2013-08-15T16:46:28-00:00 2012-09-30 Deloitte Tax LLP 424 Church Street Nashville TN 37219 990 2011-10-01 540480606 Carilion Franklin Memorial Hospital CARI 5402245112 PO Box 12385 Roanoke VA 240252385 Donald Halliwill 2013-08-15 true Francis J Bedard 6152591811 2013-08-15 2011 2016-02-24 21:20:13Z William Jacobsen PO Box 12385 Roanoke VA 24025 40203898 false X www.carilionclinic.org X 1956 VA Carilion Franklin Memorial 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. 10 8 361 112 0 10221 10674 34561621 36855602 -122992 48413 2104025 2132053 36552875 39046742 62142 7619 0 15704403 15696190 0 0 22396576 21375756 38163121 37079565 -1610246 1967177 16246347 17779880 21196503 23878848 -4950156 -6098968 X Carilion Franklin Memorial 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. false false 30915811 7619 38604088 See Schedule O 30915811 true true false true false false false false false false true false false false true true false false 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 X 0 0 true 361 true false true BD CA CJ IC false false false false false false false false X 10 8 false true false false true true true true true false false true true true true true true true true false VA X X The Organization 5402245112 213 S Jefferson Street Suite 827 Roanoke VA 24011 X Chris Aylesworth PhD 002.00 X 0 0 0 Ronald Evans 002.00 X 0 0 0 Victoria Gardner 002.00 X 0 0 0 Larry Heaton 002.00 X 0 0 0 Florella Johnson 002.00 X 0 0 0 Billy Kingery 002.00 X 0 0 0 Susan KIrby MD 002.00 X 0 0 0 Dave Peters 002.00 X 0 0 0 Jeff Powell 002.00 X 0 0 0 Mikesh Shah MD 002.00 X 0 238084 24813 William Jacobsen 050.00 X X 180231 0 38826 Donald Lorton 002.00 X 0 680251 528400 Rachel Mabe 002.00 X 0 67991 25993 Sharon Scott 050.00 X 133144 0 863 Lori McClure 050.00 X 131007 0 35385 444382 986326 654280 5 false true false Solstas Lab Partners Group LLC PO Box 751337 Charlotte NC 282751337 Laboratory services 2148312 Siemens Medical Solutions 51 Valley Stream Parkway Malvern PA 152640944 Equipment and software maintenance 263895 2 9604 1070 10674 Net Patient Service Revenues 900099 36855602 36855602 36855602 172412 172412 3 3 339070 339070 339070 351072 1033154 1063791 93365 -30637 -93365 -124002 -124002 EHR Incentive Payment 900099 1724143 1724143 Cafeteria Income 900099 44497 44497 Court Cost Recovery Income 900099 25860 25860 -1517 -1517 1792983 39046742 38604088 443982 7619 7619 0 0 0 186245 186245 0 12088423 11824034 264389 952811 952811 1585563 1503536 82027 883148 882980 168 4376251 4376251 158 158 0 5407 5407 1975 1975 4410930 4289422 121508 98 98 837081 811989 25092 74346 73325 1021 0 617579 617579 239354 231002 8352 0 0 600395 600395 0 1277004 1277004 316829 203607 113222 Bad Debt 4587955 4587955 Medical Supplies 1977831 1977831 Practice Subsidy 1957581 802921 1154660 Dues Subscriptions 38493 36391 2102 56489 43660 12829 37079565 30915811 6163754 0 1399 1399 1080 17330 5172321 5267444 9720 149167 176909 34719290 25243477 10410697 9475813 48468 2327246 43308 215681 419907 288338 16246347 17779880 2911707 3356697 76649 98343 11339497 11025788 6868650 9398020 21196503 23878848 X -4993192 -6136420 43036 37452 -4950156 -6098968 16246347 17779880 X 1967177 -3115989 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 5407 5407 false II-B 1i Portion of dues paid to American Hospital Assn. and Virginia Hospital and Healthcare Assn. spent on lobbying. false 226092 226092 18201318 10817246 7384072 16939 16939 15388518 13727762 1660756 886423 681530 204893 9475813 Qualifed Pension Liability 8322227 2001 Swap Unrealized Losses 164486 2005 Fixed Payor Swap Unreal 823409 2010 Barclays Swap Unreal Losses -86804 Swap Contra 143702 Other Assets 31000 9398020 X 2 Carilion had no material unrecognized tax benefits and no adjustments to its consolidated financial statements were required as of and for the years ended September 30, 2012 and 2011. Carilion does not expect that unrecognized tax benefits will materially increase within the next 12 months. true true X true X true X true true true false true true 4080759 4080759 0.12560 3731308 3368462 362846 0.01120 7812067 3368462 4443605 0.13680 142 5785 37025 414 36611 0.00110 7 722 56818 56818 0.00170 149 6507 93843 414 93429 0.00280 149 6507 7905910 3368876 4537034 0.13960 21 2900 6928 6928 0.00020 14 6056 7158 7158 0.00020 3 425 278 278 2 1125 1956 500 1456 40 10506 16320 500 15820 0.00040 false 1456868 258422 9624281 9130742 493539 X true true 1 1 Carilion Franklin Memorial Hospital

180 Floyd Avenue Rocky Mount VA 24151

X X X Imaging Services 1 Imaging Services 2 2 Imaging Services

35 Medical Court Hardy VA 24101

0 Imaging Services

230 South Main Street Rocky Mount VA 24151

CT and Diagnostic Radiology Part I line 3c n/a Part I line 6a Information on community benefit is reported annually through a consolidated report prepared by Carilion Clinic. 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 Carilion Franklin Memorial Hospital touched 5,253 people during 131 events offered throughout the community. Events included health fairs, screenings, and presentations offered at various community locations. Part I line 7 7e CONTINUED Monthly blood pressure and blood glucose screenings are offered at various locations 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 7 e CONTINUED Another way that Carilion Franklin Memorial Hospital touches the community is through Med Talk, a weekly radio program, providing listeners with an opportunity to learn more about a variety of health topics through a call in show that provides answers to their specific questions. Coordinated by a local health educator, guests of the show include health professionals as well as representatives of local community service organizations. 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. 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. Financial contributions were made to the American Cancer Society for support of research, patient services, early detection, treatment and education and Piedmont Community Services for behavioral health services including prevention, treatment, education, and support. Part I line 7 7i CONTINUED Carilion Franklin Memorial Hospital provided grant funding to support operations of the Free Clinic of Franklin County, a non-profit organization with mission to provide quality primary medical care for uninsured families of the poor, the working poor and elderly on fixed incomes and Southern Virginia Child Advocacy Center for the Child and Caretaker Interaction Program, Part I line 7 7i CONTINUED a comprehensive approach to identifying strengths within caretaker/child relationships for reports that provide additional insight for Judges, Department of Social Service, or other agencies that consider placements for children. In-kind support was provided to the United Way. Additionally, Carilion Franklin Memorial Hospitals Emergency Department replenishes medications for ambulances owned by local Emergency Medical Service organizations. Part I line 7 -- Ratio of cost-to-charges was used to calculate the expense. Part I line 7 -- Column f -- Bad debt expense subtracted from total expenses for the calculation is 4,587,955. Part II Line 1 - N/A Part II Line 2 - Carilion Franklin Memorial Hospital provided representation on the Smith Mountain Lake Chamber of Commerce Board in support of their goal to strengthen the social and economic environment of the community. Additional support was provided during Chamber events to raise awareness of the services available in the community. Part II Line 3 - Support and education was provided during Smith Mountain Lake Chamber events including designated driver education and support during the annual Smith Mountain Lake Chamber of Commerce wine festival and free tomato plants with nutrition education on the benefits of tomato consumption during the Smith Mountain Lake Chamber Expo. Part II Line 3 CONTINUED Additional support was provided during a fundraiser for the Presbyterian Community Center, a coalition of resources bringing together churches, caring volunteers, professionals, and financial contributions for a ministry designed to help the most needy neighbors through prayer and a wide assortment of mission activities. Part II Line 3 CONTINUED In-kind support included smart hiking education and leaders for Hike Franklin County, an initiative to encourage physical activity within Franklin County and participation in Reality Check, an opportunity for Franklin County High School students to appreciate the importance of education to achieving their dreams, while gaining a better understanding of why their parents work so hard to pay household expenses. Part II Line 4 - N/A Part II Line 5 - N/A Part II Line 6 - Support was provided for a local initiative to decrease substance abuse among Franklin County residents, and United Way fundraising events. Part II Line 7 - Safety advocacy and education about recreational activities on the water were provided during the annual Pigg River Ramble. Part II Line 8 - N/A Part III line 4 Accounts receivable are reduced by an allowance for amounts that could become uncollectible in the future. Carilion 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 Carilions collection history. Part III line 4 CONTINUED Carilion 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 X 1 2 The Hospital donates funds to other 501c3 charitable organizations with a similar mission. Such organizations also have community boards which oversee the expenditure of such funds. X true true false true false false false false false true false Mikesh Shah MD 194885 42842 357 16293 8520 262897 William Jacobsen 153384 25795 1052 27534 11292 219057 Donald Lorton 486200 129425 64626 509034 19366 1208651 63526 Lori McClure 128535 2182 290 34478 907 166392 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 Industrial Development Authority of the City of Roanoke VA 541106038 770082AA3 2010-10-13 1986000 Redemptioof Series 2003A-C bonds Costs of issuance false false false Industrial Development Authority of the City of Roanoke VA 541106038 770084EQ0 2005-12-14 5605000 Capital projects, current refunding of Series 2002 B-E bonds Costs of issuance, bond insurance false false false Industrial Development Authority of the City of Roanoke VA 541106038 770082mul 2012-02-09 3763000 Redemption of Series 2002A bonds Cost of issuance false false false 1986000 26036 2075000 true false true true 775000 5605000 34555 80771 5489673 true false true true 260000 3763000 47428 4217992 false true true true true false false false false true true true true UBS & Citicorp 0000000027.000000000000 false false true AIG 0000000000.300000000000 true false true true false false false false false X Donald Lorton Assistant Treasurer 2247467 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 Carilion Franklin Memorial Hospital exists to serve the health care needs of its community, regardless of patient ability to pay. Franklin hospital admitted 1,597 patients and provided 5,246 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. Franklin 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 and cardiac and respiratory rehab. Form 990 Part III 4a Continued Franklin also provides an emergency department with 24-hour care, emergency transportation, and a chest pain and stroke program. With 23,845 visits, Franklins emergency services are a critical component of the health safety net in its service area, acting as a primary health provider for a significant number of uninsured patients, who comprise 22 percent of ED visits. Franklin also supports community screenings and education on chronic disease prevention and management, sponsoring over 131 events touching over 5,000 people. In furtherance of its mission, Franklin provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year exceeded 4.7million. Form 990 2 - Carilion Franklin 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 Carilion Franklin Memorial Hospital. With the large growth of uninsured seeking primary care through the hospital Emergency Room, Carilion Franklin Memorial Hospital contracted with the Virginia Tech Center for Public Health Practice and Research Institute for Society, Culture and Environment to provide an independent baseline assessment for coordinated care that was completed in January 2011.Additionally, 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 - Carilion Franklin Memorial Hospital, located in Rocky Mount, Virginia, primarily serves the 56,159 residents of Franklin County. The County is 711 square miles and situated in the foothills of the Blue Ridge Mountains of Central Virginia. While much of the County is rural, recreational interests are met with more than 24,000 acres comprised of public lakes. Approximately 16 of adults under age 64 and 9 of children who live in the County are uninsured. Additionally, 14 of residents live below the poverty level and 19 did not graduate from high school. 18 of residents are 65 years of age or older. Carilion Franklin Memorial Hospital has a very busy emergency room, treating more than 23,800 patients each year. Form 990 5 - Carilion Franklin 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 - Carilion Franklin Memorial Hospital is a wholly owned hospital of 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. 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 Part VI 7a -- The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the board that may occur for any reason. Form 990 Part VI 7b -- The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO, approval of borrowings, budgets and strategic plans and amendments of Articles of Incorporation and Bylaws. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia certain extraordinary actions require member approval, such as mergers, consolidations, liquidations and the sale of substantially all of the assets of the organization. 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 V 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 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 6 -- The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers. Form 990 Part 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 54,769 transfer to Carilion Clinic for effect of pension-related changes 2,495,759 transfer to affiliate of 675,000 and rounding of 1 for net of 3,115,989. Form 990 Part III Line 4a Carilion Franklin Memorial Hospital exists to serve the health care needs of its community, regardless of patient ability to pay. Franklin hospital admitted 1,597 patients and provided 5,246 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. Franklin 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 and cardiac and respiratory rehab. Form 990 Part III Line 4a Continued Franklin also provides an emergency department with 24-hour care, emergency transportation, and a chest pain and stroke program. With 23,845 visits, Franklins emergency services are a critical component of the health safety net in its service area, acting as a primary health provider for a significant number of uninsured patients, who comprise 22 percent of ED visits. Franklin also supports community screenings and education on chronic disease prevention and management, sponsoring over 131 events touching over 5,000 people. In furtherance of its mission, Franklin provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year exceeded 4.7million. Form 990 Section Schedule H, Part VI Line 2 - Carilion Franklin 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 Carilion Franklin Memorial Hospital. With the large growth of uninsured seeking primary care through the hospital Emergency Room, Carilion Franklin Memorial Hospital contracted with the Virginia Tech Center for Public Health Practice and Research Institute for Society, Culture and Environment to provide an independent baseline assessment for coordinated care that was completed in January 2011.Additionally, 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 - Carilion Franklin Memorial Hospital, located in Rocky Mount, Virginia, primarily serves the 56,159 residents of Franklin County. The County is 711 square miles and situated in the foothills of the Blue Ridge Mountains of Central Virginia. While much of the County is rural, recreational interests are met with more than 24,000 acres comprised of public lakes. Approximately 16 of adults under age 64 and 9 of children who live in the County are uninsured. Additionally, 14 of residents live below the poverty level and 19 did not graduate from high school. 18 of residents are 65 years of age or older. Carilion Franklin Memorial Hospital has a very busy emergency room, treating more than 23,800 patients each year. Form 990 Section Schedule H, Part VI Line 5 - Carilion Franklin 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 - Carilion Franklin Memorial Hospital is a wholly owned hospital of 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. 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 well as participation in National Cancer Institute sponsored re Carilion Clinic PO Box 12385 Roanoke VA 24025 541190771 Supporting organization VA 501c3 11 Type I N/A false Carilion Clinic Foundation PO Box 12385 Roanoke VA 24025 541190773 Supporting organization VA 501c3 11 Type I N/A false Carilion Giles Community Hospital PO Box 12385 Roanoke VA 24025 540549603 Healthcare VA 501c3 3 N/A false Carilion Medical Center PO Box 12385 Roanoke VA 24025 540506332 Healthcare VA 501c3 3 N/A false Carilion New River Valley Medical Center PO Box 12385 Roanoke VA 24025 540553805 Healthcare VA 501c3 3 N/A false Carilion Services Inc PO Box 12385 Roanoke VA 24025 541190879 Supporting organization VA 501c3 11 Type I N/A false Carilion Stonewall Jackson Hospital PO Box 12385 Roanoke VA 24025 540568001 Healthcare VA 501c3 3 N/A false Carilion Tazewell Community Hospital PO Box 12385 Roanoke VA 24025 546074580 Healthcare VA 501c3 3 N/A false false false false true true false false false true true true true false false false false true false