TY 2011 Form 990

- TIN:

Form990

Department of the Treasury
Internal Revenue Service

Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

The organization may have to use a copy of this return to satisfy state reporting requirements.

OMB No. 1545-0047

2011

Open to Public Inspection

A For the calendar year, or tax year beginning 01-01-2011 and ending 12-31-2011

BCheck if applicable: Address change Name change Initial return Terminated Amended return Application pending

CName of organization
Fort Sanders Regional Medical Center

Doing Business As

Number and street (or P.O. box if mail is not delivered to street address)
1420 Centerpoint Blvd Bldg C

Room/suite

City or town, state or country, and ZIP + 4
Knoxville, TN379321960

D Employer identification number

62-0528340

E Telephone number

G Gross receipts $ 320,071,960

F Name and address of principal officer:
Anthony L Spezia
100 Fort Sanders West Blvd
Knoxville,TN37922

Tax-exempt status: 501(c)(3) 501(c) ( ) LeftBullet

(insert no.) 4947(a)(1) or 527

Website:

www.fsregional.com

H(a)

Is this a group return for
affiliates? Yes No

H(b)

Are all affiliates included?

Yes No

If "No," attach a list. (see instructions)

H(c)

Group exemption number MediumBullet

K Form of organization: Corporation Trust Association Other MediumBullet

L Year of formation: 1954

M State of legal domicile: TN

Part I

Summary

1	Briefly describe the organization’s mission or most significant activities: FSRMC provides quality hospital and other health services in the Knoxville metro area. (see Sch. O)Fort Sanders Regional Medical Center is located in the Fort Sanders community of downtown Knoxville, Tennessee, and is a member of the Covenant Health system. It serves as a regional referral center, where other hospitals send their most difficult cases. Fort Sanders Regional includes a full-service acute care hospital with 517 beds serving many specialty areas, the 24-bed Fort Sanders Transitional Care Unit, the Patricia Neal Rehabilitation Center, and specialized outpatient centers. In early 2011, Fort Sanders Regional opened its Gamma Knife Center, which houses the first advanced system in Tennessee and is one of only 30 in the United States.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	21
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	16
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	2,262
6	Total number of volunteers (estimate if necessary) ....	6	1,765
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	2,587,217
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	270,148

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	633,568	308,604
9	Program service revenue (Part VIII, line 2g) .........	304,282,711	306,053,117
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-49,117	48,688
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	8,291,808	7,552,516
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	313,158,970	313,962,925
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	127,069	149,860
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	96,421,575	96,442,806
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	201,721,142	199,080,085
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	298,269,786	295,672,751
19	Revenue less expenses. Subtract line 18 from line 12.......	14,889,184	18,290,174
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	156,856,678	164,611,848
21	Total liabilities (Part X, line 26).............	44,664,047	34,051,396
22	Net assets or fund balances. Subtract line 21 from line 20.....	112,192,631	130,560,452

Part II

Signature Block

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid preparer use only

Print/type preparer's name

Preparer's signature

Date

Check if
self-employed

PTIN

Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image

Firm's address Right pointing arrowhead image

Phone no.

May the IRS discuss this return with the preparer shown above? See instructions ......... bullet

YesNo

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 11282Y

Form 990 (2011)

Page 2

Part III

Statement of Program Service Accomplishments

Check if Schedule O contains a response to any question in this Part III .........

Briefly describe the organization’s mission: Fort Sanders Regional Medical Center provides quality healthcare, in alignment with Covenant Health's mission to serve the community by improving the quality of life through better health, regardless of the patient's ability to pay.

Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .................... Yes No

If “Yes,” describe these new services on Schedule O.

Did the organization cease conducting, or make significant changes in how it conducts, any program services? .......................... Yes No

If “Yes,” describe these changes on Schedule O.

Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.


4a	(Code: ) (Expenses $ 49,588,027 including grants of $ ) (Revenue $ 51,804,887 )
	Orthopedics, Neurology and Rehabilitation:The Ortho/Neuro/Rehab program at Fort Sanders Regional Medical Center is a comprehensive program of inpatient and outpatient services designed to restore optimal function and independence to individuals who are impaired due to orthopedic or neurological illness or injury. More information is on Schedule O.Orthopedics, Neurology and Rehabilitation: Expenses - $49,588,027; Revenue - $51,804,887.From hip, knee and shoulder replacement to other commonly performed orthopedic procedures like hand, foot and ankle and spine and back surgery, Fort Sanders Regional (FSR) possesses a commitment to service excellence and to improving the patient experience in every way. Its commitment is reflected in the comprehensive care provided orthopedic surgery patients, including: * In-depth education that fully prepares patients for surgery and recovery; * Infection prevention protocols that minimize infection risks; * Experienced, specialized surgeons and operating room teams that use state-of-the-art techniques; * A dedicated inpatient nursing unit staffed by expert nurses and caregivers who know how to help patients recover from orthopedic surgery; and * A wide array of inpatient and outpatient rehabilitation and therapy services to help patients return to an active lifestyle.At the FSR Joint and Spine Center, patients undergoing knee or hip replacement surgeries are not treated as "sick" but as healthy adults undergoing a procedure that will allow them to return to an active life. The goal is to get patients out of bed and moving as quickly as possible. This is accomplished through education, surgical expertise and intense physical therapy. Patients are provided information about joint replacement and are challenged to take the lead in their recovery. Patients go through the program with a family member, who is designated as the patient's "Coach" and is taught how to assist the patient at home.Outpatient rehabilitation services are provided on the hospital campus and at a network of community based outpatient therapy centers. These centers offer a wide variety of therapy services, many of which are unique in the community. They include: * Physical, occupational and speech therapy, * Wound care, * Aquatic therapy, * Lymphedema treatment, * Low-vision and adaptive driving programs, * Certified hand therapy, * Vestibular rehabilitation, and * Functional capacity evaluations.In 2011 the hospital had 10,097 Wound Care Center patient visits and 68,378 Outpatient Physical Therapy visits.Conditions and diseases of the brain, spinal cord and nervous system can affect how people walk, talk, comprehend and function. FSR's neurologists specialize in the diagnosis and treatment of epilepsy, tumors, stroke, Alzheimer's disease, dementia, Parkinson's disease and multiple sclerosis. As a Neuro-Spine Center of Excellence, FSR has made the commitment to offer the latest advancements in neurology, neurosurgery, spine surgery, and neuro-interventional radiology. Whether a patient needs medical, surgical or neuro-radiological intervention, the goal is to provide the most appropriate care to optimize patient outcome. In 2011 there were 383 interventional neuro-radiology cases - made up of 203 aneurysm coilings, 170 IVC filter placements, and 10 stroke treatments.At the Fort Sanders Sleep Disorders Center, the area's first accredited sleep center, neurologists work with patients who suffer from a host of sleep/wake disorders including sleep apnea, insomnia, narcolepsy, and restless leg syndrome. The Center saw 685 patients in 2011.Fort Sanders' neurosurgeons provide surgical intervention for brain tumors, aneurysms and hemorrhages, as well as a host of spine conditions. They also provide surgical relief for issues caused by nerve and muscle diseases, carpal tunnel syndrome, chronic back pain and conditions resistant to medical management, like Parkinson's disease.An example of the hospital's commitment to state-of-the-art technology is the StealthStation Treon, which helps guide Fort Sanders neurosurgeons through a variety of operations, including neurological and spinal procedures. This innovative 3D-imaging system uses global positioning technology to give physicians real time views inside the body, without radiation. This innovative technology allows less invasive operations and helps avoid brain and nerve damage.Strokes are the third leading cause of death in the United States and affect more than 795,000 Americans each year. As a Stroke Center of Excellence, the care provided by FSR and Patricia Neal Rehabilitation Center physicians and staff utilizes state-of-the-art diagnostic, treatment and rehabilitation modalities. The hospital holds a Primary Stroke Center certification from the Joint Commission (one of only a handful in the state of Tennessee) as well three separate stroke accreditations from the Commission on the Accreditation of Rehabilitation Facilities (CARF). In 2011 the hospital's Core Measure compliance related to strokes was 99.37%, and it had 358 stroke patient admissions.FSR was the first facility in the area to combine CT and bi-plane angiography with a full-time neuro-interventional radiologist to provide our region with new, minimally-invasive options for treating stroke, aneurysms, and other vascular diseases in the brain. With this system, neuro-interventional radiology procedures can be performed that would have previously required surgery and an extended hospital stay or would not have been options for some patients.Bi-plane technology improves imaging and resolution creating comprehensive 3D views of the blood vessels in the brain. Having a more precise picture of an abnormality makes it easier to diagnose and repair. A team of specialized technologists and nurses work to assist the performing radiologist with each procedure. All technologists are certified by the American Association of Radiological Technologists. Micro-catheters are inserted through the groin and then guided to the area of treatment to administer medications, coil aneurysms or retrieve clots. These new procedures often involve very short hospital stays, all while keeping radiation exposure to a safe minimum and avoiding major surgery.The Patricia Neal Rehabilitation Center is East Tennessee's recognized leader in helping stroke, spinal cord, brain injury, orthopedic and cancer patients rebuild their lives through the delivery of optimal rehabilitation services. Opened in 1978 as an integral part of the Ortho/Neuro/Rehab program at FSR, the PNRC offers a comprehensive team approach to care. Physical, occupational, recreational, behavioral medicine and speech language therapists work with nurses and physiatrists - doctors whose specialty is physical medicine and rehabilitation. This team develops the best individual care plan to return patients to their recovery potential as quickly as possible. Rehabilitation nurses and other specialists also educate patients, teaching them self-care skills to function as well as possible upon returning home. The Center holds 15 separate accreditations from the Commission on the Accreditation of Rehabilitation Facilities (CARF) and provides a comprehensive array of inpatient rehabilitation services that would otherwise be unavailable in the community. FSR is committed to maintaining access to unique services such as those at the Patricia Neal Rehabilitation Center. Through donations and other community support, the hospital, through the Fort Sanders Foundation, provides scholarships to allow patients with limited resources access to the rehab center's services.The Patricia Neal Innovative Recreation Cooperative (IRC), a service of the PNRC, was created in 1994 to meet the needs of individuals who have suffered a life-changing illness or injury. The program was designed to be part of the continuum of care in the rehabilitation process. Its scope is to host clinics under an umbrella of education and awareness: education to teach leisure skills to enhance quality of life in a safe environment and awareness to heighten the understanding of disabilities to the community. In its existence, the IRC has seen over 7,000 participants and volunteers. The goal is to remove all the barriers to develop each individual's right to self-directed leisure for a healthier lifestyle. This program is supported by community donations, grants and a hospital subsidy.Older adults are a significant portion of the patient population in Ortho/Neuro/Rehab. FSR is a NICHE (Nurses Improving Care for Health System Elders) site committed to special health care for older adults and was the first NICHE-certified facility in the East Tennessee region. Care is provided to help prevent complications such as skin breakdowns, falls/ injuries, pain, acute confusion, and the loss of strength and mobility.

4b	(Code: ) (Expenses $ 41,884,412 including grants of $ ) (Revenue $ 42,654,056 )
	Surgical Services: Quality of care and patient safety are the top priorities at Fort Sanders Regional. The quality of care at Fort Sanders Regional has been recognized by the Joint Commission that inspects hospitals, the US Department of Health and leading independent standards associations. The focus in the surgical area is to reduce the risk of wound infection after surgery. This is achieved primarily by making sure our patients get the right medicines at the right time on the day of surgery. Success in preventing infection is measured by core measures which are compared to the national and state average. Fort Sanders Regional's core measures rank above both state and national averages on all measures. More information is on Schedule O.Surgical Services: Expenses: $41,884,412 Revenue: $42,654,056Fort Sanders Regional ("FSR") has the capability to provide extensive surgical procedures for patients in East Tennessee. The surgery program offers patients numerous options, utilizing the latest surgical technology available in addition to traditional surgical options such as advanced laparoscopy and day surgery procedures. Over 9,800 surgeries were performed at FSR in 2011.As an adjunct to its goal to provide an array of minimally invasive surgical procedures, FSR introduced the da Vinci Robotics system to East Tennessee in December 2004. Since that time, the hospital has used the system to perform: * More than 350 prostatectomies, * The first robotically-assisted lung removal surgery in the state, * One of the first robotically-assisted gynecological procedures in the area and, most recently, * The first cardiac single valve replacement in the region.Through robotics technology, surgeons are given greater precision and control. The surgeon's hand and finger movements are replicated by a computer through tiny incisions. The small incisions mean less pain, a shorter hospital stay and a quicker recovery for patients. For cardiac patients, the use of the robotics system can prevent the need to crack open the patient's sternum, again reducing recovery times and complications.In addition to robotics technology, FSR surgeons perform numerous procedures using a laparoscope. Laparoscopic surgery has become the procedure of choice for many patients and surgeons in the East Tennessee area because it offers less scarring, less pain and a more rapid recovery. A laparoscope is a narrow, tube-like instrument with a camera and light on the tip. The camera is connected to a television screen, giving surgeons a magnified view of the treatment area. The laparoscope is designed to allow physicians to see tissue and organs inside the abdominal cavity without fully opening it with a surgical incision. For most procedures, the scope is inserted either through the abdominal wall or navel. Long surgical instruments are inserted through the scope to repair medical problems. Most laparoscopic surgeries are performed on an outpatient basis, with patients hospitalized less than 24 hours. Recovery time is greatly minimized with most patients returning to work in just three to five days.FSR supports surgical procedures in multiple specialty areas: * Cardiothoracic Surgery * Cardiovascular Surgery * Colon/Rectal Surgery * Day Surgery * General Surgery * Neurosurgery * Orthopedic Surgery * Plastic Surgery * Surgical Oncology * Thoracic Surgery * Vascular SurgeryFSR is particularly strong in three of these areas: cardiovascular surgery, vascular surgery, and surgical oncology.The cardiovascular surgery program includes surgical procedures to correct abnormalities within the heart and/or great vessels. Some of the more common procedures are coronary artery bypass, valve repair or replacement, correction of congenital heart defects and repair of aortic aneurysms. As part of the facility's Cardiology Center of Excellence, FSR is the only facility in the region to have both a surgical and catheter based approach to treating atrial fibrillation. The hospital had 844 cardiac surgery cases in 2011.Vascular surgery is the branch of surgery that involves the repair of arteries and veins, as well as treatments for diseases of the peripheral vascular system. Common procedures performed by vascular surgeons include: abdominal aortic aneurysm repair, varicose veins, stenting of peripheral vessels, and more. The hospital had 810 vascular surgery cases in 2011.Surgical oncology is the branch of surgery which focuses on the surgical management of cancer. The medical staff at FSR includes general surgical oncologists as well as thoracic surgical oncologists, gynecologic oncologists and other sub-specialists that specialize in treating cancer patients.

4c	(Code: ) (Expenses $ 28,463,963 including grants of $ ) (Revenue $ 40,851,967 )
	Oncology Services: Fort Sanders Regional Medical Center features extensive inpatient and outpatient oncology care provided by exceptional oncologists who practice throughout the Knoxville area. In 2011 there were 203 surgical oncology cases; 1,492 admissions to the oncology unit with 8,870 patient days; and 18,732 infusions performed in the infusion centers. More information is on Schedule O.Oncology Services: Expenses - $28,463,963; Revenue - $40,851,967.The Oncology Center of Excellence at Fort Sanders Regional ("FSR") offers a comprehensive approach to patient care which minimizes patient disruption and maximizes clinical quality and efficiency. Cancer patients and their families can be assured their loved ones will receive the most complete and exceptional oncology care available. In FSR's specialized oncology unit, all staff team members receive specialized oncology education. Chemotherapy-trained nurses work with oncologists to make sure each patient receives the correct chemotherapy drug, in the right dosage cycle, every time. Within the Oncology Center of Excellence, many nurses are also oncology certified at a national level. They have dedicated more than 1,000 hours caring for cancer patients and have successfully completed a national certification examination demonstrating their specialized knowledge in this field. Staff attends special lectures and conferences hosted by local and national medical oncologists and radiation oncologists to keep up with the newest innovative treatments available.FSR's emphasis on oncology knowledge and expertise is not limited to nurses. Each staff member on the oncology unit is also uniquely trained in the care of cancer patients. The oncology team includes a dedicated oncologic pharmacist, dietitian, social worker, and RN case manager. This team communicates regularly to ensure excellent patient care from admission to discharge. From our dietitians, to our pharmacists and radiologists, to our housekeeping staff, we have strived to provide oncology education to every employee who may come in contact with our patients. By completing this 360-degree education we provide better patient care. Safety is the number one priority in the Oncology Center of Excellence. Due to the nature and potency of the medications used in this area, strict safety processes are performed by doctors, pharmacists and certified nurses who work as a team to double and triple check these medications for accuracy. The Oncology Center of Excellence at FSR holds the prestigious Certificate of Approval from the Commission on Cancer. The Commission on Cancer Certification is awarded only to facilities with oncology programs committed to providing the best comprehensive cancer care. The Oncology Nursing Unit also serves as the inpatient component of the Stem Cell Center which is based at the Thompson Cancer Survival Center, another Covenant Health entity. This Stem Cell treatment center in conjunction with our Oncology Nursing Unit has accomplished accreditation by the Foundation of Accreditation for Cellular Therapy, also known as FACT.Surgical oncology is the branch of surgery which focuses on the surgical management of cancer. The Medical Staff at FSR includes general surgical oncologists as well as thoracic surgical oncologists, gynecologic oncologists and other sub-specialists that specialize in treating cancer patients.Outcomes in surgical cancer care are positively associated with surgeon volume -- i.e. the more cancer cases a surgeon treats, the more proficient he or she becomes, thus improving overall outcomes and survival rates.Due to the close proximity of FSR to Thompson Cancer Survival Center ("TCSC"), the surgeons and staff at FSR work closely with TCSC's multidisciplinary treatment teams in the collaboration of care and treatment plans for patients with chest and breast cancer. A team of cancer specialists in differing areas of expertise, including surgeons, gather and evaluate each patient's case to determine possible treatment options. Each specialist then meets individually with the patient to review treatment choices and answer questions. As part of outpatient Oncology care, FSR operates four outpatient Infusion Centers in the area, providing chemotherapy for cancer patients.FSR, through the Patricia Neal Rehabilitation Center ("PNRC") is the only facility in East Tennessee, and one of a handful in the country, that offers a cancer rehabilitation program.The cancer program combines many of the rehabilitation techniques currently used for patients with brain and spinal cord injuries and strokes because the impairments cancer patients experience can be very similar to those of traumatic injuries. The health-care team includes: * Each patient's personal physician * Medical, radiation and surgical oncologists * Physiatrists - doctors whose specialty is physical medicine and rehabilitation * Rehabilitation nurses * Physical, occupational and recreational therapists * Psychologists * Speech language pathologists * Pharmacists * Dietitians * Case managers At PNRC, the cancer rehab team creates a special care plan for each patient. Our goal is to help patients regain as much ability and independence as possible.We treat many of the impairments that can result from cancer, cancer surgery, radiation therapy, chemotherapy and other treatments, such as: * Fatigue * Muscle wasting * Weakness * Pain * Skin breakdown * Impaired mobility * Anxiety * Depression * Overall deconditioning * Lymphedema (swelling) * Weight loss * Communication difficulty * Impaired thinking or memory loss PNRC has a positive, encouraging atmosphere. Known for outstanding resources, from a rooftop therapy park to a computer life-skills lab, PNRC also offers: * Fully-equipped therapy gyms * Special adaptive equipment programs * Animal therapy * Support groups * Community outings * Family and caregiver training * Tools to improve communication * Adaptive driving * Balance programs * An adaptive living apartment to ease the transition back to everyday life

	(Code: ) (Expenses $ 169,685,189 including grants of $ 149,860 ) (Revenue $ 170,870,448 )
	As a full-service acute care hospital and regional referral center, Fort Sanders Regional Medical Center treats patients across a broad spectrum of medical specialties in addition to those highlighted above.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 169,685,189 including grants of $ 149,860 ) (Revenue $ 170,870,448 )
4e	Total program service expenses$ 289,621,591

Form 990 (2011)

Page 3

Part IV

Checklist of Required Schedules

Yes

Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule A Click to see attachment

.....................

Yes

Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment

........

Yes

Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........

Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................

Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................

Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part I Click to see attachment

....................

Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part II Click to see attachment

...

Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment

....................

Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV Click to see attachment

...................

Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part V Click to see attachment

Yes

If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:

Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI. Click to see attachment

11a

Yes

Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII. Click to see attachment

11b

Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII. Click to see attachment

11c

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX. Click to see attachment

11d

Yes

Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X. Click to see attachment

11e

Yes

Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X. Click to see attachment

11f

Yes

12a

Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment

12a

Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment

12b

Yes

Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E

14a

Did the organization maintain an office, employees, or agents outside of the United States?....

14a

Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........

14b

Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..

Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..

Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I

Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........

Yes

Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................

20a

Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment

20a

Yes

If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see attachment

20b

Yes

Form 990 (2011)

Page 4

Part IV

Checklist of Required Schedules (continued)

Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment

Yes

Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment

Yes

Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment

Yes

24a

Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................

24a

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...

24b

Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................

24c

Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...

24d

25a

Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......

25a

Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................

25b

Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.........................

Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........

Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):

A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................

28a

A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................

28b

An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..

28c

Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M

Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............

Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................

Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment

Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment

Yes

35a

Did the organization have a controlled entity within the meaning of section 512(b)(13)?

35a

Yes

If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment

35b

Yes

Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment

Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VI Click to see attachment

Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............

Yes

Form 990 (2011)

Page 5

Part V

Statements Regarding Other IRS Filings and Tax Compliance

Check if Schedule O contains a response to any question in this Part V .........

Yes

Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......

278

Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.

Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................

Yes

Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................

2,262

If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)

Yes

Did the organization have unrelated business gross income of $1,000 or more during the year?.............................

Yes

If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....

Yes

At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................

If "Yes," enter the name of the foreign country: MediumBullet

See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.

Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..

Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........

Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........

If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................

Organizations that may receive deductible contributions under section 170(c).

Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................

If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....

Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................

If “Yes,” indicate the number of Forms 8282 filed during the year ....

Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................

Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..

If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................

If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............

Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................

Sponsoring organizations maintaining donor advised funds.

Did the organization make any taxable distributions under section 4966?.........

Did the organization make a distribution to a donor, donor advisor, or related person?......

Section 501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on Part VIII, line 12 ...

10a

Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities

10b

Section 501(c)(12) organizations. Enter:

Gross income from members or shareholders .........

11a

Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........

11b

12a

Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?

12a

If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.

12b

Section 501(c)(29) qualified nonprofit health insurance issuers.

Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.

13a

Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.

13b

Enter the aggregate amount of reserves on hand.

13c

14a

Did the organization receive any payments for indoor tanning services during the tax year?.....

14a

If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..

14b

Form 990 (2011)

Page 6

Part VI

Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.

Check if Schedule O contains a response to any question in this Part VI .........

Section A. Governing Body and Management

Yes

Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.

Enter the number of voting members included in line 1a, above, who are independent .................

Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................

Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .

Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?

Did the organization become aware during the year of a significant diversion of the organization’s assets? .

Did the organization have members or stockholders? ................

Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................

Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............

Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

The governing body? .........................

Yes

Each committee with authority to act on behalf of the governing body? ..........

Yes

Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....

Yes

Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)

Yes

10a

Did the organization have local chapters, branches, or affiliates? ............

10a

If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....

10b

11a

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?

11a

Yes

Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....

12a

Did the organization have a written conflict of interest policy? If “No,” go to line 13.......

12a

Yes

Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................

12b

Yes

Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................

12c

Yes

Did the organization have a written whistleblower policy? ...............

Yes

Did the organization have a written document retention and destruction policy? .........

Yes

Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?

The organization’s CEO, Executive Director, or top management official ...........

15a

Yes

Other officers or key employees of the organization ................

15b

Yes

If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).

16a

Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................

16a

If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............

16b

Section C. Disclosure

List the States with which a copy of this Form 990 is required to be filed MediumBullet

Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.

Own website Another's website Upon request

Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.

State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet

Nancy Beck
1420 Centerpoint Blvd Bldg C
Knoxville,TN379321985
(865) 374-6864

Form 990 (2011)

Page 7

Part VII

Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors

Check if Schedule O contains a response to any question in this Part VII .........

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet

List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

List all of the organization’s current key employees, if any. See instructions for definition of "key employee."

List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.

Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) Anthony L Spezia President & CEO	0.00	X	X	0	2,492,642	25,707
(2) Dr Richard Brinner Director	0.00	X		0	0	0
(3) Dr Mitchell Dickson Director	0.00	X		0	1,184	0
(4) Pamela P Fansler Director	0.00	X		0	0	0
(5) Homer Fisher Director	0.00	X		0	0	0
(6) James Fitzsimmons Director	0.00	X		0	1,192	0
(7) Dr William Hall Director	0.00	X		0	1,579	0
(8) Wayne Heatherly Director	0.00	X		0	747	0
(9) Jim Johnson Jr Director	0.00	X		0	1,184	0
(10) Karla Lane Director	0.00	X		0	0	0
(11) Eddie Mannis Director	0.00	X		0	0	0
(12) Larry Mauldin Chairman	0.00	X		0	2,832	0
(13) Dr Joseph Metcalf Director	0.00	X		0	0	0
(14) George Miller Director	0.00	X		0	0	0
(15) Alvin Nance Director	0.00	X		0	1,235	0
(16) Linda Ogle Director	0.00	X		0	0	0
(17) Francis H Olmstead Jr Director	0.00	X		0	0	0

Form 990 (2011)

Page 8

Part VII

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)				(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Mitchell Steenrod Director	0.00	X				0	1,184	0
(19) Carl Storms Director	0.00	X				0	769	0
(20) Joseph E Sutter Director	0.00	X				0	1,273	0
(21) Richard Swanson Director	0.00	X				0	0	0
(22) Joe Ben Turner Director	0.00	X				0	1,192	0
(23) David C Verble Director	0.00	X				0	1,251	0
(24) John T Geppi EVP/CFO	0.00		X			0	705,467	29,048
(25) Keith Altshuler Pres. & CAO - FSRMC	44.00		X			0	325,970	29,477
(26) Ronnie Beeler VP-Financial Services	36.50		X			84,607	0	9,771
(27) Jennifer L Hanson VP-Chief Nursing Officer	45.00			X		212,710	0	8,285
(28) Mary E Dillon Medical Director	40.00				X	163,065	0	4,416
(29) Christopher Norris Pharmacy Director	40.00				X	140,041	0	25,020
(30) Marianne Oliveira Sr. Instructor - Nursing School	40.00				X	136,988	0	20,849
(31) Gary Bush Director of Surgery	40.00				X	129,929	0	12,239
(32) Nancy Granger Pharmacy Manager	40.00				X	128,740	0	25,458

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	996,080	3,539,701	190,270

Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet

Yes

Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............

For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................

Yes

Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....

Section B. Independent Contractors

Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.

(A) Name and business address	(B) Description of services	(C) Compensation
GE Healthcare PO Box 402076 Atlanta,GA303842076	Service Contracts/ Equipment Maintenance	3,249,135
Medic Regional Blood Center 1601 Ailor Avenue Knoxville,TN37921	Blood Processing	1,779,934
Brasfield & Gorrie LLC 2636 Elm Hill Pike Nashville,TN37214	Construction Mgmt	1,617,801
Angelica Textile Services Inc PO Box 535122 Atlanta,GA30353	Linen Service	1,342,265
Covenant Medical Management 280 Fort Sanders West Blvd Ste 205 Knoxville,TN37922	Physician Services	1,250,946
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 34

Form 990 (2011)

Page 9

Part VIII

Statement of Revenue

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		175,878
e	Government grants (contributions)1e		132,726

f	All other contributions, gifts, grants, and similar amounts not included above1f
g	Noncash contributions included in lines 1a-1f:$ 1,075
h	Total. Add lines 1a-1f.......			308,604
			Business Code
2a	Medical Services		622,110	303,246,753	303,246,753
b	Laboratory		621,500	1,811,339		1,811,339
c	Rental Inc - Affiliate		531,120	995,025	995,025
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			306,053,117
3	Investment income (including dividends, interest
	and other similar amounts).....			64,034			64,034
4	Income from investment of tax-exempt bond proceeds..			403	403
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross rents	3,374,604	5,732
b	Less: rental expenses	5,957,627	2,953
c	Rental income or (loss)	-2,583,023	2,779
d	Net rental income or (loss).......			-2,580,244		2,779	-2,583,023
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		9,600
b	Less: cost or other basis and sales expenses		25,349
c	Gain or (loss)		-15,749
d	Net gain or (loss)..........			-15,749			-15,749
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a		152,811
b	Less: direct expenses ...b		123,106
c	Net income or (loss) from fundraising events..			29,705			29,705
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a	Pharmacy		900,099	3,877,664			3,877,664
b	Cafeteria		722,212	2,679,057			2,679,057
c	Maintenance		811,000	885,022	854,456		30,566
d	All other revenue ....			2,661,312	1,084,721	773,099	803,492
e	Total. Add lines 11a–11d ......			10,103,055
12	Total revenue. See Instructions....			313,962,925	306,181,358	2,587,217	4,885,746

Form 990 (2011)

Page 10

Part IX

Statement of Functional Expenses

Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.		(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	113,316	113,316
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	36,544	36,544
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	315,373		315,373
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	78,139,477	77,010,972	1,128,505
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,456,209	2,430,464	25,745
9	Other employee benefits .......	9,837,180	9,730,381	106,799
10	Payroll taxes ...........	5,694,567	5,625,788	68,779
11	Fees for services (non-employees):
a	Management ......	19,199,052	18,808,162	390,890
b	Legal .........	134,708	1,131	133,577
c	Accounting ...........	33,691		33,691
d	Lobbying ...........
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......
g	Other ..........	20,363,329	19,595,745	767,584
12	Advertising and promotion ....	728,476	245,758	482,718
13	Office expenses .......	3,205,468	2,602,187	603,281
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	5,870,026	4,503,082	1,366,944
17	Travel ............	85,436	83,205	2,231
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	322,237	192,589	129,648
20	Interest ...........	446,524	446,524
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	12,422,370	12,422,370
23	Insurance ..............	835,792	819,613	16,179
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a	Unrelated Business Inco	-2,480		-2,480
b	Supplies and Equipment	90,561,189	90,505,420	55,769
c	Charity Care	26,396,492	26,396,492
d	Bad Debts	11,524,807	11,524,807
e
f	All other expenses	6,952,968	6,527,041	425,927
25	Total functional expenses. Add lines 1 through 24f	295,672,751	289,621,591	6,051,160	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Form 990 (2011)

Page 11


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			3,839	1	5,380
2	Savings and temporary cash investments .......			-2,010,391	2	-1,131,729
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			26,319,193	4	24,498,510
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............			44,555	7	44,555
8	Inventories for sale or use ..............			6,695,999	8	7,201,110
9	Prepaid expenses and deferred charges ............			534,865	9	581,288
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	354,010,557
b	Less: accumulated depreciation. .....	10b	235,846,549	121,926,998	10c	118,164,008
11	Investments—publicly traded securities ..........				11
12	Investments—other securities. See Part IV, line 11 ......				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			3,341,620	15	15,248,726
16	Total assets. Add lines 1 through 15 (must equal line 34)...			156,856,678	16	164,611,848
17	Accounts payable and accrued expenses .			22,491,125	17	21,690,427
18	Grants payable ..........				18
19	Deferred revenue ..........			563,664	19	300,599
20	Tax-exempt bond liabilities ..........			9,044,795	20	7,420,361
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			140,137	23	98,486
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....			12,424,326	25	4,541,523
26	Total liabilities. Add lines 17 through 25.....			44,664,047	26	34,051,396
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			112,192,631	27	130,560,452
28	Temporarily restricted net assets .....				28
29	Permanently restricted net assets .....				29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			112,192,631	33	130,560,452
34	Total liabilities and net assets/fund balances .....			156,856,678	34	164,611,848

Form 990 (2011)

Page 12

Part XI

Reconcilliation of Net Assets

Check if Schedule O contains a response to any question in this Part XI .........

Total revenue (must equal Part VIII, column (A), line 12) ...

313,962,925

Total expenses (must equal Part IX, column (A), line 25) ....

295,672,751

Revenue less expenses. Subtract line 2 from line 1 ...

18,290,174

Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..

112,192,631

Other changes in net assets or fund balances (explain in Schedule O) ...

77,647

Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....

130,560,452

Part XII

Financial Statements and Reporting

Check if Schedule O contains a response to any question in this Part XII .........

Yes

Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.

Were the organization’s financial statements compiled or reviewed by an independent accountant?....

Were the organization’s financial statements audited by an independent accountant?........

Yes

If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................

Yes

If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separated basis

As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................

Yes

If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..

Yes

Form 990 (2011)

Additional Data

Software ID:
Software Version:

Form 990, Special Condition Description:

Special Condition Description

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

Fort Sanders Regional Medical Center

Employer identification number

62-0528340

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2011

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2011. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2010. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2011

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2010 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2010 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2011. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2011

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2011

Name of organization

Fort Sanders Regional Medical Center

Employer identification number

62-0528340

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2

Name of organization Fort Sanders Regional Medical Center
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part I	Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3

Name of organization Fort Sanders Regional Medical Center
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part II	Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization
Fort Sanders Regional Medical Center

Employer identification number

62-0528340

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

Fort Sanders Regional Medical Center

Employer identification number

62-0528340

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2011

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back	(d)Three Years Back
1a	Beginning of year balance ....	103,913	65,000	25,000	25,000
b	Contributions ........	9,896	38,913	40,000
c	Net investment earnings, gains, and losses ...	4,390	4,233	567	999
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	4,390	4,233	567	999
f	Administrative expenses ....
g	End of year balance ......	113,809	103,913	65,000	25,000

Provide the estimated percentage of the year end balance (line 1g) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

0 %

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	100,345	7,271,989		7,372,334
b	Buildings ................	81,067,129	89,376,809	87,325,041	83,118,897
c	Leasehold improvements ............		2,530,246	1,079,227	1,451,019
d	Equipment ................		172,548,297	146,520,095	26,028,202
e	Other .................		1,115,742	922,186	193,556
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......					118,164,008

Schedule D (Form 990) 2011

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) Assets Limited as to Use				1,847,181
(2) Bond Issuance Costs, Net				27,057
(3) Deferred Compensation				897,579
(4) Due from Affiliates, Net				11,707,013
(5) Miscellaneous Non-Affiliate Receivables				655,262
(6) Rental Income Receivable				114,634



Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				15,248,726

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Book value
Federal Income Taxes
Due to Third Party Payors		2,295,545
Long-term Deferred Compensation		210,143
Long-term Reserve for Workers Comp		2,035,835






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		4,541,523
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2011

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3
4	Net unrealized gains (losses) on investments ..........................	4
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV.) .................................	8
9	Total adjustments (net). Add lines 4 through 8 .........................	9
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
Description of Intended Use of Endowment Funds:	Part V, Line 4:	Fort Sanders Foundation mantains two permanent endowments for the purpose of providing a permanent source of income for the following programs at Fort Sanders Regional Medical Center: The Pastoral Care Fund and the Caroline Can! Fund. The principal of the endowments will be kept intact in perpetuity. Only the income generated will be distributed to FSRMC to provide support for the aforementioned programs.
Description of Uncertain Tax Positions Under FIN 48:	Part X:	Note G to the consolidated audited financial statements of Covenant Health, the parent company of Fort Sanders Regional Medical Center, 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.

Schedule D (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization
Fort Sanders Regional Medical Center

Employer identification number

62-0528340

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and e-mail solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.

(i) Name and address of individual or entity (fundraiser)	(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
	(ii) Activity	Yes	No	(iv) Gross receipts from activity		(vi) Amount paid to (or retained by) organization
Total .................

List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2011

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.

		(a) Event #1 Uniform Sales (event type)	(b) Event #2 Jewelry Sales (event type)	(c) Other Events 2 (total number)	(d) Total Events (Add col. (a) through col. (c))
1	Gross receipts . . .	116,374	12,913	23,524	152,811
2	Less: Charitable contributions . . .
3	Gross income (line 1 minus line 2) . . .	116,374	12,913	23,524	152,811
4	Cash prizes . . .
5	Non-cash prizes . .
6	Rent/facility costs . .
7	Food and beverages . .
8	Entertainment . . .
9	Other direct expenses .	92,306	10,549	20,251	123,106
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........				123,106
11	Net income summary. Combine lines 3 and 10 in column (d)............				29,705

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (Add col. (a) through col. (c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes
	No

	Yes
	No

	Yes
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," Explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," Explain:

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ..........................

YesNo

Schedule G (Form 990 or 990-EZ) 2011

Page 3

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Provide the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)

Identifier	ReturnReference	Explanation

Schedule G (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

Fort Sanders Regional Medical Center

Employer identification number

62-0528340

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the

following was the family income limit for eligibility for discounted care: ............

Yes

200% 250% 300% 350% 400% Other

If the organization did not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............

Did the organization prepare a community benefit report during the tax year?...........

Yes

If "Yes," did the organization make it available to the public? ...............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Financial Assistance at cost (from Worksheet 1) ..	17,924,827	5,873,295	12,051,532	4.240 %
b Medicaid (from Worksheet 3, column a) .....	56,654,720	38,234,658	18,420,062	6.480 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .	1,724,089	577,379	1,146,710	0.400 %
dTotal Financial Assistance and Means-Tested Government Programs .....	76,303,636	44,685,332	31,618,304	11.120 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	101,254	17,742	83,512	0.030 %
f Health professions education (from Worksheet 5) ..	78,881	15,689	63,192	0.020 %
g Subsidized health services (from Worksheet 6) ..	15,256,325	10,550,449	4,705,876	1.660 %
h Research (from Worksheet 7)
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....	157,173		157,173	0.060 %
jTotal Other Benefits ...	15,593,633	10,583,880	5,009,753	1.770 %
kTotal. Add lines 7d and 7j. ..	91,897,269	55,269,212	36,628,057	12.890 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011

Schedule H (Form 990) 2011

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	14,422	14,422	0.010 %
2	Economic development
3	Community support	38,478	38,478	0.010 %
4	Environmental improvements
5	Leadership development and training for community members	1,491	1,491	0 %
6	Coalition building
7	Community health improvement advocacy	3,579	3,579	0 %
8	Workforce development
9	Other
10	Total	57,970	57,970	0.020 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense........

11,524,808

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....

5,047,866

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

73,818,990

Enter Medicare allowable costs of care relating to payments on line 5.....

65,531,705

Subtract line 6 from line 5. This is the surplus or (shortfall)........

8,287,285

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures

(see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
11 NONE
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2011

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
1	Fort Sanders Regional Medical Center 1901 Clinch Avenue Knoxville,TN37916	X	X	X	X

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Fort Sanders Regional Medical Center

Name of Hospital Facility:

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet the community health needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. ....		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........		9	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000% If "No," explain in Part VI the criteria the hospital facility used.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........		16		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18	Yes
	If “No,” indicate why:
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility’s policy was not in writing
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19	Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
	a	The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
	b	The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
	c	The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?...............................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?19
Name and address		Type of Facility (describe)
1	FSR Infusion Services TCSC 1915 White Avenue Knoxville,TN37916	Pharmacy - Infusion Services
2	FSR Infusion Services Oak Ridge 200 New York Avenue Suite 230 Oak Ridge,TN37830	Pharmacy - Infusion Services
3	Thompson Infusion Center 215 BMH Cancer Center Drive Maryville,TN37804	Pharmacy - Infusion Services
4	Fort Sanders Regional MRI Dept 1915 White Avenue Knoxville,TN37916	Magnetic Resonance Imaging (Diagnostics)
5	Patricia Neal Rehabilitation Center 1901 Clinch Avenue Knoxville,TN37916	Rehabilitation Unit
6	Fort Sanders Wound Care Center 2001 Laurel Avenue Suite G-6 Knoxville,TN37916	Wound Care
7	FSR Infusion Services Lenoir City 576 Fort Loudoun Med Ctr Dr Ste 204 Lenoir City,TN37772	Pharmacy - Infusion Services
8	Fort Sanders West Diagnostic Center MOB-3 Ste 210 Ft Sanders West Blvd Knoxville,TN37922	Diagnostic Center
9	Fort Sanders Regional Infusion Svcs 1901 Clinch Avenue Knoxville,TN37916	Pharmacy - Infusion Services
10	FSR Gamma Knife Center 1915 White Avenue 1st Floor Knoxville,TN37916	Gamma Knife Center
11	FSRMC Transitional Care Unit 1901 Clinch Avenue Knoxville,TN37916	Skilled Nursing Facility
12	FS Neurodiagnostics & Sleep Center Ft Sanders POB Ste 303 501 20th St Knoxville,TN37916	Neurodiagnostics and Sleep Center
13	Fort Sanders Regional Breast Center 1915 White Avenue Knoxville,TN37916	Breast Center (Diagnostics)
14	Fort Sanders Regional Laser Center 1915 White Avenue Knoxville,TN37916	Center for Barrett's Esophagus
15	FSR Therapy Center - Downtown 2001 Laurel Avenue Ste 504 Knoxville,TN37916	Physical Rehabilitation Therapy Center
16	Diabetes Center Outreach Program MOB-2 Ste 205 220 FSW Blvd Knoxville,TN37922	Diabetes Center
17	FSR Cardiopulmonary Rehab Ft Sanders POB Ste 301 501 20th St Knoxville,TN37916	Cardiopulmonary Rehab Therapy Center
18	FSR Therapy Center - Halls 6679 Maynardville Hwy Knoxville,TN37918	Physical Rehabilitation Therapy Center
19	FSR Therapy Center - Powell 3515 Emory Road Suite P-9 Powell,TN37849	Physical Rehabilitation Therapy Center

Schedule H (Form 990) 2011

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
		Part I, Line 6a: Covenant Health, the parent company of Fort Sanders Regional Medical Center and other affiliated acute care hospitals, prepares an annual Report to the Community on behalf of the entire system.
		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 cost from the general ledger.
		Part I, Line 7g: The organization has included $1,033,871 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 $ 11524808.
		Part II: Fort Sanders Regional Medical Center cares for the whole person and recognizes that improved social and economic conditions may lead to the improved health and well-being of the community. The hospital's community building activities and those of its parent organization, Covenant Health, address many of the root causes of health problems, such as poverty and homelessness due to lack of education and jobs.Fort Sanders Regional supports the community building activities of its parent company. 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. Contributions made in 2011 were made to or designated for: Children's group homes Temporary housing for the homeless Low-income housing projects Community support organizations Youth mentoring programs After-school programs Early childhood literacy projects Community leadership training Advocacy for health care improvements
		Part III, Line 4: Note B to the 2011 Audited Consolidated Financial Statements of the Covenant Health system, of which Fort Sanders Regional 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 allowance represents the difference between established billing rates and estimated reimbursement from Medicare, TennCare and other third-party payment programs. Operations for 2011 and 2010 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 on Part III, Line 2 is the amount recorded in the organization's financial statements. In 2011, the hospital reviewed all self-pay accounts receivable to identify patients who might have qualified for financial assistance. As of year end, the hospital could not make a final determination as to their qualification for financial assistance due to all information not yet being received but felt strongly that the patient was in need of some form of assistance. Notes in the patient record were examined to see if a charity care application had been sent to the patient or guarantor or if the account was being analyzed by a business office employee for approval for charity care. The percentage of patient accounts being analyzed as a percent of total self-pay accounts receivable has been applied to the current year total bad debt expense on Line 2 to arrive at the amount reported on Line 3.
		Part III, Line 8: Costing Methodology: Fort Sanders Regional Medical Center used a combination of sources in calculating Medicare allowable costs on Part III, Line 6 including its cost accounting system, general ledger accounting system, and facility-specific analyses and calculations.
		Part III, Line 9b: Self-pay patients automatically receive a minimum 47% discount on charges. Federal poverty guidelines are utilized in the determination of charity care eligibility. Patients who are unable to pay and have exhausted all sources of payment assistance may qualify for charity care. A sliding scale is used for extending charity care utilizing the income levels reported under the federal poverty guidelines. Patients/ guarantors with income that falls below 200% of the federal poverty guidelines receive 100% charity care. Patients/guarantors with income of 201-300% of the federal poverty guidelines receive 70% charity care.For catastrophic illness, exceptions to income and asset limitations may be made on a case-by-case basis. The amount considered for charity will be based upon the evaluation of the patient's/guarantor's ability to pay.Patients/ guarantors who qualify for partial financial assistance are responsible for paying any balance remaining after the charity adjustment and third party payments. Once an account has been processed through routine collection channels internally, it may be assigned to an attorney/agency for collection. The patient/ guarantor will be billed for all collection costs as may be applicable. Credit reports will be filed no earlier than 30 days following the assignment on all nonpaid balances.
Fort Sanders Regional Medical Center		Part V, Section B, Line 13g: Please see the explanation to Part VI, Line 3.
Fort Sanders Regional Medical Center		Part V, Section B, Line 19d: Please see the explanation to Part III, Line 9b.
		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: Fort Sanders Regional Medical Center (FSRMC) posts a sign in each registration office that states: Financial Assistance: It is FSRMC's philosophy that no one shall be denied medically necessary services based on an inability to pay. Financial assistance applications for medically necessary services are available during the registration process or through our Financial Counselor's office. To apply for financial aid, please ask our registration staff or contact the Counselor's office. The Financial Counselor is available Monday - Friday, 8 a.m. to 4:30 p.m.In addition, signs are posted in the main and registration lobbies at FSRMC that read: 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 Fort Sanders Regional 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, Fort Sanders Regional Medical Center, in compliance with Tennessee Code Annotated, Title 47, Chapter 18 and Title 68, will provide at a reduced rate, medically indicated services. A financial counselor is available to assist you with these matters by calling 865-541-1112, Monday through Friday between the hours of 8 a.m. - 4:30 p.m.FSRMC employs full-time financial counselors that meet with each uninsured patient. In addition, FSRMC contracts with First Source Solutions, an eligibility service, that places a representative in the facility full time. This representative screens patients for eligibility, assists them with TennCare and disability enrollment, and ensures enrollment in the appropriate programs.The Charity Care Policy states that patients who are unable to pay and have exhausted all sources of payment assistance may be screened for potential charity care eligibility. According to the policy, the financial counselors initiate screening of the patient and/or guarantor by obtaining income and other financial information to determine eligibility for charity care or discounted services.
		Part VI, Line 4: Fort Sanders Regional Medical Center is located in downtown Knoxville, Tennessee. Although located in metropolitan Knox County, Fort Sanders Regional Medical Center receives many specialty referrals from outlying hospitals and physicians and serves patients from 16 diverse counties, a mix of urban, suburban and rural. According to internal hospital data for 2011, 53.5% of the inpatients discharged were Knox County residents. Sevier County provides Fort Sanders Regional with the second highest number of admissions compared to other counties in the region, slightly more than 9% of the total.According to 2008 data of the U.S. Census Bureau, the collective population of the 16-county region 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 tax exempt. 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 5: Fort Sanders Regional Medical Center (FSRMC), in conjunction with its parent company, Covenant Health, uses any available surplus of receipts over disbursements to expand and modernize the facility and to support the education of healthcare professionals, both of which serve to improve patient care and serve the unmet needs of the community.Covenant Health's Board of Directors serves as FSRMC's board. It is comprised of independent community leaders with diverse educational and professional backgrounds. The board sets policies and provides oversight of FSRMC.FSRMC maintains an open medical staff, with privileges available to all qualified physicians. Additionally, the hospital operates an active and accessible emergency department that accepts all patients regardless of ability to pay.
		Part VI, Line 6: Fort Sanders Regional Medical Center, as a member of the Covenant Health system, benefits from the collaboration among all affiliated organizations to promote quality improvement, patient safety and efficient delivery of care for the communities served. As a system, Covenant assures that business processes are in place in each facility to measure and report quality, to increase the role of compliance, and to integrate risk management, utilization review, peer review, mandatory reporting and quality improvement into one cohesive function. In this way, the system is able to use analytic tools to help identify any systemic inability to satisfy the various requirements on the part of the facilities. Fort Sanders Regional, as a regional referral hospital, provides a wide range of acute care services, many of which are unique in the Covenant system. These services are therefore more easily accessible by other affiliated hospitals and health care organizations through transfer or referral helping to create a seamless continuum of care. The hospital, through its Patricia Neal Rehabilitation Center division, is the only acute inpatient rehabilitation facility in the Covenant system and the largest such provider in the service area. Programming includes specialized services for stroke, brain injury, spinal cord injury and other difficult patient populations with the primary goal of returning the patient home with the greatest gain in functional ability possible. Fort Sanders Regional also provides hospital-based skilled nursing care which serves as either a bridge back home or as an important step along the continuum of care to other long term care resources.In 2011 Fort Sanders Regional opened its Gamma Knife Center located at Thompson Cancer Survival Center, an affiliated cancer treatment center. The Gamma Knife Center features the newest and most advanced Leksell Gamma Knife Perfexion, a non-invasive radiosurgical tool used to treat brain tumors and other disorders. Patients undergoing Gamma Knife procedures benefit from reduced treatment times and minimized surgical complications. Fort Sanders Regional also provides other important services unique to the Covenant system including high risk obstetrical services and home infusion. It's outpatient diabetes center serves a large community-based population with educational, dietary and other supportive medical services that would otherwise be unavailable or difficult to access. Co-located with the diabetes center, the Coumadin clinic serves to educate another vulnerable population as well as to monitor the therapeutic effectiveness of this drug. These services, the diabetes center and the Coumadin clinic, are important to preventing unnecessary hospitalizations through the provision of effective community-based care. Fort Sanders Regional also provides other extensive outpatient services through its ambulatory infusion centers, physical therapy centers, a wound care center, and its cardiac and pulmonary rehabilitation programs. Fort Sanders Regional's patients benefit from the availability of and ease of access to Covenant affiliated entities for services not provided by the hospital itself. Transfer or referral to such services is expedited and coordinated to help create a seamless continuum of care. A full range of community mental health and psychiatric hospital services are available within the system which help support the hospital's emergency room as well as provide an accessible and efficient pathway for those patients who require such services post discharge. Home health and hospice services are also an important part of the continuum of care for a large portion of the hospital's patient population. The Covenant Health system also enhances the patient's access to care through the provision of outpatient services in a variety of settings located throughout the service area.The Fort Sanders Foundation seeks out community support for Fort Sanders Regional and other Covenant Health hospitals through a variety of fund raising mechanisms. For example, the Fort Sanders Foundation helps to arrange sponsorship for significant fund raising activities of the Patricia Neal Rehabilitation Center division of the hospital including an annual golf tournament that has become the largest, single day fundraising event in the state of Tennessee. The proceeds of these events help fund needed equipment and facilities for the center as well as to provide access to the center's services for uninsured or underinsured individuals who are in need of intensive rehabilitation but may otherwise be denied such services due to the lack of resources. The Foundation also provides temporary residential services through the Fellowship Center for patients of the hospital and their families that travel to Knoxville to receive needed care but are unable to afford the costs involved.The Fort Sanders Nursing Department at Tennessee Wesleyan College is an important affiliate of Fort Sanders Regional. The school provides a baccalaureate nursing education, helping to alleviate a shortage of registered nurses to serve a growing and aging population. It is a continuation of a nursing education tradition of the hospital that began more than eighty years ago. The hospital provides a substantial financial contribution to support the program. Training qualified nursing professionals to serve the current or future needs of the community is an important hospital mission.Fort Sanders Regional is integrated with its community in a number of ways including its active participation in the development of a Fort Sanders Neighborhood District Long Range Plan. Fort Sanders is a densely populated urban neighborhood in the City of Knoxville. With its proximity to downtown and with the location of two regional referral hospitals (East Tennessee Children's Hospital being the other) and the flagship campus of the University of Tennessee in its boundaries, it provides an ideal location for convenient access for residents and as a gateway to visitors. With these assets, it is imperative that the city and neighborhood leaders work together in order to coordinate quality growth while maintaining the rich character and history that give Fort Sanders its unique identity.Through this combination of resources and the collective development, implementation and monitoring of clinical protocols and other improvement initiatives, the affiliated entities of Covenant Health are able to deliver higher quality care in a more efficient manner than could be achieved working independently.

Schedule H (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization
Fort Sanders Regional Medical Center

Employer identification number
62-0528340

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) Thompson Cancer Survival Center1915 White Avenue Knoxville,TN37916	62-1250943	501(c)(3)	75,192	Financial support of Fellowship Center
(2) Fort Sanders Foundation280 Fort Sanders West Blvd Suite 100 Knoxville,TN37922	62-1748601	501(c)(3)	15,000	Fellowship Center maintenance and food fund
(3) Joni and Friends Ministry Knoxville1540 Robinson Road Knoxville,TN37923	62-1458199	501(c)(3)	20,000	Share the Hope

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2011

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance
(1) Provided medication and medical supplies to patients who could not be discharged without it but could not pay for it	401		24,202	Book	Prescription medications and infusion supplies
(2) Paid for ambulance service to transfer patients to other facilities	2		1,100	Cost	Transportation
(3) Paid for personal care assistant to accompany discharged patient to radiation therapy at another facility	1		1,642	Cost	Personal care services
(4) Nursing scholarships	4	8,800		Cost
(5) Paid for burial for patient	1		800	Cost	Burial expenses

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
Procedure for Monitoring Grants in the U.S.:	Part I, Line 2:	Schedule I, Part I, Line 2: The hospital provides for the post-hospitalization transportation and medication needs of its patients when there is a demonstrated need as attested to by a social services worker. The determination is made by Case Management based on the judgment of the social services worker after working with the patient and the patient's family. Assistance is approved on a case-by-case basis by Case Management, and this approval is verified upon approval of any invoices to be paid.

Schedule I (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

Fort Sanders Regional Medical Center

Employer identification number

62-0528340

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Yes

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2011

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1) Anthony L Spezia	(i) (ii)	0 924,445	0 326,250	0 1,241,947	0 9,800	0 15,907	0 2,518,349	0 759,468
(2) John T Geppi	(i) (ii)	0 393,584	0 237,900	0 73,983	0 9,800	0 19,248	0 734,515	0 0
(3) Keith Altshuler	(i) (ii)	0 254,454	0 26,896	0 44,620	0 9,800	0 19,677	0 355,447	0 0
(4) Jennifer L Hanson	(i) (ii)	161,879 0	33,199 0	17,632 0	0 0	8,285 0	220,995 0	0 0
(5) Mary E Dillon	(i) (ii)	162,284 0	0 0	781 0	0 0	4,416 0	167,481 0	0 0
(6) Christopher Norris	(i) (ii)	138,642 0	0 0	1,399 0	8,689 0	16,331 0	165,061 0	0 0
(7) Marianne Oliveira	(i) (ii)	134,652 0	0 0	2,336 0	8,280 0	12,569 0	157,837 0	0 0
(8) Nancy Granger	(i) (ii)	127,140 0	0 0	1,600 0	8,058 0	17,400 0	154,198 0	0 0

Schedule J (Form 990) 2011

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
	Part I, Line 1a	Part I, Line 1a: Tax gross-up payments are provided to certain executives and managers. These are treated as taxable compensation to the recipient.
	Part I, Line 4b	Part II, Anthony L. Spezia (compensated by Covenant Health, parent organization) - Column (B)(iii): Other reportable compensation. $1,010,702 of the total amount reported as "other reportable compensation" under Column (B)(iii) is the total amount accrued during years 2007, 2008, 2009, 2010 and 2011 under a 457(f) deferred compensation plan established for Mr. Spezia in year 2000. Amounts accrued in years 2007 through 2010 have been previously reported and included in compensation on Form 990 for the applicable year. Although all deferred amounts became fully vested and taxable in 2011, only 2007 accruals were distributed to Mr. Spezia in 2011. Accruals for 2008-2011 are distributable in future years. Consequently, the $1,103, 451 is comprised of the following: $586,516 accrued and previously reported as income on Form 990 for years 2008, 2009, and 2010; which is fully vested but has not been distributed $235,299 distributed in 2011, of which $172,952 was previously reported as income on Form 990 for year 2007, the remainder representing earnings on the deferred amount distributed $188,887 accrued in 2011, which is fully vested but has not been distributed
Supplemental Information	Part III	Part I, Line 3: Covenant Health, the parent company of Fort Sanders Regional Medical Center, used one or more of the methods listed in establishing the compensation of Anthony L. Spezia. Please see the statement to Core Part VI, Section B, Line 15a on Schedule O.

Schedule J (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

Fort Sanders Regional Medical Center

Employer identification number

62-0528340

Identifier	Return Reference	Explanation
Organization Mission Statement	Form 990, Part III, Line 1	In 1996 two healthcare systems - Fort Sanders Alliance and MMC Healthcare System of Oak Ridge consolidated to form what is known today as Covenant Health. The two organizations, which had a combined legacy of more than 100 years of service in East Tennessee, united with the strong belief that by working together, they could do more for their communities than they could alone. Nearly two decades later, the connections Covenant Health has forged with East Tennessee communities have strengthened as the health system has worked in tandem with area leaders, businesses and organizations to provide excellent local healthcare. In recent years Covenant Health has opened replacement hospitals, outpatient centers and clinics; made innovative technology and medical advances available, and achieved national recognition for quality care and service excellence. As a tax-exempt health system, Covenant Health reinvests every dollar for the benefit of the community, not profitability or shareholder interests. As the largest private employer in the greater Knoxville area, Covenant Health's staff of more than 10,000 supports local communities by purchasing goods and services, participating in local activities, and contributing volunteer time and leadership in local organizations. Covenant Health is both committed to and connected to the communities it serves, as it lives out the health system's mission. COVENANT HEALTH'S MISSION We serve the community by improving the quality of life through better health. COVENANT HEALTH'S VALUES In service to God and community, we value: Integrity, Quality, Service, Caring, Developing People, and Using Resources Wisely. COVENANT HEALTH'S VISION Covenant Health's clinical and service excellence will make us the first and best choice for patients, employees, physicians, employers, volunteers, and the community. COVENANT HEALTH MEMBER ORGANIZATIONS AND SERVICES The Covenant Health System ("the System") provides comprehensive health care services throughout East Tennessee. Headquartered in Knoxville, Tennessee, 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 System includes seven acute care hospitals with a total of more than 1,700 licensed beds, a behavioral health hospital, and numerous outpatient services and clinics. The System also includes specialty providers of behavioral, oncology and rehabilitation services, along with home health care, physician clinics, community wellness programs and managed care products and services. Member organizations and programs are listed by name below. Hospitals and Other Healthcare Providers: Covenant Homecare and Hospice Fort Loudoun Medical Center Fort Sanders Perinatal Center Fort Sanders Regional Medical Center LeConte Medical Center Methodist Medical Center of Oak Ridge Morristown-Hamblen Healthcare System Parkwest Medical Center Peninsula Hospital, a Division of Parkwest Medical Center Roane County Medical Center Thompson Cancer Survival Center Thompson Oncology Group Outpatient and Specialty Care Departments, and Joint Ventures: Fort Sanders Sevier Nursing Home Fort Sanders West Diagnostic Center Fort Sanders West Outpatient Surgery Center Morristown Regional Diagnostic Center Patricia Neal Rehabilitation Center Peninsula Outpatient Centers Surgery-Endoscopy Center of Morristown Foundations: Fort Sanders Foundation Methodist Medical Center Foundation Morristown-Hamblen Hospital Foundation Thompson Cancer Survival Center Foundation CONNECTING WITH OUR COMMUNITIES THROUGH QUALITY CARE Covenant Health delivers quality care in local settings, with services designed to meet the needs of our communities. The acute care hospitals located in Knoxville and surrounding areas comprise the foundation of the health system. They offer comprehensive care provided by board certified medical staffs, including emergency care, specialty services, and a full range of diagnostics and treatment. When specialty care is needed, Covenant Health provides: * Innovative cancer care and technologies to deliver radiation therapy and other cancer treatment at facilities affiliated with Thompson Cancer Survival Center in Knox and surrounding counties. * Nationally recognized care for patients suffering from physical disabilities, stroke and traumatic brain injury at Fort Sanders Regional Medical Center's Patricia Neal Rehabilitation Center. * Rehabilitation services including physical therapy, speech therapy, sports medicine, and specialized therapy such as hand therapy and vestibular (balance) rehabilitation are offered at a dozen Covenant Therapy Centers locations. In addition, more than 30 affiliated physician clinics throughout the region offer convenient access to primary and specialty care. BEHAVIORAL HEALTH - A COMMITMENT TO ESSENTIAL SERVICES Covenant Health provides comprehensive behavioral health services under the auspices of Peninsula, a Division of Parkwest Medical Center ("Peninsula"). Peninsula operates a behavioral health hospital and outpatient centers for treatment of addictive behaviors, depression, and other mental health issues. With 75 years of combined experience, Peninsula organizations have helped thousands of people recover from disorders and dependencies and lead healthy, positive and productive lives. In 2012 the State of Tennessee announced the closing of Lakeshore Mental Health Institute in Knoxville, as Tennessee moves toward more community-based mental health services. In response, Covenant Health announced that Peninsula would do everything it could to help the vulnerable population Lakeshore served. Peninsula pledged to take as many Lakeshore patients as it feasibly could, adding staff (including some former Lakeshore employees) and expanding facilities to handle the expected influx. It is not the first time the State has sought Peninsula's help. When Lakeshore closed its child and adolescent program in 2004, Peninsula became the only child and adolescent inpatient psychiatric facility between Chattanooga and Johnson City, Tennessee. COMMUNITY CELEBRATES PROGRESS FOR NEW ROANE COUNTY MEDICAL CENTER "One Community. One Hospital" is the theme of progress for the new Roane County Medical Center, a replacement hospital for the current facility in Harriman. The new facility is under construction near the Midtown exit off I-40, and scheduled to open in February 2013. About 200 people attended a mid-progress celebration in Spring 2012 at the hospital construction site. Covenant Health President Tony Spezia welcomed guests and introduced dignitaries, including legislative representatives, Roane County leaders, Covenant Health board members, and others. The celebration included a time capsule where speakers could place items that represent the legacy and future of Roane County Medical Center. Items will be placed in the time capsule until it is sealed in February 2013. Gaye Jolly, the President and CAO of Roane County Medical Center, said employees and physicians look forward to continuing recent quality accomplishments and the hospital's tradition of excellent care for every patient in the new facility. Key features of the new hospital include all private, modern patient rooms with large natural light windows, 15 emergency suites, technologically-advanced surgery suites, and enlarged and modern nursing units. Patient drop-off and pick-up areas will be available, as well as free parking in more than 500 parking spots. Patients and visitors can enjoy freshly prepared meals in the new Three Rivers Cafe. The new medical center campus will be wired with new and innovative technologies including computer systems, information technologies and hardware for transition to electronic medical records. Adjacent to the hospital will be a new professional office building, which will be home to medical professionals including Thompson Oncology Group, Roane Medical Patricia Neal Outpatient Center, and Roane Medical Cardiopulmonary Rehabilitation. Thompson Oncology Group will be staffed with board-certified oncology physicians, who will have access to nationally-acclaimed multidisciplinary cancer care through Thompson Cancer Survival Center. Roane Patricia Neal Outpatient Center will feature an in-ground therapy pool complete with a built-in treadmill, and Roane Cardiopulmonary Rehabilitation will offer a new, state-of-the-art telemetry monitoring system.
		CARDIAC INNOVATIONS FOR THE HEARTS OF EAST TENNESSEE Innovative Valve Centers Offer Specialty Cardiac Care The most complex cardiovascular problems can now be treated in Knoxville. Covenant Health is debuting Valve Centers at Parkwest, Fort Sanders Regional, and Methodist Medical Centers. Valve centers are staffed by experienced cardiovascular surgeons, cardiologists, nurses and other professional medical staff who are educated in the latest protocols. The coordination of care made possible by the Valve Centers will help Covenant Health hospitals deliver better outcomes, with fewer complications and higher survival rates. A new $2.6 million "hybrid" operating room opened this spring at Parkwest Medical Center and is used by Covenant Health physicians primarily for cardiac and vascular procedures. A hybrid operating room combines the best of a traditional surgical suite with large imaging equipment such as real-time X-ray and CT in a sterile setting. Hybrid operating rooms allow surgeons to perform combined open, minimally invasive, image-guided and/or catheter-based procedures in the same operating room. Patients facing aortic aneurysm surgery or aortic valve replacement may have a less invasive option and a quicker recovery. COVENANT HEALTH PERFORMS REGION'S FIRST BREAKTHROUGH TAVR PROCEDURE What if a heart valve could be replaced without surgically opening the chest cavity? That is now a reality for some patients. Parkwest Medical Center is one of only 140 sites in the nation and the first Knoxville hospital to offer Trans Aortic Valve Replacement (TAVR), an innovative procedure to replace diseased aortic valves. TAVR is appropriate for some high-risk patients with severe aortic stenosis (narrowing of the aortic valve opening) who are not candidates for surgery. In the United States, TAVR continues to be studied as part of the PARTNER (Placement of Aortic Transcatheter Valves) trial which studied inoperable patients with severe symptomatic aortic stenosis. Covenant Health has been selected by Edwards Lifesciences as the only entity in Knoxville to have surgeons trained in the TAVR procedure. STANDING STRONG FOR THE COMMUNITIES WE SERVE As a tax-exempt organization governed by a voluntary Board of Directors, Covenant Health reinvests excess revenues after expenses in improving patient care. Since 2000 Covenant Health has invested nearly $1 billion in facilities, technologies, programs and services. No other health system in East Tennessee in this decade has approached Covenant Health's investment in clinical and medical information technology, and new, renovated and expanded hospitals and services. The current economic environment has been particularly difficult and challenging for healthcare organizations, and has included cuts in reimbursement for services and the sale or closure of hospitals in our region. Covenant Health is committed to standing strong, and to the wise use of the health system's resources. Despite operating results at roughly a break-even level over the last five years, a strong balance sheet has allowed Covenant Health to continue providing substantial care to those with limited resources. In 2011 Covenant Health provided more than $150 million in charity and uncompensated care. CONNECTING MEDICAL COMMUNITIES WITH ADVANCED TECHNOLOGY When one thinks of technology, machines are often thought of - not only imposing-looking diagnostic equipment, but smaller electronic tools such as computers and hand-held devices. Often the concept of technology revolves around the hardware seen in healthcare settings. Using Technology to Achieve Quality Covenant Health's data center includes over 850 servers and 200 terabytes of storage capacity that are available to each hospital across the system via a high-speed gigabit network. The system is progressing toward a national meaningful use mandate, where healthcare organizations are challenged to use data in ways that improve patient safety and outcomes while paying close attention to information security. Some Covenant Health meaningful use initiatives include computerized patient order entry, real-time medication alerts to prevent allergy or drug interactions, and automated evidence-based care processes so that physicians and caregivers have immediate access to information about best practices. Other initiatives include computer-generated review and reconciliation of the patient's medications upon admission to the hospital, and delivery of relevant clinical information to the case management system in order to plan appropriate post-discharge care. Beyond Health System Boundaries Covenant Health is also leading the charge to expand technology benefits by participants beyond the system. The East Tennessee Health Information Network is a collaboration of leaders at other tax exempt health systems to create what will eventually be an electronic community of care that will encompass 17 counties in East Tennessee. The local initiative supports national efforts to move to electronic health records and create secure networks for sharing information through a health information exchange. REACHING OUT TO CREATE A HEALTHIER EAST TENNESSEE To improve the health of the community, Covenant Health reaches beyond hospital walls. Local initiatives and partnerships create opportunities to interact with people of all ages and encourage healthier lifestyles. * In Knoxville nearly 7,000 people participated in the 2012 Covenant Health Knoxville Marathon, which attracted local runners and hand cyclists, as well as competitors from throughout the U.S. and other countries. * The Covenant Kids Run attracted over 1,000 children who participated in a "marathon" of activities over a period of several weeks, culminating in a run to Neyland Stadium on the day before the Covenant Health Knoxville Marathon. * Covenant Health's Body Works program makes community fitness classes convenient, affordable, and fun. With more than 80 classes offered weekly throughout East Tennessee, Body Works offers a variety of exercise options for adults of all ages and fitness levels. * Covenant Health was the fitness sponsor of the Dogwood Arts Festival, held annually in April. Fitness activities included several outdoor walks, Bikes and Blooms bike rides on local dogwood trails, and a Dogwood Mile run and Kids Race held in downtown Knoxville. * Covenant Passport is a free membership program for adults age 50 and older. The program encourages healthy, active lifestyles through a newsletter, community presentations, health screenings, and travel/recreation opportunities. Nearly 25,000 members are currently enrolled. * Covenant Health annually sponsors MASH Camp at Methodist Medical Center to give high school students a sneak preview of healthcare career options and a chance to job shadow professionals in several hospital departments. * Covenant HomeCare Hospice helps children grieving the loss of a loved one through Katerpillar Kids Camp, offered with the support of Variety-The Children's Charity. The camp is staffed by health system volunteers and helps children in grades 1-12 express their feelings in a supportive environment while enjoying camp activities. * Morristown-Hamblen's Wellness of Women is dedicated to improving the lives of area women and their families. The program sponsors events such as an annual Girls' Night Out, which offers free health screenings and encourages women to have fun while learning to stay healthy. * Fort Sanders Regional Medical Center's Patricia Neal Rehabilitation Center leads the Innovation Recreation Cooperative, a collaboration of groups and individuals who help disabled persons enjoy leisure and recreation activities such as water skiing and cycling. * Fort Loudoun Medical Center sponsors "Let's Move Day" for area children and their families, featuring a day of games and activities, healthy snacks, and fitness checks.
		HEARTFELT CONNECTIONS INCREASE AWARENESS OF WOMEN AND HEART DISEASE The latest advancement in reducing heart disease in women is not a new test or treatment. Women can dramatically reduce their risks of developing heart disease by doing just four things - eating right, being physically active, not smoking, and maintaining a healthy weight. According to the most current research 62 percent of women are aware that heart disease is the number one killer of women. But many women still fail to take their risks personally or seriously. The Heart Truth Champions of Covenant Health are reaching out to help women understand that heart disease risk is a personal thing. Covenant Health was selected by the National Heart Lung and Blood Institute and the Office on Women's Health as one of a handful of sites across the United States to initiate a Heart Truth Champions program. Twelve Heart Truth Champion volunteers were selected based on their involvement in community health education activities, and their willingness to create and participate in local events to raise awareness of women and heart disease. SIX NUMBERS AT THE HEART OF GOOD HEALTH What you measure, you improve. That was the goal of Know Your Six, Chicks, a year-long community campaign to help women fight heart disease through awareness of six measures of heart health: blood pressure, cholesterol, fasting glucose, body mass index (BMI), physical activity and sleep habits. The campaign included heart health information, Lunch and Learns, community screenings, an interactive website and online health assessment, and mobile blood pressure screening units placed at local businesses. Know Your Six, Chicks is estimated to have directly reached just over 10,000 participants. Local businesses played an important role in Know Your Six, Chicks, providing locations for mobile Heart Centers and even providing spokespersons for the initiative. In addition to business participation, Know Your Six, Chicks also reached out to community centers, church locations, cultural events and trade shows - and expanded to include men in its outreach efforts. CONNECTING TO THE FUTURE THROUGH EDUCATION Covenant Health actively supports education programs for future nurses and other healthcare professionals. One example is the health system's partnership with Tennessee Wesleyan College-Fort Sanders Nursing, ("TWC"). The program offers a bachelor's degree in nursing through TWC in Athens, Tennessee, with classroom and clinical training opportunities at the school's Knoxville campus and at Covenant Health organizations. The collaboration has been in place for more than 10 years. This past Spring of 2012, more than 70 nursing students graduated from TWC. In summer 2012 the program launched an online RN-to-BSN degree designed especially for professional nurses who want to earn a baccalaureate degree while still continuing their nursing responsibilities. In addition to the TWC partnership, Covenant Health provides clinical training opportunities for students in health career programs at other area universities, community colleges and post-secondary schools, and has affiliation agreements with more than 100 schools across the country. COMMUNITY LEADERS PLAY KEY ROLES IN FOUNDATIONS' EVENTS AND PROGRAMS The Covenant Health Office of Philanthropy coordinates the philanthropic contributions of individuals and businesses throughout East Tennessee and beyond. Fund raising efforts are coordinated by four foundations: Fort Sanders Foundation, Methodist Medical Center Foundation, Morristown-Hamblen Hospital Foundation, and Thompson Cancer Survival Center Foundation. During the past year these foundations received contributions of about $4 million to help provide new equipment and facilities at the hospitals, staff training, and provide assistance to patients. While the Foundations coordinate community events and fund raisers, local community involvement is critical to the success of the events. CARING FOR THOSE UNABLE TO PAY One of the most tangible expressions of the charitable purpose of Covenant Health is providing care to people in need. As a tax-exempt system, Covenant Health provides medically necessary services to people with limited resources. Covenant Health actively participates in the state's TennCare program, and collaborates with other area providers to identify and support efforts to make community healthcare resources available for those in need. 2011 Summary of Community Benefit Totals for Uncompensated Care* Charity Care. . . . . . . . . . . . . . .$44 million TennCare . . . . . . . . . . . . . . . . $52 million Medicare . . . . . . . . . . . . . . . . . $60 million Total Uncompensated Care. . $156 million *Care which costs more to provide than reimbursements from state and national programs cover. Covenant Health provides community benefit that far exceeds the value of its tax-exempt status.
	Form 990, Part VI, Section B, line 11	Covenant Health is a large integrated health system which files twelve Forms 990. Fort Sanders Regional Medical Center is one of these twelve entities. Annually, at the September Finance Committee meeting, one of the twelve 990s is selected (a different entity each year) for distribution to each member of the Committee. Management then reviews in detail each of the Form 990 schedules and describes variances between entities, if any. The remaining eleven Forms are made available for review by any committee member. The same presentation is made to the Covenant Health Board of Directors at the October meeting. All twelve Form 990s are then made available to all Board members for their review throughout the month of October.
	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 Fort Sanders Regional Medical Center, Covenant Health (Parent Company), and affiliates are set by the Compensation Committee of the Board of Directors, which is comprised of independent members of the Board. The Committee is guided in its decision-making process by an independent, nationally-recognized executive compensation consultant experienced in advising nonprofit hospital boards. Compensation policies for Anthony Spezia and John Geppi are reported on the 2011 Form 990 of Covenant Health, EIN 62-1646734, parent company of Fort Sanders Regional Medical Center. Form 990, Part VI, Section B, Line 15b: Base salary and annual bonus opportunities for Keith Altshuler, President/CAO, are set by the Covenant Health CEO or Executive Vice President-Human Resources, subject to approval of the Compensation Committee of the Covenant Health Board of Directors ("the Committee"), after review by and discussion with the executive compensation consultant ("the consultant") to insure that total compensation is reasonable and within a fair market value range. Salary ranges are based upon the recommendations of the consultant made after comparison with similar jobs in similar size health systems across the nation. Bonuses are recommended by the CEO and approved by the Committee conditioned upon receipt of a written opinion from the consultant that total compensation for the President/CAO is reasonable and consistent with fair market value. Base salaries are initially targeted at midpoint and vary according to the individual's experience, market conditions and competition. Annual bonuses are designed to award 0-35% of base salary based upon system performance and accomplishment of certain targets established by the CEO. Base salary and annual bonus opportunities for Ronnie Beeler, VP-Financial Services, are based on established targets to insure that total compensation is reasonable and within a fair market value range. Salary ranges are based upon comparison with similar jobs in similar size health systems across the nation. Base salaries and bonuses are approved by Executive Leadership predicated upon performance, and are reasonable and consistent with fair market value. Base salaries are initially targeted at midpoint and vary according to the individual's experience, market conditions and competition. Annual bonuses are designed to award 0-20% of base salary based upon system performance and accomplishment of certain targets established by Executive Leadership.
	Form 990, Part VI, Section C, line 19	Form 990, Part VI, Section C, Line 19: Per its tax-exempt bond provisions, the parent company, Covenant Health, is required to file quarterly and annual consolidated and obligated group financial statements in addition to other documentation, with various bond insurers and other agencies, including the Electronic Municipal Market Access, EMMA, website. Any member of such a repository has access to these financial statements. In addition, Fort Sanders Regional Medical Center files a Joint Annual Report containing financial information with the Tennessee Department of Health.
Contact Addresses for Officers, Directors, Etc.:	Form 990, Part VI, Section A, Line 9 and Part VII	Anthony L. Spezia Covenant Health 100 Ft Sanders West Blvd. Knoxville, TN 37922 John T. Geppi, Larry Mauldin, and all Directors Covenant Health 1420 Centerpoint Blvd., Bldg. C Knoxville, TN 37932 All other persons listed in Part VII, Section A may be contacted at the organization's address, which is: Fort Sanders Regional Medical Center 1901 Clinch Avenue Knoxville, TN 37916
	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 Fort Sanders Regional Medical Center is a member, as a whole. The hours these individuals devoted to the system in 2011 are reported on Covenant Health's Form 990, Part VII.
Changes in Net Assets or Fund Balances:	Form 990, Part XI, line 5:	Intracompany Eliminations 77,647. Total to Form 990, Part XI, Line 5: 77,647.
	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.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

Fort Sanders Regional Medical Center

Employer identification number

62-0528340

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) Covenant Health 1420 Centerpoint Blvd Bldg C Knoxville,TN379321960 62-1646734	Supporting organization	TN	501(c)(3)	Line 11b, II	N/A		No
(2) Parkwest Medical Center 9352 Park West Boulevard Knoxville,TN37923 58-1897274	Acute care hospital & behavioral services	TN	501(c)(3)	Line 3	Covenant Health		No
(3) Methodist Medical Center 990 Oak Ridge Turnpike Oak Ridge,TN37830 62-0636239	Acute care hospital	TN	501(c)(3)	Line 3	Covenant Health		No
(4) LeConte Medical Center 742 Middle Creek Road Sevierville,TN37862 62-1114867	Acute care hospital	TN	501(c)(3)	Line 3	Covenant Health		No
(5) Roane County Medical Center dba Roane Medical Center 412 Devonia Street Harriman,TN37748 68-0673354	Acute care hospital	TN	501(c)(3)	Line 3	Covenant Health		No
(6) Fort Loudoun Medical Center 550 Fort Loudoun Medical Center Dr Lenoir City,TN37772 62-1373691	Acute care hospital	TN	501(c)(3)	Line 3	Covenant Health		No
(7) Thompson Cancer Survival Center 1915 White Avenue Knoxville,TN37916 62-1250943	Cancer treatment facility	TN	501(c)(3)	Line 3	Covenant Health		No
(8) Thompson Oncology Group 1915 White Avenue Knoxville,TN37916 62-1619239	Oncology services	TN	501(c)(3)	Line 3	Covenant Health		No
(9) Covenant Homecare 3001 Lake Brook Blvd Suite 101 Knoxville,TN37909 62-1623114	Home health services	TN	501(c)(3)	Line 9	Covenant Health		No
(10) Fort Sanders Perinatal Center 501 19th Street Suite 304 Knoxville,TN37916 04-3760551	High risk obstetrical services	TN	501(c)(3)	Line 3	Covenant Health	Yes
(11) Fort Sanders Foundation 280 Fort Sanders West Blvd Ste 100 Knoxville,TN37922 62-1748601	Fundraising and patient outreach	TN	501(c)(3)	Line 11a, I	Covenant Health		No
(12) Morristown-Hamblen Hospital Assoc dba M-H Healthcare System 908 W 4th North St Morristown,TN37814 62-0545814	Acute care hospital	TN	501(c)(3)	Line 3	Covenant Health		No
(13) Thompson Cancer Survival Center Foundation 1915 White Avenue Knoxville,TN37916 58-2130450	Fundraising and patient outreach	TN	501(c)(3)	Line 11a, I	Thompson Cancer Survival Center		No
(14) Morristown Regional Cancer Center LLC 908 W 4th North St Morristown,TN37814 20-0916364	Cancer treatment facility	TN	501(c)(3)	Line 3	Morristown- Hamblen Hospital Association		No

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2011

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Endoscopy Center of Oak Ridge LLC 988 Oak Ridge Turnpike Ste 200 Oak Ridge,TN37830 62-1667358	Outpatient medical facility	TN	N/A
(2) Fort Sanders West OP Surgery Ctr LLC 210 Fort Sanders West Blvd Ste 106 Knoxville,TN37922 62-1366907	Outpatient surgery center	TN	N/A
(3) Fort Sanders West Associates 280 Fort Sanders West Blvd Ste 214 Knoxville,TN37922 62-1384171	Building ownership	TN	N/A
(4) Assoc of the Meridian Health Outpatient Surgery Ctr LLC 908 W 4th North St Morristown,TN37814 86-1167487	Outpatient surgery center	TN	N/A
(5) Tellico Senior Living LLC PO Box 308 Caryville,TN37714 36-4353505	Retirement village	TN	N/A
(6) KOSC Properties LLC 260 Fort Sanders West Blvd Ste 200 Knoxville,TN37922 26-2444076	Building ownership	TN	N/A
(7) Knoxville Orthopaedic Surgery Center LLC 260 Fort Sanders West Blvd Ste 200 Knoxville,TN37922 26-2437385	Orthopaedic surgery	TN	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership
(1) Fortress Corporation 280 Fort Sanders West Blvd Suite 21 Knoxville,TN37922 62-1308885	Management company	TN	N/A	C
(2) KASC Acquisition Company Inc 1420 Centerpoint Blvd Bldg C Knoxville,TN37932 26-3400984	Real estate holdings	TN	N/A	C
(3) Covenant Medical Management Inc 280 Fort Sanders West Blvd Suite 20 Knoxville,TN37922 62-1282917	Physician practice management	TN	N/A	C
(4) Knoxville Heart Group 1819 Clinch Ave Suite 108 Knoxville,TN37916 27-1528941	Cardiology medical practice	TN	Fort Sanders Regional Medical Center	C	-2,337,705	154,403	100.000 %
(5) Morristown-Hamblen Health Services Inc 908 W 4th North St Morristown,TN37814 62-1588521	Inactive - dissolved 2/5/2011	TN	N/A	C

Schedule R (Form 990) 2011

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

Yes

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1) Fort Sanders Perinatal Center	A	566,742	FMV
(2) Fort Sanders Perinatal Center	L	72,006	Cost
(3) Fort Sanders Perinatal Center	N	108,809	Cost
(4) Fort Sanders Perinatal Center	O	57,339	Cost
(5) Knoxville Heart Group	A	225,503	FMV
(6) Knoxville Heart Group	N	119,634	Cost
(7) Knoxville Heart Group	O	569,909	Cost
(8) Knoxville Heart Group	P	11,830	Cost

Schedule R (Form 990) 2011

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2011

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version: