2013-08-15T13:44:57-00:00 2012-09-30 Deloitte Tax LLP 424 Church Street Nashville TN 37219 990 2011-10-01 540566100 Bedford Memorial Hospital BEDF 5402245112 PO Box 12385 Roanoke VA 24025 Donald Halliwill 2013-08-15 true Francis J Bedard 6152591811 2013-08-15 2011 2016-02-24 21:20:13Z Patti Jurkus PO Box 12385 Roanoke VA 24025 52587417 false X www.carilionclinic.org X 1957 VA The mission of Bedford Memorial Hospital, a joint venture between exempt organizations Centra and Carilion Clinic a related party, is to improve the health of the community it serves. The hospital provides inpatient and outpatient surgery, and emergency, geriatric and rehabilitative services. 18 5 447 149 0 31110 79142 32864029 35148099 758630 -37022 2019490 1982188 35673259 37172407 13492 16796 0 15379287 16987780 0 0 18276620 18589009 33669399 35593585 2003860 1578822 28016228 30762340 18859174 21594199 9157054 9168141 X See Schedule O false false 23534451 16796 31524792 See Schedule O - Hospital 9609752 5081600 Schedule O - Nursing Facility 33144203 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 true false true true false false false false false false false false false true false false false false false true false false false false true 0 0 true 447 true false true BD CA CJ EI false false false false false false false false X 18 5 true true false false false true true true true false false true true true true true true true true false VA X X The Corporation 5402245112 213 S Jefferson Street Roanoke VA 240111713 X David Adams 002.00 X 0 0 0 Lewis Addison 002.00 X 0 0 0 Linda Beahm MD 002.00 X X 0 181378 51158 Brian Buchanan MD 002.00 X 0 0 0 Paul Davenport 002.00 X 0 149360 23280 George Dawson 002.00 X 0 0 0 Patsy Dooley 002.00 X 0 0 0 Carolyn Jacques 002.00 X 0 0 0 Thomas Jividen 002.00 X 0 0 0 Michael LeMaster 002.00 X 0 0 0 Donna Littlepage 002.00 X 0 247686 101275 G C Luck Jr 002.00 X 0 0 0 John Mack 002.00 X 0 0 0 Curtis Mills 002.00 X 0 318605 240729 G E Murray Jr 002.00 X 0 0 0 Melina Perdue 002.00 X 0 386382 266044 Consuela Woods 002.00 X 0 0 0 John Bond 002.00 X 0 0 0 Patti Jurkus 050.00 X X 175329 0 102879 Donald Lorton 002.00 X 0 680251 528400 Rachel Mabe 002.00 X 0 67991 25993 Phillip Gruber 050.00 X 133930 0 48447 Georgiann Watts 050.00 X 113982 0 78324 Dana Thompson 050.00 X 104472 0 16714 Donald Creech 000.00 X 0 301344 51706 William Flattery 000.00 X 0 235572 36621 Eugene Lowe MD 000.00 X 0 199929 42764 Edward Murphy MD 000.00 X 0 6120567 118551 527713 8889065 1732885 14 true true false Solstas Lab Partners Group LLC PO Box 751337 Charlotte NC 282751337 Laboratory Services 1297365 Heritage Healthcare 536 Old Howell Road Greenville SC 29615 Healthcare Professionals 679869 Centra Health Inc 1901 Tate Springs Road Lynchburg VA 24501 Consulting 181630 Foodservice Partners of VA LLC 2823 Franklin Road Bldg B Roanoke VA 24014 Food service contractor 149044 GE Medical Systems PO Box 640944 Pittsburgh PA 152640944 Equipment maintenance 127652 6 10136 5000 12706 51300 79142 Net Patient Service Revenues 900099 35148099 35148099 35148099 485650 485650 1 1 480519 480519 480519 480519 14892337 15333951 81059 -441614 -81059 -522673 -522673 EHR Payment 900099 1381530 1381530 Cafeteria 900099 43376 43376 Court Cost Revenue 900099 15593 15593 61170 61170 1501669 37172407 36606392 486873 16796 16796 0 0 0 177511 177511 0 12690143 12238655 451488 1054138 1054138 2162051 2025100 136951 903937 903937 988944 988944 58286 58286 30950 30950 3025 3025 20627 20627 4652427 4284631 367796 63164 57465 5699 1597010 1555758 41252 139736 124327 15409 0 983866 911911 71955 73524 51780 21744 0 0 430003 430003 0 1087240 1087240 382717 222215 160502 Bad Debt 3104375 3104375 Medical Supplies 2445145 2443171 1974 Practice Subsidy 2399798 2399798 Dues Subscriptions 43828 10532 33296 84344 41835 42509 35593585 33144203 2449382 0 1620 1745 13135 10660 5902997 5173058 7049 128799 333152 38643067 29319775 9715911 9323292 6814035 15169148 5294263 576057 145468 168179 28016228 30762340 3465551 3841694 66320 11581 8274536 7850197 7052767 9890727 18859174 21594199 X 9152967 9160937 4087 7204 9157054 9168141 28016228 30762340 X 1578822 -1567735 X false true true X false X 0.00000 0.00000 0.00000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3025 3025 false II-B 1i Portion of dues paid to American Hospital Assn. and Virginia Hospital and Healthcare Assn. spent on lobbying. false 476378 476378 19234956 12029970 7204986 24189 24189 18219447 16995959 1223488 688097 269657 418440 9323292 Qualified Pension Liability 9032764 2005 Fixed Payor Swap 805778 2010 Barclays Swap -18878 2010 PNC Swap -35845 Swap Contra 106908 9890727 37172407 35593585 1578822 1063323 -2631058 -1567735 11087 35107612 1063323 -3102492 -2039169 37146781 20627 4999 25626 37172407 32438782 -29802 -29802 32468584 20627 3104374 3125001 35593585 X 2 The Hospital has determined that it does not have any material unrecognized tax benefits or obligations as of September 30, 2012. XI 8 Pension related changes other than net periodic pension cost 2,631,058. XII 2d Bad Debts of 3,104,375 and release from restricted funds 1,883, net of 3,102,492. XII 4b Restricted fund contributions of 4.999. XIII 2d Adjustment for pension 29,802, XIII 4b Bad Debts of 3,104,375 less rounding of 1, net of 3,104,374. true true true X true X true true true false true true 1876738 1876738 0.05780 5816731 4174098 1642633 0.05060 7693469 4174098 3519371 0.10840 231 6875 63658 1171 62487 0.00190 12 88 15911 15911 0.00050 10 420 14380 14380 0.00040 253 7383 93949 1171 92778 0.00280 253 7383 7787418 4175269 3612149 0.11120 27 264 3660 3660 0.00010 10 105 3674 3674 0.00010 1 10 53 53 17 240 5309 5309 0.00010 6 191 10138 10138 0.00030 61 810 22834 22834 0.00060 false 906382 191940 9660868 9312630 348238 X true true 1 1 Bedford Memorial Hospital

1613 Oakwood Street Bedford VA 24523

X X X Oakwood Manor 1 Bedford Adult Day Center 2 Blue Ridge Cardiovascular 3 Huddleston Cardiovascular 4 4 Oakwood Manor

1613 Oakwood Street Bedford VA 24523

0 Bedford Adult Day Center

1617 Oakwood Street Bedford VA 24523

Nursing Home Blue Ridge Cardiovascular

37 Laymantown Road Troutville VA 24175

Adult Day Care Huddleston Cardiovascular

10102 Leesville Road Lynch Station VA 24571

Cardiovascular testing Part I line 6a Information on community benefit is reported annually through a consolidated report prepared by Carilion Clinic, co-owner of Bedford Memorial Hospital. 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 Clinics website. Part I line 7 7e -- This line is calculated at actual cost. As part of its mission to educate the public about health risks and steps that can be taken to improve health, in fiscal year 2012 Bedford Memorial Hospital touched 6,684 people during 220 events offered throughout the community. Part I line 7 7e CONTINUED Events included health fairs, screenings, and presentations offered at various community locations. Monthly blood pressure and blood glucose screenings are offered at three post offices in the community. These screenings provide an opportunity to educate individuals about improving health and quality of life as well as determining ones risk of developing a chronic illness. Part I line 7 7e CONTINUED Additional health improvement services include blood drives, assistance with enrollment in public medical programs such as Medicaid and interpreter services for non-English speaking patients. Part I line 7 7f -- This line is calculated at actual cost. Bedford Memorial Hospital provides internships for nursing students of Lynchburg College. Part I line 7 7g -- N/A Part I line 7 7h -- N/A Part I line 7 7i -- This line is calculated at actual cost. Cash contributions were made to Central Virginia Alzheimers Association, the American Cancer Society, Bedford Community Health Foundation and Bedford Life Saving Crews. In-kind contributions were made to Bedford Hospice House, Central Virginia Alzheimers Association, Juvenile Diabetes Research Foundation and the United Way. Part I line 7 7i CONTINUED Additionally, Bedford Memorials Emergency Department replenishes medical supplies on ambulances owned by Emergency Medical Services organizations. Part I line 7 Ratio of cost-to-charges was used to calculate the expense. Part I line 7 columnf calculation -- Bad debt expense subtracted from total expenses for the calculation is 3,104,375. Part II Line 1 - N/A Part II Line 2 -- Bedford Memorial Hospital provided representation on 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. Part II Line 3 -- Bedford Memorial Hospital provides guidance and clinical expertise through community Board membership of the following organizations Bedford Christian Free Clinic, a local non-profit organization providing medical, pharmaceutical, and health education services to the residents of Bedford city and county to promote improved health for those who otherwise could not afford care. Part II Line 3 CONTINUED Another organization is the Bedford Area YMCA, which is committed to nurturing the potential of kids, promoting healthy living, and fostering a sense of social responsibility. Part II Line 4 -- N/A Part II Line 5 -- N/A Part II Line 6 -- Bedford Memorial Hospital, as a community asset, allows community groups to use rooms for organizational meetings. Part II Line 7 -- 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. Part II Line 7 CONTINUED The Hospital also provided in-kind support to the Board of Directors for Bedford Hospice House, a unique assisted living facility specializing in end-of-life care where the terminally ill can die peacefully with support and dignity and the Planning Board for Lynchburg Colleges Aging Conference for caregivers, family members, professionals, and persons who are 50 year of age and older. Part II Line 8 -- 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 jobs skills, build work experience and confidence, and continue to have economic security and well-being. Additionally, resources were provided to toward the Bedford Area Chamber of Commerces workforce development initiative. Part III line 4 An allowance for uncollectible accounts is recorded based on historical bad debt experience and managements evaluation of the accounts receivable. Balances are written off after all reasonable collection efforts have been made. Accounts receivable are reduced by an allowance for amounts that could become uncollectible in the future. Part III line 4 CONTINUED The Hospital estimates 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 is based on the Hospitals collection history. The Hospital collects substantially all of its third-party insured receivables, which include receivables from governmental agencies. Part III line 4 CONTINUED The bad debt expense reported on Line 2 was calculated using the cost-to-charges ratio applied to the provision for bad debt reported in the financial statements. Part III line 4 CONTINUED The estimated amount of bad debt expense, reported on line 3, attributable to patients eligible for charity care was determined using external credit reporting data to identify the patients that were eligible and applying the cost-to-charges ratio to the charges of the patients so identified. Sufficient information was not available to make a definite determination of their eligibility. Part III line 4 CONTINUED Patient account balances are reduced by discounts allowed and payments. Part III line 8 Medicare allowable costs are determined from the Medicare cost report using the cost-to-charges ratio. The Hospital does not consider a Medicare shortfall as a community benefit. Part III line 9b Carilion Clinic is committed to providing quality health care to all regardless of their ability to pay. Our Charity Care Policy is designed to allow relief of all or part of the charges that exceed a patients reasonable ability to pay. Carilion uses the Federal Poverty Guidelines FPG published and updated yearly in the Federal Register along with a Financial Needs Assessment Questionnaire FNAQ as developed by Carilion to determine eligibility. Part III line 9b CONTINUED Together, the family income, number of family members living on that income, and equity in real property are pertinent factors in determining how much, in the sole judgment of Carilion, a patient is reasonably able to pay for services. Patients with family income up to 400 percent of FPG with no more than 100,000 equity in real property are eligible for a Charity Care discount. Part III line 9b CONTINUED To apply for the Charity Care program complete a Financial Needs Assessment Questionnaire or contact our Billing Customer Service team with questions. All patients who are able will be expected to pay for their own healthcare services to avoid shifting the burden for their care to other patients and the general public. Part III line 9b CONTINUED The Charity Care Policy should have no impact on the collection policies and practices with regard to those balances that do not qualify for charity care. Failure to honor payment for amounts exceeding the charity adjustment may result in the total charity care being revoked. Part V Line 19d The maximum amount that can be charged to FAP-eligible individuals for necessary care is as follows Individuals at or below 100 of the Federal Poverty Guidelines FPG are eligible for a discount of their entire account balance. Individuals at 101 to 200 of FPG are eligible for a discount of the greater of 75 of the account balance or the discount necessary to lower their remaining balance to 10 of family income. Part V Line 19d CONTINUED Individuals at 201 to 250 of the FPG are eligible for a discount of the greater of 70 of the account balance or the discount necessary to lower their remaining balance to 15 of family income. Individuals at 251 to 300 of the FPG are eligible for a discount of the greater of 55 of the account balance or the discount necessary to lower their remaining balance to 20 of family income. Part V Line 19d CONTINUED Individuals at 301 to 350 of the FPG are eligible for a discount of the greater of 40 of the account balance or the discount necessary to lower their remaining balance to 25 of family income. Individuals at 351 to 400 of the FPG are eligible for a discount of the greater of 25 of the account balance or the discount necessary to lower their remaining balance to 30 of family income. Part V -- FOR Part VI - Lines 2, 3, 4, 5, 6 and 7 See Schedule O for the supplemental information. true BEDFORD VOLUNTEER FIRE COMPANY INC 315 BEDFORD AVE BEDFORD VA 24523 546060221 501c4 5500 General support 1 I 2 The Hospital donates funds to other tax-exempt organizations with a similar mission. Such organizations also have community boards which oversee the expenditure of such funds. X true true true true false false false false false true false Linda Beahm MD 148965 31643 770 31095 20063 232536 Paul Davenport 134574 7169 7617 22412 868 172640 Donna Littlepage 213915 33000 771 95859 5416 348961 Curtis Mills 219663 85929 13013 232371 8358 559334 51477 Melina Perdue 293247 49641 43494 251092 14952 652426 Patti Jurkus 150708 23675 946 94476 8403 278208 Donald Lorton 486200 129425 64626 509034 19366 1208651 63526 Phillip Gruber 103467 23245 7218 38635 9812 182377 Georgiann Watts 111353 2000 629 74308 4016 192306 Donald Creech 250232 38949 12163 46241 5465 353050 William Flattery 194341 30716 10515 22990 13631 272193 Eugene Lowe MD 145219 53966 744 21509 21255 242693 Edward Murphy MD 445000 348245 5327322 99185 19366 6239118 2503674 I 7 -- The organization pays annual bonus compensation to management based on scorecard performance. While the scorecard contains a formula as a basis for determining overall performance, senior managers have discretion to include additional elements in their assessment of managers reporting to them. In addition, for top management, the actual bonus awarded is in the discretion of the Carilion Clinic Compensation Committee, although it is based on the scorecard measures. I 4b - Donald Lorton 250,129, Curtis Mills 21,060, Melina Perdue 121,120. I 4a Edward Murphy 2,561,000 II 13 Edward Murphy, M.D. was employed by Carilion Clinic and related entities for 13 years, serving as President and CEO during the last 10 of those years. He left Carilion employment on June 30, 2011. Dr. Murphys 2011 base compensation for his employment during the six months of calendar 2011 is reported in column Bi. II 13 CONTINUED Bonus compensation in column B ii includes a scorecard bonus prorated for nine months of fiscal year 2011 which began on October 1, 2010 and prior period bonus accruals. In addition, Dr. Murphy was paid, or vested in, 5.3 million in other reportable compensation, reported in column B iii. II 13 CONTINUED Of that amount, 2.7 million represented retirement benefits through a pension restoration plan. Pursuant to that plan, Carilion accrued a benefit for Dr. Murphy throughout the 13 years of his employment, which benefit vested and became taxable on July 1, 2011. II 13 CONTINUED The pension restoration plan restored Dr. Murphys retirement benefit to the amount he would have received under Carilions pension plan but for restrictions imposed by the Internal Revenue Code on the amount any participant can receive from a tax qualified pension plan. II 13 CONTINUED The remaining amount in Column B iii includes ending compensation of 2.6 million received by Dr. Murphy in lieu of certain earned or expected benefits, plus some small non-taxable reimbursements and benefit plan contributions. Column C recognizes the accrual for the year of benefits under the qualified pension plan for Dr. Murphy. II 13 CONTINUED Finally, column F recognizes that, of the reportable compensation shown in column Biii, 2.5 million had previously been reported as deferred compensation on prior year Form 990s. All elements of Dr. Murphys compensation were approved by the Carilion Clinic Compensation Committee and/or Board of Directors in accordance with the process described in Schedule O in response to Form 990, Part VI, Section B, Line 15a. Industrial Development Authority of the City of Roanoke VA 541106038 770084ES6 2005-12-14 5790000 Capital Projects , Refunding Series 2002 B-E bonds Cost of Issuance, Bond Insurance false false false Industrial Development Authority of the City of Roanoke VA 541106038 770082mul 2012-02-09 3451000 Redemption of Series 2002A bonds Costs of issuance false false false 1812000 5790000 35696 83437 5670867 true false true true 239000 3451000 43496 3866835 false true true true true true true UBS & Citigroup 0000000027.000000000000 false false true AIG 0000000000.300000000000 true false true true false false false false false X Donald Lorton Assistant Treasurer 1660954 Lab services false IV 1 Donald Lorton 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 III 4a Bedford Memorial Hospital exists to serve the health care needs of its community, regardless of patient ability to pay. Bedfords acute hospital admitted 1,472 patients and provided 4,500 days of care during the year. Hospital programs include provision of nursing care extensive outpatient and inpatient 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 36,582 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 physical, speech, and occupational therapy programs an adult day care center and cardiac and respiratory rehab. Form 990 Part III 4a CONTINUED Bedford also provides an emergency department with 24-hour care, emergency transportation, and a chest pain and stroke program. With 15,511 visits, Bedfords 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, who comprise 22 percent of ED visits. Bedford supports community screenings and education on chronic disease prevention and management, sponsoring 220 events touching over 6,600 people. In furtherance of its mission, Bedford provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year exceeded 3.7 million. Form 990 2 -- Bedford Memorial Hospital uses demographic information and data on patients treated to determine community health needs. Additionally, information from public databases compiled on the Virginia Atlas of Community Health website is reviewed for the entire geographic area served by Bedford Memorial Hospital. A comprehensive community health needs assessment is scheduled for completion by September 30, 2013 along with a strategic implementation plan to address identified needs. Form 990 4 -- Bedford Memorial Hospital primarily serves approximately 75,000 residents of Bedford City and County. Bedford encompasses 776 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 terrain is rolling and hilly with elevations ranging from 800 to 4,200 feet above sea level. Form 990 4 CONTINUED Bedford Memorial Hospital is a 50-bed hospital that also has 110 long term care and skilled beds in its Oakwood Health and Rehabilitation Center. 10.4 of the residents in the community served by Bedford Memorial Hospital are living in poverty and approximately 8 of children and 16 of adults under age 64 are uninsured. Approximately17 of the population is 65 years of age or older and 15 of those 25 years of age or older did not graduate from high school. Form 990 5 -- Bedford Memorial Hospital serves all patients regardless of their ability to pay. The Hospitals 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. In addition to clinical care, the hospital works to achieve its mission through the education of health professionals and the community. Any 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. Form 990 6 -- Bedford Memorial Hospital is jointly owned by Carilion Clinic and Centra Health. Management is provided by Carilion Clinic, a not-for-profit healthcare organization serving approximately one million people in Western Virginia through a physician specialty group, advanced primary care practices, hospitals and outpatient centers. Carilion Clinic is based in Roanoke, Virginia and serves the residents of 18 counties and six cities in Western Virginia and southern West Virginia. Form 990 6 CONTINUED Over the past six years, Carilion Clinic has gone through a dramatic and transformative change as we transitioned from a hospital system to an integrated clinic with physician leadership. At the heart of our transformation is a passion and shared purpose to meaningfully change the way healthcare is delivered and experienced, resulting in higher value and better clinical outcomes. Form 990 6 CONTINUED This has propelled a commitment to each other as providers and caregivers and working together in new and different ways. To fulfill our vision, we developed a new organizational structure for shared decision making and collaboration, implemented an enterprise-wide electronic health record, became NCQA medical homes in 27 of our primary care sites, established an accountable care organization, developed population health management infrastructure and developed the Virginia Tech Carilion School of Medicine and Research Institute. Carilion Clinic employees 592 physicians representing more than 60 specialties who provide care at 195 practice sites. During 2012, 126 students were enrolled in Virginia Tech Carilion School of Medicine and there were 549 appointed faculty members. Form 990 6 CONTINUED To advance education of health professionals, Jefferson College of Health Sciences, within Carilion Medical Center, is a professional health sciences college offering Masters of Science in Nursing, Physician Assistant and Occupational Therapy and 12 baccalaureate and associate healthcare programs. Approximately 900 undergraduate students and 190 graduate students are enrolled annually with 99 of undergraduates receiving some type of financial aid. Carilion Clinic and Virginia Tech Carilion School of Medicine provide graduate medical education to 215 residents and fellows. Residency program include Emergency Medicine, Family Medicine, Internal Medicine, Neurosurgery, Obstetrics/Gynecology, Psychiatry, Surgery, Pediatrics, Podiatry and General Hospital Dentistry inaugural class July 2013. Form 990 6 CONTINUED Additionally, the University of Virginia sponsors a residency program in Orthopaedics. Fellowship programs include Addiction Psychology, Adult Joint Reconstruction, Advanced Endoscopy, Cardiovascular Disease, Child and Adolescent Psychiatry, Gastroenterology inaugural class July 2013, Geriatric Medicine, Geriatric Psychiatry, Hospice and Palliative Care, Infectious Disease, Interventional Cardiology inaugural class July 2013, Medical Informatics, Orthopaedic-Hand and Pulmonary Critical Care. Form 990 6 CONTINUED Advanced Clinical Services in Cardiovascular and Vascular include a hybrid operating room, transcatheter aortic valve implantation TAVI, ventricular assist device VAD program using the Heartmate II, Medtronic CRYO balloon for atrial fibrillation epicardial ventricular tachycardia ablation, Heart Alert, therapeutic hypothermia, and Thoracic Oncology services with Pulmonary Medicine. In Neurosciences advanced services include Stroke Alert, an adult and pediatric Neurosurgery program, Neuro-interventional procedures, Brain Lab Navigation, Epilepsy Monitoring Inpatient Unit and Movement Disorders. Form 990 6 CONTINUED In Musculoskeletal, a joint replacement program, anterior approach hip replacements, computer-assisted knee replacements and advanced procedures for ankle replacements. Spine Center and Imaging Services include 64 slice CT and PET/CT, 3T MAGNETOM Verio MRI, MR Profusion and Enterography, advanced interventional procedures, and nationally-recognized Breast Care Center with large-format Pathology and digital mammography. Surgery services include plastic and reconstructive surgery, robotic-assisted surgery for cardiac, urology, and gynecology, and advanced laparoscopic techniques in general surgery. Form 990 6 CONTINUED In Pulmonary medicine, advanced interventional procedures are performed as well as thoracic oncology services. Carilion Clinic Cancer Center offers CyberKnife Stereotactic Radiosurgery for inoperable tumors, High Dose Radiation HDR Brachytherapy, Linear Accelerators with IMRT, Selective Internal Radiation SIR Spheres for treatment of liver cancer, Prostate Brachytherapy Radioactive Seed Implants and Mohs surgery. Advanced gynecologic oncology includes single site/port hysterectomy, minimally invasive surgery for gynecology, including the da Vinci Robotic Surgical System and in-office chemotherapy and industry-sponsored research trials as well as participation in National Cancer Institute sponsored research. Form 990 6 CONTINUED Advanced urogynecologic services include Interstim therapy for bladder incontinence and fecography for fecal incontinence. Carilion Clinic Childrens Hospital provides Sub-specialty physicians and clinics in surgery, cardiology, pulmonology, gastroenterology, dentistry, allergy immunology, rheumatology, orthopaedics, hematology oncology, neurosurgery, and developmental pediatrics. Additionally, neonatal and pediatric intensive care units are located within Carilion Roanoke Memorial Hospital. An inpatient childrens facility, pediatric emergency department and specialized transport team are included in this program. Carilion Roanoke Memorial Hospital includes a Level One Trauma Center with EMS services that include three EMS helicopters, four first-response vehicles and 50 Advanced Life Support Ambulances. Form 990 6 CONTINUED An additional benefit to the community is Carilion Clinics economic contribution to the region. As the areas largest employer, jobs are provided for more than 11,300 residents of the region. At the Virginia Tech Carilion VTC Research Institute, scientists are carrying out leading-edge research programs on autism, depression, post-traumatic stress disorder, traumatic brain injury, cerebral palsy, cardiovascular disease, Parkinsons disease, addiction, cancer, mental retardation, epilepsy, and infectious diseases, with state-of-the-art technologies and innovative interdisciplinary science. The research is characterized by computational and quantitative approaches, and modeling in conjunction with experimentation is a critical cornerstone. Form 990 6 CONTINUED The range of research going on today in the Institute includes facilities for a worldwide hub for interactive functional brain imaging, linking Roanoke to the United Kingdom, China, South Korea, Germany, and Norway as well as to other institutions throughout the United States, including Princeton, Caltech, and Emory University. This network, which includes the Institutes three research-dedicated magnetic resonance imaging scanners, is allowing Institute investigators to launch the worlds largest longitudinal study of brain function and decision-making. The Roanoke Brain Study will use functional imaging, genetic analysis, and behavior to uncover key aspects of human brain development in health and in a range of disorders. Form 990 2 -- 1.David Adams, Lewis C. Addison, George Dawson, Carolyn Jacques, David Jividen and Consuella Woods - business relationship. 2. John Bond, Paul Davenport, Donna Littlepage, Curtis Mills, Melina Perdue - business relationship. Form 990 Part VI 6 -- The organization has two members, Centra Health, a charitable tax-exempt healthcare organization, and Carilion Clinic a charitable tax-exempt healthcare organization. Each member elects one-third of the directors of the organization and the members have certain other reserved powers. Form 990 Part VI 7a -- Each member of the organization elects one class of directors representing one-third of the members of the governing body of the organization periodically as terms expire. The members also have 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. Form 990 Part VI 7b -- The members of the organization hold reserved powers with respect to certain enumerated actions, including appointment of CEO, approval of borrowings, budgets, certain types of contracts and strategic plans and amendments of Articles of Incorporation and Bylaws. Approval by the members is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia certain extraordinary actions require member approval, such as mergers, consolidations, liquidations and the sale of substantially all of the assets of the organization. Form 990 Part VI 3 -- Certain management and related services for the organization are provided by the management and employees of Carilion Services, Inc., a related organization and supporting organization of the organization. Form 990 Part VI 11a and 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 12c -- A Conflict of Interest Questionnaire, along with a copy of the Policy, is sent out annually to all officers, directors and key employees. In addition, such individuals are instructed to inform the organization of potential conflicts which arise during the year. Answers to the Questionnaires are reviewed by the Internal Audit Department. Potential conflicts for officers and key employees are reviewed by an internal Conflict of Interest Committee, which follows up on any potential issues to ensure compliance with all policies of the organization. The answers for Directors are reviewed by the Carilion Clinic Audit and Compliance Committee. Form 990 Part VI 12c CONTINUED In addition, the governing body of the organization is provided with a list of the answers annually to make all Board members aware of potential conflicts in order to ensure compliance with policies on how to handle transactions with Board members that may involve potential conflict situations. Form 990 Part VI 15a and 15b -- Executive compensation is reviewed annually by the Carilion Clinic 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 President and Chief Executive Officer, Executive Vice Presidents, which include the Chief Financial Officer and the Chief Medical Officer. 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. This review was performed in October 2011. A similar review was last performed in October 2012. Form 990 Part VI 15a and 15b CONTINUED 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 meetings 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. Form 990 Part VI 15a and 15b CONTINUED In addition, the Compensation Committee annually reviews the compensation plan and philosophy for all vice presidents and senior vice presidents, as well as all employed physicians and physicians in leadership roles. Form 990 Part VI 19 -- The organizations governing documents, conflict of interest statement and financial statements are not generally available to the public, but are released from time to time upon request. The Articles of Incorporation are available from the Virginia State Corporation Commission. The consolidated audited financial statements of Carilion Clinic and of the Obligated Group are released annually to the local newspaper. Limited financial information is available on our web site. Form 990 Part VII Column B --- Directors and officers listed with less than 50 average hours per week who receive compensation from related organizations reported in column E also serve as directors and/or officers on other related organizations in the Carilion system. The difference between the hours shown in Column B and 50 hours would equal the hours worked by these individuals for related organizations. Form 990 Part XI 5 -- Other adjustments - unrealized gains on investments 1,063,323 transfer to Carilion Clinic for effect of pension-related changes 2,631,058 for net of 1,567,735. Form 990 Part III Line 4a Bedford Memorial Hospital exists to serve the health care needs of its community, regardless of patient ability to pay. Bedfords acute hospital admitted 1,472 patients and provided 4,500 days of care during the year. Hospital programs include provision of nursing care extensive outpatient and inpatient 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 36,582 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 physical, speech, and occupational therapy programs an adult day care center and cardiac and respiratory rehab. Form 990 Part III Line 4a CONTINUED Bedford also provides an emergency department with 24-hour care, emergency transportation, and a chest pain and stroke program. With 15,511 visits, Bedfords 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, who comprise 22 percent of ED visits. Bedford supports community screenings and education on chronic disease prevention and management, sponsoring 220 events touching over 6,600 people. In furtherance of its mission, Bedford provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year exceeded 3.7 million. Form 990 Section Schedule H, Part VI Line 2 -- Bedford Memorial Hospital uses demographic information and data on patients treated to determine community health needs. Additionally, information from public databases compiled on the Virginia Atlas of Community Health website is reviewed for the entire geographic area served by Bedford Memorial Hospital. A comprehensive community health needs assessment is scheduled for completion by September 30, 2013 along with a strategic implementation plan to address identified needs. Form 990 Section Schedule H, Part VI Line 4 -- Bedford Memorial Hospital primarily serves approximately 75,000 residents of Bedford City and County. Bedford encompasses 776 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 terrain is rolling and hilly with elevations ranging from 800 to 4,200 feet above sea level. Form 990 Section Schedule H, Part VI Line 4 CONTINUED Bedford Memorial Hospital is a 50-bed hospital that also has 110 long term care and skilled beds in its Oakwood Health and Rehabilitation Center. 10.4 of the residents in the community served by Bedford Memorial Hospital are living in poverty and approximately 8 of children and 16 of adults under age 64 are uninsured. Approximately17 of the population is 65 years of age or older and 15 of those 25 years of age or older did not graduate from high school. Form 990 Section Schedule H, Part VI Line 5 -- Bedford Memorial Hospital serves all patients regardless of their ability to pay. The Hospitals 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. In addition to clinical care, the hospital works to achieve its mission through the education of health professionals and the community. Any 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. Form 990 Section Schedule H, Part VI Line 6 -- Bedford Memorial Hospital is jointly owned by Carilion Clinic and Centra Health. Management is provided by Carilion Clinic, a not-for-profit healthcare organization serving approximately one million people in Western Virginia through a physician specialty group, advanced primary care practices, hospitals and outpatient centers. Carilion Clinic is based in Roanoke, Virginia and serves the residents of 18 counties and six cities in Western Virginia and southern West Virginia. Form 990 Section Schedule H, Part VI Line 6 CONTINUED Over the past six years, Carilion Clinic has gone through a dramatic and transformative change as we transitioned from a hospital system to an integrated clinic with physician leadership. At the heart of our transformation is a passion and shared purpose to meaningfully change the way healthcare is delivered and experienced, resulting in higher value and better clinical outcomes. Form 990 Section Schedule H, Part VI Line 6 CONTINUED This has propelled a commitment to each other as providers and caregivers and working together in new and different ways. To fulfill our vision, we developed a new organizational structure for shared decision making and collaboration, implemented an enterprise-wide electronic health record, became NCQA medical homes in 27 of our primary care sites, established an accountable care organization, developed population health management infrastructure and developed the Virginia Tech Carilion School of Medicine and Research Institute. Carilion Clinic employees 592 physicians representing more than 60 specialties who provide care at 195 practice sites. During 2012, 126 students were enrolled in Virginia Tech Carilion School of Medicine and there were 549 appointed faculty members. Form 990 Section Schedule H, Part VI Line 6 CONTINUED To advance education of health professionals, Jefferson College of Health Sciences, within Carilion Medical Center, is a professional health sciences college offering Masters of Science in Nursing, Physician Assistant and Occupational Therapy and 12 baccalaureate and associate healthcare programs. Approximately 900 undergraduate students and 190 graduate students are enrolled annually with 99 of undergraduates receiving some type of financial aid. Carilion Clinic and Virginia Tech Carilion School of Medicine provide graduate medical education to 215 residents and fellows. Residency program include Emergency Medicine, Family Medicine, Internal Medicine, Neurosurgery, Obstetrics/Gynecology, Psychiatry, Surgery, Pediatrics, Podiatry and General Hospital Dentistry inaugural class July 2013. Form 990 Section Schedule H, Part VI Line 6 CONTINUED Additionally, the University of Virginia sponsors a residency program in Orthopaedics. Fellowship programs include Addiction Psychology, Adult Joint Reconstruction, Advanced Endoscopy, Cardiovascular Disease, Child and Adolescent Psychiatry, Gastroenterology inaugural class July 2013, Geriatric Medicine, Geriatric Psychiatry, Hospice and Palliative Care, Infectious Disease, Interventional Cardiology inaugural class July 2013, Medical Informatics, Orthopaedic-Hand and Pulmonary Critical Care. Form 990 Section Schedule H, Part VI Line 6 CONTINUED Advanced Clinical Services in Cardiovascular and Vascular include a hybrid operating room, transcatheter aortic valve implantation TAVI, ventricular assist device VAD program using the Heartmate II, Medtronic CRYO balloon for atrial fibrillation epicardial ventricular tachycardia ablation, Heart Alert, therapeutic hypothermia, and Thoracic Oncology services with Pulmonary Medicine. In Neurosciences advanced services include Stroke Alert, an adult and pediatric Neurosurgery program, Neuro-interventional procedures, Brain Lab Navigation, Epilepsy Monitoring Inpatient Unit and Movement Disorders. Form 990 Section Schedule H, Part VI Line 6 CONTINUED In Musculoskeletal, a joint replacement program, anterior approach hip replacements, computer-assisted knee replacements and advanced procedures for ankle replacements. Spine Center and Imaging Services include 64 slice CT and PET/CT, 3T MAGNETOM Verio MRI, MR Profusion and Enterography, advanced interventional procedures, and nationally-recognized Breast Care Center with large-format Pathology and digital mammography. Surgery services include plastic and reconstructive surgery, robotic-assisted surgery for cardiac, urology, and gynecology, and advanced laparoscopic techniques in general surgery. Form 990 Section Schedule H, Part VI Line 6 CONTINUED In Pulmonary medicine, advanced interventional procedures are performed as well as thoracic oncology services. Carilion Clinic Cancer Center offers CyberKnife Stereotactic Radiosurgery for inoperable tumors, High Dose Radiation HDR Brachytherapy, Linear Accelerators with IMRT, Selective Internal Radiation SIR Spheres for treatment of liver cancer, Prostate Brachytherapy Radioactive Seed Implants and Mohs surgery. Advanced gynecologic oncology includes single site/port hysterectomy, minimally invasive surgery for gynecology, including the da Vinci Robotic Surgical System and in-office chemotherapy and industry-sponsored research trials as w Carilion Clinic Foundation PO Box 12385 Roanoke VA 24025 541190773 Supporting organization VA 501c3 11 Type I N/A false Carilion Services Inc PO Box 12385 Roanoke VA 24025 541190879 Supporting organization VA 501c3 11 Type I N/A false false false false false false false false false false false false true false false true false false false