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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," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number
31-1626179
Part I
General Information on Grants and Assistance
1
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? ........................
2
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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on 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 section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) AMERICAN CANCER SOCIETY
871 WEISGARGER RD
KNOXVILLE,TN37909 		64-0329009 501(C)(3) 10,000       OPERATIONAL SUPPORT
(2) AMERICAN HEART ASSOCIATION
4708 PAPERMILL DR
KNOXVILLE,TN37909 		13-5613797 501(C)(3) 75,000       OPERATIONAL SUPPORT
(3) ARTHRITIS FOUNDATION
525 HENLEY STREET
KNOXVILLE,TN37902 		58-1341679 501(C)(3) 5,000       OPERATIONAL SUPPORT
(4) AUTISM BREAKTHROUGH OF KNOXVILLE
900 E HILL AVE STE 145
KNOXVILLE,TN37915 		62-1834568 501(C)(3) 6,000       OPERATIONAL SUPPORT
(5) CANCER SUPPORT GROUP
2230 SUTHERLAND AVE
KNOXVILLE,TN37919 		58-1846210 501(C)(3) 27,500       OPERATIONAL SUPPORT
(6) EAST TENNESSEE CHILDREN'S HOSPITAL
PO BOX 15010
KNOXVILLE,TN37901 		62-6002604 501(C)(3) 5,000       OPERATIONAL SUPPORT
(7) EMERALD YOUTH FOUNDATION
1718 NORTH CENTRAL STREET
KNOXVILLE,TN37917 		62-1474791 501(C)(3) 5,000       OPERATIONAL SUPPORT
(8) ETEDA
10215 TECHNOLOGY DR STE 202
KNOXVILLE,TN37932 		62-1158958 501(C)(3) 18,000       OPERATIONAL SUPPORT
(9) GREAT SMOKY MOUNTAIN COUNCIL
PO BOX 51885
KNOXVILLE,TN37950 		62-0476811 501(C)(3) 75,000       OPERATIONAL SUPPORT
(10) GREAT SMOKY MOUNTAIN INSTITUTE OF TREMONT
9275 TREMONT ROAD
TOWNSEND,TN37882 		62-1833479 501(C)(3) 5,000       OPERATIONAL SUPPORT
(11) HELEN ROSS MCNABB
201 WEST SPRINGDALE AVENUE
KNOXVILLE,TN37917 		62-0548914 501(C)(3) 10,000       OPERATIONAL SUPPORT
(12) INNOVATION VALLEY
17 MARKET SQUARE STE 201
KNOXVILLE,TN37902 		26-2087582 501(C)(3) 40,000       OPERATIONAL SUPPORT
(13) JDRF
26 BROADWAY 14TH FLOOR
NEW YORK,NY10004 		23-1907729 501(C)(3) 5,000       OPERATIONAL SUPPORT
(14) KNOX COUNTY IMAGINATION LIBRARY
500 WEST CHURCH AVENUE
KNOXVILLE,TN37902 		62-0807696 501(C)(3) 5,000       OPERATIONAL SUPPORT
(15) KNOXVILLE ACADEMY
115 SUBURBAN RD
KNOXVILLE,TN37923 		62-1458199 501(C)(3) 20,000       OPERATIONAL SUPPORT
(16) KNOXVILLE CHAMBER OF COMMERCE
17 MARKET SQUARE 201
KNOXVILLE,TN37902 		62-0262640 501(C)(3) 11,600       OPERATIONAL SUPPORT
(17) KNOXVILLE JAZZ ORCHESTRA
2518 SHERROD ROAD
KNOXVILLE,TN37920 		62-1827891 501(C)(3) 6,000       OPERATIONAL SUPPORT
(18) KNOXVILLE NEWS SENTINEL
2332 NEWS SENTINEL DRIVE
KNOXVILLE,TN37921 		51-0141541 501(C)(3) 5,000       OPERATIONAL SUPPORT
(19) LEADERSHIP KNOXVILLE
PO BOX 326
KNOXVILLE,TN37901 		62-1212211 501(C)(3) 5,000       OPERATIONAL SUPPORT
(20) MARCH OF DIMES
322 NANCY LYNN LANE STE 11
KNOXVILLE,TN37919 		13-1846366 501(C)(3) 8,000       OPERATIONAL SUPPORT
(21) RONALD MCDONALD HOUSE
1705 W CLINCH AVENUE
KNOXVILLE,TN37916 		58-1510276 501(C)(3) 5,000       OPERATIONAL SUPPORT
(22) STAR
11800 HWY 11E
LENOIR CITY,TN37772 		62-1330640 501(C)(3) 5,000       OPERATIONAL SUPPORT
(23) SUSAN KOMEN FOUNDATION
318 NANCY LYNN LN 13
KNOXVILLE,TN37919 		75-2854955 501(C)(3) 25,000       OPERATIONAL SUPPORT
(24) THE CHANGE CENTER
203 HARRIET TUBMAN ST
KNOXVILLE,TN37915 		38-3991050 501(C)(3) 5,000       OPERATIONAL SUPPORT
(25) UNITED WAY OF GREATER KNOXVILLE
1301 HANNAH AVENUE
KNOXVILLE,TN37921 		62-0475748 501(C)(3) 115,000       OPERATIONAL SUPPORT
(26) UNIVERSITY OF TN COLLEGE OF NURSING
1200 VOLUNTEER BLVD
KNOXVILLE,TN37916 		62-6001636 GOVT 6,000       OPERATIONAL SUPPORT
(27) UNIVERSITY OF TN GRADUATE SCHOOL OF MEDICINE
301 ANDY HOLT TOWER
KNOXVILLE,TN37996 		62-6001636 GOVT 108,333       OPERATIONAL SUPPORT
(28) VARIETY OF EASTERN TN
7132 REGAL LANE
KNOXVILLE,TN37918 		33-1025696 501(C)(3) 5,000       OPERATIONAL SUPPORT
(29) YWCA KNOXVILLE
420 WEST CLINCH AVENUE
KNOXVILLE,TN37902 		62-0475701 501(C)(3) 16,500       OPERATIONAL SUPPORT
(30) ZOO KNOXVILLE
3500 KNOXVILLE ZOO DRIVE
KNOXVILLE,TN37914 		62-1034633 501(C)(3) 6,000       OPERATIONAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
28
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
2
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019
Page 2

Schedule I (Form 990) 2019
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) MEN'S HEALTH CANCER FUND 410 33,373      
(2) HELPING HANDS 200 14,315      
(3) CRISIS FUND 5793 25,747      
(4) BREAST HEALTH GIFT FUND 585 77,016      
(5) STEPHENS FUND 258 67,414      
(5)
(6)
(7)
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: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: THE ORGANIZATION HAS GUIDELINES IN PLACE THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY OF GRANTEES. FOR EMPLOYEE EDUCATION ASSISTANCE SCHOLARSHIPS, APPLICANTS MUST SUBMIT RECEIPTS FOR EXPENDITURES. FOR OTHER GRANTS, VARIOUS PROCEDURES ARE IN PLACE DEPENDING ON GRANT TYPE, INCLUDING REQUIREMENTS TO SUBMIT APPLICATIONS FOR REVIEW AND APPROVAL. ALL GRANTS REQUIRE WRITTEN DOCUMENTATION AND APPROPRIATE LEVELS OF APPROVAL.
Schedule I (Form 990) 2019



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