CARILION ROCKBRIDGE COMMUNITY HOSPITAL: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- CARILION ROCKBRIDGE COMMUNITY HOSPITAL (EIN 54-0568001)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-16
- IRS object ID
- 202022299349301107
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-16T19:00:24-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540568001 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carilion Stonewall Jackson Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CARI | BusinessNameControlTxt |
| Phone | 5402245112 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12385 | AddressLine1Txt |
| City | Roanoke | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24025 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | G ROBERT VAUGHAN JR | PersonNm |
| Person Title | ASSISTANT TREASURER | PersonTitleTxt |
| Signature | 2020-08-16 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREGORY T MADSEN | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12385 | AddressLine1Txt |
| City | Roanoke | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24025 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $74,765,457 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CARILIONCLINIC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1955 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | 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. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 310 | TotalEmployeeCnt |
| Total Volunteers | 64 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $89,421 | PYContributionsGrantsAmt |
| CY Contributions Grants | $73,800 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $39,881,816 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $44,408,198 | CYProgramServiceRevenueAmt |
| PY Investment Income | $612,038 | PYInvestmentIncomeAmt |
| CY Investment Income | $923,812 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,580,998 | PYOtherRevenueAmt |
| CY Other Revenue | $701,042 | CYOtherRevenueAmt |
| PY Total Revenue | $42,164,273 | PYTotalRevenueAmt |
| CY Total Revenue | $46,106,852 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $63,997 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $63,211 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,683,459 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,109,776 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $23,731,728 | PYOtherExpensesAmt |
| CY Other Expenses | $26,444,803 | CYOtherExpensesAmt |
| PY Total Expenses | $39,479,184 | PYTotalExpensesAmt |
| CY Total Expenses | $42,617,790 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,685,089 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,489,062 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $55,362,643 | TotalAssetsBOYAmt |
| Total Assets EOY | $63,003,950 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $23,173,575 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $27,272,733 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $32,189,068 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $35,731,217 | NetAssetsOrFundBalancesEOYAmt |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $36,911,700 | ExpenseAmt |
| Grant | $63,211 | GrantAmt |
| Revenue | $44,714,803 | RevenueAmt |
| Desc | See schedule O. | Desc |
| Total Program Service Expenses | $36,911,700 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 310 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CORPORATION ATTN H KIRK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5402245102 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 S JEFFERSON ST | AddressLine1Txt |
| City | ROANOKE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24011 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Howard Boetsch Jr DML | ||||||||||
| Director/Secretary/Treasurer | 1.2 | 2.4 | Yes (X) | Yes (X) | $0 | $10,575 | $0 | |||
| Juliet GIBSON | ||||||||||
| Director/Vice Chair | 1.2 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Greg Madsen | ||||||||||
| Director/Hospital VP | 50.0 | 0 | Yes (X) | Yes (X) | $199,541 | $7,015 | $50,792 | |||
| Richard TEAFF PhD | ||||||||||
| Director/Chair | 2.5 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Robert Berkstresser | ||||||||||
| Director | 1.2 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| Gregory Cavallaro | ||||||||||
| Director | 1.2 | 0 | Yes (X) | $0 | $736 | $0 | ||||
| James Crews MD | ||||||||||
| Director | 1.2 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| Sidney Evans | ||||||||||
| Director | 1.2 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| Ayesha KELLY MD | ||||||||||
| Director | 1.2 | 48.8 | Yes (X) | $0 | $339,792 | $41,115 | ||||
| Tracy Lyons | ||||||||||
| Director | 1.2 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| WILLIAM J SAYRE MD | ||||||||||
| Director | 1.2 | 48.8 | Yes (X) | $0 | $363,796 | $26,861 | ||||
| John SEDOVY MD | ||||||||||
| Director | 1.2 | 48.8 | Yes (X) | $0 | $496,095 | $21,539 | ||||
| Lisa Sprinkel | ||||||||||
| Director | 1.2 | 48.8 | Yes (X) | $0 | $149,335 | $19,314 | ||||
| Kerri Thornton | ||||||||||
| Director | 1.2 | 48.8 | Yes (X) | $0 | $282,391 | $9,394 | ||||
| James Williams Jr | ||||||||||
| Director | 1.2 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| Cheryl Wright | ||||||||||
| Director | 1.2 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| Nicholas Conte | ||||||||||
| Asst. Secretary | 1.0 | 49.0 | Yes (X) | $0 | $523,989 | $136,049 | ||||
| David Hagadorn | ||||||||||
| Asst. Treasurer | 0.5 | 49.5 | Yes (X) | $0 | $143,606 | $8,062 | ||||
| Donald Halliwill | ||||||||||
| Asst. Treasurer | 0.5 | 49.5 | Yes (X) | $0 | $591,117 | $93,970 | ||||
| Lauren Schantz | ||||||||||
| Asst. Secretary | 1.5 | 38.5 | Yes (X) | $0 | $74,069 | $12,875 | ||||
| G Robert Vaughan Jr | ||||||||||
| Asst. Treasurer | 0.5 | 49.5 | Yes (X) | $0 | $294,528 | $26,998 | ||||
| Nancy Howell Agee | ||||||||||
| CEO, Carilion Clinic | 2.0 | 48.0 | $0 | $1,733,867 | $125,927 | Yes (X) | ||||
| Steven Arner | ||||||||||
| Executive Vice President | 2.0 | 48.0 | $0 | $617,874 | $97,360 | Yes (X) | ||||
| LISA C CRAFT | ||||||||||
| RN Lead | 50.0 | 0 | $138,588 | $0 | $18,322 | Yes (X) | ||||
| Regina Donald | ||||||||||
| Pharmacy Manager | 50.0 | 0 | $163,486 | $0 | $34,125 | Yes (X) | ||||
| Tracy Kiely | ||||||||||
| RN Lead | 50.0 | 0 | $112,716 | $0 | $20,526 | Yes (X) | ||||
| Karen Lafon | ||||||||||
| Unit Director | 50.0 | 0 | $125,706 | $0 | $23,673 | Yes (X) | ||||
| Phyllis Snyder | ||||||||||
| RN Lead | 50.0 | 0 | $133,334 | $0 | $32,572 | Yes (X) | ||||
| Charles Carr | ||||||||||
| Former Director/Officer | 50.0 | 0 | $75,954 | $144,369 | $52,366 | Yes (X) | ||||
| Karen Lyons MD | ||||||||||
| Former Director/Officer | 5.0 | 45.0 | $26,585 | $203,947 | $31,037 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $975,910 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,977,101 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $882,877 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| GE MEDICAL SYSTEMS | ||||||
| 5517 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | MAINTENANCE CONTRACTS | $712,190 | |
| QUEST DIAGNOSTICS | ||||||
| 500 PLAZA DRIVE | SECAUCUS | NJ | 07064 | LABORATORY SERVICES | $456,601 | |
| SIEMENS MEDICAL SOLUTIONS USA INC | ||||||
| 40 LIBERTY BLVD | MALVERN | PA | 19355 | EQUIPMENT MAINTENANCE CONTRACTS | $223,328 | |
| MEDICAL SOLUTIONS LLC | ||||||
| 1010 NORTH 102ND ST | OMAHA | NE | 68114 | PROFESSIONAL FEES | $133,968 | SUITE 300 |
| TRANE US INC | ||||||
| 2303 TRANE DRIVE | ROANOKE | VA | 24017 | CONTRACTOR SERVICES | $132,052 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Related Organizations | $73,000 | RelatedOrganizationsAmt |
| Government Grants | $0 | GovernmentGrantsAmt |
| All Other Contributions | $800 | AllOtherContributionsAmt |
| Total Contributions | $73,800 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Revenue | 622110 | $44,349,818 | $44,349,818 |
| Exempt Affiliate Rent | 900099 | $58,380 | $58,380 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $44,408,198 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $407,549 | TotalRevenueColumnAmt |
| Exclusion | $407,549 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $203,877 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $203,877 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $203,877 | TotalRevenueColumnAmt |
| Exclusion | $203,877 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $29,166,468 | SecuritiesAmt |
| Other | $8,400 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $28,657,508 | SecuritiesAmt |
| Other | $1,097 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $508,960 | SecuritiesAmt |
| Other | $7,303 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $516,263 | TotalRevenueColumnAmt |
| Exclusion | $516,263 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Contract Revenue | 900099 | $240,666 | $240,666 | |
| Cafeteria | 722514 | $190,560 | $190,560 | |
| Welness Memberships | 900099 | $17,240 | $17,240 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $48,699 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $48,699 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $497,165 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,106,852 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,714,803 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,318,249 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,211 | TotalAmt |
| Program Services | $63,211 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,761 | TotalAmt |
| Management And General | $262,761 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,527,406 | TotalAmt |
| Program Services | $12,515,232 | ProgramServicesAmt |
| Management And General | $12,174 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $835,079 | TotalAmt |
| Program Services | $834,267 | ProgramServicesAmt |
| Management And General | $812 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,642,977 | TotalAmt |
| Program Services | $1,595,873 | ProgramServicesAmt |
| Management And General | $47,104 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $841,553 | TotalAmt |
| Program Services | $825,892 | ProgramServicesAmt |
| Management And General | $15,661 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,027,490 | TotalAmt |
| Management And General | $5,027,490 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,576 | TotalAmt |
| Management And General | $1,576 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,763 | TotalAmt |
| Program Services | $2,763 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,172 | TotalAmt |
| Management And General | $32,172 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,938,363 | TotalAmt |
| Program Services | $3,818,686 | ProgramServicesAmt |
| Management And General | $119,677 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $423 | TotalAmt |
| Program Services | $423 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $668,087 | TotalAmt |
| Program Services | $656,988 | ProgramServicesAmt |
| Management And General | $11,099 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,117 | TotalAmt |
| Program Services | $76,117 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $796,999 | TotalAmt |
| Program Services | $796,999 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,781 | TotalAmt |
| Program Services | $66,567 | ProgramServicesAmt |
| Management And General | $4,214 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $856,533 | TotalAmt |
| Program Services | $856,533 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,157,078 | TotalAmt |
| Program Services | $2,157,078 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $308,555 | TotalAmt |
| Program Services | $172,244 | ProgramServicesAmt |
| Management And General | $136,311 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Med Supplies | $3,447,526 | $3,447,526 |
| Bad Debt | $5,339,281 | $5,339,281 |
| Intercompany Practice Subsidy | $3,647,915 | $3,647,915 |
| Dues & Subscriptions | $33,856 | $33,856 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,288 | TotalAmt |
| Program Services | $4,249 | ProgramServicesAmt |
| Management And General | $35,039 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,617,790 | TotalAmt |
| Program Services | $36,911,700 | ProgramServicesAmt |
| Management And General | $5,706,090 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,199 | BOYAmt |
| EOY | $1,311 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,678 | BOYAmt |
| EOY | $23,466 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,627,763 | BOYAmt |
| EOY | $9,878,974 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $393,807 | BOYAmt |
| EOY | $365,650 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,813 | BOYAmt |
| EOY | $136,981 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $55,520,542 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $38,577,632 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,979,764 | BOYAmt |
| EOY | $16,942,910 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,087,949 | BOYAmt |
| EOY | $5,769,476 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,840,033 | BOYAmt |
| EOY | $25,169,545 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,278,637 | BOYAmt |
| EOY | $4,715,637 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,362,643 | BOYAmt |
| EOY | $63,003,950 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,060,635 | BOYAmt |
| EOY | $10,538,863 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,380,788 | BOYAmt |
| EOY | $15,958,134 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $598,741 | BOYAmt |
| EOY | $578,107 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $133,411 | BOYAmt |
| EOY | $197,629 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,173,575 | BOYAmt |
| EOY | $27,272,733 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,189,068 | BOYAmt |
| EOY | $35,731,217 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,189,068 | BOYAmt |
| EOY | $35,731,217 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,362,643 | BOYAmt |
| EOY | $63,003,950 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,489,062 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $121,329 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$68,242 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $2,763 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,763 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | FormAndLineReferenceDesc |
| Explanation | A portion of dues paid to various hospital industry associations is attributable to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $430,816 | OtherCostOrOtherBasisAmt |
| Book Value | $430,816 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,365,691 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,921,439 | DepreciationAmt |
| Book Value | $11,444,252 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,473,398 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,504,697 | DepreciationAmt |
| Book Value | $4,968,701 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,250,637 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,151,496 | DepreciationAmt |
| Book Value | $99,141 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $16,942,910 | TotalBookValueLandBuildingsAmt |
Financial Derivatives FinancialDerivativesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $11,249 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Alternative Investments | $20,990,630 | F |
| Comingled Funds | $4,167,166 | F |
| Investment- Stock | $500 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $25,169,545 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Due From Affiliate | $4,439,000 |
| Assets Held for Foundation | $276,637 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,715,637 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Pension Liability | $143,817 |
| Swap Liability | $53,812 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $197,629 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | false | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,492,377 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,492,377 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0398 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,873,642 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,549,979 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $323,663 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0086 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $3,366,019 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,549,979 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,816,040 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0484 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 66 | ActivitiesOrProgramsCnt |
| Persons Served | 2625 | PersonsServedCnt |
| Total Community Benefit Expns | $24,536 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,536 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0007 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Persons Served | 50 | PersonsServedCnt |
| Total Community Benefit Expns | $25,144 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,144 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0007 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 84 | ActivitiesOrProgramsCnt |
| Persons Served | 2675 | PersonsServedCnt |
| Total Community Benefit Expns | $49,680 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $49,680 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0013 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 84 | ActivitiesOrProgramsCnt |
| Persons Served | 2675 | PersonsServedCnt |
| Total Community Benefit Expns | $3,415,699 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,549,979 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,865,720 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0497 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 25 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $10,464 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,464 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0003 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $1,077 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,077 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 24 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $6,645 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,645 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0002 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 59 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $18,186 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,186 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0005 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,298,511 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $12,918,701 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,380,862 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$462,161 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARILION STONEWALL JACKSON HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 HEALTH CIRCLE | AddressLine1Txt |
| City | LEXINGTON | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24450 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://carilionclinic.org//locations/carilion-stonewall-jackson-hospital | WebsiteAddressTxt |
| State License | H 1906 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARILION STONEWALL JACKSON HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.carilionclinic.org/locations/carilion-stonewall-jackson-hospital | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | https://www.carilionclinic.org/community-health-assessments#rockbridge-area | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.carilionclinic.org/community-health-assessments#rockbridge-area | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.carilionclinic.org/billing/financial-assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.carilionclinic.org/billing/financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.carilionclinic.org/billing/financial-assistance | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 3E | The Community Health Needs Assessment report prioritizes the community's significant health needs that were identified by the assessment, and explains how the health needs were prioritized. |
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - Carilion Stonewall Jackson Hospital. Carilion Clinic's Community Health Needs Assessments (CHNAs) are community-driven projects and success is highly dependent on involving citizens, health and human service agencies, businesses, and community leaders. Community stakeholder collaborations known as "Community Health Assessment Teams" (CHAT) lead the CHNA projects. The CHAT consists of: health and human service agency leaders; persons with special knowledge of, or expertise in, public health; the local health department; and leaders, representatives, or members of populations that are medically underserved, low-income, minority, and suffer from chronic diseases. The following organizations served on the CHAT for the 2018 (tax year 2017) Rockbridge Area Community Health Needs Assessment (RACHNA)-Lexington/Rockbridge County Chamber of Commerce, City of Buena Vista, HCAT/Live Healthy Rockbridge, RACI, Rockbridge Area Community Services, Rockbridge Area Health Center, Rockbridge Area Hospice, Rockbridge Area Transportation System, Valley Program for Aging Services, Maury River Senior Center, Virginia Cooperative Extension,Rockbridge Area YMCA, Central Shenandoah Health District of the Virginia Department of Health. In addition to the CHAT, the RACHNA conducted focus groups among stakeholders and target populations, and administered a community health survey. During the CHNA process, community stakeholders, leaders, and providers were encouraged to complete the Stakeholder Survey (print and electronic versions available). This survey provided an additional perspective about the health needs and barriers facing our community. Stakeholder focus groups were conducted with the Community Health Assessment Team and with groups of stakeholders that attended a Community Visioning event. Target population focus groups were conducted to capture the story of needs and barriers to health for the uninsured, underinsured, low-income, minority, senior, and chronically ill populations. Focus group locations were chosen based on their proximity and convenience to target populations, and where existing groups meet. Six target population focus groups were held and participants discussed health needs and barriers to health, as well as access to primary, oral, and mental health care. Target population focus groups were conducted with Americare Plus, Rockbridge Area Hospice clinicians and volunteers, residents of the Kendal retirement community, two groups with different participants at the Maury River Senior Center, and a Women Small Business Owners Group. A 38-question survey was developed including questions about socioeconomic factors, access to medical, dental, and mental health care, health behaviors, physical environment, health outcomes, and demographics. The survey included commonly used questions and metrics from previously validated community surveys, including (1) Community Themes and Strengths Assessments, National Association of County and City Health Officials (NACCHO), Mobilizing for Action through Planning and Partnerships (MAPP) (2) Community Healthy Living Index, YMCA (3) Behavioral Risk Factor Surveillance System, Centers for Disease Control (CDC) (4) National Health Interview Survey, Centers for Disease Control (CDC) (5) Youth Risk Behavior Surveillance System, Centers for Disease Control (CDC) (6) Martin County Community Health Assessment, Martin County, North Carolina (7) Previous Carilion Clinic Community Health Surveys Both English and Spanish versions were available. The CHAT identified target populations, collection sites, and methods of survey distribution. The population of interest was Rockbridge Area residents 18 years of age and older. The Rockbridge Area included the CHNA service area of Buena Vista City, Lexington City and Rockbridge County. Special efforts were made to ensure inclusion of Underserved/vulnerable populations disproportionately impacted by the social determinants of health including, Income, Race/ethnicity, Education, Insurance status. The survey was also made available to all residents living in the Rockbridge Area and oversampling of the target populations occurred through targeted outreach efforts. In total, 568 surveys were collected. |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - Carilion Stonewall Jackson Hospital. Lexington/Rockbridge County Chamber of Commerce, City of Buena Vista, HCAT/Live Healthy Rockbridge, RACI, Rockbridge Area Community Services, Rockbridge Area Health Center, Rockbridge Area Hospice, Rockbridge Area Transportation System, Valley Program for Aging Services, Maury River Senior Center, Virginia Cooperative Extension, Rockbridge Area YMCA, Central Shenandoah Health District of the Virginia Department of Health. |
| Schedule H, Part V, Section B, Line 7 Facility , 1 | Facility , 1 - Carilion Stonewall Jackson Hospital. The 2018 Rockbridge Area CHNA was also shared to be posted to Community Health Assessment Team partner websites and social media. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - Carilion Stonewall Jackson Hospital. Carilion Clinic is a not-for-profit, integrated healthcare system located in Virginia's Blue Ridge Mountains with its flagship hospital in the heart of the City of Roanoke, the largest urban hub in western Virginia. There, through a comprehensive network of hospitals, primary and specialty physician practices, wellness centers and other complementary services, the system provides quality care close to home for nearly one million Virginians. Carilion's roots go back to 1899, when a group of dedicated citizens came together and built a hospital to meet the healthcare needs of the community. Today, Carilion is a key anchor institution focusing on more than just healthcare; Carilion is dedicated to its mission of improving the health of the communities we serve. With an enduring commitment to the health of our region, Carilion advances care through clinical services, medical education, research and community health investments. Carilion believes in service, collaboration and caring for all. Through ongoing investment in discovering and responding to the health needs of the community comes the understanding that the involvement of additional stakeholders is essential to effectively address community health issues and create change. The purpose of the Rockbridge Area Health Improvement implementation strategy is to describe what Carilion Stonewall Jackson Hospital (CSJH) plans to do to address the community health needs identified in the 2018 Rockbridge Area Community Health Needs Assessment (RACHNA). After all primary and secondary data collection was completed, the CHAT reviewed all data then identified and prioritized the ten most pertinent community needs using the Robert Wood Johnson Foundation framework for what influences health. The data were combined and overall priorities chosen based on the number of times a category was selected in the top 10, with the average ranking serving as a tie-breaker. Once the priorities were clearly identified, the CHAT rated the feasibility and potential impact of solutions for each health issue. The 2018 RACHNA prioritized the following 10 health-related issues in the community, identified by the Community Health Assessment Team after the data was collected. (1) Alcohol and drug use (2) Poverty / low average household income (3) Access to mental / behavioral health services (4) Poor diet (5) High prevalence of chronic disease (6) Culture-healthy behaviors not a priority (7) Lack of health literacy / lack of knowledge of healthy behaviors (8) Access to primary care (9) Access to specialty care (10) Tobacco use According to the Robert Wood Johnson Foundation's (RWJF) County Health Rankings, where an individual lives, works and plays is a strong predictor of their health outcomes (http://www.countyhealthrankings.org/). Currently in the United States, a person's zip code can help predict their life expectancy due to its direct link to the social determinants of health such as poverty, race/ethnicity, education and employment status in these areas. (https://www.rwjf.org/en/library/interactives/whereyouliveaffectshowlongyoulive.html). These factors are so important to our overall health, that they were added to the 10-year national Healthy People 2020 objectives with a goal to "create social and physical environments that promote good health for all." (https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health) Carilion responds to community health needs in innovative ways-making sure our regions have access to state-of-the-art health care close to home, providing community grants and sponsorships to extend our mission and support other organizations addressing health needs, creating and implementing community-wide strategies to reduce barriers, coordinate resources and enhance community strengths, and providing community-based health and wellness programs. Carilion Clinic's response strategies are organized by the RWJF framework for what influences health-health behaviors, social and economic factors, clinical care access and quality, and physical environment. Commitment to community service is evident at all levels of the organization. Carilion's commitment to community health is evidenced by its commitment to a population health infrastructure including a Community Health and Outreach (CHO) department dedicated to assessing and addressing community need. The department is responsible for leading and facilitating the Community Health Improvement Plan (CHIP), CHNAs, the system's community grant process, community health education, community benefit collection, and neighborhood health initiatives. CHO has staff at the system level and at each community hospital and works with each hospital's Board of Directors and Carilion Clinic's Board of Governors to create health improvement strategies to address community health needs. Each Carilion Clinic hospital has a Community Benefit Team which oversees the local hospital's plan to address community need in partnership with the local CHAT. There is also a Community Benefit Council at the system level providing oversight for Carilion Clinic as a whole. This council is responsible for overseeing and strategically guiding Carilion's community health improvement work and for community benefit strategy, collection and submission. Carilion Clinic believes in the power of collaboration and understands community health issues must be addressed in cooperation with the community. To ensure lasting community impact from the health assessment and community health improvement process, Carilion participates in and provides financial and in-kind support to community health coalitions addressing health needs. Carilion partners with Rockbridge 2020 in the Rockbridge Area. In addition, Carilion partners with multiple community and business organizations on initiatives to improve health and wellness and to impact the social determinants of health for all who live in the Rockbridge Area. Forming a true community collaborative with lasting impact is no small feat. Rockbridge 2020 (now Live Healthy Rockbridge) was founded in 1995 by Stonewall Jackson Hospital. It brought together providers of health care and related services in the Rockbridge Area for the purpose of collaboration and planning for healthcare over the next quarter of a century. Informal monthly meetings allowed participants to network and educate each other about services available through each of the agencies represented. Through the early years a few surveys were conducted to identify needs in the community. The work of Rockbridge 2020 continued in 2006 when Stonewall Jackson Hospital became part of the Carilion Health System (now Carilion Clinic). In 2011, Carilion Stonewall Jackson Hospital partnered with the Rockbridge Area Free Clinic (now the Rockbridge Area Health Center) and the Central Shenandoah Health District to conduct a Community Health Assessment. The 12-month project defined and assessed the health of our community, and enabled members of Rockbridge 2020 to develop a 3-year strategic plan to address the most pressing needs (Access to Health Services, Nutrition, Physical Activity and Obesity, Oral Health, and Mental Health). The completed assessment and community-wide strategic plan were made available to the general public in 2012. One of the key outcomes from this assessment was the transition of the Rockbridge Area Free Clinic to the Rockbridge Area Health Center. Three years later, Rockbridge 2020 undertook a second assessment. The 2015 RACHNA identified the top priorities as a need for Urgent Care, General Wellness (including nutrition, physical activity and chronic disease management), Mental Health, and Coordination of Care. In the spring of 2016, Carilion Clinic opened Velocity Care in Lexington as a direct result of the assessment. Since that time, Rockbridge 2020 has been working to implement the 2015 strategic plan. Rockbridge 2020 (now Live Healthy Rockbridge) continues to meet monthly to ensure we are implementing the community-wide strategic plan in the most efficient and effective manner. While each of the member organizations of Rockbridge 2020 has its own mission, as a coalition, its mission is working together for community well-being. (continued in Part VI) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| CARILION CLINIC INTERNAL MEDICINE | ||||
| 108 HOUSTON STREET SUITE A | LEXINGTON | VA | 24450 | PHYSICIAN OFFICES |
| CARILION CLINIC FAMILY MEDICINE-SOUTH MAIN | ||||
| 146 SOUTH MAIN STREET | LEXINGTON | VA | 24450 | PHYSICIAN OFFICES |
| CARILION CLINIC FAMILY MEDICINE | ||||
| 108 HOUSTON STREET SUITE C | LEXINGTON | VA | 24450 | PHYSICIAN OFFICES |
Supplemental Information Detail SupplementalInformationDetail (18 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 11 Addressing Needs Identified in CHNA (Continued) | (Continued from Part V, Section C) Carilion Clinic is committed to improving the health of the communities we serve by addressing key health priorities identified through our triennial Community Health Needs Assessments. Carilion fulfills this commitment in many ways, one of which is through targeted grants for community health improvement programs and those affecting the social determinants of health. Carilion provides a multitude of community grants and community health sponsorships to help local charitable organizations fulfill their missions related to the health and well-being of our communities. Community grant dollars are allocated across the entire Carilion Clinic service area based on requests received. During the 2019 fiscal year (2018 tax year), $10,000 was awarded to a community organization to offer community-based palliative care in the Rockbridge Area. The Stonewall Jackson Hospital Community Health Foundation provides additional monies for grants to local organizations that aim to improve the health of our community. Members of the Board of Directors for the Foundation sit on a committee of the CSJH Board of Directors to determine which grants to award. For the next three years, all grants will go toward programs and initiatives aimed at addressing needs identified in this Community Health Needs Assessment. -Significant Health Priorities to be Addressed- Health Behaviors Needs include alcohol and drug use, poor diet, high prevalence of chronic disease, healthy behaviors not a priority, lack of knowledge of healthy behaviors, tobacco use. Carilion Clinic addressed health behavior-related priorities from the 2018 RACHNA. Improving poor diets and the general health culture served as a start to making healthy behaviors more of a priority. Carilion provides a variety of free health education classes, screenings and flu immunizations in community settings. Community health education is provided by the Community Health and Outreach department, as well as on occasion by other departments. Health and wellness education topics include-general wellness, healthy eating and activity, exercise for balance and confidence building for seniors, and other topics as requested. The local health educator also leads guided public walks and hikes to increase access to exercise opportunities. Resources committed to these programs include staff time and often food and giveaway items that encourage healthy behaviors. In addition to traditional health education, CSJH participates in health behavior related programs including- (1) Veggie Brigade - a program put on in partnerships with Live Healthy Rockbridge Kids to encourage local elementary school children to try new fruits and vegetables. (2) Eat Healthy Rockbridge - a collaborative program encouraging healthy eating through prescription vouchers to access healthy food paired with education and coaching. In addition to community events, Carilion works to encourage healthy behaviors by offering classes to its employees and through partnerships with other employers in the Rockbridge Area. As the largest employer in the region, efforts to engage employees and their families in their own health impact community health overall. Carilion has rolled out the Virgin Pulse program to employees. This program enables employees to connect personal activity trackers and include others on the platform to encourage daily healthy behaviors such as exercise, climbing stairs, and planning healthy diets. Carilion remains committed to the Healthier Hospital Initiative pledge and continues to work to improve the amount of healthy, local, sustainable foods purchased and served through its cafeterias. -Tobacco Use- Carilion makes available a "Preparing to Quit" speakers bureau that can be requested by community groups or companies. Carilion employees and their dependents will now be eligible for a new, pharmacist-led smoking cessation program. This program includes group sessions, individual follow-up, resource referrals and free access to nicotine replacement therapy products. Another option includes free participation in the Quit for Life program. Employees are offered a financial incentive when they are tobacco free. -Alcohol and drug use- Carilion's Opioid Task Force brings together expertise from throughout the Carilion system to better understand and address the opioid epidemic in Southwest Virginia. The Opioid Task Force is working to address this epidemic internally and in the community. Efforts arising from this task force include-developing system-wide guidelines and a system dashboard for opioid prescriptions, developing treatment pathways for opioid addiction in specific high-risk groups, developing best practices for risk assessment, treatment and standard orders in Carilion's electronic medical record system, developing an inventory of community resources related to prevention, treatment and recovery services for opioid patients and community members, and providing locations for free, safe, prescription drug returns or deactivation bags. CSJH is also a participant in the Rockbridge Area Prevention Coalition and provides space for weekly AA meetings. -Clinical Care- Needs include access to mental / behavioral health services, access to primary care, access to specialty care. Issues with access to care are a focus for CSJH when addressing community health needs. In addition to providing financial support to qualifying patients who cannot afford care, Carilion is working to improve affordable access to care and resources. Carilion is committed to helping improve access to affordable medical care in our communities. With expansion of Medicaid in the Commonwealth of Virginia, in 2019, Carilion worked diligently to help patients and community members with enrollment in Medicaid for newly eligible beneficiaries. To improve access to care, impacting the need for access to primary care and specialty care, a new urgent care was opened in Raphine, VA at White's Travel Center. In the 2015 Rockbridge Area Community Health Needs Assessment, access to urgent care services was the top need. Carilion responded by opening one urgent care in Lexington and now a second was opened in Rockbridge County to serve residents and travelers. Carilion continues to bring specialty service to Lexington on a rotating basis. CSJH will continue to work with the Carilion Clinic Planning department to explore the specific specialty care needs in the region. -Mental health and substance use services- In an ongoing effort to increase access to psychiatry and mental health services, the technological infrastructure to provide telepsych services has been put in place in the CSJH Emergency Department. Carilion is committed to serving the needs of its communities and continues to work toward providing telepsych services in the Rockbridge Area. CSJH also continues to work with partners in the region to align patients and community members with available services, such as those available through the Rockbridge Area Health Center. CSJH also partners with Rockbridge Area Community Services, offering space to host free Mental Health First Aid classes. Additionally, CSJH participated on the planning committee for the Rockbridge Area Prevention Coalition's Prevention Forum geared toward parents, guardians and teachers and focused on risk factors for teens who might be inclined to use alcohol, tobacco and other drugs or self-harm. -Social and Economic Factors, Including Poverty- In its commitment to reducing inequity of care, Carilion provides financial support for people who cannot afford insurance or health care. Carilion also replenishes medication carried aboard emergency medical services vehicles. Support is also provided to a variety of not-for-profit organizations, helping to reduce the impacts of poverty on health through investments in social determinants such as housing, transportation, employment, education, access to healthy foods and many other important causes. Each year, Carilion Clinic coordinates a system-wide United Way campaign through which employees can provide additional support to these causes. |
| Schedule H, Part V, Section B, Line 11 Addressing Needs Identified in CHNA (Continued) | -Physical Environment- While physical environment did not necessarily arise as a top priority in the 2018 RACHNA, Carilion still recognizes the impact the environment has on the health of our communities. Therefore, efforts continue to improve the efficiency of Carilion's hospitals and other structures, the utilization of recycling and recyclable or bio-degradable materials where possible, the reduction of waste and the utilization of local, sustainable foods. -Implementation and Measurement- Carilion has invested in multiple systems to manage data and track outcomes of our community work. Clear Impact software will be utilized to develop community, system-wide, hospital-specific and project-specific scorecards with appropriate outcome measures. Community health education programs and screenings will contain program level outcomes assigned based on the topic. These outcomes will be tracked with pre- and post-tests as well as through screening results. Community programs supported by Carilion grants will be responsible for regularly reporting program outcomes. Scorecards developed contain key secondary data points which are updated annually to track the impact of community health initiatives. Specifically, Carilion tracked and measured impact on certain aligned indicators contributing to the Robert Wood Johnson Foundation County Health Factors Ranking and County Health Outcomes Ranking. Our goal is to improve County Health Rankings for the entire Rockbridge Area, but we understand that by the nature of County Health Rankings, improvements are relative to progress in other communities within the Commonwealth of Virginia. -Priority Areas Not being Addressed and the Reasons- A community approach to determine and address priority needs as described earlier in this document was used to determine which needs cannot be immediately addressed. The needs not identified as "priority" are those that will not be actively addressed in this time period. It is CSJH's intent to address all identified priority health issues through the aforementioned initiatives, programs and/or grants if possible. After completing the 2018 RACHNA, CSJH worked with Rockbridge 2020 (now Live Healthy Rockbridge) to develop a plan for addressing key issues in the community with the focus of program provision for those living in poverty and/or in medically underserved areas. Please visit https://carilionclinic.org/community-health-assessments#rockbridge-area to review the 2018 Rockbridge Area Community Health Needs Assessment. Learn more about Carilion Clinic Community Health and Outreach at https://www.carilionclinic.org/community-health-outreach. |
| Schedule H, Part I, Line 3c Other Financial Assistance Eligibility Criteria | Patients' eligibility is determined by family size, family income, real property equity and liquid assets. Families with family income equal or below 200% of the FPG and assets equal or below $15,000 receive 100% adjustment under FAP. Families with family income greater than 200% of the FPG but less than or equal to 400% of the FPG or assets above $15,000 and less than or equal to $100,000 receive a partial adjustment under FAP. The partial adjustment matches the AGB percentage for each service area. |
| 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/about-carilion-clinic#our-values |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | Part I, Line 7, Column (f): Bad debt expense of $5,298,511, as included in Part IX, Statement of Expenses on line 25 was excluded from the calculation of Part I Line 7 Column (f) Percent of total expense. Line 7e - Community Health Improvement Services and Community Benefit Operations - This line is reported at actual cost. Carilion's commitment to community service is evident at all levels of the organization. Carilion's commitment to community health is evidenced by its population health infrastructure including its Community Health and Outreach (CHO) department dedicated to assessing and addressing community needs. The department is responsible for leading and facilitating the Community Health Improvement Plan, Community Health Needs Assessments, the system's community grants process, community health education, community benefit collection, and neighborhood health initiatives. CHO staff works with the hospital's Board of Directors and Carilion Clinic's Board of Governors to create health improvement strategies to address community health needs. The hospital has a Community Benefit Team overseeing the hospital's plan to address community need in partnership with the local community health assessment team. There is also a Community Benefit Council providing oversight for Carilion's community health improvement work and for community benefit strategy, collection and submission. Carilion Stonewall Jackson Hospital (CSJH) provides education to the public about health risks and steps that can be taken to improve health. Events include regularly scheduled youth nutrition education events in schools called Veggie Brigades, Healthy Walks and Talks, as well as support of community partners' events such as YMCA's Healthy Kids Day. Carilion's community health and outreach department also provides screenings for cholesterol as well as free community flu immunization clinics. Community benefit operations include expenses associated with tracking community health improvement activities and the cost associated with coordinating responses to community health needs identified through the most recent Rockbridge Area Community Health Needs Assessment. This coordination includes participation in and leadership of Live Healthy Rockbridge (previously Rockbridge 2020), a collaboration of health and human service organizations coming together to address community health needs. 7f - Health professions education - n/a 7g - Subsidized Health Services - n/a 7h - Research - n/a 7i - Cash and In-Kind Contributions - At cost. Carilion has long been committed to improving the health of the communities we serve. We know significant change doesn't happen without collaboration, it takes a community of partners working toward common goals. Carilion's dedication to this mission is evidenced by the support provided annually to various nonprofit partners, furthering its efforts to positively impact health. Financial and in-kind contributions are made each year to dozens of organizations directly impacting the issues identified in our triennial Community Health Needs Assessment and a variety of social determinants that impact people's health. Support provided in fiscal year 2019 (tax year 2018) primarily helped with access to healthcare through partners such as the Rockbridge Area Health Center, Rockbridge Area Hospice, and the local Emergency Medical Services. |
| Schedule H, Part II Community Building Activities | Line 1 - Physical improvements and housing - n/a Line 2 - Economic development - As the largest employer in Southwest Virginia, Carilion participates in programming and supports local Chambers of Commerce, improving economic development efforts through pro-business advocacy. Carilion Stonewall Jackson Hospital takes an active role in local economic development endeavors by conversing with local businesses about the region's current business climate and prospects and through participation in Main Street Lexington, a volunteer-led non-profit organization that improves and promotes Downtown Lexington. Line 3 - Community support - Research demonstrates the strong connection between social determinants of health such as transportation, housing and education, and the overall health and well-being of communities. Support is provided in a variety of ways for nonprofit organizations that address barriers to good health arising from these social determinants. Through support of local partners, Carilion can help provide better education and opportunities for children and families as well as improved housing, better nutrition and additional supportive resources for its neighbors in need, removing a range of obstacles to good health. Carilion Stonewall Jackson Hospital is deeply involved with a variety of health and social determinant-related initiatives and supports local organizations through coordination of activities and participation as volunteers and on boards in addition to providing financial support. For example, in fiscal year 2019 (tax year 2018) Carilion employees dedicated their time to impact the need for access to exercise opportunities and health programming by providing support for the local YMCA. Financial support also promoted community engagement and volunteerism through organizations such as the Lexington Rockbridge Jaycees, Rockbridge NAACP and Fellowship of Christian Athletes. Line 4 - Environmental improvements - n/a Line 5 - Leadership development and training for community members - n/a Line 6 - Coalition building - Carilion believes in the power of collaboration and understands that community health issues must be addressed in concert with the community. To ensure lasting community impact from the health assessment and community health improvement process, Carilion participates in community health coalitions that address health, safety and social determinant needs in the Rockbridge Area. In addition, Carilion partners with multiple community and business organizations around initiatives to improve health and wellness and to impact the social determinants of health for all who live in the Rockbridge Area. This includes Carilion's representation and participation in the Local Emergency Preparedness Committee, Live Healthy Rockbridge Kids, the Rockbridge Area Prevention Coalition, and the Rockbridge Area Outdoor Partnership as well as the Virginia Rural Health Association and the Community Foundation of Rockbridge, Bath and Alleghany. Line 7 - Community health improvement advocacy - n/a Line 8 - Workforce development - n/a |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | Carilion Stonewall Jackson 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 | Accounts receivable are stated at net realizable amounts due from patients, third-party payors, and other insurers for which Carilion Stonewall Jackson Hospital expects to be entitled in exchange for providing patient care. For patient accounts receivable resulting from revenue recognized prior to October 1, 2018, an allowance for doubtful accounts was established to reduce the carrying value of such receivables to net realizable value. Subsequent to the adoption of 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 rather than an allowance for doubtful accounts. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | 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 operating an emergency room open to all persons regardless of ability to pay and providing hospital care for all patients able to pay, including those 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. Medicare allowable costs are determined from the Medicare cost report using the cost-to-charge ratio. |
| 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 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 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 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 before further collection activity occurs. DRD will also investigate any accounts that require special handling. For example, when the billing office becomes aware that a patient is deceased, 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 STONEWALL JACKSON HOSPITAL: Line 16a URL: https://www.carilionclinic.org/billing/financial-assistance; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - CARILION STONEWALL JACKSON 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 STONEWALL JACKSON 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, Carilion closely monitors community health indicators and responds to needs as they arise. Each year, Carilion updates scorecards with refreshed County Health Rankings indicators provided by the Robert Wood Johnson Foundation. Carilion is also responsive to needs identified through clinical data and departments. Carilion's call center is available for community members to ask questions and to direct callers to community resources as issues are raised. The Planning department monitors data such as self-pay and Medicaid rates, patient origin and travel time, and age and income distributions to drive Carilion's access to care strategies. Carilion Clinic's community health improvement process was adapted from Associates in Process Improvement's Model for Improvement and the Plan-Do-Study-Act (PDSA) 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 is repeated every three years. Carilion Clinic fosters community development in its CHNA and community health improvement processes by using the Strive Collective Impact Model for the CHAT. This evidence-based model focuses on solving problems together with coalitions of cross-sector partners and has been proven to lead to large-scale changes. It focuses on relationship-building between organizations and the progress towards shared strategies. Carilion Clinic and Rockbridge 2020 (now Live Healthy Rockbridge) partnered to conduct the 2018 Rockbridge Area Community Health Needs Assessment. This process was community-driven and focused on high levels of community engagement involving health and human services leaders, stakeholders, and providers, the target population, and the community as a whole. |
| 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 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, 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, the Eligibility staff is trained as Certified Application Counselors and will assist patients in enrollment in the insurance exchange Marketplace. Eligibility staff will also complete Carilion's financial assistance application and counsel patient on the requirements for financial assistance. |
| Schedule H, Part VI, Line 4 Community information | The 2018 RACHNA revealed distinct communities with significant differences in size and population and significant disparities both in health and in social determinants. The 2014-2018 American Community Survey (ACS) found the total population of the cities of Lexington and Buena Vista to be 7,110 and 6,399 respectively and the population of Rockbridge County to be 22,509 (U.S. Census Bureau, 2014-2018 5-year American Community Survey, Table S0101 https://data.census.gov/cedsci/table?q=S0101&tid=ACSST5Y2018.S0101&hidePreview=true). For all communities, the U.S. Census Bureau predicts positive future population change, but to varying degrees (Virginia Employment Commission Community Profiles (2020). https://virginiaworks.com/community-profiles). Median age in the Rockbridge Area localities ranges from 21.7 in the City of Lexington to 48.7 in Rockbridge County (U.S. Census Bureau, 2014-2018 5-year American Community Survey, Table S0101 https://data.census.gov/cedsci/table?q=S0101&tid=ACSST5Y2018.S0101&hidePreview=true). The ACS finds that for most of the Rockbridge Area, a larger percentage of the population is White than in the State of Virginia as a whole (U.S. Census Bureau, 2014-2018 5-year estimates, American Community Survey, Table DP05 https://data.census.gov/cedsci/table?tid=ACSDP5Y2018.DP05&hidePreview=true). In Rockbridge County, 93.6% of the population is White, 3.3% of the population is Black and 2% identify as more than one race (U.S. Census Bureau, 2014-2018 5-year estimates, American Community Survey, Table DP05 https://data.census.gov/cedsci/table?tid=ACSDP5Y2018.DP05&hidePreview=true). All other races make up just over 1% of the population (U.S. Census Bureau, 2014-2018 5-year estimates, American Community Survey, Table DP05 https://data.census.gov/cedsci/table?tid=ACSDP5Y2018.DP05&hidePreview=true). Hispanic or Latino residents make up 1.8% of the population (U.S. Census Bureau, 2014-2018 5-year estimates, American Community Survey, Table DP05 https://data.census.gov/cedsci/table?tid=ACSDP5Y2018.DP05&hidePreview=true). Lexington and Buena Vista are slightly more racially and ethnically diverse than Rockbridge County, with populations that are 86.7% and 88.7% White, 6.4% and 6.0% Black, and 3.7% and 4.3% Asian, with 3.2% and 0.6% respectively representing more than one race and the remainder representing small minorities of American Indian/Alaskan Native, Native Hawaiian/Pacific Islander or some other race at less than 1% (U.S. Census Bureau, 2014-2018 5-year estimates, American Community Survey, Table DP05 https://data.census.gov/cedsci/table?tid=ACSDP5Y2018.DP05&hidePreview=true). Of the population, 5.1% of Lexington and 1.0% of Buena Vista identify as Hispanic or Latino (U.S. Census Bureau, 2014-2018 5-year estimates, American Community Survey, Table DP05 https://data.census.gov/cedsci/table?tid=ACSDP5Y2018.DP05&hidePreview=true). The region is divided into urban and rural areas, which vary greatly in the economic means of the residents who live there. The low-income population in the Rockbridge Area has a federal designation as a Medically Underserved Area (MUA) (Department of Health and Human Services, Health Resources and Services Administration Data Warehouse (2020) https://data.hrsa.gov/geo). Many communities are designated as Primary and Dental Health Professional Shortage Areas (HPSA) and the entire Rockbridge Service Area is designated as a Mental Health HPSA (Department of Health and Human Services, Health Resources and Services Administration Data Warehouse (2020) https://data.hrsa.gov/geo). Key safety net providers in the region in addition to Carilion Clinic include the Central Shenandoah Health District, Rockridge Area Health Center, and many other service organizations. Despite the presence of these entities, there remain thousands of low-income, uninsured, and underinsured residents who do not have access to affordable health care services. |
| Schedule H, Part VI, Line 5 Promotion of community health | Carilion Clinic is a not-for-profit, integrated health care system located among the Blue Ridge Mountains with its flagship hospital in the heart of the City of Roanoke, which serves as the largest urban hub in western Virginia. Quality care is provided 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 a century, when a group of dedicated citizens came together and built a hospital to meet the health care needs of the community. Today, Carilion is a key anchor institution focusing on more than just health care; Carilion is dedicated to its mission of improving the health of the communities it serves. With an enduring commitment to the health of our region, care is advanced through clinical services, medical education, research and community health investments. Carilion believes in service, collaboration and caring for all. Through ongoing investment in discovering and responding to the health needs of its community comes the understanding that additional stakeholders must be involved to effectively address community health issues and create change. Carilion Stonewall Jackson Hospital (CSJH) is a non-profit, critical access hospital dedicated to quality care and patient comfort. The hospital was founded in 1907 by the United Daughters of the Confederacy, and was originally located in the former home of confederate general Thomas "Stonewall" Jackson. Commitment and support through the last century allowed the hospital to grow, expand, and in 1954 move across town to its present site. A new structure and enhanced patient care tower was completed on the same site in 2002. Carilion Health System (now Carilion Clinic) purchased 80% of Stonewall Jackson Hospital in 2006. The other 20% continues to be owned by the community in the trust of the SJH Community Health Foundation. The Foundation provides monies for grants to local organizations that aim to improve the health of our community. Members of the Board of Directors for the Foundation sit on a committee of the CSJH Board of Directors to determine which grants to award. For the next three years, all grants will go toward programs and initiatives aimed at addressing needs identified in this Community Health Needs Assessment. Carilion Stonewall Jackson Hospital serves all patients regardless of their ability to pay. The Hospital's governing Board is elected annually and the majority of members are neither employees nor contractors of the Hospital. Medical staff privileges are extended to qualified providers. Surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. This includes providing free, discounted and subsidized care as well as critical medical services that operate at a loss. (https://www.carilionclinic.org/locations/carilion-stonewall-jackson-hospital) |
| Schedule H, Part VI, Line 6 Affiliated health care system | Carilion Stonewall Jackson Hospital is 80% owned by Carilion Clinic, a not-for-profit health care organization based in Roanoke, Virginia. Through a comprehensive network of hospitals, primary and specialty physician practices, and complementary services, Carilion provides exceptional care for nearly one million Virginians. With an enduring commitment to the health of the region, Carilion also seeks to advance care through medical education and research, help its community stay healthy and inspire the region to grow stronger. In the mid-2000s, Carilion made the strategic decision to transform from a collection of hospitals to a physician-led, integrated health care system. It was a courageous move. In every moment since, Carilion has worked to evolve further-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, and opening a medical school and research institute. Each decision, each adaptation, has fundamentally changed the way Carilion collaborates and provides care. (https://www.carilionclinic.org/about-carilion-clinic) Carilion's Community Health and Outreach (CHO) department is the health system's engine for providing collaborative opportunities to improve and promote the health of the community. The department's Community Health Assessments process helps identify the strengths and barriers impacting health. It's 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. CHO is also the driving force for the health system's many partnerships with cross-sector organizations that create a collaborative culture of community health and wellness. To advance the education of health professionals, Carilion Medical Center operated Jefferson College of Health Sciences a private higher education institution within the hospital that "prepares, within a scholarly environment, ethical, knowledgeable, competent and caring healthcare professionals." Jefferson College provided more than 1,100 students with opportunities to become part of the health care profession, serving communities ranging from southwest Virginia to the Shenandoah Valley and beyond. Jefferson College merged with Radford University July 1, 2019 and remains in partnership with Carilion Clinic, teaching students in our clinical setting on the campus of Carilion Medical Center to continue to meet the healthcare workforce needs in the community and beyond. Through a unique public-private partnership between Virginia Tech and Carilion Clinic, the Virginia Tech Carilion School of Medicine within Virginia Tech educates physician thought leaders through inquiry, research, and discovery on Carilion Clinic's main campus in Roanoke. Virginia Tech students learn, train, and work side by side with Carilion's highly experienced medical staff. This innovative approach stresses the importance of research, quality, safety, evidence-based medicine, interdisciplinary and interprofessional teamwork, chronic disease management, wellness and prevention and public health. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| YMCA of Roanoke Valley | |||||||
| 790 N Lee Highway | Lexington | VA | 24450 | 540515736 | 501 (c) (3) | $15,500 | Enrich Summer Camp Programs |
| Washington & Lee University | |||||||
| 204 W Washington St | Lexington | VA | 24450 | 540505977 | 501 (c) (3) | $5,000 | Fresh Foods prescription program |
| Rockbridge Area Transportation | |||||||
| 712 N Main St | Lexington | VA | 244502032 | 043586915 | 501 (c) (3) | $5,000 | Wheelchair accessible Vehicle |
| Rockbridge Church of the Nazarene | |||||||
| PO Box 1007 | Buena Vista | VA | 24416 | 134210449 | 501 (c) (3) | $5,000 | Emergency supplies for homeless |
| Samuel's Supper | |||||||
| Po Box 132 | Fairfield | VA | 24435 | 831702290 | 501 (c) (3) | $5,250 | Funding families struggling financially due to a child's life-threatening medical crisis |
| Rockbridge Area Hospice | |||||||
| 315 Myers St | Lexington | VA | 24450 | 541288305 | 501 (c) (3) | $10,000 | Community palliative care program |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. | FormAndLineReferenceDesc |
| Explanation | 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 every 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, 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | false | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Charles Carr | ||||||||||||||
| Former Director/Officer | $75,954 | $119,492 | $0 | $22,303 | $0 | $2,574 | $15,909 | $30,239 | $2,144 | $4,074 | $94,007 | $178,682 | $0 | $0 |
| Karen Lyons MD | ||||||||||||||
| Former Director/Officer | $26,585 | $122,877 | $0 | $78,295 | $0 | $2,775 | $0 | $30,739 | $0 | $298 | $26,585 | $234,984 | $0 | $0 |
| Greg Madsen | ||||||||||||||
| Director/Hospital VP | $176,576 | $7,015 | $21,761 | $0 | $1,204 | $0 | $41,544 | $0 | $9,248 | $0 | $250,333 | $7,015 | $0 | $0 |
| Ayesha KELLY MD | ||||||||||||||
| Director | $0 | $311,542 | $0 | $26,150 | $0 | $2,100 | $0 | $26,683 | $0 | $14,432 | $0 | $380,907 | $0 | $0 |
| WILLIAM J SAYRE MD | ||||||||||||||
| Director | $0 | $275,191 | $0 | $86,577 | $0 | $2,028 | $0 | $10,553 | $0 | $16,308 | $0 | $390,657 | $0 | $0 |
| John SEDOVY MD | ||||||||||||||
| Director | $0 | $452,130 | $0 | $40,412 | $0 | $3,553 | $0 | $5,308 | $0 | $16,231 | $0 | $517,634 | $0 | $0 |
| Lisa Sprinkel | ||||||||||||||
| Director | $0 | $138,876 | $0 | $1,800 | $0 | $8,659 | $0 | $10,279 | $0 | $9,035 | $0 | $168,649 | $0 | $0 |
| Kerri Thornton | ||||||||||||||
| Director | $0 | $239,741 | $0 | $40,758 | $0 | $1,892 | $0 | $3,352 | $0 | $6,042 | $0 | $291,785 | $0 | $0 |
| Nicholas Conte | ||||||||||||||
| Asst. Secretary | $0 | $455,282 | $0 | $62,409 | $0 | $6,298 | $0 | $118,913 | $0 | $17,136 | $0 | $660,038 | $0 | $0 |
| David Hagadorn | ||||||||||||||
| Asst. Treasurer | $0 | $133,333 | $0 | $1,800 | $0 | $8,473 | $0 | $7,243 | $0 | $819 | $0 | $151,668 | $0 | $0 |
| Donald Halliwill | ||||||||||||||
| Asst. Treasurer | $0 | $515,337 | $0 | $70,983 | $0 | $4,797 | $0 | $78,134 | $0 | $15,836 | $0 | $685,087 | $0 | $0 |
| G Robert Vaughan Jr | ||||||||||||||
| Asst. Treasurer | $0 | $259,842 | $0 | $30,582 | $0 | $4,104 | $0 | $10,275 | $0 | $16,723 | $0 | $321,526 | $0 | $0 |
| Nancy Howell Agee | ||||||||||||||
| CEO, Carilion Clinic | $0 | $1,242,837 | $0 | $285,745 | $0 | $205,285 | $0 | $114,597 | $0 | $11,330 | $0 | $1,859,794 | $0 | $0 |
| Steven Arner | ||||||||||||||
| Executive Vice President | $0 | $539,549 | $0 | $73,492 | $0 | $4,833 | $0 | $80,224 | $0 | $17,136 | $0 | $715,234 | $0 | $0 |
| LISA C CRAFT | ||||||||||||||
| RN Lead | $133,123 | $0 | $400 | $0 | $5,065 | $0 | $6,758 | $0 | $11,564 | $0 | $156,910 | $0 | $0 | $0 |
| Regina Donald | ||||||||||||||
| Pharmacy Manager | $151,677 | $0 | $1,200 | $0 | $10,609 | $0 | $28,770 | $0 | $5,355 | $0 | $197,611 | $0 | $0 | $0 |
| Phyllis Snyder | ||||||||||||||
| RN Lead | $131,382 | $0 | $400 | $0 | $1,552 | $0 | $21,043 | $0 | $11,529 | $0 | $165,906 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 1a Tax indemnification and gross-up payments | Employees are occasionally awarded small gifts or prizes which are grossed up for taxes at management's discretion and included in taxable compensation. During the reporting period, Ms. Lafon and Ms. Snyder received such benefit. |
| Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses | Management determines tax gross-up decisions based on IRS requirements, amount, and the non-cash status of the benefits. |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | The organization's majority member, Carilion Clinic, serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation, including that of the Hospital Vice President, is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee.This Committee is made up of Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of 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' and 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 detailed minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives. |
| 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) in which the employer, at the discretion of Carilion Clinic's Compensation Committee, makes a contribution to an account established on its books for each eligible participant. If a participant ceases to be a participant prior to the vesting date, the account shall be forfeited. A lump sum distribution shall be made upon the participant's vesting date, death, or disability. Unvested contributions made to the DC SERP in 2018 are included on the Form 990 as "retirement and other deferred compensation." No distributions were made under this plan in the reporting year. Ms. Agee participated in an executive flexible benefit plan, in which an allowance is provided annually to the participant for use in obtaining certain insurance benefits. In prior years, the amount of allowance in excess of elected benefits was credited to a capital accumulation account (CAA) with a deferred vesting date of at least two years from the first day of the plan year, distributable upon vesting while employed by a Carilion Clinic affiliate, death, disability, or 24 months following certain qualifying separations from service. Deferrals no longer occur under this plan. No distributions of prior deferred amounts were made under this plan in the reporting year. |
| Schedule J, Part I, Line 7 Non-fixed payments | The organization pays annual "at-risk" compensation to certain members of management based on performance of an applicable scorecard. 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 reporting to them. In addition, for top management, the actual non-fixed payment awarded is in the discretion of the Carilion Clinic Board of Directors Compensation Committee, although it is based on the scorecard measures. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (18 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part I, Line 6 Volunteers | Volunteers greet and assist visitors, answer phones, help with general restocking of supplies, transport of patients, make up swing bed packages, make up IV kits for nursing as well as many other activities. Volunteers take patients back to the pre-op rooms prior to surgery. Volunteers provide escort service; assist with mailings, resource materials, special projects; assist the Emergency Department staff by maintaining the waiting room desk and helping to facilitate good customer service. Areas the Volunteers assist in are the Emergency Department, Med/Surg, Second Floor Lobby and waiting area, Physical Therapy, Cardiac Rehab, Fit for Life and the Patient Access (front) desk. |
| Form 990, Part III, Line 4a PROGRAM ACCOMPLISHMENTS | Carilion Stonewall Jackson 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 facility provides a full range of inpatient and outpatient services, specializing in imaging services, orthopaedic services, surgical services and therapy services. Carilion Stonewall Jackson Hospital, a critical access hospital, exists to serve the health care needs of its community, regardless of a patient's ability to pay. The acute hospital admitted 1,204 patients and provided 4,474 days of care during the year. Hospital programs include the provision of nursing care; 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 two Rural Health Clinics. The hospital provides several services targeting the specific health needs of its population, including diabetes management, physical, speech, and occupational therapy programs, and cardiac and respiratory rehab. Further, the hospital served 13,559 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 13 percent of ED visits. In June 2016, the VelocityCare urgent care center opened in a medical office complex adjacent to the hospital. In August 2019, an additional VelocityCare facility opened at White's Truck Stop in Raphine, expanding services to northeastern part of the community and motorists visting the travel center. The hospital supports community screenings and education on chronic disease prevention and management, sponsoring 143 events touching over 2,675 people. In furtherance of its mission, the hospital provides extensive uncompensated care. Stated at cost, charity and unreimbursed Medicaid costs 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 Stonewall Jackson Hospital's behalf by Carilion Services, Inc., a related organization providing management and administrative services, including payment processing. |
| Form 990, Part VI, Line 1a VOTING MEMBERS OF GOVERNING BODY | The Board consists of eleven (11) to fifteen (15) members divided into two (2)classes: the Carilion Class which consists of three (3) members and the Stonewall Class which consists of eight (8) to twelve (12) members. The Carilion Class has 80% of the vote on any issue that properly comes before the Board and the Stonewall Class has 20% of the vote on any issue that properly comes before the Board. |
| Form 990, Part VI, Line 2 Family/business relationships amongst interested persons | Nancy Howell Agee, Steve Arner, Nicholas Conte, David Hagadorn, Donald Halliwill, Ayesha Kelly, William Sayre, Lauren Schantz, John Sedovy, Lisa Sprinkel, Kerri Thornton, and G. Robert Vaughan, Jr. - 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.: Nancy Howell Agee, Steve Arner, Nicholas C. Conte, Donald B. Halliwill, Lauren J. Schantz, Lisa T. Sprinkel, Kerri L. Thornton, and G. Robert Vaughan, Jr. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | The organization has two (2) members. Carilion Clinic, a charitable tax-exempt health care organization, has an 80% membership interest and is entitled to elect directors having 80% of the vote on any issue. The Stonewall Jackson Community Foundation, a tax-exempt community foundation which supports health care within the local community, has a 20% membership interest and is entitled to elect directors having 20% of the vote on any issue. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | The organization has two (2) members. Carilion Clinic, a charitable tax-exempt health care organization, has an 80% membership interest. Carilion Clinic is entitled to appoint all three (3) members of the Carilion Class of directors; the Carilion Class has 80% of the vote on any issue that properly comes before the Board. The Stonewall Jackson Community Health Foundation, a tax-exempt community foundation which supports health care within the local community, has a 20% membership interest. The Stonewall Jackson Community Health Foundation is entitled to appoint one (1) member of the Stonewall Class of directors. The remaining members of the Stonewall Class include one (1) ex officio director (Chief of the Carilion Stonewall Jackson Hospital Medical Staff) and six (6) to ten (10) members of the local community, who elect their own successors. The Stonewall Class has 20% of the vote on any issue that properly comes before the Board. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | 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 Accounting management. Several days prior to filing, all Board Members were notified via email of its availability on Carilion's Board portal, which is the mechanism used to disseminate meeting materials to the directors, and directors were encouraged to call with any questions they might have. |
| 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 Organizational Integrity & 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 Organizational Integrity & 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 two (2) members. Carilion Clinic, a charitable tax-exempt health care organization, has an 80% membership interest and is entitled to elect directors having 80% of the vote on any issue. The Stonewall Jackson Community Foundation, a tax-exempt community foundation which supports health care within the local community, has a 20% membership interest and is entitled to elect directors having 20% of the vote on any issue. Executive compensation is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. With respect to Carilion Clinic, the Compensation Committee reviews the compensation of the Board of Governors annually, which includes the President and Chief Executive Officer, the Executive Vice Presidents (Chief Financial Officer, Chief Medical Officer, Chief Operating Officer, Chief Administrative Officer and Chief Legal Officer), and select Senior Vice Presidents who are the physician Chairs of the Clinical Departments. For the fiscal year covered by this return, the Compensation Committee also used the same process to review the compensation of other Disqualified Individuals, including the Hospital Vice Presidents. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders, which includes Vice Presidents, Senior Vice Presidents, Executive Vice Presidents, and the CEO, as well as the compensation philosophy for employed physicians. Some 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 review. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of 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' and 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 detailed minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives. |
| 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 financial statements are released from time to time during the tax year upon request. The Articles of Incorporation are available from the Virginia State Corporation Commission. Limited financial information is available on our website. |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | MISCELLANEOUS - Total Revenue: 28016, Related or Exempt Function Revenue: 28016, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; COURT COST RECOVERY - Total Revenue: 10092, Related or Exempt Function Revenue: 10092, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; OTHER REVENUE - Total Revenue: 2201, Related or Exempt Function Revenue: 2201, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; RETURNED CHECK FEES - Total Revenue: 70, Related or Exempt Function Revenue: 70, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; CONTRACT REVENUE - Total Revenue: 8320, Related or Exempt Function Revenue: 8320, 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 Stonewall Jackson Hospital. Required information for the Bonds, including Schedule K, is reported in the Carilion Clinic (EIN: 54-1190771) IRS Form 990. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Pension-related changes other than net periodic pension costs - -68242; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CARILION CLINIC | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 541190771 | SUPPORTING ORGANIZATION | VA | 501(c)(3) | Type II | NA | false |
| CARILION CLINIC FOUNDATION | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 541190773 | FUNDRAISING | VA | 501(c)(3) | 7 | CARILION CLINIC | Yes (true) |
| CARILION FRANKLIN MEMORIAL HOSPITAL | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 540480606 | HEALTHCARE | VA | 501(c)(3) | 3 | CARILION CLINIC | Yes (true) |
| CARILION GILES COMMUNITY HOSPITAL | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 540549603 | HEALTHCARE | VA | 501(c)(3) | 3 | CARILION CLINIC | Yes (true) |
| CARILION MEDICAL CENTER | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 540506332 | HEALTHCARE | VA | 501(c)(3) | 3 | CARILION CLINIC | Yes (true) |
| CARILION NEW RIVER VALLEY MEDICAL CENTER | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 540553805 | HEALTHCARE | VA | 501(c)(3) | 3 | CARILION CLINIC | Yes (true) |
| CARILION SERVICES INC | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 541190879 | SUPPORTING ORGANIZATION | VA | 501(c)(3) | Type II | CARILION CLINIC | Yes (true) |
| CARILION TAZEWELL COMMUNITY HOSPITAL | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 546074580 | HEALTHCARE | VA | 501(c)(3) | 3 | CARILION CLINIC | Yes (true) |
| SJH COMMUNITY HEALTH FOUNDATION | ||||||||||
| 1 HEALTH CIRCLE | LEXINGTON | VA | 24450 | 203592795 | SUPPORTING ORGANIZATION | VA | 501(c)(3) | Type III-FI | NA | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|---|
| FRANKLIN COUNTY VENTURES LLC | |||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 474365316 | REAL ESTATE | VA | NA | N/A | |
| COMMUNITY MEDICAL ASSOCIATES LLP | |||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 541517662 | REAL ESTATE | VA | NA | N/A | |
| CARILION CLINIC MEDICARE SHARED SAVINGS COMPANY LLC | |||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 455235473 | MEDICARE HMO | VA | NA | N/A | |
| RAVEN ASSET-BASED OPPORTUNITY FUND IV LP | |||||||||
| 110 Greene Street | New York | NY | 10012 | 824119491 | PRIVATE EQUITY | DE | NA | N/A | Suite 9G |
| SOUTHWEST VIRGINA HEALTH PROPERTIES LLC | |||||||||
| 1102 Jefferson Street SE | Roanoke | VA | 24016 | 010691570 | REAL ESTATE | VA | NA | N/A | |
| STARWOOD VEP II CO-INVEST LLC | |||||||||
| 591 W Putnam Avenue | Greenwich | CT | 06830 | 833262407 | INVESTMENTS | DE | NA | N/A | |
| TI PLATFORM CC SMA LP | |||||||||
| 1160 Battery Street East | San Francisco | CA | 94111 | 842852539 | INVESTMENTS | DE | NA | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|
| SCA CREDIT SERVICES INC | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 541180398 | COLLECTION AGENCY | VA | NA | C Corporation | Yes (true) | |
| MEDKEY INC | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 541645357 | FINANCING SERVICES | VA | NA | C Corporation | Yes (true) | |
| CHS INC | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 541725732 | SERVICES | VA | NA | C Corporation | Yes (true) | |
| CARILION HEALTHCARE CORPORATION | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 541586601 | HEALTHCARE | VA | NA | C Corporation | Yes (true) | |
| CARILION EMERGENCY SERVICES INC | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 542033006 | HEALTHCARE | VA | NA | C Corporation | Yes (true) | |
| CARILION CLINIC MEDICARE RESOURCES LLC | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 263729975 | MEDICARE HMO | VA | NA | C Corporation | Yes (true) | |
| CARILION BEHAVIORAL HEALTH INC | ||||||||||
| PO BOX 12385 | ROANOKE | VA | 24025 | 203136891 | HEALTHCARE | VA | NA | C Corporation | Yes (true) | |
| SPROTT PRIVATE RESOURCE LENDING (C-CO-INVEST) LP | ||||||||||
| 981378742 | INVESTMENTS | NA | C Corporation | Yes (true) | CA | |||||
| BLACKMOOR OWNERSHIP HOLDINGS LIMITED | ||||||||||
| INVESTMENTS | NA | C Corporation | Yes (true) | CJ | ||||||
| MAGNITUDE SYSTEMATIC LONGSHORT FUND | ||||||||||
| INVESTMENTS | NA | C Corporation | Yes (true) | CJ | ||||||
| TANGIBLE SEGREGATED PORTFOLIO OF THE SOUTH AFRICA ALPHA SPC | ||||||||||
| INVESTMENTS | NA | C Corporation | Yes (true) | CJ | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (9 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CARILION MEDICAL CENTER | ||
| A | $9,276 | COST |
| CARILION HEALTHCARE CORPORATION | ||
| A | $123,752 | COST |
| CARILION MEDICAL CENTER | ||
| M | $1,791,987 | COST |
| CARILION SERVICES INC | ||
| M | $5,847,027 | COST |
| CHS INC | ||
| M | $172,422 | COST |
| CARILION HEALTHCARE CORPORATION | ||
| M | $2,531,175 | COST |
| CARILION SERVICES INC | ||
| A | $49,104 | COST |
| SJH COMMUNITY HEALTH FOUNDATION | ||
| C | $73,000 | COST |
| SCA CREDIT SERVICES INC | ||
| M | $65,298 | COST |