2025-08-15T17:59:57+00:00 2024-09-30 990 2023-10-01 540480606 Carilion Franklin Memorial 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 Carl Cline PO BOX 12385 Roanoke VA 24025 98883988 false X WWW.CARILIONCLINIC.ORG X 1956 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. 11 5 624 27 0 0 510297 27101 81320995 95723320 180347 973023 249085 280663 82260724 97004107 86946 61900 0 27723123 29586446 0 0 44715199 50796105 72525268 80444451 9735456 16559656 52574219 56375322 18637420 19997447 33936799 36377875 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 66998390 61900 95732561 See Schedule O. 66998390 true true false true false false false false false true true false false true false false true false false false false false false false false true true true false true false false false false false false true false false false false false false true true true false false true X 0 0 624 true false false false false false false false false false false false false X 11 5 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 Carl Cline Jr Dir./Sec./Treas./Hospital VP 50.0 0 X X 223091 0 109940 Victoria Gardner Director/Vice Chair 1.2 0.0 X X 0 768 0 William Kingery Jr Director / Chair 2.5 2.9 X X 0 10250 0 Barbara Jackman Director 1.2 0 X 0 0 0 Dave Peters Director 1.2 0.0 X 0 768 0 Katherine Goff PhD Director 1.2 0 X 0 0 0 Sarah Stubbs MD Director 1.2 48.8 X 0 213853 13628 Shannon Moore Director 1.2 7.7 X 0 39921 26909 Stephanie Lareau MD Director 1.2 48.8 X 0 349729 6961 Steven Arner Director/COO, Carilion Clinic 2.0 48.0 X 0 1410192 209618 W Mark Church PhD Director 1.2 0.0 X 0 480 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 Donn Bergman Physical Therapist 40.0 0 X 133731 0 41045 Kristin Brandenberger Pharmacist 49.5 0.5 X 122228 10570 23031 Lori McClure Pharmacy Manager 40.0 0 X 182957 0 1140 Shirley Landon-King Occupational Therapist 39.0 1.0 X 140196 650 -7891 Tracy McCown Nursing Director 40.0 0 X 135180 0 26955 David Hagadorn Former Officer 0.0 0.0 X 0 159104 25072 937383 4892095 907387 22 true true false SKANSKA USA BUILDING INC 4309 EMPEROR BLVD SUITE 200 DURHAM NC 27703 CONSTRUCTION SERVICES 3542175 QUEST DIAGNOSTICS 500 PLAZA DRIVE SECAUCUS NJ 07094 LABORATORY SERVICES 2250722 QUALIVIS LLC 1601 ASSEMBLY ST UNIT 1439 COLUMBIA SC 29201 TEMPORARY STAFFING 1920465 F & S BUILDING INNOVATIONS INC 2944 ORANGE AVE NE ROANOKE VA 24012 CONTRACTOR SERVICES 656767 AVANT HEALTHCARE PROFESSIONALS 2301 LUCIEN WAY MAITLAND FL 32751 TEMPORARY STAFFING 298672 11 23148 3953 27101 Net Patient Revenue 622110 95331586 95331586 Rent From Affiliates 531120 391734 391734 0 0 0 0 95723320 166922 166922 116018 116018 0 116018 116018 2685982 1879881 806101 0 806101 806101 Dining Services 722514 155404 155404 9241 9241 0 0 164645 97004107 95732561 0 1244445 61900 61900 290964 290964 125305 125305 23408755 23391464 17291 703676 703156 520 3368483 3296582 71901 1689263 1668935 20328 12481571 12481571 6909 6909 19304 19304 6860451 6576052 284399 0 6396 6396 1391780 1345367 46413 215952 215603 349 1315633 1315633 540045 538345 1700 134011 134011 2814862 2814862 396777 187544 209233 Medical Supplies 8984899 8984899 Bad Debt 8975121 8975121 Assessment Fees 3652984 3652984 Affiliate Practice Subsidy 2917698 2917698 81712 79624 2088 0 80444451 66998390 13446061 0 717 305 326 956 12996796 14473766 0 0 0 0 590055 589131 65492985 37932325 27263302 27560660 3345603 4498311 8364825 9239489 0 12595 12704 52574219 56375322 8115724 7347479 127435 117097 5342420 5199324 0 0 5051841 7333547 18637420 19997447 X 33936799 36377875 33936799 36377875 52574219 56375322 X 16559656 1018301 -15136881 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 6909 6909 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. 408022 408022 39602407 18717745 20884662 67956 7264 60692 23758990 18252985 5506005 1655610 954331 701279 27560660 270167 F Alternative Investments 8969322 F 9239489 Pension Liability 6567690 Interest Rate Swap Liability 189385 Lease Liability 576197 Due to Affiliate 275 7333547 true true X true X 300 true X 500 true true true false true true 1033642 1033642 0.0145 16555144 18746669 0 0.0 0 0.0 0 0 17588786 18746669 1033642 0.0145 357254 775 356479 0.0050 0 0.0 0 0.0 0 0.0 86925 86925 0.0012 0 0 444179 775 443404 0.0062 0 0 18032965 18747444 1477046 0.0207 0 0.0 2608 2608 0.0000 10371 10371 0.0001 0 0.0 0 0.0 12453 12453 0.0002 377 377 0.0000 1318 1318 0.0000 0 0.0 0 0 27127 0 27127 0.0004 true 8975121 16646534 17765707 -1119173 X true true 1 1 CARILION FRANKLIN MEMORIAL HOSPITAL 390 South Main Street ROCKY MOUNT VA 24151 https://carilionclinic.org/locations/carilion-franklin-memorial-hospital H 1836 X X X CARILION FRANKLIN MEMORIAL 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_cfmh_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 can 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 FRANKLIN MEMORIAL HOSPITAL. Carilion Clinic's Community Health Needs Assessments (CHNA) 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. The CHATs include 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) Franklin County Area Community Health Needs Assessment (FCACHNA): Bernard Healthcare Center & Free Clinic of Franklin County, Disability Rights & Resource Center, Essig Center (Office on Aging), Feeding Southwest Virginia, Franklin County Department of Public Safety, Franklin County Habitat for Humanity, Franklin County NETS, Franklin County Parks and Recreation, Franklin County Public Library System, Franklin County Public Schools, Piedmont Community Services, Rocky Mount Police Department, Smith Mountain Lake Good Neighbors, Southern Area Agency on Aging, Southern VA Child Advocacy Center, TriArea Healthcare, United Way of Roanoke Valley, VA Harm Reduction Coalition, Virginia Harm Reduction, West Piedmont Health District. To obtain input from the community, the FCACHNA conducted a listening session among CHAT stakeholders, held a listening session with community members, and administered a 27-question community health survey broadly across the service area. This occurred from October 1, 2023, through December 31, 2023. The survey was developed in English and Spanish and asked questions 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 to collect qualitative data to understand health-related needs further. A facilitated listening session was held with clients of the Franklin County Public Library System. CHAT members could offer additional perspectives on the needs and barriers to health facing our community during a Healthy Franklin County meeting that included other community stakeholders. Carilion staff from across the organization facilitated small group discussions. CHAT members were asked to complete the Stakeholder Survey after participating in a listening session to quantify listening session 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 Franklin County and Henry County residents 18 and older. There were special efforts to include underserved/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; and families with young children. The survey was also available online to all Franklin County and Henry County residents. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - CARILION FRANKLIN MEMORIAL HOSPITAL. The CHAT conducted the 2024 Franklin County Area Community Health Needs Assessment with: Bernard Healthcare Center & Free Clinic of Franklin County, Disability Rights & Resource Center, Essig Center (Office on Aging), Feeding Southwest Virginia, Franklin County Department of Public Safety, Franklin County Habitat for Humanity, Franklin County NETS, Franklin County Parks and Recreation, Franklin County Public Library System, Franklin County Public Schools, Piedmont Community Services, Rocky Mount Police Department, Smith Mountain Lake Good Neighbors, Southern Area Agency on Aging, Southern VA Child Advocacy Center, Tri-Area Healthcare, United Way of Roanoke Valley, VA Harm Reduction Coalition, Virginia Harm Reduction, West Piedmont Health District. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - CARILION FRANKLIN MEMORIAL HOSPITAL. The Community Health Assessment Team shared the 2024 Franklin County Area Community Health Needs Assessment (FCACHNA) on partner websites, social media, and regional news coverage. The FCACHNA was 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 FRANKLIN MEMORIAL HOSPITAL. The following information describes the implementation strategy used by Carilion Franklin Memorial Hospital (CFMH) to address the community health needs identified in the 2024 Franklin County Area Community Health Needs Assessment (FCACHNA). The complete implementation strategy is available online at https://issuu.com/carilionclinic/docs/implementation_strategy_final_cfmh The hospital is working to address all significant health needs prioritized through the CHNA. The top prioritized needs for the 2024 FCACHNA were grouped into three overarching categories: chronic disease, mental health and substance use, and injury/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 implementing a fruit and vegetable prescription program, implementing a Healthy Heart Ambassadors program, and implementing evidence-based health and nutrition education programs. Strategies to address injury and violence include 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 a pop-up clinic model 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 supporting and participating in the development of a community-wide strategic framework through the Healthy Franklin County coalition to address community health needs further. 0 CARILION CLINIC HOSPICEHOME HEALTH-FRANKLIN 453 South Main Street Rocky Mount VA 24151 HOSPICE AND HOME HEALTH Carilion Clinic Outpatient Therapy 415 South Main Street Rocky Mount VA 24151 Outpatient Therapy 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 about 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 8975121 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, increasing wages for employees and various capital building projects. In addition, Carilion had in-kind expenses from supporting the Smith Mountain Lake Chamber of Commerce and direct economic development expense support of Cruisin' Rocky Mount, an event that benefits local businesses and builds a vibrant community. Support was also provided to the Community Partnership, promoting economic strength and development of Rocky Mount and Franklin County. Line 3 - Community support: Research demonstrates the strong connection between social determinants of health-such as transportation 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, as well as improved housing and better nutrition for our neighbors in need. These efforts help to remove a range of obstacles to good health for our region's residents. CFMH is involved with various health and social determinant-related initiatives, providing organizational support and monetary donations. For example, Carilion supported Virginia Cooperative Extension, local Parks and Recreation, the agricultural fair, and Ferrum College. 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. Carilion participates in coalitions that address health, safety and social determinant needs in the Franklin County area to ensure lasting impact from the health assessment and community health improvement process. We also partner with multiple community and business organizations on initiatives to improve health and wellness for everyone living in the Franklin County area. An example is Carilion's representation on the Rocky Mount Rotary Club-a group working together to advance goodwill in the area. Carilion also participated on the local Red Cross board, Healthy Franklin County, the Roanoke Valley Hearing and Speech Center board, and with the NAACP, CASA, and Local Emergency Planning Committee. Line 7 - Community health improvement advocacy: Carilion's mission of community health improvement focuses not only on what the organization does directly but also on supporting the advocacy efforts of other organizations. Carilion supported the Virginia Health Care Foundation and the Virginia Public Access Project and started a group of community health stewards to raise awareness on specific community health improvement topics and projects. These efforts promote better health by advocating for particular causes under the larger umbrella of health, safety, and the social determinants of health. Carilion also participated in the Franklin County strategic planning process to ensure community health improvement continued to be a priority for the local government. 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 supported the STEM Health and Applied Program Advisory Board and the Franklin County High School Auxiliary. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Carilion Franklin Memorial 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 Franklin Memorial 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 FRANKLIN MEMORIAL HOSPITAL: Line 16a URL: https://www.carilionclinic.org/billing/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - CARILION FRANKLIN MEMORIAL 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 FRANKLIN MEMORIAL 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 the 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. 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 Franklin County is part of the Roanoke Valley Metropolitan Statistical Area, a region flush with resources, including food, health and human services, arts and culture, and outdoor amenities. Additionally, within the service area, resources are accessible to residents in Martinsville, the Town of Rocky Mount, the Smith Mountain Lake area, and other smaller communities. Health and human service organizations work to reduce the disparities in access to care and access to resources for many residents of the region. The Franklin County Area comprises distinct communities with disparities in size, population, and social determinants of health. The 2019-2023 American Community Survey (ACS) found the total population of the counties of Franklin and Henry to be 54,958 and 50,365, respectively. The median age is 48.5 in Franklin County and 47.9 in Henry County. The Weldon Cooper Center of Public Service predicts positive future population change for Franklin County and negative population change for Henry County by 2040. The ACS finds that both Franklin and Henry Counties have a more significant percentage of the population that is White (86.69% and 69.75%) than in the Commonwealth of Virginia (61.73. Henry County also has a larger percentage of the population that is Black (22.38%) than in the Commonwealth of Virginia (18.75%) (US Census Bureau, ACS, 2019-2023). Franklin and Henry Counties are federally-designated Health Professional Shortage Areas for primary care, mental health, and dental health for low-income residents and are Medically Underserved Areas for primary care. There is another hospital in Henry County owned by Sovah Health. CFMH is the only hospital in Franklin County. (https://data.hrsa.gov/tools/shortage-area) The 2019-2023 ACS states that the average household income in Franklin County is $90,740 and $64,932 in Henry County. Franklin County has 11.53% of the population living at or below the Federal Poverty Level. In Henry County, that number is 14.80%. Both counties have higher poverty rates than Virginia (9.92%) (US Census Bureau, ACS, 2019-2023). The ACS shows that 21.94% of the insured population in Franklin County receives Medicaid, and 6.64% have no insurance coverage. In Henry County, 30.48% of insured people receive Medicaid and 6.11% have no insurance. Of the patients receiving care at CFMH in FY24, 23.61% have Medicaid coverage, and 5.06% are self-pay (Strata internal data). Schedule H, Part VI, Line 5 Promotion of community health Carilion Franklin Memorial Hospital is 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 more than 125 years when a group of dedicated citizens came together and built a hospital to meet the community's health care 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's Office of Sustainability leads these efforts and empowers employees to be involved in environmental health-related projects. Carilion Franklin Memorial Hospital (CFMH) provides a full range of top-quality inpatient and outpatient care for residents of the Franklin County area. The facility includes an inpatient hospital and medical offices for acute and specialty care. CFMH's health care professionals provide patients with reliable, safe care to get them on the road to recovery close to home. For inpatient care, CFMH physicians diagnose and treat illnesses, anticipate problems and rapidly respond to changes in patient conditions. Emergency services are onsite 24/7, and CFMH offers direct access to Carilion's Level 1 Trauma Center if an advanced level of care is needed. Other onsite services include imaging, inpatient and outpatient surgical, therapy services (PT, OT, ST, RT), and laboratory. CFMH serves all 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, staff development, and charitable efforts. Reinvestments include free, discounted and subsidized care and critical medical services not otherwise offered in our region. Schedule H, Part VI, Line 6 Affiliated health care system Carilion Franklin Memorial Hospital is wholly 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 Children's Advocacy Prog of Blue Ridge 300 S Main St Rocky Mount VA 24151 541950268 501(c)(3) 6000 Trauma focused support Stepping Stone Mission of Franklin Co 1105 N Main St Rocky Mount VA 24151 203075565 501(c)(3) 7000 Nutritionally dense meals Healing Strides of Virginia PO Box 456 Boones Mill VA 24065 541594325 501(c)(3) 6000 Family Emotional expression Free Clinic of Franklin County 1171 Franklin St Rocky Mount VA 24151 541634138 501(c)(3) 15000 Primary Care Access 4 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. X false true false true false false false false false true false Carl Cline Jr Dir./Sec./Treas./Hospital VP 194104 0 19262 0 9725 0 93024 0 16916 0 333031 0 0 0 Steven Arner Director/COO, Carilion Clinic 0 1044670 0 164317 0 201205 0 184622 0 24996 0 1619810 0 195888 Stephanie Lareau MD Director 0 329304 0 17640 0 2785 0 -2099 0 9060 0 356690 0 0 Sarah Stubbs MD Director 0 195734 0 16632 0 1487 0 -9907 0 23535 0 227481 0 0 David Hagadorn Former Officer 0 120679 0 0 0 38425 0 13363 0 11709 0 184176 0 0 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 Donn Bergman Physical Therapist 132896 0 0 0 835 0 19865 0 21180 0 174776 0 0 0 Kristin Brandenberger Pharmacist 120574 0 1350 10570 304 0 193 0 22838 0 145259 10570 0 0 Lori McClure Pharmacy Manager 181796 0 0 0 1161 0 149 0 991 0 184097 0 0 0 Tracy McCown Nursing Director 129232 0 0 0 5948 0 3984 0 22971 0 162135 0 0 0 Schedule J, Part I, Line 1a Tax indemnification and gross-up payments EMPLOYEES ARE OCCASIONALLY PROVIDED SMALL GIFTS, PRIZES OR AWARDS WHICH MAY BE INCLUDED IN TAXABLE COMPENSATION AT AMOUNTS GROSSED UP FOR TAXES. DURING THE REPORTING PERIOD, MR. CLINE AND DR. LAREAU A RECEIVED SUCH BENEFIT. 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 phhilosophy 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. LETTITIA FURROW FAMILY MEMBER OF WILLIAM KINGERY, DIRECTOR 125305 EMPLOYEE false Form 990, Part I, Line 6 VOLUNTEERS Our volunteers assisted by delivering items to patients' rooms, ensuring they had everything needed for a comfortable stay. They also act as friendly escorts, guiding patients to their appointments or various hospital departments. They greet and welcome patients as they enter our doors, creating a welcoming and reassuring environment. Our volunteers truly exemplify our hospital's dedication to exceptional patient service. Hospice volunteers crafted handmade cards for patients to receive on birthdays, holidays, and for Veteran Pinning Ceremonies. They participated in Veteran Pinning Ceremonies for Hospice Veteran patients. This consists of providing a patient with a handmade quilt, handmade card, certificate of recognition, USA flag pin, and a fabric star from a retired flag that is presented to the caregiver/spouse. Veteran volunteers then do a final salute to the patient. Respite was provided for caregivers as well as socialization for patients. Local volunteer quilting groups provide quilts for patient's birthdays and Veteran Pinning Ceremonies. Volunteers help with Grief Support Group, delivering birthday bags to patients, fundraising, and office administrative support. Form 990, Part III, Line 4a Program Service Accomplishments Carilion Franklin Memorial Hospital (CFMH), 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 Rocky Mount, VA, this 37-bed hospital offers a wide range of medical and surgical services, including convenient outpatient and emergency department services. Carilion Franklin Memorial Hospital exists to serve the health care needs of its community, regardless of a patient's ability to pay. The hospital admitted 1,866 patients and provided 6,683 days of care during the year. Hospital programs include the provision of nursing care, extensive outpatient and inpatient surgical and endoscopic services, and diagnostic imaging services including CT, MRI, mammography and nuclear medicine. CFMH provides several services targeting the specific health needs of its population, including diabetes management, home health and hospice, physical, speech, and occupational therapy programs, plastics & reconstructive surgery, ENT, and cardiac and respiratory rehab. A desk area at the hospital's medical office building is staffed by volunteers who welcome patients and visitors. CFMH also provides an emergency department with 24-hour care, emergency transportation, and STEMI and stroke programs. With 21,564 visits, CFMH's emergency services are a critical component of the health safety net in its service area. It acts as a primary health provider for a significant number of uninsured patients, who comprise 6 percent of ED visits. CFMH also supports community screenings and education on chronic disease prevention and management. In furtherance of its mission, CFMH provides extensive uncompensated care and community support. Stated at cost, nearly $1.5 million in financial assistance and other community benefits were provided. 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 Franklin Memorial 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, G. Robert Vaughan Jr., Julie Smith-Hamilton, J. Harrison Lapuasa, Sarah Stubbs, Stephanie Lareau and Shannon Moore - 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.: Steven Arner, Nicholas Conte, David Hagadorn, Donald Halliwill, J. Harrison Lapuasa, Julie Smith-Hamilton, Shannon Moore, 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 Other - Total Revenue: 9241, Related or Exempt Function Revenue: 9241, 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 Franklin Memorial 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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