Covenant Health Named Among Top 10 Health Systems in U.S. for Investing "Fair Share" in Community

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Recognition adds to total impact of health system’s investment in local communities

Knoxville, Tenn. – April 2024 – Covenant Health, a locally owned, clinically integrated healthcare enterprise headquartered in Knoxville, Tennessee, recently was named among the top 10 health systems in the U.S. for “fair share spending,” or investing in local communities beyond the value of tax breaks for nonprofit hospitals. The recognition is included in a new report from the Lown Institute, an independent healthcare think tank. The report named 43 U.S. health systems in its “fair share spending” list.

Nonprofit hospitals are exempt from paying most federal, state, and local taxes in exchange for providing free or discounted care and services that address community health needs, such as primary care clinics, mental health services, substance abuse treatment, and other community benefit programs.

According to the Lown report, in 2021 Covenant Health hospitals spent $48 million more than the estimated value of its member hospitals’ tax exemptions on charity care and community investment. “Community investment” includes community health improvement activities, cash/in-kind contributions to community groups, community building activities, and subsidized health services, which are services provided to meet community needs despite incurring a financial loss. Data were sourced from hospitals’ IRS Form 990s for fiscal year ending 2021.

Covenant Health’s records for FY 2021 show that the health system provided nearly $66 million in charity care and financial assistance and nearly $61 million in subsidized health services that year, plus millions of dollars in other discounted, uncollected care. The total of all categories counted as community benefit (per IRS definition) was over $182 million in 2021. 

“Covenant Health’s mission is to serve our communities by improving the quality of life through better health. As a nonprofit healthcare delivery enterprise, Covenant Health continually provides more charity care and financial assistance than any other healthcare organization in our region,” said Jim VanderSteeg, president and CEO.

Covenant Health is among only 20 percent of nonprofit hospitals nationwide to have a fair share spending surplus, according to the Lown report.

“Hospitals increasingly recognize the importance of going beyond their walls to improve community health,” said Vikas Sainin, MD, president of the Lown Institute. “These hospitals are leading the way in essential community health investment.”

“In addition to the categories mentioned in the Lown report, our full scope of community investment also includes uncompensated care which is not reimbursed by government programs, and investment in health professionals’ education. In some instances, Covenant Health’s total community investments have approached or exceeded $300 million annually,” VanderSteeg noted. “We also provided over $770 million annually in employee wages, salaries and benefits, and have invested over a billion dollars in facilities and equipment for our member hospitals and other service locations over the past decade.

“Covenant Health is privileged to provide care for people of all ages throughout East Tennessee,” he said. “Investing in our communities is a top priority, and we’re honored to be recognized for ‘giving back’ to meet the needs of those we serve.”  

The Lown Institute Hospitals Index defines measurable standards for hospital social responsibility and takes into account the full breadth of what hospitals do as care providers, employers and community partners. The full list of healthcare organizations recognized for “fair share spending” is linked here.

About Covenant Health

Covenant Health is a Tennessee-based healthcare enterprise committed to providing the right care at the right time and place. As a nonprofit health system, we are dedicated to being the region’s premier healthcare network through service, community, and innovation. We provide patient-centered care that inspires clinical and service excellence and strive to be the first and best choice for our patients, employees, physicians, employers, volunteers, and communities. Covenant Health is the area’s largest employer and has more than 11,000 compassionate caregivers, expert clinicians, and dedicated employees and volunteers. Learn more at

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