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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
2020
Open to Public
Inspection
Name of the organization
Covenant Health
 
Employer identification number
62-1646734
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 N WEISGARBER RD
KNOXVILLE,TN37909 		13-1788491 501c(3) 5,000       General support
(2) AMERICAN HEART ASSOCIATION
4708 PAPERMILL RD
KNOXVILLE,TN37909 		13-5613797 501c(3) 10,000       Funds for heart disease awareness
(3) CATHOLIC CHARITIES OF EAST TN
119 DAMERON AVENUE
KNOXVILLE,TN37917 		62-1377551 501c(3) 11,250       General support
(4) CITY SHEPHERDS
8285 ELM HILL CIRCLE
KNOXVILLE,TN37919 		83-3117536 501c(3) 5,000       Emergency assistance for families at holidays
(5) DOGWOOD ARTS FESTIVAL
123 W JACKSON AVE
KNOXVILLE,TN37902 		62-6074113 501c(3) 5,000       General support
(6) FRANK H MCCLUNG MUSEUM
UNIV OF TN 1327 CIRCLE PARK DR
KNOXVILLE,TN37996 		62-6001636 501c(3) 5,000       General support for education programs
(7) FORT SANDERS FOUNDATION
280 FORT SANDERS WEST BLVD STE 202
KNOXVILLE,TN37922 		62-1748601 501c(3) 10,000       Support for fundraisers benefitting Covenant HomeCare & Hospice and Peninsula Behavioral Hospital
(8) GREAT SMOKY MOUNTAINS INSTITUTE INC
9275 TREMONT RD
TOWNSEND,TN37882 		62-1833479 501c(3) 5,000       General support for educational outreach and nature programs
(9) HONOR AIR KNOXVILLE
PO BOX 12990
KNOXVILLE,TN37912 		26-2825063 501c(3) 10,000       Support for flights for veterans to visit Washington, D.C. war memorialsSupport for flights for veterans to visit Washington, D.C. war memorials
(10) KNOX EDUCATION FOUNDATION
912 S GAY ST SUITE L210
KNOXVILLE,TN37902 		62-1765303 501c(3) 100,000       General support for The Great Schools Partnership
(11) KNOXVILLE ACADEMY OF MEDICINE
115 SUBURBAN RD
KNOXVILLE,TN37923 		62-1458199 501c(3) 15,000       General support
(12) KNOXVILLE SYMPHONY ORCHESTRA
100 S GAY ST SUITE 302
KNOXVILLE,TN37902 		62-6008097 501c(3) 5,000       General support
(13) KNOXVILLE TRACK CLUB
PO BOX 53442
KNOXVILLE,TN37950 		62-0731345 501c(3) 50,000       Sponsorship of fundraiser marathon
(14) KNOXVILLE ZOOLOGICAL GARDEN INC
3500 KNOXVILLE ZOO DRIVE
KNOXVILLE,TN37914 		62-1034633 501c(3) 6,000       Sponsorship of fundraiser for general support
(15) MORRISTOWN HAMBLEN HOSPITAL FOUNDATION
1621 WEST MORRIS BLVD
MORRISTOWN,TN37813 		62-1697090 501c(3) 8,300       Sponsorship of fundraiser benefitting Morristown Hamblen Healthcare System
(16) PELLISSIPPI STATE FOUNDATION
10915 HARDIN VALLEY RD PO BOX 22990
KNOXVILLE,TN37933 		58-1493050 501c(3) 10,000       Support for education center
(17) THOMPSON CANCER CTR FOUNDATION
280 FORT SANDERS WEST BLVD SUITE
202
KNOXVILLE,TN37922 		58-2130450 501c(3) 9,500       Sponsorship of fundraisers benefitting Thompson Cancer Survival Center
(18) UNITED WAY
1301 HANNAH AVE
KNOXVILLE,TN37921 		62-0475748 501c(3) 60,000       Support for Interfaith Health Clinic
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
18
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020
Page 2

Schedule I (Form 990) 2020
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)
(2)
(3)
(4)
(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: Grant funds are provided to charitable organizations for the purpose of enhancing and promoting health care and improving quality of life in the community. The organization has guidelines in place to review the eligibility of grantees and how funds will be used, and all grants require written documentation and appropriate levels of approval. When an organization receives a charitable contribution from Covenant Health, a letter confirming how funds must be used to support the organization's request is sent to the organization. Recipient organizations verify use of funds in one or more of the following ways: follow-up reports or newsletters, sponsor acknowledgement at a program or event or on their charity's website, itemized receipts, or year-end summaries.
Schedule I (Form 990) 2020



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