outpatient services and clinics. The System also includes specialty providers of behavioral, oncology, and rehabilitation services, along with home care, physician clinics, community wellness programs and managed care products and services. The System has more than 1,000 affiliated physicians and 9,000 employees. Covenant Health, a tax-exempt entity pursuant to section 501(c)(3) of the Internal Revenue Code, is the parent company and sole member of several controlled entities: Fort Loudoun Medical Center, Fort Sanders Regional Medical Center, LeConte Medical Center, Methodist Medical Center of Oak Ridge, Morristown-Hamblen Hospital Association, Parkwest Medical Center, Peninsula, a Division of Parkwest Medical Center, Roane Medical Center, Thompson Cancer Survival Center, Covenant HomeCare and Fort Sanders Perinatal Center. These entities were established to provide healthcare services primarily to East Tennesseans in the surrounding 16-county area. Operating as an integrated network of health services, Covenant Health and its affiliates seek to provide affordable, superior healthcare to patients through continued operation of both acute care and non-hospital programs. The history of the System demonstrates a clear and consistent charitable purpose: the provision of healthcare services to all residents of the community without regard to age, race, gender, creed, national origin, ability to pay, or physical or mental handicap. Beyond the services documented in this report are countless acts of generosity by employees that will never be completely captured and reported, nor will they be forgotten by those who benefited from them. One of the most tangible expressions of the System's charitable purpose is the provision of care to people unable to pay. The System embraces its purpose and strives to grow the types of services not provided by other area health care providers; examples of such services include but are not limited to services provided by Peninsula, a Division of Parkwest, which provides inpatient and outpatient behavioral health services, and the Hope Center, which provides comprehensive support services for patients with HIV/AIDS and other serious illnesses, and their families and caregivers. The System provides medically necessary services to all people, regardless of their ability to pay. Patients who fall below 300 percent of the federal poverty income guidelines for a 12-month period, who are unable to pay, and who have exhausted all sources of payment assistance may be eligible for charity care. According to policy, patients whose annual income falls between 0-200% of federal poverty guidelines receive 100% discount while those whose income is between 201-300% of the federal poverty guidelines receive a 70% discount. For those who do not fall below the guidelines but are facing difficult economic circumstances, ability to pay is determined on a case-by-case basis. In particular, cases involving serious illness and/or unusually high-cost care are individually evaluated, and expectation of payment by the System is adjusted to recognize the reasonable ability of the individual patient to pay for services received. For the year ending December 31, 2010, the System provided services under the previously stated policy which resulted in significant losses to the System. Both inpatients and outpatients were provided care under the aforementioned policy. No patient was refused necessary medical care on the basis of his or her ability to pay. In addition to the level of services identified above, the System is an active participant in the State of Tennessee TennCare program. The System is the area's largest TennCare provider of services to residents of East Tennessee. The TennCare program seeks to provide payment for healthcare services to individuals who meet certain financial and categorical requirements. Financial requirements include evaluation of both assets and income. TennCare program reimbursement rates are substantially below Medicare reimbursement rates. In addition to the provision of care without expectation of payment or the provision of care to TennCare-eligible people at rates substantially below charges, the System provided services to people covered under the federal Medicare program. Medicare recipients were the largest single payor classification of patients served by the System. The payment rate for inpatient services was on a per case rate, calculated based on the diagnostic-related group into which the patient was categorized, coupled with other factors related to area wage rates, capital costs and other variables. Outpatient services were reimbursed on a pre-determined case rate. Moreover, the System works diligently throughout the year to achieve its mission by supporting community health education and outreach programs. The System underwrites the cost of community screenings, health fairs, outreach programs for seniors, outdoor fitness programs, community exercise classes, support groups for new parents and other specific populations, smoking cessation classes, and local wellness education programs. Notable examples of these programs include: Covenant Health Check, a multi-county annual screening event, now in its 27th year, which has served more than 150,000 people; Body Works, a multi-location exercise program for adults; Passport, an organization promoting health and active lifestyles for adults 50 and older; Monthly Lunch 'n Learns and Health Nights in Knox and surrounding counties; Covenant Health at the Mall, freestanding health information kiosks at two local malls; Community fitness events such as the Covenant Health Knoxville Marathon and a bike ride and foot race held in conjunction with Knoxville's Dogwood Arts Festival; Wellness programs, support groups, and outreach services sponsored by Covenant Health's member hospitals. The system also funds two "hospitality house" outreach programs, one at Fort Sanders Regional Medical Center in Knoxville, and one at Methodist Medical Center in Oak Ridge. These facilities provide temporary "homes away from home" for non-local patients and caregivers who are receiving ongoing medical treatment care at Covenant Health member organizations. The System is committed to education in order to prepare qualified nurses and other healthcare workers for the future, and to provide continuing education for current healthcare professionals. This support is shown in multiple ways, including support of Tennessee Wesleyan College - Fort Sanders Nursing, a baccalaureate level nursing education program offered under the auspices of Tennessee Wesleyan College in Athens, Tennessee, with classroom and clinical training opportunities offered in Knoxville and at various Covenant Health facilities. The System also provides clinical training rotations at its hospitals and member facilities for students in area nursing and ancillary health education programs. Additional program support and scholarships are given to students and to schools providing healthcare education throughout the area. Special programs are offered to high school and middle school students who are interested in careers in healthcare. Continuing education opportunities are provided for physicians, nurses, and other healthcare professionals on a variety of topics. During 2010, the System subsidized services related to sports medicine, services for women and children, and behavioral health assessments. Subsidized services are those services which are typically provided to meet an identified community need. If no longer offered, the services would either be unavailable in the area or fall to the responsibility of the government or another not-for-profit system to provide. The system also designated specific amounts as Physician subsidies to support the recruitment by the System and its affiliates of physicians and other health professionals for areas underserved or specialties not adequately served in the community. High populations of Tenncare patients and uninsured patients typically reside in these areas. The System supported the important work of many unaffiliated organizations and charities during 2010. While the principal community donation by the System was in the area of indigent care, donations within the context of the organization's established charitable contribution policy were also made to other causes. More than 50 organizations received charitable contributions from Covenant Health and/or its member organizations in 2010, including: American Cancer Society American Heart Association Catholic Charities East Tennessee Children's Hospital Great Schools Partnership Holston Home for Children Innovation Valley Knoxville Track Club (for sponsorship of Covenant Health Knoxville Marathon) Senior Services Contributions and Sponsorships Susan G. Komen Foundation University of Tennessee Variety Children's Charity of East Tennessee Wellness Community Donations also included support of medical mission trips to Guatemala and Haiti. Community Building activities included cash, in-kind donations, and budgeted expenditures for the development of community health programs and partnerships. These activities include physical improvements and housing, economic development and support system enhancements like disaster readiness, mentoring programs, and youth asset development initiatives. In 2010 the System provided Community Building support to many organizations, including but not limited to: Boys & Girls Club Emerald Youth Foundation Family Promise of Knoxville Interfaith Health Clinic Knoxville Academy of Medicine Project Access Roane Alliance Second Harvest Food Bank United Way Wee Course Classic In a separate but related donation category, in 2010 employees of the System also contributed financially to the System's United Way drive and Covenant Health's We Care campaign, which raises funds for charitable services provided by the System such as patient assistance with medication costs, chaplain's fund for employees in need, hospitality houses for patients from outside the area, and nursing scholarship programs. The volunteer programs at the System's acute care organizations are active and vital parts of the System's success. Volunteers donate time and service to Fort Loudoun Medical Center, Fort Sanders Regional Medical Center, LeConte Medical Center, Methodist Medical Center, Morristown-Hamblen Hospital Association, Parkwest Medical Center, Thompson Cancer Survival Center, and Covenant HomeCare. At the acute care facilities, volunteers include adults, college students and teenagers working in a variety of settings such as inpatient and outpatient facility departments, patient reception areas, gift shops, fellowship centers, etc. Funds raised by volunteers are donated for hospital equipment, supplies and special projects, as well as to meet charitable community needs. Covenant Health 1410 Centerpoint Blvd Suite 401 Knoxville TN 37932 621646734 Supporting organization TN 501(c)(3) 11(a) - Type II N/A 0 LeConte Medical Center 742 Middle Creek Road Sevierville TN 37862 621114867 Acute care hospital TN 501(c)(3) 3 Covenant Health 0 Fort Sanders Regional Medical Center 1901 W Clinch Avenue Knoxville TN 37916 620528340 Acute care hospital TN 501(c)(3) 3 Covenant Health 0 Methodist Medical Center 990 Oak Ridge Turnpike Oak Ridge TN 37830 620636239 Acute care hospital TN 501(c)(3) 3 Covenant Health 0 Roane County Medical Center dba Roane Medical Center 412 Devonia Street Harriman TN 37748 680673354 Acute care hospital TN 501(c)(3) 3 Covenant Health 0 Fort Loudoun Medical Center 550 Fort Loudoun Medical Ctr Loudon TN 37772 621373691 Acute care hospital TN 501(c)(3) 3 Covenant Health 0 Thompson Cancer Survival Center 1915 White Avenue Knoxville TN 37916 621250943 Cancer treatment facility TN 501(c)(3) 3 Covenant Health 0 Thompson Oncology Group 1915 White Avenue Knoxville TN 37916 621619239 Oncology services TN 501(c)(3) 3 Thompson Cancer Survival Center 0 Covenant Homecare 3001 Lake Brook Blvd Suite 101 Knoxville TN 37909 621623114 Home Health Services TN 501(c)(3) 9 Covenant Health 0 Fort Sanders Perinatal Center 501 19th St Suite 304 Knoxville TN 37916 043760551 High risk obstetrical services TN 501(c)(3) 3 Fort Sanders Regional Medical Center 0 Fort Sanders Foundation 280 Fort Sanders West Blvd Suite 10 Knoxville TN 37922 621748601 Fundraising and development TN 501(c)(3) 11(a) - Type I Covenant Health 0 Morristown-Hamblen Hospital Assoc dba M-H Healthcare System 908 W 4th North St Morristown TN 37814 620545814 Acute care hospital TN 501(c)(3) 3 Covenant Health 0 Fort Sanders Endoscopy Center LLC 100 Fort Sanders West Blvd Knoxville TN 37922 Inactive - Dissolved, October 2010 TN N/A 0.00000 Fort Sanders OP Cardiac Catheterization Ctr LLC 100 Fort Sanders West Blvd Knoxville TN 37922 Inactive - Dissolved, October 2010 TN N/A 0.00000 Parkwest Endoscopy Center LLC 100 Fort Sanders West Blvd Knoxville TN 37922 Inactive - Dissolved, October 2010 TN N/A 0.00000 Endoscopy Center of Oak Ridge LLC 988 Oak Ridge Turnpike Ste 200 Oak Ridge TN 37830 621667358 Outpatient medical facility TN N/A 0.00000 Fort Sanders West OP Surgery Ctr LLC 210 Fort Sanders West Blvd Ste 106 Knoxville TN 37922 621366907 Outpatient surgery center TN N/A 0.00000 Fort Sanders West Associates 280 Fort Sanders West Blvd Knoxville TN 37922 621384171 Building ownership TN N/A 0.00000 Assc of Meridian OP Surgery Ctr LLC 908 W 4th North St Morristown TN 37814 861167487 Outpatient surgery center TN N/A 0.00000 Fortress Corporation 280 Fort Sanders West Blvd Suite 21 Knoxville TN 37922 621308885 Management Company TN N/A C Covenant Medical Management 280 Fort Sanders West Blvd Suite 20 Knoxville TN 37922 621282917 Physician practice management TN N/A C KASC Acquistion Company 1410 Centerpoint Blvd Suite 401 Knoxville TN 37932 263400984 Real estate holdings TN N/A C Knoxville Heart Group 1819 Clinch Avenue Suite 108 Knoxville TN 37916 271528941 Cardiology medical practice TN N/A C Morristown-Hamblen Health Services Inc 908 W 4th North St Morristown TN 37814 621588521 Inactive - administratively dissolved 02/05/2011 TN N/A C 0 1 1 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1