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Nonprofiteer
← FORT LOUDOUN MEDICAL CENTER

Form 990 for tax year 2022

Filed by FORT LOUDOUN MEDICAL CENTER.

Totals

Total revenue
$45,777,328
Total expenses
$40,508,733
Contributions and grants received
$912,511
Grants paid
$2,620
Program service revenue
$44,620,604
Investment income
$8,709
Other revenue
$235,504
Total assets, end of year
$20,744,558
Total liabilities, end of year
$4,213,943
Net assets or fund balances, end of year
$16,530,615
Program services expenses (Part IX)
$38,973,364
Management and general expenses
$1,535,369
Fundraising expenses
$0
Program service expenses (Part III)
$38,973,364

Program services were 96.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1e · Government grants (contributions)

    $912,511

  • 2a · Program service revenue: Net Patient Revenue

    total $44,620,604 · related or exempt $44,620,604

  • 3 · Investment income

    total $14,852 · excluded $14,852

  • 7b · Less cost or other basis and sales expenses

    other assets $6,143

  • 7c · Gain or loss

    other assets -$6,143

  • 7d · Net gain or loss

    total -$6,143 · excluded -$6,143

  • 11a · Other revenue: Cafeteria

    total $117,158 · excluded $117,158

  • 11b · Other revenue: Gift Shop

    total $113,166 · excluded $113,166

  • 11c · Other revenue: Student Sponsorships

    total $4,800 · related or exempt $4,800

  • 11d · All other revenue

    total $380 · excluded $380

  • 11e · Other revenue, total

    $235,504

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $2,620 · program services $2,620

  • 5 · Compensation of officers, directors and key employees

    total $185,126 · management and general $185,126

  • 7 · Other salaries and wages

    total $12,585,303 · program services $11,999,527 · management and general $585,776

  • 8 · Pension plan contributions

    total $387,788 · program services $375,038 · management and general $12,750

  • 9 · Other employee benefits

    total $1,240,244 · program services $1,186,556 · management and general $53,688

  • 10 · Payroll taxes

    total $912,601 · program services $869,105 · management and general $43,496

  • 11a · Fees: management

    total $4,583,827 · program services $4,522,835 · management and general $60,992

  • 11b · Fees: legal

    total $905 · management and general $905

  • 11g · Fees: other

    total $7,314,715 · program services $7,259,465 · management and general $55,250

  • 12 · Advertising and promotion

    total $83,297 · program services $79,422 · management and general $3,875

  • 13 · Office expenses

    total $332,244 · program services $221,912 · management and general $110,332

  • 16 · Occupancy

    total $1,140,859 · program services $866,098 · management and general $274,761

  • 17 · Travel

    total $5,536 · program services $5,041 · management and general $495

  • 19 · Conferences, conventions and meetings

    total $2,389 · program services $2,389

  • 22 · Depreciation, depletion and amortization

    total $1,939,455 · program services $1,939,455

  • 23 · Insurance

    total $46,986 · program services $7,638 · management and general $39,348

  • 24a · Other expenses: Medical Supplies

    total $4,773,292 · program services $4,773,292

  • 24b · Other expenses: Bad Debt

    total $3,348,752 · program services $3,348,752

  • 24c · Other expenses: Minor Equipment

    total $1,170,803 · program services $1,120,360 · management and general $50,443

  • 24d · Other expenses: Food and Dietary

    total $229,267 · program services $229,160 · management and general $107

  • 24e · All other expenses

    total $222,724 · program services $164,699 · management and general $58,025

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $1,800 · end of year $1,800

  • 2 · Savings and temporary cash investments

    beginning of year -$240,048 · end of year -$172,196

  • 4 · Accounts receivable

    beginning of year $4,529,943 · end of year $4,940,438

  • 8 · Inventories for sale or use

    beginning of year $324,235 · end of year $324,923

  • 9 · Prepaid expenses and deferred charges

    beginning of year $116,832 · end of year $106,507

  • 10a · Land, buildings and equipment: cost or other basis

    $48,231,256

  • 10b · Land, buildings and equipment: accumulated depreciation

    $33,131,449

  • 10c · Land, buildings and equipment, net

    beginning of year $15,177,630 · end of year $15,099,807

  • 15 · Other assets

    beginning of year $942,744 · end of year $443,279

  • 17 · Accounts payable and accrued expenses

    beginning of year $4,194,563 · end of year $2,938,237

  • 25 · Other liabilities

    beginning of year $1,204,344 · end of year $1,275,706

  • 27 · Net assets without donor restrictions

    beginning of year $15,454,229 · end of year $16,530,615

Mission and programs · 2022

Mission

Fort Loudoun 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 a patient's ability to pay.

Activities or mission (Part I)

Fort Loudoun Medical Center is a 50-bed full service, acute care hospital located in Loudon County, Tennessee. It is a member of the Covenant Health system.

  • Withheld by Nonprofiteer: this text may name a private individual.

    Expenses $38,973,364 · Grants $2,620 · Revenue $44,625,404

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here. A text marked withheld matched a screen for wording that may name a private individual, such as an honorific or "in memory of". Most of what it withholds names no one; it is withheld so that what does is never shown.

Listed in Part VII

  • Gerald Boyd

    Director

    Total calculated
    $0
    Hours/week
    0 + 1 related

  • Willard Campbell MD

    Director

    Total calculated
    $0
    Hours/week
    0 + 1 related

  • Michael Casey MD

    Director

    Total calculated
    $0
    Hours/week
    0 + 1 related

  • Ronni Chandler

    Director

    Total calculated
    $0
    Hours/week
    0 + 1 related

  • Mitchell Dickson MD

    Director

    Total calculated
    $268
    From this org
    $0
    From related orgs
    $268
    Other
    $0
    Hours/week
    0 + 1 related

  • Stephanie Flood

    Director

    Total calculated
    $849
    From this org
    $0
    From related orgs
    $849
    Other
    $0
    Hours/week
    0 + 1 related

  • James Gibson

    Director

    Total calculated
    $74
    From this org
    $0
    From related orgs
    $74
    Other
    $0
    Hours/week
    0 + 1 related

  • Edgar Gray

    Director

    Total calculated
    $1,432
    From this org
    $0
    From related orgs
    $1,432
    Other
    $0
    Hours/week
    0 + 1 related

  • Leslye Hartsell

    Director

    Total calculated
    $889
    From this org
    $0
    From related orgs
    $889
    Other
    $0
    Hours/week
    0 + 1 related

  • Donald Hickman

    Director

    Total calculated
    $1,538
    From this org
    $0
    From related orgs
    $1,538
    Other
    $0
    Hours/week
    0 + 1 related

  • Timothy Matthews

    Director

    Total calculated
    $906
    From this org
    $0
    From related orgs
    $906
    Other
    $0
    Hours/week
    0 + 1 related

  • Janice McKinley

    Director

    Total calculated
    $1,097
    From this org
    $0
    From related orgs
    $1,097
    Other
    $0
    Hours/week
    0 + 1 related

  • Dave Miller

    Director

    Total calculated
    $1,208
    From this org
    $0
    From related orgs
    $1,208
    Other
    $0
    Hours/week
    0 + 1 related

  • Bill Myers

    Director

    Total calculated
    $0
    Hours/week
    0 + 1 related

  • Alvin Nance

    Director

    Total calculated
    $0
    Hours/week
    0 + 1 related

  • Linda Ogle

    Director

    Total calculated
    $0
    Hours/week
    0 + 1 related

  • King Purnell

    Director/Chair

    Total calculated
    $1,050
    From this org
    $0
    From related orgs
    $1,050
    Other
    $0
    Hours/week
    0 + 1 related

  • Jorge Sanabria

    Director

    Total calculated
    $1,485
    From this org
    $0
    From related orgs
    $1,485
    Other
    $0
    Hours/week
    0 + 1 related

  • William Seale

    Director

    Total calculated
    $1,251
    From this org
    $0
    From related orgs
    $1,251
    Other
    $0
    Hours/week
    0 + 1 related

  • Cosby Stone

    Director

    Total calculated
    $1,408
    From this org
    $0
    From related orgs
    $1,408
    Other
    $0
    Hours/week
    0 + 1 related

  • Joe Sutter

    Director

    Total calculated
    $979
    From this org
    $0
    From related orgs
    $979
    Other
    $0
    Hours/week
    0 + 1 related

  • James Tramontana MD

    Director

    Total calculated
    $1,208
    From this org
    $0
    From related orgs
    $1,208
    Other
    $0
    Hours/week
    0 + 1 related

  • James D VanderSteeg

    President & CEO

    Total calculated
    $2,662,703
    From this org
    $0
    From related orgs
    $2,346,646
    Other
    $316,057
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,425,507 related
    Bonus
    $0 + $742,500 related
    Other
    $0 + $178,639 related
    Deferred
    $0 + $284,975 related
    Nontaxable benefits
    $0 + $31,082 related
    Filer's total
    $0 + $2,662,703 related

  • John T Geppi

    EVP/CFO

    Total calculated
    $1,133,767
    From this org
    $0
    From related orgs
    $1,099,851
    Other
    $33,916
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $679,719 related
    Bonus
    $0 + $309,084 related
    Other
    $0 + $111,048 related
    Deferred
    $0 + $11,600 related
    Nontaxable benefits
    $0 + $22,316 related
    Filer's total
    $0 + $1,133,767 related

  • Jeffrey L Feike

    Fmr Pres & CAO (through Apr 2022)

    Total calculated
    $328,551
    From this org
    $0
    From related orgs
    $306,366
    Other
    $22,185
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $89,596 related
    Bonus
    $0 + $71,369 related
    Other
    $0 + $145,401 related
    Deferred
    $0 + $11,600 related
    Nontaxable benefits
    $0 + $10,585 related
    Filer's total
    $0 + $328,551 related

  • Connie B Martin

    President & CAO

    Total calculated
    $283,062
    From this org
    $0
    From related orgs
    $244,887
    Other
    $38,175
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $169,207 related
    Bonus
    $0 + $31,775 related
    Other
    $0 + $43,905 related
    Deferred
    $0 + $15,849 related
    Nontaxable benefits
    $0 + $22,326 related
    Filer's total
    $0 + $283,062 related

  • M Scott Hamilton

    VP - Financial Services

    Total calculated
    $288,984
    From this org
    $0
    From related orgs
    $247,377
    Other
    $41,607
    Hours/week
    10 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $191,681 related
    Bonus
    $0 + $39,975 related
    Other
    $0 + $15,721 related
    Deferred
    $0 + $9,440 related
    Nontaxable benefits
    $0 + $32,167 related
    Filer's total
    $0 + $288,984 related

  • Suzanne Miller

    VP - Chief Nursing Officer

    Total calculated
    $185,126
    From this org
    $168,636
    From related orgs
    $0
    Other
    $16,490
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $122,254
    Bonus
    $26,362
    Other
    $20,020
    Deferred
    $6,019
    Nontaxable benefits
    $10,471
    Filer's total
    $185,126

  • Ashley N Touton

    Clinical Nurse

    Total calculated
    $159,294
    From this org
    $142,700
    From related orgs
    $0
    Other
    $16,594
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $139,250
    Bonus
    $3,440
    Other
    $10
    Deferred
    $7,225
    Nontaxable benefits
    $9,369
    Filer's total
    $159,294

  • Brenda L Smith

    Clinical Nurse

    Total calculated
    $158,204
    From this org
    $130,878
    From related orgs
    $0
    Other
    $27,326
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $127,541
    Bonus
    $3,190
    Other
    $147
    Deferred
    $5,915
    Nontaxable benefits
    $21,411
    Filer's total
    $158,204

  • Matthew A Messer

    Pharmacist

    Total calculated
    $158,303
    From this org
    $119,108
    From related orgs
    $0
    Other
    $39,195
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $112,907
    Bonus
    $1,220
    Other
    $4,981
    Deferred
    $7,287
    Nontaxable benefits
    $31,908
    Filer's total
    $158,303

  • Julie A Roberts

    Team Leader - Ultrasound

    Total calculated
    $144,256
    From this org
    $118,401
    From related orgs
    $0
    Other
    $25,855
    Hours/week
    50

  • Steven M Mccullar Jr

    Administrative Supervisor

    Total calculated
    $149,645
    From this org
    $121,947
    From related orgs
    $0
    Other
    $27,698
    Hours/week
    50

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Tax indemnification and gross-up payments
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Part I, Line 1a
Tax gross-up payments related to deferred compensation are provided to certain executives and managers. Amounts are included in taxable compensation.
Part I, Line 3
Covenant Health, the parent company of Fort Loudoun Medical Center, used the following methods in establishing the compensation of President/CEO, James D. VanderSteeg: compensation committee, independent compensation consultant, written employment contract, compensation survey or study, and approval by the board or compensation committee. Additional detail is provided in response to Form 990, Part VI, Section B, Lines 15a and 15b within Schedule O.
Part I, Line 4b
Covenant Health maintains a nonqualified deferred compensation ("NQDC") plan intended to support retention of President and CEO, James D. VanderSteeg. Employer contributions of $273,375 are reported as deferred compensation on Schedule J, Part II, Column C. Contributions along with 2022 earnings of $70,560 are subject to a substantial risk of forfeiture. Amounts are combined with other compensation and considered for reasonableness. Compensation procedures are discussed in detail in Schedule O (Form 990, Part VI, Section B, Line 15a).

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • Covenant-AmSurg ASC Ventures LLC

    Management Company · TN

  • Covenant-KEC ASC Ventures LLC

    Management Company · TN

  • TEC North LLC

    Physician Services · TN

  • The Endoscopy Center of Knoxville LLC

    Physician Services · TN

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • Fortress Corporation

    C · Management company · TN

  • Covenant Medical Group Inc

    C · Physician practice management · TN

  • Knoxville Heart Group

    C · Cardiology medical practice · TN

  • East TN Cardiovascular Surgery Group Inc

    C · Cardiovascular surgical practice · TN

  • VortexT Analytics Inc

    C · Computer programming services · TN

  • TenHats LLC

    C · Data storage · TN

Provenance

Return type
form_990
Tax year
2022
Filed
8 November 2023
IRS schema version
2022v5.0
Source object
202303179349309695

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