TY 2013 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 private foundations)

Do not enter Social Security numbers on this form as it may be made public. By law, the IRS

generally cannot redact the information on the form.

Information about Form 990 and its instructions is at www.IRS.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

A For the 2013 calendar year, or tax year beginning 01-01-2013 , 2013, and ending 12-31-2013

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 province, country, and ZIP or foreign postal code
Knoxville, TN379321960

D Employer identification number

62-0528340

E Telephone number

G Gross receipts $ 335,478,671

F Name and address of principal officer:
Anthony L Spezia
100 Ft Sanders W 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
subordinates? Yes No

H(b)

Are all subordinates
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 two located in the state of Tennessee.
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	17
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	2,054
6	Total number of volunteers (estimate if necessary) .............	6	525
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	2,442,273
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	194,671

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	721,126	685,884
9	Program service revenue (Part VIII, line 2g) .........	324,121,456	319,931,931
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	23,838	-17,357
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	10,673,384	10,587,084
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	335,539,804	331,187,542
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	353,902	365,025
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)	94,613,824	87,994,122
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–24e)....	226,349,258	220,742,760
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	321,316,984	309,101,907
19	Revenue less expenses. Subtract line 18 from line 12.......	14,222,820	22,085,635
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	179,732,943	196,375,842
21	Total liabilities (Part X, line 26).............	35,018,112	29,539,558
22	Net assets or fund balances. Subtract line 21 from line 20.....	144,714,831	166,836,284

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 MediumBullet

Firm's EIN MediumBullet

Firm's address MediumBullet

Phone no.

May the IRS discuss this return with the preparer shown above? (see instructions) ............YesNo

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 11282Y

Form 990 (2013)

Page 2

Part III

Statement of Program Service Accomplishments

Check if Schedule O contains a response or note to any line 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 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 $ 59,113,191 including grants of $ ) (Revenue $ 54,918,235 )
	Orthopedics, Neurology and Rehabilitation:The Ortho/Neuro/Rehab program at Fort Sanders Regional Medical Center is a comprehensive program of inpatient and outpatient services designed to restore optimal function and independence to individuals who are impaired due to orthopedic or neurological illness or injury. More information about these services is on Schedule O.Orthopedics, Neurology and Rehabilitation: Expenses - $59,113,191; Revenue - $54,918,235.From hip, knee and shoulder replacement to other commonly performed orthopedic procedures like hand, foot and ankle and spine and back surgery, Fort Sanders Regional (FSR) possesses a commitment to service excellence and to improving the patient experience in every way. These commitments are reflected in the comprehensive care provided orthopedic surgery patients, including:* In-depth education that fully prepares patients for surgery and recovery;* Infection prevention protocols that minimize infection risks;* Experienced, specialized surgeons and operating room teams that use state-of-the-art techniques;* A dedicated inpatient orthopedic nursing unit staffed by expert nurses and caregivers who know how to help patients recover from orthopedic surgery; and* A wide array of rehabilitation and therapy services, inpatient and outpatient, to help patients return to an active lifestyle.At the FSR Joint and Spine Center, patients undergoing knee or hip replacement surgeries are not treated as "sick" but as healthy adults undergoing a procedure that will allow them to return to an active life. The goal is to get patients out of bed and moving as quickly as possible. This is accomplished through education, surgical expertise and intense physical therapy. Patients are provided information about joint replacement and are challenged to take the lead in their recovery. Patients go through the program with a family member, who is designated as the patient's "Coach" and is taught how to assist the patient at home.Outpatient rehabilitation services are provided on the hospital campus and at a network of community based outpatient therapy centers. These centers offer a wide variety of therapy services, many of which are unique in the community. They include: * Physical, occupational and speech therapy, * Wound care, * Aquatic therapy, * Lymphedema treatment, * Low-vision and adaptive driving programs, * Certified hand therapy, * Vestibular rehabilitation, and * Functional capacity evaluations.In 2013 the hospital recorded 9,813 Wound Care Center patient visits and 86,901 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 2013 there were 208 Interventional neuro-radiology cases - made up of 82 Aneurysm coilings, 74 IVC Filter placements, and 52 stroke treatments.At the Fort Sanders Sleep Disorders Center, the area's first accredited sleep center, neurologists work with patients who suffer from a host of sleep/wake disorders including sleep apnea, insomnia, narcolepsy, and restless leg syndrome. The Center treated 709 patients in 2013.Fort Sanders' neurosurgeons provide surgical intervention for brain tumors, aneurysms and hemorrhages, as well as a host of spine conditions. They also provide surgical relief for issues caused by nerve and muscle diseases, carpal tunnel syndrome, chronic back pain and conditions resistant to medical management, like Parkinson's disease.An example of the hospital's commitment to state-of-the-art technology is the StealthStation Treon, which helps guide FSR's neurosurgeons through a variety of operations, including neurological and spinal procedures. This innovative 3D-imaging system uses global positioning technology to give physicians real time views inside the body, without radiation. This innovative technology allows less invasive operations and helps avoid brain and nerve damage.Strokes are the third leading cause of death in the United States and affect more than 795,000 Americans each year. As a Stroke Center of Excellence, the care provided by FSR and Patricia Neal Rehabilitation Center physicians and staff utilizes state-of-the-art diagnostic, treatment and rehabilitation modalities. The hospital holds a Comprehensive Stroke Center certification from the Joint Commission (one of only 66 in the nation) as well three separate stroke accreditations from the Commission on the Accreditation of Rehabilitation Facilities (CARF). In 2013, FSR's aggregate score related to strokes was 98.60%, and it had 422 Ischemic and 83 Hemorrhagic stroke patient admissions.FSR was the first facility in the area to combine CT and bi-plane angiography with a full-time neuro-interventional radiologist to provide our region with new, minimally-invasive options for treating stroke, aneurysms, and other vascular diseases in the brain. With this system, neuro-interventional radiology procedures can be performed that would have previously required surgery and an extended hospital stay or would not have been options for some patients.Bi-plane technology improves imaging and resolution creating comprehensive 3D views of the blood vessels in the brain. Having a more precise picture of an abnormality makes it easier to diagnose and repair. A team of specialized technologists and nurses work to assist the performing radiologist with each procedure. All technologists are certified by the American Association of Radiological Technologists. Micro-catheters are inserted through the groin and then guided to the area of treatment to administer medications, coil aneurysms or retrieve clots. These new procedures often involve very short hospital stays, all while keeping radiation exposure to a safe minimum and avoiding major surgery.The Patricia Neal Rehabilitation Center (PNRC) is East Tennessee's recognized leader in helping stroke, spinal cord, brain injury, orthopedic and cancer patients rebuild their lives through the delivery of optimal rehabilitation services. Opened in 1978 as an integral part of the Ortho/Neuro/Rehab program at FSR, the PNRC offers a comprehensive team approach to care. Physical, occupational, recreational, behavioral medicine and speech language therapists work with nurses and physiatrists - doctors whose specialty is physical medicine and rehabilitation. This team develops the best individual care plan to return patients to their recovery potential as quickly as possible. Rehabilitation nurses and other specialists also educate patients, teaching them self-care skills to function as well as possible upon returning home. The Center holds 15 separate accreditations from the Commission on the Accreditation of Rehabilitation Facilities (CARF) and provides a comprehensive array of inpatient rehabilitation services that would otherwise be unavailable in the community.FSR is committed to maintaining access to unique services such as those at the PNRC. Through donations and other community support, the hospital, through the Fort Sanders Foundation, provides scholarships to allow patients with limited resources access to the rehab center's services.The Patricia Neal Innovative Recreation Cooperative (IRC) was created in 1994 to meet the needs of individuals who have suffered a life-changing illness or injury. The program was designed to be part of the continuum of care in the rehabilitation process. Its scope is to host clinics under an umbrella of education and awareness: education to teach leisure skills to enhance quality of life in a safe environment and awareness to heighten the understanding of disabilities to the community. In its existence, the IRC has seen over 7,000 participants and volunteers. The goal is to remove all the barriers to develop each individual's right to self-directed leisure for a healthier lifestyle. This program is supported by community donations, grants and a hospital subsidy.Older adults are a significant portion of the patient population in Ortho/Neuro/Rehab. FSR is committed to special health care for older adults and was the first NICHE-certified (Nurses Improving Care for Health System Elders) facility in the East Tennessee region. Care is provided to help prevent complications such as skin breakdowns, falls/injuries, pain, acute confusion, and the loss of strength and mobility.

4b	(Code: ) (Expenses $ 40,077,587 including grants of $ ) (Revenue $ 56,109,141 )
	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 2013 Fort Sanders Regional Medical Center had 1,352 admissions to the oncology unit with 7,512 patient days. More information about oncology services is on Schedule O.Oncology Services: Expenses - $40,077,587; Revenue - $56,109,141.The Oncology Center of Excellence at Fort Sanders offers a comprehensive approach to patient care which minimizes patient disruption and maximizes clinical quality and efficiency. Cancer patients and their families can be assured their loved ones will receive the most complete and exceptional oncology care available. Safety is the number one priority in the Oncology Center of Excellence. Due to the nature and potency of the medications used in this area, strict safety processes are performed by doctors, pharmacists and certified nurses who work as a team to double and triple check these medications for accuracy. Chemotherapy-trained nurses work with oncologists to make sure each patient receives the correct chemotherapy drug, in the right dosage cycle, every time. Within the Oncology Center of Excellence, many of the nurses are also oncology certified at a national level. They have dedicated more than 1,000 hours caring for cancer patients and have successfully completed a national certification examination demonstrating their specialized knowledge in this field. Staff attends special lectures and conferences hosted by local and national medical oncologists and radiation oncologists to keep up with the newest innovative treatments available.Fort Sanders' emphasis on oncology knowledge and expertise isn't just limited to nurses. Each staff member on the oncology unit is also uniquely trained in the care of cancer patients. The oncology team includes a dedicated oncologic pharmacist, dietitian, social worker, and RN case manager. This team communicates regularly to ensure excellent patient care from admission to discharge. From dietitians, to pharmacists and radiologists, to housekeeping staff, Fort Sanders has done a lot of work to provide oncology education to every employee who may come in contact with patients. By completing this 360-degree education, Fort Sanders provides better patient care. The Oncology Center of Excellence at Fort Sanders Regional holds the prestigious Certificate of Approval from the Commission on Cancer. The Commission on Cancer Certification is awarded only to facilities with oncology programs committed to providing the best comprehensive cancer care. The Oncology Nursing Unit also serves as the inpatient component of the Stem Cell Center which is based at the Thompson Cancer Survival Center. This Stem Cell treatment center in conjunction with our Oncology Nursing Unit has accomplished accreditation by the Foundation of Accreditation for Cellular Therapy, also known as FACT.Surgical oncology is the branch of surgery which focuses on the surgical management of cancer. The Medical Staff at Fort Sanders Regional Medical Center includes general surgical oncologists as well as thoracic surgical oncologists, gynecologic oncologists and other sub-specialists that specialize in treating cancer patients. Outcomes in surgical cancer care are positively associated to surgeon volume -- i.e. the more cancer cases a surgeon treats, the more proficient he becomes, thus improving overall outcomes and survival rates. In 2013 FSR had 362 surgical oncology cases.Due to the close proximity of Fort Sanders Regional Medical Center to Thompson Cancer Survival Center, the surgeons and staff at Fort Sanders Regional work closely with the cancer center's multidisciplinary treatment teams in the collaboration of care and treatment plans for patients with chest and breast cancer. A team of cancer specialists in differing areas of expertise, including surgeons, gather and evaluate each patient's case to determine possible treatment options. Each specialist then meets individually with the patient to go over treatment choices and answer questions. As part of outpatient Oncology care, Fort Sanders Regional has opened five outpatient Infusion Centers in the area providing many of the chemotherapy medications for cancer patients. There were 61,378 infusion visits to the infusion centers in 2013.Fort Sanders Regional Medical Center, through the Patricia Neal Rehabilitation Center is the only place in East Tennessee, and one of a handful in the country, who offers a cancer rehabilitation program. The cancer program combines many of the rehabilitation techniques currently used for patients with brain and spinal cord injuries and strokes because the impairments cancer patients experience can be very similar to those of traumatic injuries. The health-care team includes:* Each patient's personal physician * Medical, radiation and surgical oncologists * Physiatrists doctors whose specialty is physical medicine and rehabilitation * Rehabilitation nurses * Physical, occupational and recreational therapists * Psychologists * Speech language pathologists * Pharmacists * Dietitians * Case managers At Patricia Neal, the cancer rehab team creates a special care plan for each patient with the goal of helping patients regain as much ability and independence as possible. The center treats many of the impairments that can result from cancer, cancer surgery, radiation therapy, chemotherapy and other treatments, such as:* Fatigue * Muscle wasting * Weakness * Pain * Skin breakdown * Impaired mobility * Anxiety * Depression * Adjustment problems * Overall deconditioning * Lymphedema swelling * Weight loss * Communication difficulty * Impaired thinking or memory loss Patricia Neal has a positive, encouraging atmosphere and is known for outstanding resources, from a rooftop therapy park to a computer life-skills lab. The center also offers:* Fully-equipped therapy gyms * Special adaptive equipment programs * Animal therapy * Support groups * Community outings * Family and caregiver training * Tools to improve communication * Adaptive driving programs* Balance programs * An adaptive living apartment to ease the transition back to everyday life

4c	(Code: ) (Expenses $ 29,499,221 including grants of $ ) (Revenue $ 28,779,264 )
	Cardiovascular Services:From diagnosis to rehabilitation, Fort Sanders Regional's award-winning Heart Center has one of the most comprehensive cardiac services available. Our advanced diagnostics, interventional technologies, cardiovascular surgery, and clinical trials are tailored to meet each patient's cardiac needs. Fort Sanders Regional's program is designed to help patients regain their strength and stamina. In 2013 the hospital recorded 1,149 admissions to the Cardiology unit with 5,860 patient days. More information about cardiology services is on Schedule O. Cardiovascular Services: Expenses - $29,499,221; Revenue - $28,779,264.The team of cardiologists, cardiovascular surgeons, nurses, and technologists has the right treatment and the right people to give heart patients the best possible care. Cardiopulmonary rehabilitation is an integral part of the healing process for many cardiac patients. Fort Sanders Regional Medical Center earned an AMI (Acute Myocardial infarction) Aggregate Core Measure Score of 100% for 2013. The American Heart Association awarded Fort Sanders Regional Medical Center's Cardiac Services the 2012 Mission: Lifeline "STEMI Receiving Center" Bronze Performance Achievment Award. Fort Sanders Regional Medical Center's Cardiology Department is the recipient of the 2012 American College of Cardiology Foundation's NCDR ACTION Registry 2012 GWTG Platinum Performance Achievement Award. FSRMC is one of just 164 hospitals nationwide to receive this honor. The award recognizes the hospital's commitment and success in implementing a higher standard of care for heart attack patients. Honored hospitals have maintained a rate of performance of 90% or better for eight consecutive quarters, ending quarter four in 2011. The Joint Commission named Fort Sanders Regional Medical Center one of the nation's Top Performers on Key Quality Measures. Fort Sanders was the only hospital in Knoxville and one of only 620 hospitals in the U.S. to earn the distinction. Coronary artery disease is the term used to identify the presence of atherosclerosis in the arteries that carry blood to the heart muscle. Atherosclerosis is a buildup up of fatty substances on the inner walls of blood vessels which can block or restrict blood flow. Atherosclerosis is a major risk factor of heart attacks. For some patients, medications are the best course of action. For others, surgical intervention may be necessary. Before a plan of treatment is chosen, a definitive diagnosis is needed.Even the most complex cardiovascular problems can now be treated in Knoxville. Covenant Health is debuting "valve centers" at Fort Sanders Regional Medical Center and its sister hospitals. Covenant Health is also the first health system in East Tennessee and only one of 140 nationwide to offer TAVR, a breakthrough procedure for replacing heart valves. State-of-the-Art Cardiac DiagnosticsYou may have heard the phrase "time is muscle." This refers to heart attack survivability. When blood flow does not reach heart tissue and muscle, it dies. The faster someone can receive medical care, the better their chances for recovery. That is why a fast, accurate diagnosis of a heart condition is so important. There were 36,086 cardiac diagnostic procedures performed at Fort Sanders Regional Medical Center's Cardiology Department in 2013.State-of-the-art diagnostic tools available at Fort Sanders Regional include:* The area's first Lightspeed 64-slice VCT Scanner captures an incredibly precise image of the heart in just five heartbeats. * Vivid 7 echocardiography uses ultrasound to produce a moving cardiac image in real time. * Nuclear stress tests find difficult-to-detect problems in the heart's outer covering. * Electrocardiograms provide reliable diagnostics and stress tests performed right in the hospital assure immediate care if a problem is discovered. The Latest MedicinesPhysicians at Fort Sanders Regional participate in clinical trials of new medicines for a wide range of heart conditions. Three potentially life-saving medicines for unstable angina and heart attacks are currently being tested. A new trial is investigating a drug to prevent heart attacks and strokes in acute coronary syndrome patients. Minimally-Invasive TreatmentGreat strides have been made in minimally-invasive procedures for heart-related issues. Minimally-invasive procedures allow physicians to implant valves and repair holes in the heart wall without a major incision.* The new Innova 2100-IQ all-digital cath lab gives cardiologists unprecedented image clarity to better view hard-to-see blood vessels, with less radiation exposure for patients and physicians. * Radiofrequency ablation controls rapid heartbeats with radio waves. * Drug-eluting stents open blocked arteries and help prevent a recurrence of the blockage. Cardiovascular SurgeryCardiovascular surgery includes surgical procedures to correct abnormalities within the heart and/or great vessels. The hospital recorded 317 cardiology surgical cases in 2013. Some of the more common procedures are coronary artery bypass, valve repair or replacement, correction of congenital heart defects and repair of aortic aneurysms.Coronary Artery Bypass Surgery Coronary Artery Bypass Surgery, also referred to as CABG, is a treatment option for coronary artery disease. Based on the size, number, and locations of artery blockages, your doctor may decide that bypass surgery is the best treatment. Valve Repair and Replacement Heart valves work like gates which open to let blood move forward and close to allow the heart chamber to fill with more blood. Problems occur when a valve does not open wide enough (stenosis) or close tight enough (regurgitation). When these problems occur, the heart cannot pump enough blood forward which causes problems over time like shortness of breath or heart failure. Your doctor may suggest that you have the valve repaired or replaced. Aortic Aneurysm Repair The aorta is the large artery which carries blood from the heart to the major organs and other areas. This artery can develop a weakening in the wall of the vessel. If this occurs your doctor may suggest that you have it repaired. Robotically-Assisted Surgery - The daVinci robotics system gives surgeons the capability to perform select heart procedures without opening the patient's chest and patients usually experience fewer side effects and faster recovery times. Cardiac Rehabilitation - Leaving the hospital is just the first step in recovering from a heart attack, heart surgery or angioplasty. Heart patients often need to strengthen weakened heart muscles and learn heart-healthy practices. Fort Sanders Regional's complete Cardiac Rehabilitation Outpatient Program (CROP) combines education, exercise, counseling, and more to help heart patients regain their functional capacity and reduce the possibility of future heart problems. In 2013 there were 11,236 cardiac rehabilitation visits recorded.Information for Heart Failure Patients - Fort Sanders Regional has developed a resource booklet for patients who are being treated for heart failure. This booklet includes details about heart failure, how it is diagnosed and treated, and lifestyle information for those seeking to be as healthy and active as possible while dealing with heart failure. The booklet also contains tracking sheets to record information that will be helpful for you and your healthcare provider, as well as a list of related resources and services within Covenant Health.

	(Code: ) (Expenses $ 173,266,336 including grants of $ 365,025 ) (Revenue $ 182,991,442 )
	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 $ 173,266,336 including grants of $ 365,025 ) (Revenue $ 182,991,442 )
4e	Total program service expenses301,956,335

Form 990 (2013)

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 (see instructions)? 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, or have a section 501(h) election in effect during the tax year? 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 for escrow or custodial account liability; 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, line 10?
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 and XII 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 and XII 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, Parts I and IV.........

14b

Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV

Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...

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 (see instructions)....

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

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 hospital facilities? 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 statements to this return?

20b

Yes

Form 990 (2013)

Page 4

Part IV

Checklist of Required Schedules (continued)

Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government 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 or 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, line 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................

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

Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, 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 direct or indirect 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, Part II, III, or IV, and Part 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 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............

Yes

Form 990 (2013)

Page 5

Part V

Statements Regarding Other IRS Filings and Tax Compliance

Check if Schedule O contains a response or note to any line in this Part V ..............

Yes

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

343

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

2,054

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” to line 3b, 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, securities account, or other financial 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 as charitable contributions?...

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. See the instructions for additional information the organization must report on Schedule O.

13a

Enter the 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 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 (2013)

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 or note to any line 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 there are material differences in voting rights among members of the governing body, or 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 this 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 Other (explain in Schedule O)

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 Beck1420 Centerpoint Blvd Bldg CKnoxvilleTN379321960 (865) 374-6864

Form 990 (2013)

Page 7

Part VII

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

Check if Schedule O contains a response or note to any line 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. 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 organization compensated any current officer, director, or trustee.

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(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 .......................50.00	X	X	0	1,543,512	228,486
(2) Gerald Boyd........................................................................ Director	0.00 .......................1.00	X		0	1,445	0
(3) Dr Richard Brinner........................................................................ Director	0.00 .......................1.00	X		0	1,576	0
(4) Dr Mitchell Dickson........................................................................ Director	0.00 .......................1.00	X		0	1,873	0
(5) Pamela P Fansler........................................................................ Director	0.00 .......................1.00	X		0	0	0
(6) James Fitzsimmons........................................................................ Director	0.00 .......................1.00	X		0	1,461	0
(7) Kimberly Greene........................................................................ Director	0.00 .......................1.00	X		0	0	0
(8) Wayne Heatherly........................................................................ Director	0.00 .......................1.00	X		0	1,661	0
(9) Jim Johnson Jr........................................................................ Director	0.00 .......................1.00	X		0	1,465	0
(10) Karla Lane........................................................................ Director	0.00 .......................1.00	X		0	0	0
(11) Eddie Mannis........................................................................ Director	0.00 .......................1.00	X		0	0	0
(12) Larry Mauldin........................................................................ Chairman	0.00 .......................1.00	X		0	1,542	0
(13) Dr Joseph Metcalf........................................................................ Director	0.00 .......................3.00	X		0	26,641	0
(14) George Miller........................................................................ Director	0.00 .......................1.00	X		0	1,434	0
(15) Alvin Nance........................................................................ Director	0.00 .......................1.00	X		0	1,464	0
(16) Linda Ogle........................................................................ Director	0.00 .......................1.00	X		0	0	0
(17) Mitchell Steenrod........................................................................ Director	0.00 .......................1.00	X		0	1,311	0

Form 990 (2013)

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 (list any hours for related organizations below dotted line)	(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) Carl Storms........................................................................ Director	0.00 .......................1.00	X				0	1,453	0
(19) Joseph E Sutter........................................................................ Director	0.00 .......................1.00	X				0	1,761	0
(20) Richard Swanson........................................................................ Director	0.00 .......................1.00	X				0	0	0
(21) Joe Ben Turner........................................................................ Director	0.00 .......................1.00	X				0	1,636	0
(22) David C Verble........................................................................ Director	0.00 .......................1.00	X				0	1,362	0
(23) John T Geppi........................................................................ EVP/CFO	0.00 .......................50.00		X			0	710,276	25,177
(24) Keith Altshuler........................................................................ Pres. & CAO - FSRMC	44.00 .......................6.00		X			0	339,726	31,897
(25) Ronnie S Beeler........................................................................ VP-Financial Services	30.00 .......................10.00		X			169,639	0	28,571
(26) Jennifer L Hanson........................................................................ VP-Chief Nursing Officer	35.00 .......................15.00			X		220,718	0	13,700
(27) Mary E Dillon MD........................................................................ Medical Director	40.00 .......................				X	203,025	0	2,936
(28) Christopher Norris........................................................................ Pharmacy Director	40.00 .......................				X	146,615	0	27,569
(29) Nancy Granger........................................................................ Pharmacy Manager	40.00 .......................				X	136,842	0	26,961
(30) Marianne Oliveira........................................................................ Sr. Instructor - Nursing S	40.00 .......................				X	133,891	0	20,878
(31) Bridgette Welch........................................................................ Director Surgical Services	40.00 .......................				X	130,022	0	12,597

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,140,752	2,641,599	418,772

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 HealthcarePO Box 402076AtlantaGA303842076	Equipment Maintenance/Service	3,020,296
Medic Regional Blood Center1601 Ailor AvenueKnoxvilleTN379216702	Blood Processing	1,601,346
Angelica Textile Services IncPO Box 535122AtlantaGA30353	Linen Service	1,451,582
Summit Medical Group1225 E Weisgarber Road Ste 200KnoxvilleTN37909	Hospitalist Fees	1,302,287
Sodexo Inc and AffiliatesPO Box 536922AtlantaGA303536922	Housekeeping Services	942,621
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 31

Form 990 (2013)

Page 9

Part VIII

Statement of Revenue

Check if Schedule O contains a response or note to any line in this Part VIII .............

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		528,218
e	Government grants (contributions)1e		157,666

f	All other contributions, gifts, grants, and similar amounts not included above1f

g	Noncash contributions included in lines 1a-1f:$		6,380
h	Total. Add lines 1a-1f.......			685,884
			Business Code
2a	Medical Services		622110	317,435,981	317,435,981
b	Laboratory		621500	1,721,708		1,721,708
c	Rental Inc - Exempt Affiliate		531120	774,242	774,242
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			319,931,931
3	Investment income (including dividends, interest, and other similar amounts).......			-4,291			-4,291
4	Income from investment of tax-exempt bond proceeds..			364	364
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	4,452,026	50,391
b	Less: rental expenses	4,199,904	77,795
c	Rental income or (loss)	252,122	-27,404
d	Net rental income or (loss).......			224,718		-117,437	342,155
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses		13,430
c	Gain or (loss)		-13,430
d	Net gain or (loss)..........			-13,430			-13,430
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
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	Meaningful Use		900099	3,574,459	3,574,459
b	Food Services		722212	2,616,010			2,616,010
c	Pharmacy		900099	1,264,476			1,264,476
d	All other revenue ....			2,907,421	1,013,036	838,002	1,056,383
e	Total. Add lines 11a–11d ......			10,362,366
12	Total revenue. See Instructions......			331,187,542	322,798,082	2,442,273	5,283,863

Form 990 (2013)

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).Check if Schedule O contains a response or note to any line 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	312,114	312,114
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	52,911	52,911
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 ....	432,628		432,628
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	72,389,141	71,866,939	522,202
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,296,822	2,279,427	17,395
9	Other employee benefits .......	7,632,839	7,551,702	81,137
10	Payroll taxes ...........	5,242,692	5,179,797	62,895
11	Fees for services (non-employees):
a	Management ......	20,602,633	19,589,438	1,013,195
b	Legal .........	115,807	12,005	103,802
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	22,061,952	21,849,948	212,004
12	Advertising and promotion ....	706,529	698,593	7,936
13	Office expenses .......	2,877,068	2,260,812	616,256
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	5,616,210	3,749,848	1,866,362
17	Travel ............	65,685	63,332	2,353
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	308,979	208,763	100,216
20	Interest ...........	209,030	208,953	77
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	13,104,899	11,597,183	1,507,716
23	Insurance ..............	731,786	718,222	13,564
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Unrelated Business Inco	137,500		137,500
b	Supplies and Equipment	86,786,378	86,736,065	50,313
c	Charity Care	32,225,193	32,225,193
d	Bad Debts	23,613,883	23,613,883
e	All other expenses	11,579,228	11,181,207	398,021
25	Total functional expenses. Add lines 1 through 24e	309,101,907	301,956,335	7,145,572	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 (2013)

Page 11


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			5,678	1	5,676
2	Savings and temporary cash investments .........			-248,849	2	-1,866,522
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			25,455,368	4	27,953,596
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net .............			44,555	7	44,555
8	Inventories for sale or use ..............			6,738,665	8	6,296,806
9	Prepaid expenses and deferred charges ..........			491,390	9	618,447
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	377,879,486
b	Less: accumulated depreciation .....	10b	267,052,124	115,496,100	10c	110,827,362
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 ...........			31,750,036	15	52,495,922
16	Total assets. Add lines 1 through 15 (must equal line 34)......			179,732,943	16	196,375,842
17	Accounts payable and accrued expenses .........			24,131,966	17	23,309,697
18	Grants payable .................				18
19	Deferred revenue ................			237,390	19	141,682
20	Tax-exempt bond liabilities .............			5,710,243	20	2,961,902
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other 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 ..			110,284	23	0
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....................			4,828,229	25	3,126,277
26	Total liabilities. Add lines 17 through 25.........			35,018,112	26	29,539,558
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			144,714,831	27	166,836,284
28	Temporarily restricted net assets ...........				28
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........			144,714,831	33	166,836,284
34	Total liabilities and net assets/fund balances ........			179,732,943	34	196,375,842

Form 990 (2013)

Page 12

Part XI

Reconcilliation of Net Assets

Check if Schedule O contains a response or note to any line in this Part XI ..............

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

331,187,542

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

309,101,907

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

22,085,635

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

144,714,831

Net unrealized gains (losses) on investments ...............

Donated services and use of facilities .................

Investment expenses .....................

Prior period adjustments .....................

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

35,818

Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))

166,836,284

Part XII

Financial Statements and Reporting

Check if Schedule O contains a response or note to any line 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?

If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

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

Yes

If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

If "Yes," to line 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?

Yes

If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.

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?

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.

Form 990 (2013)

Form 990, Special Condition Description:

Special Condition Description

Additional Data

Software ID:
Software Version:

- 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.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

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 described in 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. See section 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 - Non-functionally integrated

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 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 monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2013

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2013 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. 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—2012. If the organization did not check a 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—2013. 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—2012. 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) 2013

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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.)..

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 2013 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. 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—2012. 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) 2013

Page 4

Part IV

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013

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.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Name of the 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 for 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 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 its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization Fort Sanders Regional Medical Center

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, RESTRICTEDRESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization Fort Sanders Regional Medical Center

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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

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) (2013)

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. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

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 section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, 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 XIII, 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2013

Page 2

Part III

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

Using the organization’s acquisition, 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 XIII.

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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........

Part V

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

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	129,426	113,809	103,913	65,000	25,000
b	Contributions ........	1,490	15,617	9,896	38,913	40,000
c	Net investment earnings, gains, and losses	4,041	3,914	4,390	4,233	567
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	4,041	3,914	4,390	4,233	567
f	Administrative expenses ....
g	End of year balance ......	130,916	129,426	113,809	103,913	65,000

Provide the estimated percentage of the current year end balance (line 1g, column (a)) 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 XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. 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 ................	82,436,143	93,223,535	99,457,086	76,202,592
c	Leasehold improvements ............		2,530,246	1,587,496	942,750
d	Equipment ................		191,190,487	165,002,703	26,187,784
e	Other .................		1,126,741	1,004,839	121,902
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......					110,827,362

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) Assets Limited as to Use				1,435,793
(2) Bond Issuance Costs, Net				8,425
(3) Deferred Compensation				1,211,552
(4) Due from Affiliates, Net				49,144,635
(5) Miscellaneous Non-Affiliate Receivables				457,985
(6) Rental Income Receivable				237,532



Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				52,495,922

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes
Due to Third Party Payors		1,600,015
Long-term Deferred Compensation		190,427
Long-term Reserve for Workers Comp		1,335,835






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		3,126,277
2. Liability for uncertain tax positions In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................

Schedule D (Form 990) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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 XIII.) ............	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 XIII.) ...........	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 XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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 XIII.) ............	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 XIII.) ............	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 XIII

Supplemental Information

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
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.
Part X, Line 2:	Note B to the consolidated audited financial statements of Covenant Health, parent company to Fort Sanders Regional Medical Center, reads in part: "Income Taxes: Covenant and certain of its subsidiaries or controlled entities are exempt from income taxes pursuant to Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for income taxes on qualifying activities has been made for these entities in the accompanying consolidated financial statements. However, certain entities and operations are subject to income taxes which are accounted for in accordance with Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 740, Income Taxes (See Note G)." Note G reads in part: "Covenant had no unrecognized tax benefits at December 31, 2013 and 2012. As such, no interest or penalties were recognized in the Consolidated Statements of Operations related to unrecognized tax benefits. At December 31, 2013, tax returns for 2010 through 2013 are subject to examination by the Internal Revenue Service. Covenant has no uncertain tax positions that would require financial statement recognition or disclosure under generally accepted accounting principles at December 31, 2013 or 2012."

Return Reference

Explanation

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.

Part X, Line 2:

Note B to the consolidated audited financial statements of Covenant Health, parent company to Fort Sanders Regional Medical Center, reads in part: "Income Taxes: Covenant and certain of its subsidiaries or controlled entities are exempt from income taxes pursuant to Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for income taxes on qualifying activities has been made for these entities in the accompanying consolidated financial statements. However, certain entities and operations are subject to income taxes which are accounted for in accordance with Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 740, Income Taxes (See Note G)." Note G reads in part: "Covenant had no unrecognized tax benefits at December 31, 2013 and 2012. As such, no interest or penalties were recognized in the Consolidated Statements of Operations related to unrecognized tax benefits. At December 31, 2013, tax returns for 2010 through 2013 are subject to examination by the Internal Revenue Service. Covenant has no uncertain tax positions that would require financial statement recognition or disclosure under generally accepted accounting principles at December 31, 2013 or 2012."

Schedule D (Form 990) 2013

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.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Fort Sanders Regional Medical Center

Employer identification number

62-0528340

Part I

Financial Assistance 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) as a factor in determining 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 as a factor in determining 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 used factors other than FPG in determining 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, as a factor in determining 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? ......

Yes

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

Financial Assistance and Means-Tested Government Programs		(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) ..	17,972,320	5,469,197	12,503,123	4.380 %
b	Medicaid (from Worksheet 3, column a) ....	54,576,025	40,078,143	14,497,882	5.080 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .	1,596,355	644,736	951,619	0.330 %
d	Total Financial Assistance and Means-Tested Government Programs .	74,144,700	46,192,076	27,952,624	9.790 %
Other Benefits		115,298	16,751	98,547	0.030 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	115,298	16,751	98,547	0.030 %
f	Health professions education (from Worksheet 5) ..	84,452	10,075	74,377	0.030 %
g	Subsidized health services (from Worksheet 6) ..	28,257,211	19,290,498	8,966,713	3.140 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	163,495	51,410	112,085	0.040 %
j	Total. Other Benefits ..	28,620,456	19,368,734	9,251,722	3.240 %
k	Total. Add lines 7d and 7j .	102,765,156	65,560,810	37,204,346	13.030 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013

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	18,571	18,571	0.010 %
2	Economic development	17,411	17,411	0.010 %
3	Community support	202,729	202,729	0.070 %
4	Environmental improvements
5	Leadership development and training for community members	900	900	0 %
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	239,611	239,611	0.090 %

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. Explain in Part VI the methodology used by the organization to estimate this amount. ......

23,613,883

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

10,342,881

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

65,183,143

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

56,271,447

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

8,911,696

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(owned 10% or more by officers, directors, trustees, key employees, and physicians—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) 2013

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number
1	Fort Sanders Regional Medical Center 1901 Clinch Avenue Knoxville,TN37916 www.fsregional.com 00000043	X	X	X	X

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	Fort Sanders Regional Medical Center
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): www.fsregional.com

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Yes

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	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.
11	Used FPG to determine eligibility for providing discounted care?.................	11	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.
12	Explained the basis for calculating amounts charged to patients?.................	12	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	Residency
i	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	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 website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	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?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’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 Section C)
17	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 individual’s eligibility under the facility’s FAP?..........	17		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 Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

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?..........

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference	Explanation
Fort Sanders Regional Medical Center	Part V, Section B, Line 3: "Together! Healthy Knox" (T!HK) was launched by the Knox County Health Department in May 2010 and was designed to create a community approach to better health. The T!HK initiative is based on the Mobilizing for Action through Planning and Partnerships (MAPP) model for community health planning, which consists of specific steps meant to be repeated every three to five years. What began with a twenty partner Leadership Team grew to involve over seventy community and organizational partners. The assessment process, led by the Health Department, had broad participation from the public health community, including all Knox County hospitals. All four MAPP assessments were completed in 2011, and the T!HK Leadership Team determined the most critical issues to be addressed in Knox County. After nearly three years of data collection, analysis and meetings, the priority areas were announced to the broader community in a press conference on November 1, 2012. Three action teams formulated goals and strategies to address the three priority areas identified.
Fort Sanders Regional Medical Center	Part V, Section B, Line 4: Knox County hospitals who participated in the "Together! Healthy Knox" initiative included Fort Sanders Regional Medical Center, Parkwest Medical Center, East Tennessee Children's Hospital, and The University of Tennessee Medical Center.
Fort Sanders Regional Medical Center	Part V, Section B, Line 14g: Please see the explanation to Part VI, Line 3.
Fort Sanders Regional Medical Center	Part V, Section B, Line 20d: Please see the explanation to Part III, Line 9b.

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section D. 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 Therapy Center - Downtown 2001 Laurel Avenue Ste 504 Knoxville,TN37916	Physical Rehabilitation Therapy Center
2	Fort Sanders West Diagnostic Center MOB-3 Ste 210 Ft Sanders West Blvd Knoxville,TN37922	Diagnostic Center
3	FSR Infusion Services TCSC 1915 White Avenue Knoxville,TN37916	Pharmacy - Infusion Services
4	FSR Infusion Services Oak Ridge 200 New York Avenue Suite 230 Oak Ridge,TN37830	Pharmacy - Infusion Services
5	FSR Cardiopulmonary Rehab Ft Sanders POB Ste 301 501 20th St Knoxville,TN37916	Cardiopulmonary Rehab Therapy Center
6	Fort Sanders Wound Care Center 2001 Laurel Avenue Suite G-6 Knoxville,TN37916	Wound Care
7	FSR Therapy Center - Powell 3515 Emory Road Suite P-9 Powell,TN37849	Physical Rehabilitation Therapy Center
8	FSR Therapy Center - Halls 6679 Maynardville Hwy Knoxville,TN37918	Physical Rehabilitation Therapy Center
9	Fort Sanders Regional Breast Center 1915 White Avenue Knoxville,TN37916	Breast Center (Diagnostics)
10	Thompson Infusion Center 215 BMH Cancer Center Drive Maryville,TN37804	Pharmacy - Infusion Services
11	Fort Sanders Regional MRI Dept 1915 White Avenue Knoxville,TN37916	Magnetic Resonance Imaging (Diagnostics)
12	Diabetes Center Outreach Program MOB-2 Ste 205 220 FSW Blvd Knoxville,TN37922	Diabetes Center
13	Fort Sanders Regional Infusion Svcs 1901 Clinch Avenue Knoxville,TN37916	Pharmacy - Infusion Services
14	FSR Infusion Services Lenoir City 576 Fort Loudoun Med Ctr Dr Ste 204 Lenoir City,TN37772	Pharmacy - Infusion Services
15	FS Neurodiagnostics & Sleep Center Ft Sanders POB Ste 303 501 20th St Knoxville,TN37916	Neurodiagnostics and Sleep Center
16	Fort Sanders Regional Laser Center 1915 White Avenue Knoxville,TN37916	Center for Barrett's Esophagus
17	Patricia Neal Rehabilitation Center 1901 Clinch Avenue Knoxville,TN37916	Rehabilitation Unit
18	FSRMC Transitional Care Unit 1901 Clinch Avenue Knoxville,TN37916	Skilled Nursing Facility
19	FSR Gamma Knife Center 1915 White Avenue 1st Floor Knoxville,TN37916	Gamma Knife Center

Schedule H (Form 990) 2013

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
Fort Sanders Regional Medical Center	Part V, Section B, Line 3: "Together! Healthy Knox" (T!HK) was launched by the Knox County Health Department in May 2010 and was designed to create a community approach to better health. The T!HK initiative is based on the Mobilizing for Action through Planning and Partnerships (MAPP) model for community health planning, which consists of specific steps meant to be repeated every three to five years. What began with a twenty partner Leadership Team grew to involve over seventy community and organizational partners. The assessment process, led by the Health Department, had broad participation from the public health community, including all Knox County hospitals. All four MAPP assessments were completed in 2011, and the T!HK Leadership Team determined the most critical issues to be addressed in Knox County. After nearly three years of data collection, analysis and meetings, the priority areas were announced to the broader community in a press conference on November 1, 2012. Three action teams formulated goals and strategies to address the three priority areas identified.
Fort Sanders Regional Medical Center	Part V, Section B, Line 4: Knox County hospitals who participated in the "Together! Healthy Knox" initiative included Fort Sanders Regional Medical Center, Parkwest Medical Center, East Tennessee Children's Hospital, and The University of Tennessee Medical Center.
Fort Sanders Regional Medical Center	Part V, Section B, Line 14g: Please see the explanation to Part VI, Line 3.
Fort Sanders Regional Medical Center	Part V, Section B, Line 20d: Please see the explanation to Part III, Line 9b.

Schedule H (Form 990) 2013

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
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

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. Part II can be duplicated if additional space is needed.

(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 Center 1915 White Avenue Knoxville,TN37916	62-1250943	501(c)(3)	75,192	Financial support of Fellowship Center
(2) Fort Sanders Foundation 280 Ft Sanders West Blvd Ste 202 Knoxville,TN37922	62-1748601	501(c)(3)	229,222	Fellowship Center maintenance and food fund
(3) Joni and Friends Ministry Knoxville 1540 Robinson Road Knoxville,TN37923	62-1458199	501(c)(3)	5,500	Support & ministry to the disabled

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

Cat. No. 50055P

Schedule I (Form 990) 2013

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.
Part III can be duplicated 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) Assistance with health insurance premiums	1	2,323
(2) To provide critical medications to indigent hospital patients at discharge in order to facilitate earlier discharge or to prevent readmission	440		44,227	Cost	Prescription medications
(3) Patient well being items- gift cards, tickets and clothing	169		6,360	Cost or FMV	Donated gift cards, tickets and clothing passed on to patients

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference

Explanation

Part I, Line 2:

The hospital provides for the post-hospitalization 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) 2013

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, line 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

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 of 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
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2013

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 (E) amounts for that individual.

(A) Name and Title		(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 and Title		(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 SpeziaPresident & CEO	(i) (ii)	0 955,101	0 443,088	0 145,323	0 214,000	0 14,486	0 1,771,998	0 0
(2)John T GeppiEVP/CFO	(i) (ii)	0 448,213	0 184,500	0 77,563	0 10,000	0 15,177	0 735,453	0 0
(3)Keith AltshulerPres. & CAO - FSRMC	(i) (ii)	0 255,884	0 40,948	0 42,894	0 10,000	0 21,897	0 371,623	0 0
(4)Ronnie S BeelerVP-Financial Services	(i) (ii)	151,294 0	5,000 0	13,345 0	7,000 0	21,571 0	198,210 0	0 0
(5)Jennifer L HansonVP-Chief Nursing Officer	(i) (ii)	178,779 0	10,000 0	31,939 0	6,260 0	7,440 0	234,418 0	0 0
(6)Mary E Dillon MDMedical Director	(i) (ii)	202,152 0	0 0	873 0	0 0	2,936 0	205,961 0	0 0
(7)Christopher NorrisPharmacy Director	(i) (ii)	146,310 0	0 0	305 0	8,940 0	18,629 0	174,184 0	0 0
(8)Nancy GrangerPharmacy Manager	(i) (ii)	134,268 0	0 0	2,574 0	8,316 0	18,645 0	163,803 0	0 0
(9)Marianne OliveiraSr. Instructor - Nursing S	(i) (ii)	131,645 0	0 0	2,246 0	5,945 0	14,933 0	154,769 0	0 0

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
Part I, Line 1a	Tax gross-up payments are provided to certain executives and managers. These are treated as taxable compensation to the recipients.
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.
Part I, Line 4b	Anthony L. Spezia was a participant in two nonqualified deferred compensation plans, which will be referred to as Plan A and Plan B. In 2011 Mr. Spezia vested in Plan A, and the accumulated balance as of August 1, 2011 was included in his 2011 taxable income. An Amendment to Plan A was adopted effective August 1, 2011 which terminated further accruals (contributions) to the plan. However, the Amendment does allow the accrual of interest on undistributed amounts which will be subject to risk of forfeiture until such time as indicated in the Amendment. Interest earned by Plan A in 2013 amounted to $77,542 and is not required to be reported in Part II, as Mr. Spezia is not substantially vested in earnings accumulated after July 31, 2011. Plan B was established in 2011. Employer contributions to Plan B during 2013 totaled $204,000, which is reported in Column C of Schedule J, Part II. Interest earned by Plan B during 2013 of $30,427 is not required to be reported in compensation in Part II, as Mr. Spezia is not substantially vested in Plan B.

Schedule J (Form 990) 2013

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.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

Fort Sanders Regional Medical Center

Employer identification number

62-0528340

Return Reference	Explanation
Form 990, Part III, Line 1	REPORT TO THE COMMUNITY Covenant Health was formed in 1996 with the mission to serve its communities by improving the quality of life through better health. The health system is nationally recognized as a top performer in many areas: patient care, quality performance, cost, integration, information technology, finances, ethics and innovation. Amid a challenging healthcare environment, Covenant Health has committed to these imperatives: * Serving the communities as a not-for-profit health system. * Leading in quality and service. * Outstanding governance and leadership. * An engaged work force with the right skill sets. * Being the practice environment of choice for physicians. * Reinvesting in the communities, providing programs, services, technologies and facilities that improve local healthcare services and patient care. Covenant Health has invested well over a billion dollars in its communities since 2000 - a commitment no other healthcare organization has approached. It has opened new hospitals, expanded services, and brought cutting-edge medical technology to the region. * Meeting the challenges of the healthcare environment through effective strategic planning and wise use of resources. * Providing excellent care to every patient, every time. Covenant Health's Board of Directors and its administration are challenged by a complex and changing healthcare environment. These challenges require strong collaboration and a common vision among all of Covenant Health's constituents: employees, physicians, board members, patients and the communities served by Covenant Health. Providing quality care and an excellent patient experience remain high priorities for the board, especially in a new era of reimbursement based on outcomes and patient satisfaction. Because of the focused commitment of Covenant's administration and caregivers, the health system performs well in these areas. Covenant Health is committed to maintaining its not-for-profit status while providing needed services to the communities. Despite the increasing shift of responsibilities for charity care to the hospitals, Covenant Health remains strong in delivering care that improves the quality of life at the lowest possible cost. It works closely with physicians to develop strategies for service lines and health system operations and has the financial strength to weather impending storms while investing in new technologies, people, and other opportunities as they arise. In the face of today's challenges, Covenant Health has a firm foundation on which to stand, balancing lessons learned with strengths gained from a disciplined execution of thoughtful strategies. The board has a clear vision of the importance of fulfilling the mission and is prepared to address challenges with determination, commitment, knowledge and community focus. Covenant Health Member Organizations Covenant Health Board members and administrative leaders serve their communities through strategic planning and successful operation of these member organizations: Hospitals and Other Healthcare Providers: Claiborne Medical Center (joined the system April 1, 2014) Cumberland Medical Center (joined the system February 1, 2014) Covenant Homecare and Hospice Fort Loudoun Medical Center (Fort Loudoun) Fort Sanders Perinatal Center (Perinatal Center) Fort Sanders Regional Medical Center (Fort Sanders Regional) LeConte Medical Center (LeConte) Methodist Medical Center (Methodist) Morristown-Hamblen Healthcare System (Morristown-Hamblen) Parkwest Medical Center (Parkwest) Peninsula Hospital, a Division of Parkwest Medical Center (Peninsula) Roane County Medical Center (Roane) Thompson Cancer Survival Center Thompson Oncology Group Knoxville Heart Group Outpatient and Specialty Care Departments and Joint Ventures: Hospital-based Therapy Centers Fort Sanders West Diagnostic Center Fort Sanders West Outpatient Surgery Center Morristown Regional Diagnostic Center Patricia Neal Rehabilitation Center Peninsula Outpatient Centers Thompson Cancer Survival Center hospital-based Infusion Centers Fort Sanders Sevier Nursing Home Foundations: Fort Sanders Foundation Methodist Medical Center Foundation Morristown-Hamblen Hospital Foundation Thompson Cancer Survival Center Foundation Other Programs and Services: Fortress Corporation Covenant Medical Management, Inc. Covenant Health is also a partner in joint ventures with physicians that provide surgical and other services. Recognized Excellence in Caring for Our Communities Covenant Health delivers quality care, with services designed to meet the specific needs of people in the communities it serves. Nine acute care hospitals located in Knoxville and surrounding areas comprise the foundation of the health system. The hospitals offer comprehensive care, including emergency care, specialty services, and a full range of diagnostics and treatment provided by board-certified medical staffs. Three Covenant Health hospitals - Fort Sanders Regional, Methodist, and Parkwest Medical Centers - were named among the top 10 hospitals in Tennessee in 2013 by U.S. News and World Report, recognizing excellence in both overall and specialty care. Covenant Health hospitals also have been recognized for clinical accomplishments by VHA, Inc., a cooperative of non-profit healthcare organizations.
Form 990, Part III, Line 1	At the Forefront of Local Behavioral Health Care and Community Collaboration Following the closure of Lakeshore Mental Health Institute in 2012, patient volumes at Peninsula, a division of Parkwest Medical Center ("Peninsula") increased significantly. Efforts are made to keep patients in the community in order to provide a better continuum of care. While mental health resources are available in other Tennessee locations, outside transfers make a seamless transition and follow-up care more difficult. Therefore the staff at Peninsula continue to work on internal process improvements to be able to care for more patients. Outpatient treatment follows a 'best practice' model of care whereby new patients get immediate appointments with a nurse, therapist, physician or nurse practitioner. If a patient misses an appointment, it is rescheduled for the same day or the next. Patients have a better chance for success in treatment when there is no lag time. As a result of this approach, outpatient "no show" rates have decreased and outpatient satisfaction rates are in the 90th percentile. Other best practices include involving families or patient support systems in treatment plans and using a computerized call-back scheduling system so that phone calls are returned promptly. Peninsula staff members take a yearly refresher in Therapeutic Crisis Intervention to help behavioral staff recognize and verbally de-escalate situations that could otherwise turn into a crisis. Peninsula also works with police officers to help them recognize symptoms of mental illness among those they encounter as part of their work. Police officers may encounter someone with mental illness as often as once every shift. Peninsula also collaborates with other area mental health organizations and primary care physicians to enhance care and resources for behavioral health patients. The goal is to help people get the mental health services they need, rather than winding up in the Emergency Department, on the streets or in prison. The state of Tennessee provided funds for medications for indigent patients, transportation assistance and other outpatient programs. United Way provided a grant to assist patients transitioning to independent living. In addition to the 155-bed inpatient psychiatric hospital in Blount County, Peninsula also has outpatient facilities in Knox, Blount, Loudon, and Sevier counties. The provision of care may include hospitalization, therapy sessions, visits with psychiatrists, medication management, intensive outpatient programs and support groups. Covenant Health Hospitals Help Families Welcome New Babies More than 6,500 babies were born in a Covenant Health hospital in 2013. The health system offers a variety of birthing options and hospital amenities to help parents and families welcome their newborns. Families come in all shapes and sizes and so do expectations and beliefs about childbirth. Some mothers prefer minimum intervention. Others are comforted that pain relief is available during labor and delivery. Some mothers decide on an obstetrician before planning for their babies. Others choose the hospital first and then choose a qualified physician who delivers at that hospital. Covenant Health hospitals work to provide excellent care and comfort while accommodating patients' preferences for room-in or nursery care after delivery. Maternity suites at Covenant hospitals are spacious, beautifully decorated and designed to maximize comfort and provide immediate access to technology. Room options include private suites equipped with bassinets for rooming in and sleeper furniture for a family member. Some hospitals also have post-partum rooms available. Depending on the hospital, patients may have access to whirlpool tubs or entertainment units. All maternity units are secured with monitored entries and exits. Additional security devices and procedures are in place to monitor babies' safety. Covenant Hospitals Recognized for Reducing Early Elective Deliveries In addition to overall excellence in maternity and newborn care, five Covenant Health hospitals that offer obstetrics services have been recognized by the Tennessee Hospital Association (THA) for reducing the number of babies born electively between 37 and 39 weeks gestation. Fort Sanders Regional, Parkwest, LeConte, Methodist and Morristown-Hamblen medical centers each received recognition from the THA's Tennessee Center for Patient Safety for reducing elective early deliveries, thereby increasing babies' chances for better lifelong health. All five hospitals met the goal of decreasing early elective deliveries to five percent or less, and maintained the goal level for a minimum of six consecutive months. In 2011, about 12 percent of the hospitals' deliveries that occurred prior to 39 weeks gestation were considered elective. By 2014 the number had dropped to less than one percent. The Covenant hospitals are part of a statewide Healthy Tennessee Babies Are Worth the Wait initiative launched less than two years ago to increase awareness of the benefits of full-term delivery. Among other initiatives such as patient and staff education programs, Covenant Health obstetrics departments adopted a strict policy that prohibits early elective deliveries before 39 weeks unless there is a clear medical risk to the mother or the baby. The two-week wait dramatically increases the chances for good physical and developmental health for babies. Babies born too early are at risk for respiratory distress, jaundice, hypoglycemia and other conditions or complications that require more medical care and put them at greater risk for death before their first birthdays. Waiting until 39 weeks allows for better growth and development of vital organs such as the brain, lungs and liver. Waiting is also better for the health and safety of the mother. Covenant Health is proud to lead this effort to decrease the number of infants delivered electively before 39 weeks. Two additional weeks may not seem like much time, but for an infant, it can mean the difference between complications leading to lifelong health issues and a healthy and robust start. Specialized Services for High-Risk Deliveries Specialized services are available in cases of a high-risk pregnancy. When a risk factor, either with the mother or unborn child, threatens a positive outcome it's important to know resources are available to discuss options and answer questions for concerned parents. Covenant Health hospitals plan and prepare for the unexpected with nurses trained in critical newborn care, access to neonatal intensive care services, and perinatologists at the Perinatal Center. At the Perinatal Center, perinatologists work with women of all reproductive ages and backgrounds to help them deliver a healthy baby - or babies. The referring physician, nurses, ultrasonographers, genetic counselors and support staff work together to help mothers during a difficult time and to deliver a healthy baby. Covenant Health has a comprehensive list of more than 50 physicians credentialed to provide care during pregnancy and while in the hospital. In addition, childbirth education classes are available to help parents prepare for their new arrival. Covenant Health Hospitals are Stroke Ready For a patient having a stroke, the care received immediately after it happens is critical. The hospitals of Covenant Health have been deemed "Stroke Ready" by the Healthcare Facilities Accreditation Program. This means Covenant hospitals are qualified to give patients the best initial care at the onset of a stroke. The hospitals of Covenant Health are working together to provide state-of-the-art emergency treatment and the most advanced stroke care in the region. The risk factors for stroke - high blood pressure, smoking, sedentary lifestyle and a Southern diet of deep-fried food - are high in this region. In 2013, Fort Sanders Regional's Comprehensive Stroke Center treated an average of 35-40 strokes per month. Stroke damage is often permanent and speed is vitally important to improving a patients' success at rehabilitation. A decade ago there were no local physicians that could perform procedures inside the arteries of the brain. Today, patients have access to highly qualified doctors and staff, and faster and more specialized procedures and care that significantly increase their chances of recovery. Recognized by The Joint Commission and the American Heart Association/American Stroke Association for its ability to care for stroke patients, Fort Sanders Regional is a referral center for complex stroke cases. In addition to the comprehensive Stroke Center, for patients recovering from the effects of a stroke, the nationally renowned Patricia Neal Rehabilitation Center offers a full spectrum of rehabilitation services.
Form 990, Part III, Line 1	Excellence in Orthopedic Care The hospitals of Covenant Health offer comprehensive orthopedic care, including joint replacement surgery and follow-up rehabilitation services. Specialized Joint Replacement Centers are located at Parkwest, Methodist, Fort Sanders Regional and Morristown-Hamblen medical centers. The Joint Centers have teams of experienced orthopedic surgeons, nurses, clinicians and therapists who work together to provide care for hip or knee replacement patients. When patients schedule joint replacement surgery they receive personalized care and a team approach that focuses on creating positive outcomes from the surgery. Covenant Joint Center patients are prepared beforehand, guided through the process step by step, and given extraordinary care afterwards. The first step is an educational program, with an optional tour. Therapy following the surgery helps patients concentrate on developing strength in their new joints and regaining mobility. The Covenant Joint Centers' unique approach emphasizes patient education, family involvement and group support during rehabilitation. The expert team approach combined with a unique healing environment puts patients on the road to recovery faster and with fewer complications. Performing as Promised in Local Communities As a not-for-profit 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 over $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. Despite a challenging economic environment, Covenant Health's financial strength allows it to continue pursuing a strategy of excellence and a commitment to state-of-the-art facilities, medical technology and medical information systems. Achieving Quality Partnerships with Physicians Covenant Health collaborates with physicians to accomplish its mission of improving the quality of life through better health. Physicians partner with the health system in many ways including employment, as members of hospital medical staffs and Covenant's board of directors, in committee leadership roles, through joint ventures and in the development of service line strategies. Covenant Medical Group, Inc. (CMG) is the new name for the health system's employed physician practices. Formerly Covenant Medical Management, CMG has grown substantially over the past several years and has more than 140 physicians in more than 70 practice locations. CMG includes both primary care and specialty physicians, with significant growth among specialty physicians. Physicians often struggle with the complexity of running a medical practice in the current healthcare environment. A physician with a solo practice may struggle economically to make that practice work. Many physicians consider employment by hospitals and health systems as an effective way to continue providing medical care in their communities. Physicians who become part of CMG do so for more than just the economic aspect of practicing medicine, and often seek employment of Covenant Health for broader reasons. Physicians who become employed by Covenant Health often decide to do so based on confidence in the health system's leadership team, because of Covenant's strategic direction and performance, and because of the quality of care delivered. Other attributes that influence the decision include the health system's local governance and strong market position and relationships. Covenant Health builds and maintains partnerships with physicians through joint ventures such as surgery centers and the development of service line strategies that focus on improving quality and cost of patient care. Nearly 1500 physicians are affiliated with Covenant Health hospitals and member organizations as active or consulting members of the health system's medical staffs. Overall, Covenant Health's desire for alignment with both employed and non-employed physicians is driven by the need to fully evolve as a healthcare system in today's environment. The health system's goal is to work side by side with physicians to provide a seamless continuum of care and excellent outcomes for patients. Connecting to Meet the Need through Philanthropy Covenant Health's Office of Philanthropy coordinates the philanthropic contributions of individuals and businesses throughout East Tennessee and beyond in support of health care in our region. Fund raising efforts are led by volunteer boards and staff at four foundations: Fort Sanders Foundation (serving the needs of Fort Sanders Regional, Fort Loudoun, Parkwest, Roane, Peninsula, and the Patricia Neal Rehabilitation Center), Methodist Medical Center Foundation, Morristown- Hamblen Hospital Foundation, and Thompson Cancer Survival Center Foundation. The Dr. Robert F. Thomas Foundation is independent from Covenant Health but partners with LeConte to serve the needs of that hospital. During the past year the foundations of Covenant Health received contributions of approximately $3 million from generous individuals and businesses. These donors are partnering with Covenant Health to meet the challenges of providing the best health care possible for the communities served. Funds are used to provide new equipment and facilities at the hospitals, as well as for staff training, pastoral care and patient care programs. Covenant Health strives to go beyond excellent care and to find ways of improving health on all levels - physical, mental and spiritual. Pastoral care is a critical part of healing body, mind and spirit for many of the patients and their families. No patient is ever billed for the support and counseling offered by the hospital chaplains. In the health care environment, chaplains and volunteer spiritual counselors are seen as partners in the healing process, and their services are underwritten by many generous donors. Each year, the Fort Sanders Regional and Parkwest pastoral care departments host the Gammon-Heatherly Lecture Series which provides continuing education to area ministers and other caregivers. The annual event is provided through charitable gifts. The series aims to be thought-provoking and insightful and provides a good networking opportunity with clergy and laypersons from the community. In May 2013 a new Serenity Garden was dedicated at Roane County Medical Center. The garden offers a quiet spot for reflection and respite just outside the hospital's front entrance. It features specially engraved stone pavers recognizing generous community organizations, churches and individuals who supported the campaign for the new hospital and pastoral care services for patients and families. Together with many generous members of our community, the Foundations of Covenant Health are meeting important physical and spiritual needs on the path to improved health for all. Leadership Academy Welcomes Second Group of Participants for "Up Close" Healthcare Experience While the Office of Philanthropy staff coordinates community events and fund raisers, local community leadership and involvement is critical to fund raising success. To expand the number of informed volunteer leaders in the community, the Office of Philanthropy launched a new program, Covenant Answers: A Healthcare Leadership Academy. Inaugural Academy participants included representatives from the boards of Covenant Health, and Fort Sanders and Thompson Cancer Survival Center Foundations. Future Leadership Academy classes will include business and community representatives from throughout Covenant's service area. During a five-month period class members attend half-day sessions at five different Covenant hospitals. Classes include behind-the-scenes tours and hands-on access to the latest technologies and treatments. Participants have opportunities to discuss the challenges of the current healthcare environment with leading Covenant physicians and clinicians, and speak firsthand with patients whose recovery hinges on the excellent care provided at one of the Covenant hospitals. The first group of participants were given the chance to try their hands at using adaptive rehab equipment and maneuvering a surgical robot.
Form 990, Part III, Line 1	Reaching Beyond Hospital Walls In addition to taking care of the patients and families who receive direct services, Covenant Health is committed to making a positive impact in the health of the surrounding community. In all the communities Covenant Health serves, local initiatives and partnerships create opportunities to interact with people of all ages and encourage healthier lifestyles. * In April 2013 approximately 7,000 people participated in the 9th anniversary of the Covenant Health Knoxville Marathon, which attracted local runners and hand cyclists, as well as competitors from throughout the U.S. and other countries. * The Covenant Health Biggest Winner Weight Loss Challenge continued as a friendly competition that encourages East Tennesseans to get off the couch and get moving for a fit and healthy lifestyle. Team members train together for five months, with the goal of crossing the finish line in Covenant Health Knoxville Marathon events. Participants challenge other East Tennesseans to start a health journey that will change their lives for the better. * Some of the funds raised through the Covenant Health Knoxville Marathon were contributed to The Patricia Neal Rehabilitation Center's Innovative Recreation Cooperative, a collaboration of groups and individuals who help disabled persons enjoy leisure and recreation activities such as water skiing and cycling. * The Covenant Kids Run attracted over 1,000 children who participated in a "marathon" of activities over a period of several weeks, culminating in a run to Neyland Stadium on the day before the Covenant Health Knoxville Marathon. * Covenant 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. Each year participating children make quilt squares, which are later used to create quilts representing each camp session. In 2013, several quilts were selected for display at the Oak Ridge Children's Museum. * Covenant Health hospitals are partnering with local organizations to perform assessments of health status and to identify the primary health issues affecting our region. Once assessments are complete, the hospitals will be developing local programs and communicating availability of existing services to help address some of these health issues. Community Benefit Report One of the most tangible expressions of the charitable purpose of Covenant Health is providing care to people in need. As a not-for-profit system, Covenant Health provides medically necessary services to people with limited resources. Covenant Health actively participates in the state's TennCare program, and collaborates with other area providers to identify and support efforts to make community healthcare resources available for those in need. Summary of System Community Benefit Totals for Uncompensated Care 2013 Charity Care . . . . . . . . . . . . . . . . . . $48.5 million TennCare* . . . . . . . . . . . . . . . . . . . $40.5 million Medicare* . . . . . . . . . . . . . . . . . . . . $71.1 million Total Uncompensated Care . . . . . . . . . . . $160.1 million Each hospital in the Covenant Health system reports its specific Uncompensated Care on its Form 990. *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. 2013 Summary of Additional Community Benefit Health Professions Education Continuing education; preparation of future healthcare professionals . $1,558,904 Subsidized Health Services Clinical services provided to meet community needs despite financial loss . . . . . . . . . . . . . . . $18,815,965 Donations, Medical Missions and Community Building Funds and in-kind services donated to the community, including funds to support charitable endeavors and address challenges such as poverty and homelessness, as well as mission trips to areas outside the U.S . $3,438,855 Total Contributions . . . . . . . . . $183,913,724
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 Code of Conduct to all employees. The Code covers among other subjects, conflicts of interest. Additionally, managers are required to complete and sign an annual management certification that addresses conflicts of interest. Board members' conflicts of interests are dealt with in the corporate bylaws, and Board members are required to complete and sign a conflict of interest questionnaire on an annual basis. The Integrity Compliance Office maintains records that contain conflict of interest information obtained from Board members, officers and employees. These records are available to be queried prior to engaging in business transactions. The Integrity Compliance Officer initially reviews all conflict of interest data. Based on this information, the officer determines what conflicts of interest exist at that point in time. Between times when surveys are collected Board members are expected to disclose any new conflicts that have arisen that affect pending Board decisions. As well, managers and other employees are expected to report conflicts to the Integrity Compliance Officer as they arise. Depending on the nature of the conflict and the circumstances surrounding the conflict and transaction, the Integrity Compliance Officer, Senior Leadership, or the Board of Directors may review the conflict of interest. Where appropriate these bodies may also consult legal counsel. Restrictions imposed on persons with a conflict of interest are determined on a case by case basis. For Covenant Health employees, the Integrity Compliance Officer in conjunction with Executive Leadership determines how to appropriately handle the conflict. In any conflict involving a Board member, such member is expected to excuse himself or herself from voting on matters that give rise to the conflict.
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 ("the Committee"), 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 2013 Form 990 of Covenant Health, EIN 62-1646734. Form 990, Part VI, Section B, Line 15b: Base salary and annual bonus opportunities for Keith Altshuler, President and Chief Administrative Officer, are set by the Covenant Health CEO or Executive Vice President-Human Resources, subject to approval of the Compensation Committee of the Covenant Health Board of Directors ("the Committee"), after review by and discussion with the executive compensation consultant ("the Consultant") to ensure that total compensation is reasonable and within a fair market value range. Salary ranges are based upon the recommendations of the Consultant made after comparison with similar jobs in similar size health systems across the nation. Bonuses are recommended by the CEO and approved by the Committee conditioned upon receipt of a written opinion from the Consultant that total compensation for the President/CAO is reasonable and consistent with fair market value. Base salary is initially targeted at midpoint and may 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 salaries and annual bonus opportunities for Ronnie Beeler, Vice President of Financial Services, and Jennifer Hanson, Vice President and Chief Nursing Officer, are based on established targets to ensure that total compensation for each executive 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	Fort Sanders Regional Medical Center files a Joint Annual Report containing financial information with the Tennessee Department of Health. Per its tax-exempt bond provisions, Covenant Health, the parent company of the organization, 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) service of the Municipal Securities Rulemaking Board (MSRB). Any member of such a repository has access to these financial statements.
Form 990, Part VI, Section A, Line 9:	Contact Addresses for Officers, Directors, Etc. 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 XI, line 9:	Intracompany Eliminations 35,818.
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) 2013

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
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Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

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 (if applicable) 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 entity?
(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 health 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 8045 Roane Medical Center Dr 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	Thompson Cancer Survival Center		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	Fort Sanders Regional Medical Center	Yes
(11) Fort Sanders Foundation 280 Fort Sanders West Blvd Ste 202 Knoxville,TN37922 62-1748601	Fundraising and patient outreach	TN	501(c)(3)	Line 11b, II	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 11b, II	Covenant Health		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2013

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 V-UBI 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 V-UBI 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 200 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) KOSC Properties LLC 256 Fort Sanders West Blvd Ste 200 Knoxville,TN37922 26-2444076	Building ownership	TN	N/A
(6) Knoxville Orthopaedic Surgery Center LLC 256 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	(i) Section 512(b)(13) controlled entity?
(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		Yes	No
(1) Fortress Corporation 280 Fort Sanders West Blvd Suite 21 Knoxville,TN37922 62-1308885	Management company	TN	N/A	C					No
(2) Covenant Medical Group Inc 1400 Centerpoint Blvd Bldg A Suite Knoxville,TN37932 62-1282917	Physician practice management	TN	N/A	C					No
(3) Knoxville Heart Group 1819 Clinch Ave Suite 108 Knoxville,TN37916 27-1528941	Cardiology medical practice	TN	Fort Sanders Regional Medical Center	C	-2,613,762	384,488	100.000 %	Yes
(4) East TN Cardiovascular Surgery Group Inc 9125 Cross Park Dr Ste 200 Knoxville,TN37923 62-1018541	Cardiovascular surgery practice	TN	N/A	C					No

Schedule R (Form 990) 2013

Page 3

Part V

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

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

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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

s 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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Fort Sanders Perinatal Center	A	543,692	Cost
(2) Fort Sanders Perinatal Center	N	128,282	Cost
(3) Fort Sanders Perinatal Center	Q	64,969	Cost
(4) Knoxville Heart Group	A	249,943	Cost
(5) Knoxville Heart Group	M	607,000	Cost
(6) Knoxville Heart Group	N	71,351	Cost

Schedule R (Form 990) 2013

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 V?UBI 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 V?UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:
Software Version: