2015-08-18T14:22:13-05:00 2014-09-30 KPMG LLP 1676 International Drive McLean VA 22102 990 2013-10-01 540566100 Bedford Memorial Hospital % LEWIS C ADDISON BEDF 5405873385 1613 OAKWOOD STREET Suite BEDFORD VA 24523 Patti Jurkus VP & CEO 5405873385 2015-08-11 true MARGARET A BRADSHAW P00501222 5405873385 2015-08-12 2013 2016-04-25 22:37:26Z X PATTI JURKUS CEO 1613 OAKWOOD STREET BEDFORD VA 24523 43521173 false X WWW.BEDFORDMEMORIAL.ORG X 1957 VA TO IMPROVE THE HEALTH OF THE COMMUNITY IT SERVES. THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT SURGERY, EMERGENCY, GERIATRIC AND REHABILITATIVE SERVICES. 19 7 451 135 0 0 31917 87895 34285410 28566957 839099 809796 1598454 737573 36754880 30202221 14120 13400 0 0 16815856 17918882 0 0 0 18978993 14810755 35808969 32743037 945911 -2540816 31513270 40304465 15772325 15636169 15740945 24668296 X THE MISSION OF BEDFORD MEMORIAL HOSPITAL, A 501(C)(3) HOSPITAL, IS TO IMPROVE THE HEALTH OF THE COMMUNITY IT SERVES. THE HOSPITAL IS COMMITTED TO A COMMON PURPOSE OF BETTER PATIENT CARE, BETTER COMMUNITY HEALTH AND LOWER COSTS. THE 50-BED HOSPITAL PROVIDES INPATIENT AND OUTPATIENT SURGERY, EMERGENCY, GERIATRIC AND REHABILITATIVE SERVICES AND IS DEDICATED TO IMPROVING THE QUALITY OF LIFE IN THE COMMUNITY IT SERVES BY PROVIDING HIGH QUALITY HEALTH CARE. false false 27607814 13400 28864886 BEDFORD MEMORIAL HOSPITAL EXISTS TO SERVE THE HEALTHCARE NEEDS OF ITS COMMUNITY, REGARDLESS OF PATIENT ABILITY TO PAY. BEDFORD'S ACUTE HOSPITAL ADMITTED 1,084 PATIENTS AND PROVIDED 3,560 DAYS OF CARE DURING THE YEAR. HOSPITAL PROGRAMS INCLUDE PROVISION OF NURSING CARE; EXTENSIVE INPATIENT AND OUTPATIENT SURGICAL AND ENDOSCOPIC SERVICES; AND DIAGNOSTIC IMAGING SERVICES INCLUDING CT, MRI AND MAMMOGRAPHY. BEDFORD MEMORIAL IS ALSO HOME TO OAKWOOD MANOR, A LONG-TERM CARE FACILITY PROVIDING 36,747 DAYS OF SKILLED AND INTERMEDIATE CARE. BEDFORD PROVIDES A NUMBER OF SERVICES TARGETING THE SPECIFIC HEALTH NEEDS OF ITS POPULATION, INCLUDING DIABETES MANAGEMENT; HOME HEALTH AND HOSPICE CARE; PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPY PROGRAMS; AN ADULT DAY CARE CENTER; AND CARDIAC AND RESPIRATORY REHAB. BEDFORD ALSO PROVIDES AN EMERGENCY DEPARTMENT WITH 24-HOUR CARE, EMERGENCY TRANSPORTATION, AND A CHEST PAIN AND STROKE PROGRAM. WITH 13,901 VISITS, BEDFORD'S EMERGENCY DEPARTMENT SERVICES ARE A CRITICAL COMPONENT OF THE HEALTH SAFETY NET IN ITS SERVICE AREA, ACTING AS A KEY HEALTH PROVIDER FOR A SIGNIFICANT NUMBER OF UNINSURED PATIENTS. COMMUNITY BENEFIT HIGHLIGHTS IN FURTHERANCE OF ITS MISSION, BEDFORD PROVIDES EXTENSIVE UNCOMPENSATED CARE. DURING FYE 9/30/14, $3,494,481 IN CHARGES AT AN ESTIMATED COST OF $1,391,577 WAS CONTRIBUTED AS TRADITIONAL CHARITY CARE TO PATIENTS WHO DID NOT HAVE THE ABILITY TO PAY. ELIGIBILITY FOR CHARITY CARE IS BASED ON POVERTY INCOME LEVELS SET BY THE STATE. CHARGES OF $3,634,846 AT AN ESTIMATED COST OF $1,447,485 WERE CONTRIBUTED AS BAD DEBT TO PATIENTS WHO DID NOT HAVE THE ABILITY TO PAY. LOSS FROM MEDICARE BASED ON COST TO CHARGE RATIO TOTALED $565,995. LOSS FROM MEDICAID BASED ON COST TO CHARGE RATIO TOTALED $1,100,987. BEDFORD SUPPORTS COMMUNITY SCREENINGS AND EDUCATION ON CHRONIC DISEASE PREVENTION AND MANAGEMENT. BEDFORD MEMORIAL HOSPITAL EMPLOYEES CONTINUALLY OFFER SUPPORT TO THE COMMUNITY VIA PROFESSIONAL HEALTH EDUCATION ON CHRONIC DISEASE PREVENTION AND MANAGEMENT, HEALTH SCREENINGS, COUNSELING, AND SUPPORT GROUPS. SOME EXAMPLES ARE LISTED BELOW. COMMUNITY EDUCATION AND HEALTH SCREENINGS: EDUCATION/CLASSES - " CANCER EDUCATION " DIABETES EDUCATION " HEART DISEASE/HEALTHY HEART EDUCATION " NUTRITION/WEIGHT MANAGEMENT EDUCATION " ORTHOPEDIC EDUCATION " SPORTS INJURY PREVENTION " SENIORS EDUCATION AND OUTREACH " CPR CERTIFICATION AND BABY SITTING CLASSES HEALTH SCREENINGS - " HEALTH FAIRS " BLOOD PRESSURE SCREENINGS " BONE DENSITY SCREENINGS " SKIN CANCER SCREENINGS " OBESITY SCREENINGS " MAMMOGRAMS " CHOLESTEROL TESTING 27607814 true true false true false false false false false false true false false false true true true true false false false false false false false false true true false false true true false false false false false false false false false true false false false false true true false false false true 0 0 true 451 true false false false false false false false false false false X 19 7 true true true false true true true true true false false true true true true true true false false false VA X LEWIS C ADDISON 4342004708 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 X David Adams Director/Centra SVP & CSO 2.0 50.0 X X 0 405836 88784 Johnson Kerr Jr MD Director/Chief of Staff 2.0 48.0 X X 0 324272 28374 Lewis Addison Director/Centra SVP & CFO 2.0 50.0 X X 0 685482 76136 Michael LeMaster Director/Vice Chair 2.0 0.0 X X 0 0 0 Patsy Dooley Director/Chair 2.0 0.0 X X 0 0 0 Amanda Stanley Director 2.0 0.0 X 0 0 0 Brian Buchanan MD Director 2.0 0.0 X 0 0 0 Carolyn Jacques Director/Centra VP 2.0 50.0 X 0 218204 41256 Charles Kolakowski Director 2.0 0.0 X 0 0 0 Consuella Woods Director 2.0 0.0 X 0 0 0 Cynthia Smith Director/Sr. Director 2.0 48.0 X 0 138637 -16021 Deborah Shipman Director/Centra VP 2.0 50.0 X 0 174484 18837 G Robert Vaughan Director/VP 2.0 48.0 X 0 255568 -13062 John Bond Director 2.0 2.0 X 0 13200 0 John Mack Director 2.0 0.0 X 0 0 0 Melina Perdue Director/EVP 2.0 48.0 X 0 438512 109899 Paul Davenport Director/VP 2.0 48.0 X 220798 2770 R Wayne Gandee MD Director/EVP 2.0 48.0 X 0 733197 29321 Theodore Stryker Director/Centra VP 2.0 50.0 X 0 205395 48843 Patti Jurkus CEO/Secretary/Treasurer 50.0 0.0 X 186358 0 70815 Rachel Mabe Asst. Secretary 2.0 48.0 X 0 69609 89 Donald Halliwill Asst. Treasurer/EVP 2.0 48.0 X 0 343160 -13889 Dana Thompson Manager 50.0 0.0 X 121839 0 2999 Georgiann Watts Sr. Director-Nursing 50.0 0.0 X 123985 0 -16438 Jessica Saville Pharmacy Manager 50.0 0.0 X 123856 0 6568 Lisa Girani Nurse 40.0 0.0 X 102314 0 10845 Phillip Gruber Pharmacist 50.0 0.0 X 121268 0 11761 Donald Lorton Former Asst. Treas./EVP 0.0 50.0 X 0 3772316 -29521 Eugene Lowe MD Former Officer/Physician 0.0 50.0 X 0 205593 28390 Linda Beahm MD Former Vice Pres./Physician 0.0 50.0 X 0 183268 17084 William Flattery Former Administrator/Secre 0.0 50.0 X 0 249555 21386 779620 8637086 525226 7 true true false Heritage Healthcare 536 Old Howell Road Greenville SC 29615 Professional Fees 716746 Soltas Lab Partners Group LLC PO Box 751337 Charlotte NC 28275 Laboratory Services 660178 Foodservice Partners of Virginia 2823 Franklin Road Bldg B Roanoke VA 24014 Food Service 150917 Comprehensive Breast Imaging 2605 Coffee Road Lynchburg VA 24503 Physician Services 127723 GE Medical Systems PO Box 640944 Pittsburgh PA 152640944 Equip. Maintenance 109916 5 10620 52707 24568 87895 NET PATIENT SERVICE REVENUE 900099 28566957 28566957 28566957 284187 284187 0 0 402281 402281 0 402281 402281 13844497 64 13318952 525545 64 525609 525609 0 0 0 0 Misc Revenue 900099 286684 286684 CAFETERIA 900099 37363 37363 Court Cost Recovery 900099 11245 11245 335292 30202221 28864886 0 1249440 X 13400 13400 0 0 0 195505 195505 0 13982486 13395006 587480 981853 981853 2056704 1857385 199319 702334 702334 779967 779967 21587 21587 32950 32950 2962 2962 0 7757 7757 0 4866528 4289104 577424 56335 56335 1177772 1092873 84899 120366 119366 1000 0 936880 675294 261586 68316 57108 11208 0 123697 113244 10453 322731 322731 0 1119285 1119285 705445 542273 163172 MEDICAL SUPPLIES 2232469 2232469 I/C PRACTICE SUBSIDY 2171941 2171941 DUES AND SUBSCRIPTIONS 25512 7596 17916 OTHER EXPENSES 38255 27196 11059 0 32743037 27607814 5135223 0 1996 11510172 1891 0 0 0 5017936 4437782 0 0 0 0 0 0 13436 714835 144034 103062 19520349 350476 9360631 19169873 16175384 0 665523 0 0 0 0 3137519 132439 1231222 31513270 40304465 3227665 2699297 0 0 25120 1780 7295646 6856127 0 0 0 0 0 0 0 0 5223894 6078965 15772325 15636169 X 15735374 24668296 5571 0 0 0 15740945 24668296 31513270 40304465 X -2540816 749386 10718781 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2962 2962 false false Explanation of Lobbying Activities PART II-B, LINE 1 PORTION OF DUES PAID TO AMERICAN HOSPITAL ASSOCIATION AND VIRGINIA HOSPITAL HEALTHCARE ASSOCIATION SPENT ON LOBBYING. 2057432 2057432 12154499 124387 12030112 415000 10375 404625 4466671 215714 4250957 426747 426747 19169873 0 EST. PAYABLES TO THIRD PARTIES 927826 DUE TO RELATED PARTIES 5151139 6078965 X 30943850 749386 749386 30194464 7757 7757 30202221 32735280 32735280 7757 7757 32743037 Description of Uncertain Tax Positions Under FIN 48 PART X, LINE 2 THE HOSPITAL HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30,2014. true true X true X 133. true X true true false true true 1391577 1391577 0.04250 3964647 2863660 1100987 0.03360 5356224 2863660 2492564 0.07610 74501 74501 0.00220 20563 20563 0.00060 95064 95064 0.00280 5451288 2863660 2587628 0.07890 3405 3405 0.00010 3365 3365 0.00010 404 404 7533 7533 0.00020 14707 14707 0.00040 true 1447485 0 9222490 9788485 -565995 X true true 1 1 BEDFORD MEMORIAL HOSPITAL 1613 OAKWOOD STREET BEDFORD VA 24523 WWW.BEDFORDMEMORIAL.ORG H 1828 X X X BEDFORD MEMORIAL HOSPITAL 1 true X X X X X X X X X 12 true false true X WWW.BEDFORDMEMORIAL.ORG X www.carilionclinic.org/about/CHNA X X X X X X X false false true true 133. true 400. true X X X X X X X true true X X true false true X false false PART V, SECTION B, LINE 3: THE BEDFORD COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOCUSED ON HIGH LEVELS OF COMMUNITY ENGAGEMENT, SOLICITING INPUT FROM STAKEHOLDERS, PROVIDERS, THE TARGET POPULATION, AND THE COMMUNITY AS A WHOLE. MEMBERS FROM THE ENERGIZE BEDFORD COMMUNITY ACTION COALITION SERVED AS THE COMMUNITY HEALTH ASSESSMENT TEAM (CHAT) THAT LED THE ASSESSMENT. ENERGIZE BEDFORD IS A GRASSROOTS INITIATIVE LED BY THE BEDFORD COMMUNITY HEALTH FOUNDATION MADE UP OF INTERESTED AND ENGAGED INDIVIDUALS WHO ARE COMMITTED TO HELPING IMPROVE THE HEALTH AND WELL-BEING OF BEDFORD FAMILIES. THE MAJORITY OF CHAT MEMBERS SERVE THE LOW-INCOME, UNINSURED, UNDERSERVED, AND CHRONICALLY ILL AND OTHER VULNERABLE POPULATIONS IN BEDFORD COUNTY. THE BEDFORD CHAT MET THREE TIMES BETWEEN JANUARY AND AUGUST OF 2013. CHAT MEMBERS REPRESENTED THE FOLLOWING ORGANIZATIONS: BEDFORD ADULT DAY CENTER, BEDFORD AREA CHAMBER, BEDFORD CHRISTIAN MINISTERIES, BEDFORD CITY PARKS & REC, BEDFORD COMMUNITY HEALTH FOUNDATION, BEDFORD COUNTY HEALTH FOUNDATION, BEDFORD COUNTY PARKS & REC DEPT., BEDFORD COUNTY SCHOOLS, BEDFORD COUNTY YOUTH SERVICES, BEDFORD MEMORIAL HOSPITAL, BEDFORD POLICE, BEDFORD PUBLIC LIBRARY SYSTEM, BEDFORD YMCA, BEDFORD YOUTH AND FAMILY, CARILION CLINIC STRATEGIC DEVELOPMENT, CENTRAL VIRGINIA COMMUNITY SERVICES BOARD, CENTRAL VIRGINIA HEALTH DISTRICT, COMPLETE COUNSELING SERVICES, COVENANT DOVE, FOREST MIDDLE SCHOOL, MONETA YMCA, NUTRITION DIMENSIONS, STAUNTON RIVER HIGH SCHOOL, VIRGINIA HOUSE OF DELEGATES, VIRGINIA COOPERATIVE EXTENSION, AND VIRGINIA DEPARTMENT OF HEALTH. PART V, SECTION B, LINE 6i: BEDFORD MEMORIAL HOSPITAL IS WORKING WITH ENERGIZE BEDFORD TO FOSTER A COMMUNITY COLLABORATION TO ADDRESS ISSUES IDENTIFIED IN THE CHNA. PART V, SECTION B, LINE 7: MULTIPLE OTHER NEEDS WERE IDENTIFIED DURING THE CHNA PROCESS, INCLUDING HIGH COST OF LIVING AND PREFERENCES FOR NECESSITIES, ACCESS TO ADULT DENTAL CARE, AND THE NEED FOR URGENT CARE SERVICES. BEDFORD MEMORIAL HOSPITAL WILL NOT FOCUS ON THOSE INITIATIVES IN THE SCOPE OF THIS PROJECT DUE TO THE FACT THAT THE CHAT DID NOT IDENTIFY THOSE ISSUES AS BEING THE MOST PERTINENT COMMUNITY NEEDS. IT WOULD NOT BE PRUDENT TO SPREAD LIMITED HOSPITAL AND COMMUNITY RESOURCES ACROSS TOO MANY INITIATIVES. PART V, SECTION B, LINE 12i: OTHER (LIQUID ASSETS AND EQUITY IN REAL PROPERTY) PART V, SECTION B, LINE 20d: PRIOR TO JULY 1, 2014, FAP ELIGIBLE UNINSURED PATIENTS WERE CHARGED GROSS CHARGES LESS A DISCOUNT. FAP ELIGIBLE INSURED PATIENTS WERE CHARGED UNDER TERMS OF THEIR INSURANCE CONTRACT AND WERE ELIGIBLE FOR ADDITIONAL DISCOUNTS. THE DISCOUNT RATE WAS BASED ON THE SYSTEM'S DOMINANT LOWEST NEGOTIATED COMMERCIAL INSURANCE RATE. AS OF JULY 1, 2014, THE HOSPITAL USED THE AVERAGE OF ITS THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. 6 OAKWOOD MANOR 1613 OAKWOOD STREET BEDFORD VA 24523 NURSING HOME BEDFORD ADULT DAY CENTER 1617 OAKWOOD STREET BEDFORD VA 24523 ADULT DAY CARE BLUE RIDGE CARDIOVASCULAR 37 LAYMANTOWN ROAD TROUTVILLE VA 24175 CARDIOVASCULAR TESTING CMG BEDFORD GENERAL SURGERY CENTER 1615 OAKWOOD STREET SUITE B BEDFORD VA 24523 GENERAL SURGERY CMG BEDFORD PULMONOLOGY CENTER 1613 OAKWOOD STREET SUITE 202 BEDFORD VA 24523 PULMONARY SVCS CMG BEDFORD WOMEN'S CENTER 1615 OAKWOOD STREET SUITE D BEDFORD VA 24523 WOMEN'S HEALTH SVCS Part I, Line 3c PRIOR TO JULY 1, 2014, THE HOSPITAL USED ASSET TEST TO DETERMINE FREE AND/OR DISCOUNTED CARE. ALSO, EQUITY VALUE IN REAL PROPERTY WAS USED. AS OF JULY 1, 2014, THE HOSPITAL USED FPG FACTORS IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE. Part I, Line 6a PRIOR TO JULY 1, 2014, INFORMATION ON COMMUNITY BENEFIT WAS REPORTED ANNUALLY THROUGH A CONSOLIDATED REPORT PREPARED BY CARILION CLINIC, CO-OWNER OF BEDFORD MEMORIAL HOSPITAL. PRINTED COPIES OF THIS REPORT WERE DISTRIBUTED THROUGHOUT THE COMMUNITIES SERVED BY HOSPITALS AFFILIATED WITH CARILION CLINIC. ADDITIONALLY, THE COMMUNITY BENEFIT REPORT WAS AVAILABLE ON CARILION CLINIC'S WEBSITE. AS OF JULY 1, 2014, INFORMATION ON COMMUNITY BENEFITS IS REPORTED ANNUALLY THROUGH A REPORT PREPARED BY CENTRA HEALTH, INC., SOLE MEMBER OF BEDFORD MEMORIAL HOSPITAL. Part I, Line 7 COST-TO-CHARGE RATIO WAS USED TO CALCULATE THE EXPENSE. Part II, Lines 1-9 LINE 2 ECONOMIC DEVELOPMENT: BEDFORD MEMORIAL HOSPITAL PROVIDED RESOURCES FOR THE BEDFORD AREA CHAMBER OF COMMERCE BOARD, AN ORGANIZATION PROVIDING LEADERSHIP PROGRAMS AND OPPORTUNITIES AS WELL AS VOLUNTEER PROGRAMS, NETWORKING OPPORTUNITIES AND OTHER BUSINESS-BUILDING INITIATIVES THAT FOCUS ON THE CRITICAL PRIORITIES OF THE COMMUNITY TO IMPROVE ECONOMIC VITALITY AND QUALITY OF LIFE. LINE 3 COMMUNITY SUPPORT: BEDFORD MEMORIAL HOSPITAL PROVIDED FINANCIAL SUPPORT TO THE BEDFORD AREA YMCA, COMMITTED TO NURTURING THE POTENTIAL OF KIDS, PROMOTING HEALTHY LIVING, AND FOSTERING A SENSE OF SOCIAL RESPONSIBILITY; BEDFORD PREGNANCY CENTER; AND THE BEDFORD VOLUNTEER FIRE DEPARTMENT. LINE 7 COMMUNITY HEALTH IMPROVEMENT ADVOCACY: BEDFORD MEMORIAL HOSPITAL PROVIDED IN-KIND SUPPORT TO ENERGIZE BEDFORD COMMUNITY ACTION COALITION, A GRASSROOTS INITIATIVE MADE UP OF INTERESTED AND ENGAGED INDIVIDUALS, REPRESENTING VARIOUS ORGANIZATIONS WITHIN BEDFORD CITY/COUNTY AND FROM THE COMMUNITY AT LARGE, WHO ARE COMMITTED TO HELPING IMPROVE THE HEALTH AND WELL-BEING OF BEDFORD FAMILIES. LINE 8 WORKFORCE DEVELOPMENT: BEDFORD MEMORIAL HOSPITAL SERVES AS A GOODWILL SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM PARTNER, OFFERING ON-THE-JOB TRAINING AND EMPLOYMENT TO HELP THOSE AGED 55 AND OLDER UPDATE THEIR JOB SKILLS, BUILD WORK EXPERIENCE AND CONFIDENCE, AND CONTINUE TO HAVE ECONOMIC SECURITY AND WELL-BEING. Part III, Line 1 ACCOUNTING STANDARDS UPDATE (ASU) 2011-07, CHANGED CENTRA HEALTH, INC. AND SUBSIDIARIES PRESENTATION OF PROVISION FOR DOUBTFUL ACCOUNTS TO A DEDUCTION FROM NET PATIENT SERVICE REVENUE. THEREFORE, CENTRA HEALTH AND ITS SUBSIDIARIES, INCLUDING BEDFORD MEMORIAL HOSPITAL (AS OF JULY 1, 2014), REPORT BAD DEBT IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. Part III, Line 2 THE ORGANIZATION ESTIMATES BAD DEBT EXPENSE BY RESERVING A PERCENTAGE OF ALL SELF-PAY ACCOUNTS RECEIVABLE BY AGING CATEGORY, BASED ON COLLECTION HISTORY, ADJUSTED FOR EXPECTED RECOVERIES, AND, IF PRESENT, ANTICIPATED CHANGES IN TRENDS. THE PERCENTAGE USED TO RESERVE FOR ALL SELF-PAY ACCOUNTS WAS BASED ON THE ORGANIZATION'S COLLECTION HISTORY. Part III, Line 4 PRIOR TO JULY 1, 2014, AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WAS RECORDED BASED ON HISTORICAL BAD DEBT EXPERIENCE AND MANAGEMENT'S EVALUATION OF THE ACCOUNTS RECEIVABLE. BALANCES WERE WRITTEN OFF AFTER ALL REASONABLE COLLECTION EFFORTS HAD BEEN MADE. ACCOUNTS RECEIVABLE WERE REDUCED BY AN ALLOWANCE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE. THE HOSPITAL ESTIMATED THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY RESERVING A PERCENTAGE OF ALL SELF-PAY ACCOUNTS RECEIVABLE BY AGING CATEGORY. BASED ON COLLECTION HISTORY, ADJUSTED FOR EXPECTED RECOVERIES, AND, IF PRESENT, ANTICIPATED CHANGES IN TRENDS. THE PERCENTAGE USED TO RESERVE FOR ALL SELF-PAY ACCOUNTS WAS BASED ON THE HOSPITAL'S COLLECTION HISTORY. THE HOSPITAL COLLECTED SUBSTANTIALLY ALL OF ITS THIRD-PARTY INSURED RECEIVABLES, WHICH INCLUDED RECEIVABLES FROM GOVERNMENT AGENCIES AND COMMERCIAL INSURERS. AS OF JULY 1, 2014, BEDFORD MEMORIAL HOSPITAL ADOPTED THE PROCEDURES OF CENTRA HEALTH, INC., ITS SOLE MEMBER, WHICH INCLUDES ITS METHODOLOGY USED TO ESTIMATE BAD DEBT EXPENSE. "PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR BAD DEBTS/CHARITY. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, BEDFORD ANALYZES HISTORICAL COLLECTIONS AND WRITE OFFS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR BAD DEBTS/CHARITY AND PROVISION FOR BAD DEBTS/CHARITY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR BAD DEBTS/CHARITY. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, BEDFORD ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR BAD DEBTS/CHARITY, ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS, PROVISION FOR BAD DEBTS/CHARITY, AND PROVISION FOR CONTRACTUAL ADJUSTMENTS ON ACCOUNTS FOR WHICH THE THIRD PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS OR WITH BALANCES REMAINING AFTER THE THIRD PARTY COVERAGE HAS ALREADY PAID, BEDFORD RECORDS A PROVISION FOR BAD DEBTS/CHARITY IN THE PERIOD OF SERVICE ON THE BASIS OF ITS HISTORICAL COLLECTIONS, WHICH INDICATES THAT SOME PATIENTS ARE UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE DISCOUNTED RATES AND THE AMOUNTS COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR BAD DEBTS/CHARITY." Part III, Line 8 MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE MEDICARE COST REPORT USING THE COST TO CHARGE RATIO. THE TOTAL AMOUNT OF MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE BEDFORD MEMORIAL HOSPITAL'S MISSION IS TO PROMOTE HEALTH IN THE COMMUNITY AND WE DO NOT LIMIT THE CARE AVAILABLE TO ANY OF OUR PATIENTS, INCLUDING THOSE COVERED BY MEDICARE. WE ARE RELIEVING A GOVERNMENT BURDEN BY PROVIDING CARE TO MEDICARE PATIENTS EVEN THOUGH REIMBURSEMENTS WERE LESS THAN THE COST TO PROVIDE SERVICE. TOTAL MEDICARE SHORTFALL FOR FYE 9/30/14 WAS $565,995. Part III, Line 9b BEDFORD MEMORIAL HOSPITAL APPLIES UNIFORM COLLECTION PROTOCOLS TO ALL UNPAID ELIGIBLE CHARGES REGARDLESS OF RACE, SEX, AGE, DISABILITY, NATIONAL ORIGIN, OR RELIGION. PATIENTS KNOWN BY BEDFORD TO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT SUBJECT TO COLLECTION PROTOCOLS. IF DURING COLLECTION PROTOCOLS, OR AFTER REFERRAL TO AN OUTSIDE COLLECTION AGENCY, IT IS DISCOVERED PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY, INCLUDING ANY AND ALL EXTRAORDINARY COLLECTION EFFORT, IS IMMEDIATELY STOPPED. FINANCIAL ASSISTANCE FOR ELIGIBLE CHARGES IS AVAILABLE TO ALL BEDFORD PATIENTS WHO QUALIFY BASED ON ESTABLISHED INCOME AND ASSET CRITERIA. PART V, LN 10 PRIOR TO JULY 1, 2014, BEDFORD USED 133% AS THE FPG FAMILY INCOME LIMIT FOR ELIGIBILITY FOR PROVIDING FREE CARE. AS OF JULY 1, 2014, BEDFORD USES 200% AS THE FPG FAMILY INCOME LIMIT FOR ELIGIBILITY FOR PRIVIDING FREE CARE. PART VI, LINE 2 NEEDS ASSESSMENT DURING 2013 CARILION CLINIC COMPLETED BEDFORD MEMORIAL HOSPITAL'S FY2012-2015 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN TO MEASURE THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. THE ASSESSMENT INCLUDED THE SERVICE AREA OF BEDFORD MEMORIAL HOSPITAL, BEDFORD, VIRGINIA, LOCATED IN THE PIEDMONT REGION OF VIRGINIA. THROUGH THE CHNA, THE BEDFORD COMMUNITY HEALTH ASSESSMENT TEAM (CHAT) FOCUSED ON HIGH LEVELS OF COMMUNITY ENGAGEMENT INVOLVING HEALTH AND HUMAN SERVICE LEADERS, STAKEHOLDERS, AND PROVIDERS; THE TARGET POPULATION, AND THE COMMUNITY AS A WHOLE. THE TARGET POPULATION WAS THOSE LIVING IN THE TOWN OF BEDFORD AND BEDFORD COUNTY. IN GATHERING DATA, AN EMPHASIS WAS PLACED ON VULNERABLE POPULATIONS, SUCH AS LOW-INCOME, UNINSURED/UNDERINSURED, OLDER ADULTS, AND THOSE WITH CHRONIC DISEASES. HEALTH CARE NEEDS AND REQUESTS WERE ASSESSED THROUGH FOCUS GROUPS, AND SURVEYS OF COMMUNITY RESIDENTS AND CIVIC LEADERS AS WELL AS HOSPITAL AND HEALTH CARE SYSTEM PATIENTS. COMMUNITY MEMBERS WERE ENCOURAGED TO TAKE THE COMMUNITY HEALTH SURVEY. A NEWS RELEASE WAS POSTED ON BEDFORD MEMORIAL HOSPITAL'S WEBSITE. POSTERS AND FLYERS WERE PLACED IN THE COMMUNITY LETTING COMMUNITY MEMBERS KNOW HOW TO TAKE THE SURVEY. THE SURVEY WAS AVAILABLE IN PRINT, ONLINE, AND OVER THE PHONE FROM FEBRUARY THROUGH MID-MAY 2013. THERE WERE 614 SURVEYS RETURNED FROM BEDFORD COUNTY. SURVEYS WERE ANALYZED AND REPORTED USING SURVEY MONKEY AND MICROSOFT EXCEL. ALL RESPONSES WERE ENTERED INTO SURVEY MONKEY EITHER DIRECTLY BY THE RESPONDENTS OR BY VOLUNTEERS WHO ENTERED RESPONSES FROM PAPER OR PHONE SURVEYS. TO ADDRESS THE NEEDS OF THE COMMUNITY, BEDFORD MEMORIAL HOSPITAL DEVELOPED A MULTI-DISCIPLINARY TEAM TO ENSURE THAT RESOURCES ARE ALIGNED WITH THE NEEDS IDENTIFIED DURING THE CHNA. THE TEAM INITIALLY CONSISTED OF BMH EMPLOYEES AND AREA PROVIDERS, AND EXPANDED TO INCLUDE MEMBERSHIP FROM COMMUNITY AGENCIES AS NEEDED TO ENSURE IMPROVEMENTS ARE ACHIEVED IN THE IDENTIFIED AREAS OF FOCUS. Part vi, line 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PRIOR TO JULY 1, 2014, THE ORGANIZATION INFORMED AND EDUCATED PATIENTS BY REVIEWING HIGH DOLLAR OUTPATIENT AND ALL INPATIENT "SELF-PAY" ACCOUNTS IN ORDER TO SEEK ELIGIBILITY FOR FEDERAL/STATE PROGRAMS FOREMOST, AND THEN TOWARD THE CARILION FINANCIAL ASSISTANCE PROGRAM. THIS INVOLVED CONTACT DIRECTLY WITH THE PATIENT AND/OR THE PATIENT'S REPRESENTATIVE (FAMILY, ETC.). THIS PROGRAM WAS AVAILABLE UPON REQUEST FOR ANY AND ALL SERVICES, AND WAS AVAILABLE THROUGH THE CARILION INTERNET SITE, AND WAS ALSO AVAILABLE THROUGH THE PATIENT INFORMATION PAMPHLET AVAILABLE IN THE PATIENT ACCESS POINTS. AS OF JULY 1, 2014, INFORMATION ABOUT FINANCIAL ASSISTANCE AND CHARITY CAN BE FOUND ON CENTRA BEDFORD MEMORIAL HOSPITAL'S INTERNET PAGE PROVIDING FULL DISCLOSURE ABOUT QUALIFICATIONS AND THE APPLICATION PROCESS. INDIVIDUALS MAY OBTAIN INFORMATION AND AN APPLICATION FROM ANY REGISTRATION POINT OR CUSTOMER SERVICE UNIT IN PERSON OR BY PHONE. SIGNS ARE POSTED IN CONSPICUOUS LOCATIONS ALERTING INDIVIDUALS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND WHERE TO OBTAIN ADDITIONAL INFORMATION. BROCHURES ABOUT FINANCIAL ASSISTANCE ARE MADE AVAILABLE IN REGISTRATION AND CUSTOMER SERVICE. WHILE PATIENTS ARE HOSPITALIZED, A FINANCIAL COUNSELOR PROVIDES FINANCIAL ASSISTANCE INFORMATION, SCREENS PATIENTS FOR FEDERAL AND STATE PROGRAMS AND GIVES AN OPPORTUNITY TO ASK QUESTIONS. ADDITIONALLY, AN INSERT ABOUT FINANCIAL ASSISTANCE IS MAILED IN EVERY UNINSURED BILL AND EVERY PATIENT BILL, WHETHER UNINSURED OR INSURED, REFERENCING AVAILABILITY OF FINANCIAL ASSISTANCE WITH CONTACT INFORMATION ON WHERE TO OBTAIN MORE INFORMATION. PART VI, LINE 4 COMMUNITY INFORMATION ON JULY 1, 2013, THE CITY OF BEDFORD, LOCATED IN BEDFORD COUNTY, WAS CONVERTED INTO A TOWN. BEDFORD MEMORIAL HOSPITAL PRIMARILY SERVES APPROXIMATELY 75,000 RESIDENTS OF THE TOWN OF BEDFORD AND BEDFORD COUNTY. BEDFORD EMCOMPASSES APPROXIMATELY 760 SQUARE MILES OF PIEDMONT PLATEAU IN THE WESTERN CENTRAL PORTION OF VIRGINIA AND IS BORDERED BY THE BLUE RIDGE MOUNTAINS TO THE WEST, THE JAMES RIVER ON ITS NORTHEAST AND SMITH MOUNTAIN LAKE TO THE SOUTH. THE TERRAINE IS ROLLING AND HILLY WITH ELEVATIONS RANGING FROM 800 TO 4,200 FEET ABOVE SEA LEVEL. BEDFORD MEMORIAL HOSPITAL IS A 50-BED HOSPITAL FACILITY THAT ALSO HAS 110 LONG TERM CARE AND SKILLED CARE BEDS IN ITS OAKWOOD HEALTH AND REHABILITATION CENTER. BEDFORD COUNTY IS GROWING AT A FASTER RATE THAN VIRGINIA AND HAS A LARGER PERCENT OF OLDER ADULTS. ADDITIONALLY, 24.4% OF THE TOWN OF BEDFORD/BEDFORD COUNTY RESIDENTS HAVE A BACHELOR'S DEGREE OR HIGHER, MUCH LESS THAN THE STATE AVERAGE OF 34.4%. THE TOWN OF BEDFORD HAS A MEDIAN HOUSEHOLD INCOME OF $34,647 AS COMPARED TO THE STATE AVERAGE OF $63,302. IN 2011, 10% OF THE TOWN OF BEDFORD/BEDFORD COUNTY POPULATIONS WERE LIVING IN POVERTY AND 14.9% OF CHILDREN WERE LIVING IN POVERTY. PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH BEDFORD MEMORIAL HOSPITAL SERVES ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO QUALIFIED PROVIDERS AND, IN ADDITION TO CLINICAL CARE, THE HOSPITAL WORKS TO ACHIEVE ITS MISSION THROUGH THE EDUCATION OF HEALTH PROFESSIONALS AND THE COMMUNITY. THE HOSPITAL ALSO PARTICIPATES IN NUMEROUS HEALTH FAIRS AND SCREENINGS THROUGHOUT THE COMMUNITY AT LOCAL EMPLOYERS, COLLEGES, CHURCHES, ETC., IN ORDER TO PROVIDE HEALTH SCREENINGS AND INFORMATION ON MANY HEALTH ISSUES... FOR EXAMPLE, BLOOD PRESSURE, DIABETES, PSA, BLADDER AND CANCER SCREENINGS, ETC. PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM PRIOR TO JULY 1, 2014, BEDFORD MEMORIAL HOSPITAL WAS JOINTLY OWNED BY CARILION CLINIC AND CENTRA HEALTH. MANAGEMENT WAS PROVIDED BY CARILION CLINIC, A NOT-FOR-PROFIT HEALTHCARE ORGANIZATION SERVING APPROXIMATELY ONE MILION INDIVIDUALS IN VIRGINIA THROUGH A COMPREHENSIVE NETWORK OF HOSPITALS, PRIMARY AND SPECIALTY PHYSICIAN PRACTICES, AND OTHER COMPLIMENTARY SERVICES. CARILION CLINIC IS BASED IN ROANOKE, VIRGINIA AND SERVES THE RESIDENTS OF 18 COUNTIES AND SIX SITIES IN WESTERN VIRGINIA AND SOUTHERN WEST VIRGINIA. OVER THE PAST SIX YEARS CARILION CLINIC HAS GONE THROUGH A DRAMATIC AND TRANSFORMATIVE CHANGE AS THEY TRANSITIONED FROM A HOSPITAL SYSTEM TO AN INTEGRATED CLINIC WITH PHYSICIAN LEADERSHIP. AS OF JULY 1, 2014, CENTRA HEALTH BECAME SOLE MEMBER OF BEDFORD MEMORIAL HOSPITAL. CENTRA HEALTH SERVES AS A KEY PARTNER IN MANAGING AND PROMOTING HEALTHCARE THROUGHOUT ITS SYSTEM TO ENSURE EXCELLENT CARE TO THE REGIONAL COMMUNITIES IT SERVES. BEDFORD MEMORIAL HOSPITAL'S SOLE AFFILIATION WITH CENTRA HEALTH WILL STRENGTHEN THE ORGANIZATION THROUGH AN EXCHANGE OF BEST PRACTICES AND ACCESS TO MULTI-DISCIPLINARY TEAMS, INCLUDING, BUT NOT LIMITED TO, PHYSICIANS FROM CENTRA'S NETWORK OF PRACTICES AND EXPERTS IN LONG-TERM CARE AND REHABILITATION. false true false false false false false true false David Adams Director/Centra SVP & CSO 0 362391 0 35200 0 8245 0 66800 0 21984 0 494620 0 0 Johnson Kerr Jr MD Director/Chief of Staff 0 265691 0 55398 0 3183 0 8224 0 20150 0 352646 0 0 Lewis Addison Director/Centra SVP & CFO 0 391103 0 44110 0 250269 0 54592 0 21544 0 761618 0 218425 Carolyn Jacques Director/Centra VP 0 142289 0 12920 0 62995 0 15922 0 25334 0 259460 0 54007 Deborah Shipman Director/Centra VP 0 167967 0 5000 0 1517 0 2969 0 15868 0 193321 0 0 G Robert Vaughan Director/VP 0 211713 0 38988 0 4867 0 -27255 0 14193 0 242506 0 0 Melina Perdue Director/EVP 0 369856 0 65726 0 2930 0 99688 0 10211 0 548411 0 0 Paul Davenport Director/VP 178928 31265 10605 1187 1583 223568 R Wayne Gandee MD Director/EVP 0 542850 0 181896 0 8451 0 18675 0 10646 0 762518 0 Theodore Stryker Director/Centra VP 0 178036 0 25718 0 1641 0 21268 0 27575 0 254238 0 0 Patti Jurkus CEO/Secretary/Treasurer 156660 0 28498 0 1200 0 60728 0 10087 0 257173 0 0 0 Donald Lorton Former Asst. Treas./EVP 0 314369 0 67943 0 3390004 0 -34833 0 5312 0 3742795 0 3389344 Eugene Lowe MD Former Officer/Physician 0 186931 0 15875 0 2787 0 15425 0 12965 0 233983 0 0 Linda Beahm MD Former Vice Pres./Physician 0 153526 0 27535 0 2207 0 4040 0 13044 0 200352 0 0 William Flattery Former Administrator/Secre 0 201544 0 39200 0 8811 0 3718 0 17668 0 270941 0 0 Donald Halliwill Asst. Treasurer/EVP 0 284640 0 52500 0 6020 0 -27463 0 13574 0 329271 0 0 Part I, Line 3 "PRIOR TO JULY 1, 2014, EXECUTIVE COMPENSATION WAS REVIEWeD ANNUALLY BY THE CARILION CLINIC COMPENSATION COMMITTEE. THIS COMMITTEE WAS MADE UP OF BOARD MEMBERS OF CARILION CLINIC WHO DID NOT HAVE A CONFLICT OF INTEREST WITH ANY OF THE EXECUTIVES BEING REVIEWED. WITH RESPECT TO CARILION CLINIC, THE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION OF THE BOARD OF GOVERNORS WHICH INCLUDED THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENTS, CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER, AND CHAIRS OF THE CLINICAL DEPARTMENTS. FOR THE FIRST NINE MONTHS OF 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. THIS REVIEW INCLUDED A COMPREHENSIVE REPORT FROM AN OUTSIDE COMPENSATION CONSULTANT SPECIALIZING IN HEALTHCARE ORGANIZATIONS. THE REPORT INCLUDED A DETAILED COMPARISON OF TOTAL COMPENSATION AND EACH ELEMENT THEREOF, INCLUDING BASE SALARY, BONUSES AND OTHER CASH COMPENSATION, AND BENEFITS, INCLUDING DEFERRED AND RETIREMENT BENEFITS. COMPENSATION WAS COMPARED TO A PEER GROUP OF ORGANIZATIONS SIMILAR IN SIZE AND STRUCTURE TO THE ORGANIZATION, WHICH LIST WAS REVIEWED BY THE COMPENSATION COMMITTEE. DETAILED MINUTES OF THE MEETING OF THE COMPENSATION COMMITTEE ARE KEPT AND APPROVED AT THE NEXT MEETING OF THE COMMITTEE, SETTING FORTH THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION OF THESE EXECUTIVES. IN ADDITION, THE COMPENSATION COMMITTEE ANNUALLY REVIEWED THE COMPENSATION PLAN AND PHILOSOPHY FOR ALL VICE PRESIDENTS AND SENIOR VICE PRESIDENTS, AS WELL AS ALL EMPLOYED PHYSICIANS AND PHYSICIANS IN LEADERSHIP ROLES. AS OF JULY 1, 2014, THE ORGANIZATION'S SOLE MEMBER AND RELATED PARTY, CENTRA HEALTH, INC, ESTABLISHED A MANAGEMENT AGREEMENT WITH BEDFORD, WHEREAS IT WAS DETERMINED THAT THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER'S COMPENSATION WILL BE ESTABLISHED IN ACCORDANCE WITH CENTRA HEALTH'S EXECUTIVE COMPENSATION PRACTICES WHICH INCLUDE "THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT(S) AND COMPENSATION STUDY OR SURVEY." Part I, Line 4b THE FOLLOWING INDIVIDUALS RECEIVED A PAYOUT FROM A NONQUALIFIED RETIREMENT PLAN DURING FY2013. THE AMOUNT WAS INCLUDED IN THEIR 2013 W-2 WAGES. NAME TITLE AMOUNT OF PAYOUT DONALD LORTON FORMER ASST. TREASURER/EVP $3,321,613 LEWIS ADDISON DIRECTOR/CENTRA SVP & CFO $ 218,425 CAROLYN JACQUES DIRECTOR/CENTRA VP $ 54,007 THE FOLLOWING INDIVIDUALS HAD AMOUNTS DEFERRED INTO A NONQUALIFIED RETIREMENT PLAN DURING FY2013. NAME TITLE AMOUNT DEFERRED MELINA PERDUE DIRECTOR/EVP $94,592 DAVID ADAMS DIRECTOR/CENTRA SVP & CSO $59,150 LEWIS ADDISON DIRECTOR/CENTRA SVP & CFO $46,942 CAROLYN JACQUES DIRECTOR/CENTRA VP $11,400 THEODORE STRYKER DIRECTOR/CENTRA VP $18,420 Part I, Line 7 PRIOR TO JULY 1, 2014, THE ORGANIZATION PAID ANNUAL BONUS COMPENSATION TO MANAGEMENT BASED ON SCORECARD PERFORMANCE. WHILE THE SCORECARD CONTAINED A FORMULA AS A BASIS FOR DETERMINING OVERALL PERFORMANCE, SENIOR MANAGERS HAD DISCRETION TO INCLUDE ADDITIONAL ELEMENTS IN THEIR ASSESSMENT OF MANAGERS REPORTING TO THEM. IN ADDITION, FOR TOP MANAGEMENT, THE ACTUAL BONUS AWARD WAS IN THE DISCRETION OF THE CARILION CLINIC COMPENSATION COMMITTEE, ALTHOUGH IT WAS BASED ON THE SCORECARD MEASURES. AS OF JULY 1, 2014, THE ANSWER TO THIS QUESTION IS "NO". A INDUSTRIAL DEV AUTH OF THE CITY OF ROANOKE VA 541106038 770084ES6 2005-12-14 5790000 CURRENT REFUNDING OF SERIES 2002 B false false false B INDUSTRIAL DEV AUTH OF THE CITY OF ROANOKE VA 541106038 770082AE5 2012-02-09 3451000 Redemption Series 2002A,Iss Costs false false false A 2300000 0 5790000 0 0 0 35696 83437 0 0 5670867 0 true false true true B 708000 0 3910331 0 0 0 43496 0 0 0 3866835 0 false true true true A false false false false 0 false false false true B false false false false 0 false false false true A true true true UBS & CITIGROUP 27. false false true AIG 0.3 true false true B true false false 0 false 0 false true A true B true SCHEDULE K PART II BOND PROCEEDS ALL BOND ISSUES MULTIPLE ENTITIES ACROSS MULTIPLE JURSIDICTIONS, THEREFORE PROCEEDS ALLOCATED TO MULTIPLE HOSPITALS. SOLSTA LAB PARTNERS LLC SEE PART V 660178 LAB SERVICES false Form Sch L Part IV Part IV, Line 1, Column (b) Donald Lorton, a former officer of Bedford Memorial Hospital, served on the Board of Solstas Lab Partners, LLC. G. Robert Vaughan, Director, serves on the Board of Solstas Lab Partners, LLC, of which Carilion has a minority financial interest and from whom the organization purchases lab services. FORM 990, PART I, LINE 6: WITHIN THE HOSPITAL, VOLUNTEERS STAFF THE GIFT SHOP, GREET PATIENTS AT THE INFORMATION DESK, VISITORS LOUNGE, AND EMERGENCY DEPARTMENT; WORK WITH STUDENTS PROVIDING ACTIVITIES IN THE NURSING HOME AND FOOD AND NUTRITION STAFF; ENTER DATA FOR NUTRITIONAL SERVICES AND ASSIST STAFF IN THE FOLLOWING DEPARTMENTS: CHAPLAINS SERVICES, PHYSICAL AND OCCUPATIONAL THERAPY, SECURITY, TRANSPORT, BUSINESS OFFICE AND GIFT SHOP. FOR HOSPICE, VOLUNTEERS SIT WITH THE PATIENT SO FAMILY MEMBERS CAN RUN ERRANDS AND KEEP APPOINTMENTS. THEY ALSO PROVIDE CLERICAL SUPPORT, SOCIALIATION FOR PATIENTS IN FACILITIES, ASSIST WITH YARD WORK, AND CALL PATIENTS BEFORE THE WEEKEND TO ENSURE THEY HAVE EVERYTHING NEEDED. THEY ALSO ASSIST WITH HEALING ARTS PROGRAMS, FUNDRAISING ACTIVITIES AND COMMUNITY EVENTS. VOLUNTEER CHAPLAINS PROVIDE SERVICES AS NEEDED/ASSIGNED. FORM 990, PART VI, SECTION A, LINE 2: 1. DAVID ADAMS, LEWIS C. ADDISON, CAROLYN JACQUES, DEBORAH SHIPMAN, THEODORE STRYKER AND CONSUELLA WOODS - BUSINESS RELATIONSHIP. 2. JOHN BOND, PAUL DAVENPORT, R. WAYNE GANDEE, M.D., DONALD B. HALLIWILL, MELINA PERDUE, CYNTHIA P. SMITH, AND G. ROBERT VAUGHN, JR - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 3: PRIOR TO JULY 1, 2014, CERTAIN MANAGEMENT AND RELATED SERVICES FOR THE ORGANIZATION WERE PROVIDED BY MANGEMENT AND EMPLOYEES OF CARILION SERVICES, INC., A PARTIAL-YEAR RELATED AND SUPPORTING ORGANIZATION. AS OF JULY 1, 2014, MANAGEMENT AND RELATED SERVICES FOR THE ORGANIZATION WERE PROVIDED BY MANAGEMENT OF CENTRA HEALTH, INC., SOLE MEMBER OF ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 4: THE ARTICLES AND BYLAWS WERE AMENDED. PRIOR TO JULY 1, 2014, THE ORGANIZATION HAD TWO MEMBERS. EACH MEMBER OF THE ORGANIZATION ELECTED ONE CLASS OF DIRECTORS REPRESENTING ONE-THIRD OF THE MEMBERS OF THE GOVERNING BODY OF THE ORGANIZATION PERIODICALLY AS TERMS EXPIRE. THE MEMBERS ALSO HAD THE RIGHT TO REMOVE DIRECTORS THEY HAVE ELECTED AND FILL ANY VACANCIES ON THE BOARD THAT MAY OCCUR AMONG THEIR ELECTED DIRECTORS FOR ANY REASON. THE REMAINING CLASS OF DIRECTORS CAME FROM THE LOCAL COMMUNITY AND THESE DIRECTORS ELECT THEIR OWN SUCCESSORS. AS OF JULY 1, 2014, CENTRA HEALTH, INC. BECAME THE SOLE MEMBER OF THE ORGANIZATION AND THEREFORE HAS THE POWER TO ELECT/APPROVE THE BOARD OF DIRECTORS OF BEDFORD'S GOVERNING BODY AND APPROVE DECISIONS MADE BY BEDFORD'S BOARD. FORM 990, PART VI, SECTION A, LINE 6: PRIOR TO JULY 1, 2014, THE ORGANIZATION HAD TWO MEMBERS; CENTRA HEALTH, INC, A CHARITABLE TAX-EXEMPT HEALTHCARE ORGANIZATION, AND CARILION CLINIC, A CHARITABLE TAX-EXEMPT HEALTHCARE ORGANIZATION. AS OF JULY 1, 2014, CENTRA HEALTH, INC. BECAME THE SOLE MEMBER OF THE ORGANIZATION. Form 990, Part VI, Section A, LINE 7A AND B PRIOR TO JULY 1, 2014, THE ORGANIZATION HAD TWO MEMBERS. EACH MEMBER OF THE ORGANIZATION ELECTED ONE CLASS OF DIRECTORS REPRESENTING ONE-THIRD OF THE MEMBERS OF THE GOVERNING BODY OF THE ORGANIZATION PERIODICALLY AS TERMS EXPIRE. THE MEMBERS ALSO HAD THE RIGHT TO REMOVE DIRECTORS THEY HAVE ELECTED AND FILL ANY VACANCIES ON THE BOARD THAT MAY OCCUR AMONG THEIR ELECTED DIRECTORS FOR ANY REASON. THE REMAINING CLASS OF DIRECTORS CAME FROM THE LOCAL COMMUNITY AND THESE DIRECTORS ELECT THEIR OWN SUCCESSORS. AS OF JULY 1, 2014, CENTRA HEALTH, INC. BECAME THE SOLE MEMBER OF THE ORGANIZATION AND THEREFORE HAS THE POWER TO ELECT/APPROVE THE BOARD OF DIRECTORS OF BEDFORD'S GOVERNING BODY AND APPROVE DECISIONS MADE BY BEDFORD'S BOARD. FORM 990, PART VI, SECTION B, LINE 11B: THE FINAL FORM 990 WAS EMAILED OR DELIVERED IN HARD COPY TO EACH MEMBER OF THE BOARD OF DIRECTORS SEVERAL DAYS PRIOR TO FILING AND BOARD MEMBERS WERE ENCOURAGED TO CALL WITH ANY QUESTIONS THEY MIGHT HAVE. FORM 990, PART VI, SECTION B, LINE 12C: ALL BEDFORD MEMORIAL HOSPITAL OFFICERS, DIRECTORS, AND KEY EMPLOYEES, MUST COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ON AN ANNUAL BASIS, CERTIFYING THAT NEITHER THEY NOR ANY OF THEIR IMMEDIATE FAMILY MEMBERS HAVE ENGAGED IN ANY ACTIVITIES THAT COULD LEAD TO A POTENTIAL CONFLICT OF INTEREST. ADDITIONALLY, ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES MUST AGREE TO PROMPTLY REPORT ANY POTENTIAL CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR TO THE PRESIDENT OR CHAIRMAN OF BEDFORD MEMORIAL HOSPITAL'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15: PRIOR TO JULY 1, 2014, EXECUTIVE COMPENSATION WAS REVIEWD ANNUALLY BY THE CARILION CLINIC COMPENSATION COMMITTEE. THIS COMMITTEE WAS MADE UP OF BOARD MEMBERS OF CARILION CLINIC WHO DID NOT HAVE A CONFLICT OF INTEREST WITH ANY OF THE EXECUTIVES BEING REVIEWED. WITH RESPECT TO CARILION CLINIC, THE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION OF THE BOARD OF GOVERNORS WHICH INCLUDED THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENTS, CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER, AND CHAIRS OF THE CLINICAL DEPARTMENTS. FOR THE FIRST NINE MONTHS OF 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. THIS REVIEW INCLUDED A COMPREHENSIVE REPORT FROM AN OUTSIDE COMPENSATION CONSULTANT SPECIALIZING IN HEALTHCARE ORGANIZATIONS. THE REPORT INCLUDED A DETAILED COMPARISON OF TOTAL COMPENSATION AND EACH ELEMENT THEREOF, INCLUDING BASE SALARY, BONUSES AND OTHER CASH COMPENSATION, AND BENEFITS, INCLUDING DEFERRED AND RETIREMENT BENEFITS. COMPENSATION WAS COMPARED TO A PEER GROUP OF ORGANIZATIONS SIMILAR IN SIZE AND STRUCTURE TO THE ORGANIZATION, WHICH LIST WAS REVIEWED BY THE COMPENSATION COMMITTEE. DETAILED MINUTES OF THE MEETING OF THE COMPENSATION COMMITTEE ARE KEPT AND APPROVED AT THE NEXT MEETING OF THE COMMITTEE, SETTING FORTH THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION OF THESE EXECUTIVES. IN ADDITION, THE COMPENSATION COMMITTEE ANNUALLY REVIEWED THE COMPENSATION PLAN AND PHILOSOPHY FOR ALL VICE PRESIDENTS AND SENIOR VICE PRESIDENTS, AS WELL AS ALL EMPLOYED PHYSICIANS AND PHYSICIANS IN LEADERSHIP ROLES. AS OF JULY 1, 2014, THE ORGANIZATION'S SOLE MEMBER AND RELATED PARTY, CENTRA HEALTH, INC, ESTABLISHED A MANAGEMENT AGREEMENT WITH BEDFORD, WHEREAS IT WAS DETERMINED THAT THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER'S COMPENSATION WILL BE ESTABLISHED IN ACCORDANCE WITH CENTRA HEALTH'S EXECUTIVE COMPENSATION PRACTICES WHICH INCLUDE THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT(S) AND COMPENSATION STUDY OR SURVEY. THEREFORE, FORM 990, PART VI, LINES 15A & 15B WERE ANSWERED AS "NO". FORM 990, PART VI, SECTION C, LINE 18: AS OF JULY 1, 2014, PHOTOCOPIES OF THE ORGANIZATION'S FORM 1023 AND RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. ADDITIONALLY, FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG . FORM 990, PART VI, SECTION C, LINE 19: PRIOR TO JULY 1, 2014, THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENT AND FINANCIAL STATEMENTS WERE NOT GENERALLY AVAILABLE TO THE PUBLIC, BUT WERE RELEASED FROM TIME TO TIME UPON REQUEST. THE ARTICLES OF INCORPORATION ARE AVAILABLE FROM THE VIRGINIA STATE CORPORATION COMMISSION. AS OF JULY 1, 2014, PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENT AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FORM 990, PART XI, LINE 9, OTHER CHANGES IN NET ASSETS: CHANGE IN NET ASSETS IS DUE TO: RE-EVALUATION OF ASSETS BY THIRD PARTY 7,581,262 GOODWILL 3,137,519 ---------- 10,718,781 FORM 990, PART XII, LINE 2C: THE AUDIT PROCESS OF THE ORGANIZATION INCLUDING THE OVERSIGHT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT AUDITOR IS OVERSEEN BY THE AUDIT & COMPLIANCE COMMITTEE OF CENTRA HEALTH, INC., SOLE MEMBER AND RELATED ORGANIZATION. FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1520978 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT FEES TOTAL FEES:1340462 FORM 990 PART IX LINE 11G DESCRIPTION:REFERENCE LABS TOTAL FEES:813421 FORM 990 PART IX LINE 11G DESCRIPTION:MISCELLANEOUS TOTAL FEES:481048 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE CONTRACTS TOTAL FEES:296462 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:224508 FORM 990 PART IX LINE 11G DESCRIPTION:LAUNDRY SERVICES TOTAL FEES:189649 CENTRA MEDICAL GROUP BEDFORD LLC 1613 OAKWOOD STREET BEDFORD VA 24523 465341463 PHYS SVCS VA 601654 859460 BMH Carilion Clinic Foundation PO Box 12385 Roanoke VA 24025 541190773 Support org VA 501(c)(3) 11a NA false Carilion Services Inc PO Box 12385 Roanoke VA 24025 541190879 Support org VA 501(c)(3) 11a NA false CENTRA HEALTH INC 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 540715569 HEALTHCARE VA 501(c)(3) 3 NA false CENTRA HEALTH FOUNDATION 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 541604094 SUPPORT ORG VA 501(c)(3) 11a NA false CCRC INC 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 541929580 CONTINUE CARE VA 501(c)(3) 11a NA false SOUTHSIDE COMMUNITY HOSPITAL 800 OAK STREET FARMVILLE VA 23901 540555201 HEALTHCARE VA 501(c)(3) 3 NA false General Business Concerns Inc 1920 Atherholt Rd Lynchburg VA 24501 541299682 R/E Physicians SV VA N/A C false false false false false false false false false false false false false true false false true false false false