2025-08-15T18:05:13+00:00 2024-09-30 990 2023-10-01 540568001 Carilion Rockbridge Community Hospital CARI 5402245102 PO BOX 12385 Roanoke VA 24025 G ROBERT VAUGHAN JR TREASURER 5402245102 2025-08-15 2023 2025-03-06 01:10:19Z GREGORY T MADSEN PO BOX 12385 Roanoke VA 24025 89713304 false X WWW.CARILIONCLINIC.ORG X 1955 VA Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost. 15 10 531 11 0 0 1078194 534217 73612630 78624537 547549 3373778 641879 592249 75880252 83124781 388780 401564 0 28522132 30129422 0 0 41320921 43614770 70231833 74145756 5648419 8979025 85418994 86807190 27441837 21250913 57977157 65556277 Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost. false false 61445050 401564 78858479 See schedule O. 61445050 true true false true false false false false false true true false true true false false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true X 0 0 531 true false false false false false false false false false false false false X 15 10 true true false false true true true true true false false true true true true true true true true false VA X MATTHEW BARR 5402245021 213 S JEFFERSON ST ROANOKE VA 24011 James Williams Jr Director/Chair 2.5 2.4 X X 0 10250 0 Juliet Gibson Director/Vice Chair 1.2 0 X X 0 0 0 Kimberly Shaw Director/Sec/Treasurer 1.2 0 X X 0 0 0 Alicia Devine MD Director 1.2 48.8 X 0 281605 25916 Amy DeHart Director 1.2 0 X 0 0 0 Ayesha Kelly MD Director 1.2 48.8 X 0 339991 19835 George Godette MD Director 1.2 48.8 X 0 575434 61050 Greg Madsen Director/Hospital VP 50.0 0 X 229189 0 44461 Josh Elrod Director 1.2 0 X 0 0 0 Lisa Sprinkel Director 1.2 48.8 X 0 231740 58636 Marylin Alexander Director 1.2 0 X 0 0 0 Nathan Ramsey Director 1.2 0 X 0 0 0 P Duaine Fitzgerald Director 1.2 0 X 0 0 0 Reginald Early Director 1.2 0 X 0 0 0 Tracy Lyons Director 1.2 0 X 0 0 0 Donald Halliwill Asst. Treasurer 0.5 49.5 X 0 1119248 167911 G Robert Vaughan Jr Asst. Treasurer 0.5 49.5 X 0 458008 71002 J Harrison Lapuasa Asst. Treasurer 0.5 39.5 X 0 34109 -1202 Julie Smith-Hamilton Asst. Secretary 0.5 39.5 X 0 60728 18375 Nicholas Conte Asst. Secretary 1.0 49.0 X 0 1023717 174893 Steven Arner Asst. Secretary/COO, Carilion Clinic 2.0 48.0 X 0 1410192 209618 Aaron Glenn Nursing Senior Director 40.0 0 X 139923 0 28362 Jessica Saville Pharmacy Manager 37.0 3.0 X 177925 0 12095 Laura Mays Nurse Practitioner 50.0 0 X 122156 0 5258 Phyllis Snyder RN Lead 40.0 0 X 163405 0 52234 Tracy Higgins Nursing Unit Director 40.0 0 X 157120 0 13948 David Hagadorn Former Officer 0.0 0.0 X 0 159104 25072 989718 5704126 987464 22 true true false F & S BUILDING INNOVATIONS INC 2944 ORANGE AVE NE ROANOKE VA 24012 CONTRACTOR SERVICES 4363736 QUALIVIS LLC 1601 ASSEMBLY ST UNIT 1439 COLUMBIA SC 29201 TEMPORARY STAFFING 2122025 QUEST DIAGNOSTICS 500 PLAZA DRIVE SECAUCUS NJ 07094 LABORATORY SERVICES 1534745 SIEMENS MEDICAL 40 LIBERTY BLVD MALVERN PA 19355 EQUIPMENT MAINTENANCE 239533 AVANT HEALTHCARE PROFESSIONALS 2301 LUCIEN WAY MAITLAND FL 32751 TEMPORARY STAFFING 119747 5 525239 8978 534217 Net Patient Revenue 622110 77053389 77053389 Rent from affiliates 531120 71395 71395 Patient Pharmacy Revenue 446110 1499753 1499753 0 0 0 0 78624537 578147 578147 147723 147723 0 147723 147723 9383763 391 6567564 20959 2816199 -20568 2795631 2795631 School Health Services 621399 226794 226794 Dining Services 722514 210584 210584 Other Revenue 900099 7148 7148 0 0 0 0 444526 83124781 78858479 0 3732085 401564 401564 278697 278697 24397944 24373890 24054 490190 489707 483 3592686 3540783 51903 1369905 1354410 15495 10993129 10993129 5707 5707 69576 69576 7133386 6187921 945465 0 4044 1848 2196 1137021 1045194 91827 343538 335318 8220 1464798 1464798 87401 85675 1726 81483 81483 2857743 2857743 552637 355779 196858 Bad Debt 7268293 7268293 Med Supplies 6925555 6925555 Affiliate Practice Subsidy 4600622 4600622 Dues & Subscriptions 52598 52598 37239 16162 21077 0 74145756 61445050 12700706 0 1899 1349 615 1 13430992 11168455 0 0 0 0 611639 716355 239507 262036 72173840 49968528 22517015 22205312 12657722 15794746 27947208 31693400 0 8012397 4965536 85418994 86807190 11568702 6169275 56472 11826727 11830591 0 0 437208 419372 3609200 2775203 27441837 21250913 X 57728089 65219254 249068 337023 57977157 65556277 85418994 86807190 X 8979025 3643701 -5043606 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 5707 5707 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY A portion of dues paid to various healthcare industry associations is attributable to lobbying activities. 1117453 1117453 38871962 25140647 13731315 352772 344592 8180 26765319 21389119 5376200 5066334 3094170 1972164 22205312 199766 F Alternative Investments 31493634 F 31693400 Due From Affiliate 4739139 Right of Use Asset 226397 4965536 Pension Liability -212693 Deferred Comp Swap Liability 69500 Due to Affiliate Lease Liability 2918396 2775203 true true X true X 300 true X 500 true true false true true 629883 629883 0.0094 8011838 7015864 995974 0.0149 0 0.0 0 0 8641721 7015864 1625857 0.0243 164025 28034 135991 0.0020 0 0.0 0 0.0 0 0.0 421498 360159 61339 0.0009 0 0 585523 388193 197330 0.0030 0 0 9227244 7404057 1823187 0.0273 0 0.0 4769 4769 0.0001 7239 7239 0.0001 0 0.0 0 0.0 671 671 0.0000 0 0.0 552 552 0.0000 0 0.0 0 0 13231 0 13231 0.0002 true 7268293 17508199 17570803 -62604 X true true 1 1 Carilion Rockbridge Community Hospital 1 HEALTH CIRCLE LEXINGTON VA 24450 https://carilionclinic.org//locations/carilion-rockbridge-community-hospital H 1906 X X X X Carilion Rockbridge Community Hospital 1 false false true X X X X X X X X X 23 true false true true X https://www.carilionclinic.org/cho-community-health-assessments#reports X https://issuu.com/carilionclinic/docs/2024_crbh_cha_final_report X X true 24 true https://www.carilionclinic.org/cho-community-health-assessments#reports false true X 300.0 500.0 X X X X true true X X X true X https://www.carilionclinic.org/billing/financial-assistance X https://www.carilionclinic.org/billing/financial-assistance X https://www.carilionclinic.org/billing/financial-assistance X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E The publicly available Community Health Needs Assessment (CHNA) report details the prioritization process for the community's significant health needs identified through the CHNA. The Community Health Assessment Team (CHAT), comprised of community stakeholders, reviews all data and completes a prioritization survey. Through the survey, each CHAT member selects the most pertinent community needs. Following the survey, CHAT members further refine the priorities through a consensus-building activity. CHAT members prioritize needs according to the perceived burden, scope, severity or urgency; the importance the community places on addressing the need through survey responses and other interactions; and each member's unique perspective on community health. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Carilion Rockbridge Community Hospital. Carilion Clinic's Community Health Needs Assessments (CHNAs) are community-driven projects. Their success depends highly on engaging citizens, health and human service agencies, businesses and community leaders. Stakeholder collaborations known as Community Health Assessment Teams (CHATs) lead the CHNAs. The CHATs are dynamic and include health and human service agency leaders, people with exceptional knowledge of, or expertise in, public health, and local health department officials. Each CHAT also includes other individuals or organizations serving or representing the community's medically underserved, low-income and minority populations. The following organizations served on the CHAT for the 2024 (tax form year 2023) Rockbridge Area Community Health Needs Assessment (RACHNA): Anthem Medicaid, Chamber of Commerce Serving Rockridge, Lexington and Buena Vista, Central Shenandoah Health District, City of Buena Vista, ConnectionsPlus Healthcare, FOR Swimming, Girl Scouts Skyline Council, Grace Episcopal Church, Lexington City Office on Youth, Live Healthy Rockbridge Kids, Natural Bridge State Park, Project Horizon, Rockbridge Area Prevention Council, Rockbridge Area Community Services, Rockbridge Area Health Center, Rockbridge Area Relief Association, Rockbridge Area Transportation System, Rockbridge Baths Community Organization, Rockbridge Community Health Foundation, Rockbridge County, TAP Head Start, United Way of Rockbridge, Virginia Cooperative Extension, Valley Program for Aging Services, and Washington and Lee University. To obtain input from the community, the RACHNA conducted a focus group among CHAT stakeholders, a community listening session among the target population (low-income), and administered a 27-question community health survey broadly across the service area. These efforts occurred from October 1, 2023, through December 31, 2023. The community health survey was developed in English and Spanish and inquired about access to care and other services, health status, community strengths, quality of life, subjective well-being and demographics. The survey included commonly used questions and metrics from previously validated community surveys conducted by organizations such as the National Association of County and City Health Officials and the Centers for Disease Control and Prevention. Community members were invited to participate in a Community Listening Session, facilitated by staff from Carilion and the Rockbridge Area Health Center to collect qualitative data to understand health-related needs better. CHAT members were invited to provide an additional perspective on the needs and barriers to health facing our community during a Live Healthy Rockbridge meeting that included other community stakeholders. Carilion staff from across the organization facilitated small group discussions. Participants were asked to complete the Stakeholder Survey after participating in a listening session to help quantify focus group data. Carilion representatives shared the online survey via email and at the CHAT meetings. The CHAT assisted with survey distribution to reach particular target populations. The survey focused on Rockbridge Area residents 18 years of age and older in the following service area: Rockbridge County, Lexington City and Buena Vista City. There were special efforts to include underserved and vulnerable populations disproportionately impacted by social determinants of health such as poverty, race/ethnicity, education and lack of insurance. Specific populations served by CHAT representatives include people who are uninsured or underinsured; people experiencing low income, homelessness, and/or food insecurity; business owners; and families with young children. The survey was also available online to all residents living in the Rockbridge Area. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Carilion Rockbridge Community Hospital. The CHAT conducted the 2024 Rockbridge Area Community Health Needs Assessment with: Anthem Medicaid, Chamber of Commerce Serving Rockridge, Lexington and Buena Vista, Central Shenandoah Health District, City of Buena Vista, ConnectionsPlus Healthcare, FOR Swimming, Girl Scouts Skyline Council, Grace Episcopal Church, Lexington City Office on Youth, Live Healthy Rockbridge Kids, Natural Bridge State Park, Project Horizon, Rockbridge Area Prevention Council, Rockbridge Area Community Services, Rockbridge Area Health Center, Rockbridge Area Relief Association, Rockbridge Area Transportation System, Rockbridge Baths Community Organization, Rockbridge Community Health Foundation, Rockbridge County, TAP Head Start, United Way of Rockbridge, Virginia Cooperative Extension, Valley Program for Aging Services, and Washington and Lee University. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - Carilion Rockbridge Community Hospital. The Community Health Assessment Team shared the 2024 Rockbridge Area Community Health Needs Assessment (RACHNA) on partner websites, social media, and through regional news coverage. The RACHNA was also shared through multiple internal presentations for staff and presentations to partner organizations and collaboratives. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Carilion Rockbridge Community Hospital. The following information describes the implementation strategy Carilion Rockbridge Community Hospital (CRBH) used to address the community health needs identified in the 2024 Rockbridge Area Community Health Needs Assessment (RACHNA). The complete implementation strategy is available online at https://issuu.com/carilionclinic/docs/implementation_strategy_final_crbh The hospital is working to address all significant needs prioritized by the CHNA. The top prioritized needs for the 2024 RACHNA were grouped into three overarching categories: chronic disease, mental health and substance use, and injury and violence. We also focus on layered interventions that address multiple priority areas through place-based strategies. We are addressing prioritized needs with the following strategies and committing financial resources, staff time and leadership. Strategies to address mental health and substance use include expanding Carilion's peer support specialist workforce and implementing evidence-based mental health education and well-being programs. Strategies to address chronic disease include exploring the implementation of a fruit and vegetable prescription program, implementing the Healthy Heart Ambassadors program, and implementing evidence-based health and nutrition education programs. Strategies to address injury and violence include supporting an initiative to grow transitional housing for people experiencing homelessness due to domestic violence and working with our forensic nursing program to identify opportunities and fill gaps in transitioning patients from acute care to the community. Place-based strategies addressing multiple priority areas include implementing health and wellness programming through the Rockbridge CAN dinners, exploring the implementation of pop-up clinic models for safety net partnerships, expanding Carilion's community health worker workforce, developing an employee volunteer program to support the capacity of local organizations working to address CHA identified needs, and coordinating a community-wide strategic plan through Live Healthy Rockbridge to address community health needs further. 6 CARILION CLINIC FAMILY & INTERNAL MEDICINE 108 HOUSTON STREET SUITE A C LEXINGTON VA 24450 PHYSICIAN OFFICES CARILION CLINIC FAMILY MEDICINE-SOUTH MAIN 146 SOUTH MAIN STREET LEXINGTON VA 24450 PHYSICIAN OFFICES CARILION CLINIC FAMILY MEDICINE - BEDFORD 548 BLUE RIDGE AVE BEDFORD VA 24523 PHYSICIAN OFFICES CARILION CLINIC FAMILY MEDICINE - BUCHANAN 18080 MAIN STREET BUCHANAN VA 24066 PHYSICIAN OFFICES CARILION CLINIC FAMILY MEDICINE - CLIFTON FORGE 609 CHURCH STREET CLIFTON FORGE VA 24422 PHYSICIAN OFFICES CARILION CLINIC FAMILY MEDICINE - BUENA VISTA 2252 MAGNOLIA AVENUE BUENA VISTA VA 24416 PHYSICIAN OFFICES Schedule H, Part I, Line 3c Other Financial Assistance Eligibility Criteria Financial assistance policy in effect for fiscal year 2024: families with family income equal or below 300% of the Federal Poverty Guidelines and countable assets equal or below $25,000 receive 100% adjustment under FAP. Families with family income greater than 300% of the Federal Poverty Guidelines but less than or equal to 500% of the Federal Poverty Guidelines or countable assets above $25,000 and less than or equal to $100,000 receive a partial adjustment under FAP. The partial adjustment matches the highest AGB percentage determined for all facilities. Schedule H, Part I, Line 6a Public Availability of Community Benefit Report Information on community benefit is reported annually through a consolidated report prepared by Carilion Clinic (EIN 54-1190771). Printed copies of this report are distributed throughout communities served by hospitals affiliated with Carilion Clinic. Additionally, the community benefit report is available on Carilion Clinic's website: https://www.carilionclinic.org/cho-community-health-assessments#community-impact-reports Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 7268293 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Line 7a and 7b: For activities reported on the Medicaid Cost Report, a cost-to-charge ratio as determined from the Medicaid Cost Report was used. For all other activities, a cost to charge ratio derived from Worksheet 2 of the 990 instructions was used. Lines 7e and 7i are reported at actual cost. Schedule H, Part II Community Building Activities Line 2 - Economic development: As the largest employer in Southwest Virginia, Carilion impacts economic development by investing in jobs, higher wages for employees and various capital construction projects. In addition, Carilion has direct economic development expenses from programming and support of the local Chamber of Commerce, Main Street Lexington and pro-business advocacy. These initiatives promote the community's health by improving economic vitality and making the region a vibrant place to live, work and play. Line 3 - Community support: Research demonstrates the strong connection between social determinants of health-such as transportation, housing and education-and communities' overall health and well-being. Carilion supports nonprofit organizations addressing barriers to good health arising from these social determinants in various ways. Carilion also collaborates with local partners to support better education and opportunities for children and families, improved housing, better nutrition, and additional resources for our neighbors in need. Carilion is involved with various health and social determinant-related initiatives through monetary donations and organizational support. For example, Carilion supports local Ruritan groups, CARE Rockbridge (Community Anti-Racism Effort), and the local YMCA and serves on the Local Emergency Preparedness Council, working to improve the community's resilience in emergencies. Line 6 - Coalition building: Carilion believes in the power of collaboration and understands that we must address our most significant health issues in concert with the community. To ensure lasting impact from the health assessment and community health improvement process, Carilion participates in coalitions that address health, safety and social determinant needs in the Rockbridge area. We also partner with multiple community and business organizations on initiatives to improve health and wellness for everyone in the Rockbridge area. Carilion participates in Live Well Alleghany, a health coalition in a neighboring county, and serves on the Community Foundation for Rockbridge Bath and Alleghany Board of Directors. Line 8 - Workforce development: With the understanding that employment is directly linked to health and wellness, Carilion partners to provide workforce development and training for community members. Carilion works to ensure our workforce and communities are vibrant by participating in the Lexington-Rockbridge Chamber of Commerce. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Carilion Rockbridge Community Hospital estimates bad debt expense by reserving a percentage of all self-pay patient accounts receivable by aging category, based on collection history, adjusted for expected recoveries and, if present, anticipated changes in trends. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Patient accounts receivable are stated at net realizable amounts due from patients, third-party payors, and other insurers for which Carilion Rockbridge Community Hospital expects to be entitled in exchange for providing patient care. In accordance with Accounting Standards Update (ASU) No. 2014-09, Revenue from Contracts with Customers (Topic 606) (ASU 2014-09), the estimated uncollectible amounts are generally considered implicit price concessions that are a direct reduction to patient accounts receivable. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Medicare allowable costs are determined from the Medicare cost report using the cost-to-charge ratio. The hospital believes our Medicare shortfall is a cost we incur as a benefit to the community. IRS REV. RUL. 69-545 provides that one of the factors demonstrating community benefit is caring for patients who pay their bills through public programs such as Medicare. In order to operate for the benefit of the broad community that we serve we must include our significant Medicare population, even if we are required to subsidize care to our Medicare patients due to being reimbursed at less than cost by Medicare's nonnegotiable rates. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance When accounts receivable efforts are exhausted, the account may be placed with a collection agency and extraordinary collection actions (ECAs) may be considered. Accounts will not be placed with a collection agency prior to 120 days from the date the first post-discharge billing statement is provided except when mailings are returned with no forwarding address and combining multiple accounts of varying age with those already transferred or for legal verification regarding other liabilities. Reasonable efforts will be made to identify appropriate forwarding addresses. When a financial assistance application (FAA) is received during the application period (within 240 days after the date the first post-discharge billing statement is provided), but after initiation of ECAs, all ECAs will be suspended. Best efforts will be made to process completed applications within 30 days of receipt of the application; financial assistance eligibility will be determined and communicated to the individual. Incomplete applications must be completed within 30 days of the initial notification of additional items required; otherwise, the application will be deemed incomplete and closed. If an individual is eligible for financial assistance, ECAs, other than the sale of debt, will be reversed and any payments related to eligible care refunded to the extent no longer owed. ECAs will be reinstated if the individual is not eligible for financial assistance or does not complete the FAA by the deadline. At least 30 days before initiating an ECA, Carilion will send the patient written notice of intended ECA(s), a plain language summary explaining financial assistance available and the process for determining eligibility, and the deadline for applying for assistance. Carilion will also attempt to call individuals at least 30 days before initiating an ECA to make them aware of the financial assistance available and how to obtain assistance with the application process. Carilion shall enter into a written contract with any collection agency to which it refers bad debt. The contract will obligate the collection agency to observe and comply with Carilion's obligations under this policy and the Financial Assistance Policy. A collection agency to which bad debt is referred for collection may not engage in any ECAs without the prior written consent of Carilion. After making reasonable efforts to determine if a patient qualifies for financial assistance and the patient either does not qualify for financial assistance or fails to submit an application as requested, within 240 days from the date the first post-discharge billing statement is provided, Carilion may engage in one or more of the following ECAs: 1. Place a lien on an individual's property; 2. Attach or seize an individual's bank account or any other personal property; 3. Commence a civil action against an individual; 4. Garnish an individual's wages; 5. Sell an individual's debt to another party; or 6. Report the account to credit agencies. Individual account balances greater than $5,000 are not sent to a collection agency. These are handled through the Debt Recovery Department (DRD) for verification of financial assistance status before further collection activity occurs. DRD will also investigate any accounts that require special handling. For example, in cases of a deceased patient, auto accident, or any other unique circumstances requiring special handling, the accounts are placed with the DRD. When all collection efforts have been exhausted, all hospital accounts will be returned and closed as uncollectible. No further collection activity is taken at that time. Accounts with satisfactory payment arrangements, legal activity or accounts with pending payment will be considered active and are not returned. Schedule H, Part V, Section B, Line 16a FAP website - Carilion Rockbridge Community Hospital: Line 16a URL: https://www.carilionclinic.org/billing/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - Carilion Rockbridge Community Hospital: Line 16b URL: https://www.carilionclinic.org/billing/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Carilion Rockbridge Community Hospital: Line 16c URL: https://www.carilionclinic.org/billing/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment In addition to conducting regular Community Health Needs Assessments (CHNAs), Carilion Clinic closely monitors community health indicators and responds to needs as they arise. Each year, Carilion updates scorecards with refreshed health data from various secondary sources and County Health Rankings indicators provided by the Robert Wood Johnson Foundation. Carilion also responds to needs identified through clinical data and internal departments, including data collected through social determinants of health screenings. A health equity and social determinants of health steering committee exists to provide oversight and guidance related to health equity and screenings, and a resource navigation subcommittee tackles more nuanced topics around current community needs as seen in the patient population. Carilion's call center, Carilion Direct, allows community members to ask questions and connect with community resources. Community Health Workers (CHWs) help address needs, and data is reviewed periodically to identify trends in healthcare needs of patients served by CHWs. Healthcare needs are also identified through current collaborative relationships and community partnerships, including collaboration with the Virginia Department of Health and local safety net partners. Ongoing collaboration with stakeholders allows for regular communication and gives our partners opportunities to respond cohesively. Carilion has adapted its community health improvement process from Associates in Process Improvement's Model for Improvement and the Plan-Do-Study-Act cycle developed by Walter Shewhart. It consists of five steps: (1) conducting the CHNA, (2) strategic planning, (3) creating the implementation strategy, (4) program implementation and (5) evaluation. This cycle repeats every three years. Continuous quality improvement is a key principle of the process. The Strive Collective Impact Model for the Community Health Assessment Team helps Carilion foster community development in its CHNA and community health improvement processes. This evidence-based model focuses on "the commitment of a group of important players from different sectors to a common agenda for solving a specific social problem(s) can lead to large-scale changes. It focuses on relationship-building between organizations and the progress toward shared strategies. Working through the Collective Impact Model, Carilion works with Live Healthy Rockbridge coalition members to develop a community-wide strategic plan to address community needs. This strategic plan is reviewed and updated twice yearly to reflect completed and ongoing initiatives and emerging needs. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Information on Financial Assistance is provided to the patient at hospital admission and ambulatory areas in the form of signage, a plain language summary which includes contact information, financial assistance application and documentation in the inpatient handbook. Patient Access staff, Hospital social workers and customer service representatives verbally inform patients on availability of assistance. Each patient billing statement and patient financial responsibility letter includes information on the Financial Assistance policy including who to contact for additional information and location of in-person assisters. The Application, the Policy, and the plain language summary are available free of charge to the patient. They are available by mail and on the web site if the patient did not receive written information at the time of service. Financial Assistance policy and application are also distributed to community partners through electronic mailing groups. Carilion Clinic employs an Eligibility staff that counsel patients on federal and state programs. The staff completes applications for Medicaid and provides information on Social Security, Social Security Disability and Medicare. The staff provides support services ensuring the applications are processed correctly based on federal and state policy. In addition, Eligibility staff are trained as Certified Application Counselors and will assist patients in enrollment in the Marketplace. Eligibility staff will also complete Carilion's financial assistance application and counsel patients on the requirements for financial assistance. Schedule H, Part VI, Line 4 Community information The Rockbridge Area comprises distinct communities with significant disparities in size, population and social determinants of health. The 2019-2023 American Community Survey (ACS) found the total population of Lexington and Buena Vista to be 7,420 and 6,612, respectively, and the population of Rockbridge County to be 22,578. The Weldon Cooper Center for Public Service predicts positive future population change for Rockbridge County and Lexington but a slight population loss in Buena Vista by 2040. The median age in the Rockbridge Area localities ranges from 22.5 in Lexington to 49.7 in Rockbridge County. The ACS finds that for most of the Rockbridge Area, a more significant percentage of the population is White than in the Commonwealth of Virginia. In Rockbridge County, 89.57% of the population is White, 3.97% is Black, 3.34% identify as more than one race and 2.27% identify as Hispanic or Latino (US Census Bureau, ACS, 2019-2023). Lexington and Buena Vista are slightly more racially and ethnically diverse than Rockbridge County, with populations that are 81.68% and 86.04% White, 4.66% and 1.59% Black, and 3.21% and 0.65% Asian. 8.56% and 10.74% of these populations represent more than one race, and the remainder represent small minorities of American Indian/Alaskan Native, Native Hawaiian/Pacific Islander or some other race. Of the population, 4.88% of Lexington and 0.95% of Buena Vista identify as Hispanic or Latino (US Census Bureau, ACS, 2019-2023). The region is divided into urban and rural areas, which vary greatly in the economic means of the residents. The low-income population in the Rockbridge Area is designated as a Medically Underserved Area. The Rockbridge service area is federally-designated as a low-income Health Professional Shortage Area for primary, dental and mental health care. (https://data.hrsa.gov/tools/shortage-area). Carilion Rockbridge Community Hospital (CRBH) is the only hospital located in the service area. The 2019-2023 ACS states that the average income in Rockbridge County is $85,339, whereas in Lexington and Buena Vista, it is $95,201 and $83,521, respectively. Rockbridge County has the lowest population percentage below the Federal Poverty Level (FPL) at 8.02%. In Lexington and Buena Vista, the percentage of the population below the FPL is 15.93% and 21.98%, higher than Virginia's poverty rate (9.92%). The ACS also shows that 17.39% of the insured population in Rockbridge County are receiving Medicaid, and 5.26% of the total population have no insurance coverage. In Lexington, 11.52% of the insured population receive Medicaid and 2.07% of the total population have no insurance, and in Buena Vista, 29.44% of the insured population receive Medicaid and 5.09% of the total population have no insurance (US Census Bureau, ACS, 2019-2023). Of the patients receiving care at CRBH in FY24, 18.71% have Medicaid coverage, and 4.52% are self-pay (Strata internal data). Schedule H, Part VI, Line 5 Promotion of community health Carilion Rockbridge Community Hospital is a part of the non-profit Carilion Clinic integrated health care system located in the Blue Ridge Mountains. Carilion provides quality care for nearly one million individuals through a comprehensive network of hospitals, primary and specialty physician practices, wellness centers, and other complementary services. Carilion's roots go back 125 years, when a group of dedicated citizens came together and built a hospital to meet the community's healthcare needs. Today, Carilion is a vital anchor institution focused on health care and dedicated to our mission of improving the health of the communities we serve. With an enduring commitment to our region's health, care is advanced through clinical services, medical education, research and community health investments. Carilion believes in service, collaboration and caring for all. Carilion invests in discovering and responding to local and regional health needs, understanding that we must involve additional stakeholders to address community health issues and create change effectively. Carilion recognizes the impact the environment has on the health of our communities. Efforts continue to make our hospitals and other facilities more energy-efficient, increase recycling and use of recyclable or bio-degradable materials, reduce waste materials and serve local, sustainable foods to patients and in our cafeterias. Carilion has an office of sustainability that leads these efforts and empowers employees to be involved in environmental health-related projects. Carilion Rockbridge Community Hospital (CRBH) is a nonprofit, critical access hospital dedicated to quality care and patient comfort. Commitment and support throughout the last century allowed the hospital to grow, expand and move across town to its present site in 1954. A new structure and enhanced patient care tower were completed on the same site in 2002. Rockbridge Community Health Foundation supports CRBH by investing in the community through providing funds for the hospital's grants to local organizations working to address needs identified in the most recent Rockbridge Area Community Health Assessment. The Foundation additionally invests in hospital improvements such as equipment and supplies. CRBH provides a full range of top-quality inpatient and outpatient care for Rockbridge Area residents. CRBH's health care professionals provide patients with reliable, safe care to get them on the road to recovery close to home. For inpatient care, CRBH physicians diagnose and treat illnesses, anticipate problems and rapidly respond to changes in patient conditions. Emergency services are onsite 24/7, and a medical transport helicopter is located onsite if an advanced level of care is needed. Other onsite services include imaging, inpatient and outpatient surgical, sleep studies, swing bed/recovery care, therapy (PT, OT, ST, RT), and laboratory. CRBH serves patients regardless of their ability to pay. The hospital's governing board members reside in the region and are elected for 3-year terms, with board officers elected annually. The majority of members are neither hospital employees nor contractors. Medical staff privileges are extended to qualified providers. Surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. Reinvestments include providing free, discounted and subsidized care and critical medical services not otherwise offered in our region (https://www.carilionclinic.org/locations/carilion-rockbridge-community-hospital). Schedule H, Part VI, Line 6 Affiliated health care system Carilion Rockbridge Community Hospital is owned by Carilion Clinic, a not-for-profit healthcare organization based in Roanoke, Virginia. Carilion Clinic includes a comprehensive network of hospitals, primary and specialty physician practices, and complementary services comprising six hospital entities, 86 specialties, and 295 practice sites across Southwest Virginia. All of these are centered on a common mission and shared values. In the mid-2000s, Carilion decided to transform from a collection of hospitals to a physician-led, integrated healthcare system. Advances include developing a multi-specialty physician group, transforming our primary care practices into patient-centered medical homes,implementing electronic health records system-wide,creating a robust partnership with Virginia Tech, including developing the Virginia Tech Carilion (VTC) School of Medicine and the Fralin Biomedical Research Institute at VTC and hosting Radford University Carilion's healthcare professional educational offerings on-site of a Carilion hospital. Each decision and adaptation has fundamentally changed how Carilion collaborates and provides care (https://www.carilionclinic.org/about-carilion-clinic). Carilion's community and population health infrastructure is the health system's engine for providing collaborative opportunities to improve and promote the community's health. Carilion's Community Health Assessment process helps identify the strengths and barriers impacting health. Our community-based programs reflect the Robert Wood Johnson Foundation's framework of four main influences of health: health behaviors, social and economic factors, clinical care access and quality, and physical environment. Our many partnerships with cross-sector organizations create a collaborative culture of health and wellness. true Boxerwood Education Association 541937944 501(c)(3) 22565 Project NEST education Commty Fdn RockbridgeBathAlleghany 273422429 501(c)(3) 10000 Program support Concerned Citizens of Glasgow 541548440 501(c)(3) 15000 Thompson Community Center ConnectionsPlus HealthcareHospice 541288305 501(c)(3) 16375 Grief support County of Rockbridge 546001578 Rockbridge County 10000 Inmate training program Friends of Natural Bridge State Park 824215328 501(c)(3) 19500 Visually impaired assistance Project Horizon 521390194 501(c)(3) 20000 Violence Prevention Educ Rockbridge Area Relief Association 237303807 501(c)(3) 25000 Emergency housing Rockbridge Area Transportation System 043586915 501(c)(3) 54500 Free meals, Transportation Rockbridge Area Community Services 541234799 501(c)(3) 80000 Sch Intervention Specialist Rockbridge Christmas Basket Inc 541194522 501(c)(3) 7750 Healthy food baskets Blue Ridge CASA for Children 541721227 501(c)(3) 13000 Abused neglected children advocacy Washington & Lee University 540505977 501(c)(3) 10000 Food for mobile pantry distribution Valley Program for Aging Services 540958526 501(c)(3) 7500 Hot meals program age 60 and above Rockbridge Area Free Clinic Inc 541642220 501(c)(3) 20000 Vehicle to support off-site clinics Rockbridge Area Recreation Organization 546001392 Rockbridge County 6000 Outdoor recreation publication Yellow Brick Road Early Learning Center Inc 541101888 501(c)(3) 30000 Facility updates to expand services 17 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds The hospital donates funds to other charitable organizations in support of health and community improvement. Such organizations also have community boards which oversee the expenditure of such funds. Carilion Clinic is committed to improving the health of the communities that we serve by addressing key health priorities identified through our triennial Community Health Assessments. Carilion fulfills this commitment in many ways, one of which is through targeted grants for community health improvement programs, and those that impact the social determinants of health. For Carilion Clinic's Community Grant Program, each grantee must sign a letter of agreement with Carilion Clinic that delineates the terms and specific objectives of the project. By accepting a Carilion award, grantees are asked to acknowledge the support of Carilion Clinic in all materials and/or related special events or fundraisers throughout the award cycle where other donors are publicly recognized. One mid-cycle progress report and a final program evaluation are required for each funded project. Site visits may be made to grantees. Program evaluation includes alignment with Community Health Assessment priorities, program impact, organizational effectiveness and community benefit through collection of data including clients served, cost effectiveness of the program (cost per client or service), tangible community or client outcomes, collaboration with other organizations, and specific efforts to cultivate diverse funding sources for program sustainability. Each grantee must agree to submit requested data and reports on a timely basis and to complete the evaluation process as requested. false true false false false false false true false Alicia Devine MD Director 0 266004 0 11544 0 4057 0 23989 0 1927 0 307521 0 0 George Godette MD Director 0 518178 0 48610 0 8646 0 36964 0 24086 0 636484 0 0 Ayesha Kelly MD Director 0 311539 0 25841 0 2611 0 -4348 0 24183 0 359826 0 0 Greg Madsen Director/Hospital VP 206982 0 20666 0 1541 0 21870 0 22591 0 273650 0 0 0 Lisa Sprinkel Director 0 185852 0 37159 0 8729 0 41639 0 16997 0 290376 0 0 David Hagadorn Former Officer 0 120679 0 0 0 38425 0 13363 0 11709 0 184176 0 0 Steven Arner Asst. Secretary/COO, Carilion Clinic 0 1044670 0 164317 0 201205 0 184622 0 24996 0 1619810 0 195888 Nicholas Conte Asst. Secretary 0 731687 0 111366 0 180664 0 156813 0 18080 0 1198610 0 172601 Donald Halliwill Asst. Treasurer 0 767976 0 117511 0 233761 0 142915 0 24996 0 1287159 0 227735 G Robert Vaughan Jr Asst. Treasurer 0 353161 0 41359 0 63488 0 46006 0 24996 0 529010 0 57282 Aaron Glenn Nursing Senior Director 133287 0 0 0 6636 0 6664 0 21698 0 168285 0 0 0 Tracy Higgins Nursing Unit Director 151829 0 0 0 5291 0 13226 0 722 0 171068 0 0 0 Jessica Saville Pharmacy Manager 170481 0 0 0 7444 0 4115 0 7980 0 190020 0 0 0 Phyllis Snyder RN Lead 158554 0 0 0 4851 0 34163 0 18071 0 215639 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The Carilion Clinic Board of Directors Compensation Committee reviews the compensation philosophy for all executive leaders in the health system, including the Hospital Vice President, the organization's top management official. An independent, outside compensation consultant specializing in healthcare organizations conducted a detailed analysis of total compensation and each element thereof, including base salary, bonus, 'at-risk other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, which list was reviewed by the Compensation Committee. The study's data and findings were shared with the health system's EVP/COO. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Mr. Arner, Mr. Conte, Mr. Halliwill, and Mr. Vaughan participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP). Contributions to the plan are at the discretion of Carilion Clinic's Compensation Committee. Amounts vest and become non-forfeitable and payable upon the first of the following (1) attainment of scheduled vesting date (2) attainment of age and years of service requirements (3) disability or death while an eligible employee or (4) entitlement to severance benefits from an involuntary termination without reasonable cause or resignation with good reason. Unvested contributions made to the DC SERP in the reporting period are included in Part II, Column C of this schedule with "retirement and other deferred compensation," while vested contributions paid out during the year are included in Part II, Column B(iii). The following distributions were made to these individuals under this plan in the reporting year. Deferred in prior year and paid out in current year: $227,735 - Donald Halliwill $195,888 - Steven Arner $57,282 - G. Robert Vaughan, Jr. $172,601 - Nicholas Conte Schedule J, Part I, Line 7 Non-fixed payments The organization pays annual 'at risk' compensation to certain members of management and physicians based on performance of applicable scorecard metrics. While the scorecard contains a formula as a basis for determining overall performance, in certain cases, senior managers have discretion to include additional elements in their assessment of managers or physicians reporting to them. In addition, for top management, the actual non fixed payment awarded is determined in the discretion of the Carilion Clinic Board of Directors and its compensation committee. Form 990, Part III, Line 4a PROGRAM ACCOMPLISHMENTS Carilion Rockridge Community Hospital, part of Carilion Clinic, is a not-for-profit healthcare organization committed to improving health outcomes for every patient while advancing the quality of care in the community it serves. Located in Lexington, Virginia, this 25-bed critical access hospital provides 24-hour emergency care and a full range of inpatient and outpatient services, including imaging, orthopedic, surgical and therapies. Carilion Rockbridge Community Hospital exists to serve the health care needs of its community, regardless of a patient's ability to pay. The acute hospital admitted 1,490 patients and provided 5,463 days of care during the year. Hospital programs include the provision of nursing care, swing bed services, extensive outpatient and inpatient surgical and endoscopic services, respiratory therapy, and diagnostic imaging services including CT, MRI, mammography, ultrasound, DEXA scan and nuclear medicine, women's services and sleep medicine. The hospital also offers integrated and comprehensive primary care services through multiple Rural Health Clinics, serving over 46,559 patient visits. The hospital provides several services targeting the specific health needs of its population, including diabetes management, physical, speech, and occupational therapy programs, participation in cardiac rehabilitation, pulmonary rehabilitation and disease management programs. Further, the hospital served 14,169 patient visits in its emergency department, which provides 24-hour care, emergency transportation, and a chest pain program. Emergency services are a critical component of the health safety net in the hospital's service area, acting as a vital health provider for a significant number of uninsured patients, who comprise nearly 6 percent of ED visits. The hospital supports community screenings and education on chronic disease prevention and management. In furtherance of its mission, the hospital provides extensive uncompensated care and community support. Stated at cost, financial assistance and other community benefits for the year exceeded $1.8 million. Form 990, Part IV, Line 11f Disclosure of Uncertain Tax Positions Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. Form 990, Part V, Line 1a FORMS 1099 1099's are issued on Carilion Rockbridge Community Hospital's behalf by Carilion Services, Inc., a related organization providing management and administrative services, including payment processing. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons Steven Arner, Nicholas Conte, Donald Halliwill, J. Harrison Lapuasa, G. Robert Vaughan, Jr., Julie Smith-Hamilton, Alicia Devine, Ayesha Kelly, George Godette, David Hagadorn, and Lisa Sprinkel - Business relationship Form 990, Part VI, Line 3 Delegation of management duties Certain management and related services for the organization are provided by the management and employees of Carilion Services, Inc., a related and supporting organization of the filing organization. Some or all of the compensation of the following individuals listed in Part VII, Section A was provided by Carilion Services, Inc.: Steve Arner, Nicholas C. Conte, David Hagadorn, Donald B. Halliwill, J. Harrison Lapuasa, Julie Smith-Hamilton, Lisa T. Sprinkel, and G. Robert Vaughan, Jr. Form 990, Part VI, Line 6 Classes of members or stockholders The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the Board that may occur for any reason. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO; approval of borrowings, budgets, and strategic plans; and amendments of Articles of Incorporation and Bylaws, among others. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia, certain extraordinary actions require member approval, such as mergers, consolidations, liquidations, and the sale of substantially all of the assets of the organization. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a. Form 990, Part VI, Line 11b Review of form 990 by governing body The Form 990 was prepared by Carilion's internal Tax Department with input from various Carilion departments as applicable, and reviewed by internal management. Several days prior to filing, all Board Members were notified via email that the final Form 990 was available for their access on the organization's Board portal and were provided contact information to reach out to for any questions. Form 990, Part VI, Line 12c Conflict of interest policy Our organization monitors and reviews proposed and current transactions for conflicts of interest in a variety of ways. At the governing board level, we have board members complete an initial (upon appointment) and annual conflict of interest questionnaire to disclose actual or potential conflicts. Board members are required to update their disclosure as needed in between questionnaires. All disclosures are reviewed by the Compliance Office and as needed escalated to the appropriate leaders/board members for further discussion/review. If a disclosure is viewed as an actual or potential conflict, an action is recommended to the Compliance Committee of the Carilion Clinic Board and implemented as approved. Actions can include recusal in discussion/voting at board meetings, limitation/termination of the transaction, removal from board appointment or other appropriate controls. In addition, at any time, board members are encouraged to disclose any potential conflicts as they arise at a board meeting and to recuse themselves as deemed appropriate. The same process takes place as described above for key employees (upon hire and annually thereafter), including all officers, members of the management team, physicians/mid-level practitioners, pharmacists and key supply chain buyers. After review and further discussion as needed, action may be required to manage an actual conflict or to reduce the appearance of such as approved by the Compliance Office and other key management team members. As needed, the governing board leaders are notified of any conflicts which may impact board proceedings. Form 990, Part VI, Line 15a Process to establish compensation of top management official The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The Carilion Clinic Board of Directors Compensation Committee reviews the compensation of the Carilion Clinic Board of Governors annually, which includes the Carilion Clinic President and Chief Executive Officer, Executive Vice Presidents (Chief Financial Officer, Chief Physician Executive, Chief Operating Officer, Chief Administrative Officer and Chief Legal Officer), and select Senior Vice Presidents who are the physician Chairs of the Clinical Departments. Certain of these same individuals also hold roles as officers of the filing organization. The Compensation Committee is made up of independent Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. The Compensation Committee also annually reviews the compensation philosophy for all executive leaders in the health system, which includes Vice Presidents, Senior Vice Presidents, Executive Vice Presidents, and the CEO, among them the filing organization's top management official and certain other officers. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for certain select positions and the prior year's report on all the reviewed positions . The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, which list was reviewed by the Compensation Committee. The Compensation Committee maintained minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives. For the filing organization's top management official and certain officers who are not directly reviewed by the Compensation Committee, the independent external compensation consultant conducts the same analysis and shares the data/findings with the system EVP/COO. Certain assistant officers of the organization who are not compensated in their capacity as an officer but rather in their role as employee in a position not mentioned above are not subject to Committee or consultant review but are compared to market benchmarks by the Human Resources department. Form 990, Part VI, Line 15b Process to establish compensation of other employees See response to line 15A. Form 990, Part VI, Line 19 Required documents available to the public The organization's governing documents, conflict of interest statement, and consolidated financial statements are released from time to time during the tax year upon request. The conflict of interest policy is included in our Code of Excellence which is available to the public on our website. The Articles of Incorporation are available from the Virginia State Corporation Commission. Limited consolidated financial information is available on our website. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part X, Line 20 Tax-Exempt Bond Liabilities The amount reported as Tax-Exempt Bonds is the portion of Carilion Clinic Bonds allocated to Carilion Rockbridge Community Hospital. Required information for the Bonds, including Schedule K, is reported in the Carilion Clinic (EIN: 54-1190771) IRS Form 990. 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