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BEDFORD MEMORIAL HOSPITAL: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
BEDFORD MEMORIAL HOSPITAL (EIN 54-0566100)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-15
IRS object ID
201102279349303480
Schema version
2009v1.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-08-15T15:52:15-00:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1424 Church StreetAddressLine1
CityNashvilleCity
StateTNState
ZIP Code37027ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN540566100EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Bedford Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBEDFNameControl
Phone5402245112Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 12385AddressLine1
CityRoanokeCity
StateVAState
ZIP Code240252385ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDonald LortonName
TitleAssistant TreasurerTitle
Date Signed2011-08-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameFrancis BedardName
Phone6152591811Phone
Date Prepared2011-08-12DatePrepared
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonWilliam FlatteryNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO Box 12385AddressLine1
CityRoanokeCity
StateVAState
ZIP Code24025ZIPCode
FieldValueIRS element (for citing)
Gross Receipts38713799GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.carilion.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1957YearFormation
State Legal DomicileVAStateLegalDomicile
Activity Or Mission DescriptionSee Schedule OActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees437TotalNbrEmployees
Total Nbr Volunteers127TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year70283ContributionsGrantsPriorYear
Contributions Grants Current Year102896ContributionsGrantsCurrentYear
Program Service Revenue Prior Year34704503ProgramServiceRevenuePriorYear
Program Service Revenue CY34212903ProgramServiceRevenueCY
Investment Income Prior Year-739085InvestmentIncomePriorYear
Investment Income Current Year351155InvestmentIncomeCurrentYear
Other Revenue Prior Year607998OtherRevenuePriorYear
Other Revenue Current Year545440OtherRevenueCurrentYear
Total Revenue Prior Year34643699TotalRevenuePriorYear
Total Revenue Current Year35212394TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year16437331SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year34244595OtherExpensePriorYear
Other Expenses Current Year19156282OtherExpensesCurrentYear
Total Expenses Prior Year34244595TotalExpensesPriorYear
Total Expenses Current Year35593613TotalExpensesCurrentYear
Revenues Less Expenses Prior Year399104RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-381219RevenuesLessExpensesCY
Total Assets BOY27920936TotalAssetsBOY
Total Assets EOY27378215TotalAssetsEOY
Total Liabilities BOY16807752TotalLiabilitiesBOY
Total Liabilities EOY16946302TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY11113184NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY10431913NetAssetsOrFundBalancesEOY
Mission DescriptionSee Schedule OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense31527766Expense
Revenue34268647Revenue
DescriptionSee Schedule O.Description
Total Program Service Expense31527766TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees437NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryCANameOfForeignCountry
Name Of Foreign CountryCJNameOfForeignCountry
Name Of Foreign CountryEINameOfForeignCountry
Name Of Foreign CountryUKNameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledVAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonThe CorporationNamePerson
Telephone Number5402245112TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1213 S Jefferson StreetAddressLine1
CityRoanokeCity
StateVAState
ZIP Code240111331ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
David Adams
Director002.00X000
Lewis Addison
Director002.00X000
George Dawson
Director002.00X000
Patsy Dooley
Director002.00X000
Carolyn Jacques
Director002.00X000
Tom Jividen
Director002.00X000
G C Luck Jr
Director002.00X000
Eugene Lowe MD
Director040.00X017654539124
Donna Littlepage
Director040.00X0240698115996
John Mack
Director002.00X000
Curtis Mills Jr
Director040.00X0260456270576
Edward Murphy MD
Director040.00X01328088805186
Guy Murray Jr
Director002.00X000
Melina Perdue
Director040.00X0265630154608
Rayburn Thompson
Director040.00X0439191183089
Consuela Woods
Director002.00X000
David Allgood MD
Director002.00X000
Donald Creech
Director040.00X028334566289
Paul Davenport
Director040.00X012051433293
John Bond
President002.00X000X
Linda Beahm MD
Vice President002.00X000
William Flattery
Admin./Sec./Treas.040.00X216400041606X
Donald Lorton
Asst. Treasurer040.00X0545546565924X
Phillip Gruber
Pharmacist040.00127549057045X
Georgiann Watts
Sr. Director040.00108826075950X
FieldValueIRS element (for citing)
Total Reportable Comp From Org452775TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3660013TotalReportableCompFrmRltdOrgs
Total Other Compensation2408686TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Heritage Healthcare
536 Old Howell RoadGreenvilleSC29615Physical Therapy Services354527
Foodservice Partners of VA
2823 Franklin Road Bldg BRoanokeVA24014Food service146496
GE Medical Systems
5517 Collections Center DrChicagoIL60693Equipment maintenance139681
Cardinal Health
1330 Enclave PkwyHoustonTX77077Equipment maintenance137383
Computer Programs and Systems
6600 Wall StMobileAL36695Software Maintenance126273
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Government Grants73813GovernmentGrants
All Other Contributions29083AllOtherContributions
Total Contributions102896TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNet Patient Service RevenuesDescription
Business Code900099BusinessCode
Total Revenue Column34212903TotalRevenueColumn
Related Or Exempt Function Income34212903RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue34212903TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column-72963TotalRevenueColumn
Exclusion-$72,963ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column2TotalRevenueColumn
Exclusion$2ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real447157Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real447157Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column447157TotalRevenueColumn
Exclusion$447,157ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3925521Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3501405Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities424116Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column424116TotalRevenueColumn
Exclusion$424,116ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Cafeteria90009942539$42,539
Miscellaneous9000993219132191
Other Revenue9000992355323553
FieldValueIRS element (for citing)
Total Other Revenue98283TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column35212394TotalRevenueColumn
Related Or Exempt Function Income34268647RelatedOrExemptFunctionIncome
Exclusion$840,851ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total221508Total
Program Services221508ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total13254141Total
Program Services12811375ProgramServices
Management And General442766ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total555476Total
Program Services555476ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1440656Total
Program Services1341005ProgramServices
Management And General99651ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total965550Total
Program Services965550ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total884592Total
Management And General884592ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total38485Total
Management And General38485ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total28600Total
Management And General28600ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total5737Total
Program Services5737ProgramServices
FieldValueIRS element (for citing)
Fees For Services Prof FundraisingFeesForServicesProfFundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total24055Total
Management And General24055ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4250362Total
Program Services3910599ProgramServices
Management And General339763ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total63076Total
Program Services58282ProgramServices
Management And General4794ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3542690Total
Program Services3466103ProgramServices
Management And General76587ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total272869Total
Program Services271348ProgramServices
Management And General1521ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total912447Total
Program Services845860ProgramServices
Management And General66587ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total61725Total
Program Services49103ProgramServices
Management And General12622ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total380660Total
Program Services380660ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1613902Total
Program Services1613902ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total412408Total
Program Services238796ProgramServices
Management And General173612ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debt47212114721211
Practice Subsidy17618791761879
Dues Subscriptions78065720870857
Miscellaneous19572172617846
Other expenses839476231721630

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total35593613Total
Program Services31527766ProgramServices
Management And General4065847ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1620BOY
EOY1620EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY544478BOY
EOY701787EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4722827BOY
EOY4281511EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY178075BOY
EOY126220EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis37670949LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec26560251LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY12073589BOY
EOY11110698EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6258344BOY
EOY6758553EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4007785BOY
EOY4285446EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY134218BOY
EOY112380EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY27920936BOY
EOY27378215EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3587808BOY
EOY3776886EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY38939BOY
EOY20277EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY9165072BOY
EOY8705319EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4015933BOY
EOY4443820EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY16807752BOY
EOY16946302EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY11107958BOY
EOY10426873EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5226BOY
EOY5040EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11113184BOY
EOY10431913EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY27920936BOY
EOY27378215EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
Public Support Pertcentage1700.00000PublicSupportPertcentage170
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$5,737OtherActivitiesAmount
Total Lobbying Expenditures IIB5737TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierII-BIdentifier
Return Reference1iReturnReference
ExplanationPortion of dues paid to American Hospital Assn., Virginia Hospital and Healthcare Assn. and other healthcare related organizations spent on lobbying.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Included On FSfalseIncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis476378OtherCostOrOtherBasis
Book Value476378BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis19068616OtherCostOrOtherBasis
Depreciation10722202Depreciation
Book Value8346414BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis24189OtherCostOrOtherBasis
Depreciation24189Depreciation

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis17800233OtherCostOrOtherBasis
Depreciation15551296Depreciation
Book Value2248937BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis301533OtherCostOrOtherBasis
Depreciation262564Depreciation
Book Value38969BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings11110698TotalOfBookValueLandBuildings

Closely Held Equity Interests CloselyHeldEquityInterests

FieldValueIRS element (for citing)
Book Value4285446BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities4285446TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
2005 Fixed Swap Unreal Losses
2005 Fixed Payor Swap Unreal$597,903
2005 Fixed Payor Swap Accrued
Qualifed Pension Liability$3,845,917
FieldValueIRS element (for citing)
Total Of Amounts4443820TotalOfAmounts
Total Revenue35212394TotalRevenue
Total Expenses35593613TotalExpenses
Excess Or Deficit For Year-381219ExcessOrDeficitForYear
Net Unrealized GL On Investments-8377NetUnrealizedGLOnInvestments
Other-$291,675OtherAmount
Total Adjustments-300052TotalAdjustments
Excess Or Deficit Per FS-681271ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt35204018TotRevenueEtcAuditedFinclStmt
Other Revenues1OtherRevenues
Revenue Not Rptd F9901RevenueNotRptdF990
Revenue Subtotal35204017RevenueSubtotal
Other Revenues Not Included8377OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt8377RevenueNotRptdOnFinStmt
Total Revenue Per Form99035212394TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt35885288TotExpensesEtcAuditedFinclStmt
Other Expenses Included291675OtherExpensesIncluded
Expenses Not Rptd F990291675ExpensesNotRptdF990
Expenses Subtotal35593613ExpensesSubtotal
Total Expenses Per Form99035593613TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
XIUnrealized loss on investments of 8,377.
XIAdjustment for pension of 291,6758
XIIRounding of 1.3a
XIIUnrealized loss on investments of 8,377.4b
XIIIAdjustment for pension of 291,6754d

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1241739TotalCommunityBenefitExpense
Net Community Benefit Expense1241739NetCommunityBenefitExpense
Percent Of Total Expense0.03990PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense5743739TotalCommunityBenefitExpense
Direct Offsetting Revenue4759693DirectOffsettingRevenue
Net Community Benefit Expense984046NetCommunityBenefitExpense
Percent Of Total Expense0.03170PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense6985478TotalCommunityBenefitExpense
Direct Offsetting Revenue4759693DirectOffsettingRevenue
Net Community Benefit Expense2225785NetCommunityBenefitExpense
Percent Of Total Expense0.07160PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs224NumberOfActivitiesOrPrograms
Persons Served6709PersonsServed
Total Community Benefit Expense85880TotalCommunityBenefitExpense
Direct Offsetting Revenue6647DirectOffsettingRevenue
Net Community Benefit Expense79233NetCommunityBenefitExpense
Percent Of Total Expense0.00250PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served232PersonsServed
Total Community Benefit Expense6921TotalCommunityBenefitExpense
Net Community Benefit Expense6921NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs10NumberOfActivitiesOrPrograms
Persons Served268PersonsServed
Total Community Benefit Expense17273TotalCommunityBenefitExpense
Net Community Benefit Expense17273NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs242NumberOfActivitiesOrPrograms
Persons Served7209PersonsServed
Total Community Benefit Expense110074TotalCommunityBenefitExpense
Direct Offsetting Revenue6647DirectOffsettingRevenue
Net Community Benefit Expense103427NetCommunityBenefitExpense
Percent Of Total Expense0.00330PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs242NumberOfActivitiesOrPrograms
Persons Served7209PersonsServed
Total Community Benefit Expense7095552TotalCommunityBenefitExpense
Direct Offsetting Revenue4766340DirectOffsettingRevenue
Net Community Benefit Expense2329212NetCommunityBenefitExpense
Percent Of Total Expense0.07490PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served149PersonsServed
Total Community Building Expense1188TotalCommunityBuildingExpense
Net Community Building Expense1188NetCommunityBuildingExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs15NumberOfActivitiesOrPrograms
Persons Served811PersonsServed
Total Community Building Expense2612TotalCommunityBuildingExpense
Net Community Building Expense2612NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served16PersonsServed
Total Community Building Expense112TotalCommunityBuildingExpense
Net Community Building Expense112NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served50PersonsServed
Total Community Building Expense789TotalCommunityBuildingExpense
Net Community Building Expense789NetCommunityBuildingExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs21NumberOfActivitiesOrPrograms
Persons Served275PersonsServed
Total Community Building Expense1171TotalCommunityBuildingExpense
Net Community Building Expense1171NetCommunityBuildingExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served150PersonsServed
Total Community Building Expense8520TotalCommunityBuildingExpense
Net Community Building Expense8520NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs54NumberOfActivitiesOrPrograms
Persons Served1451PersonsServed
Total Community Building Expense14392TotalCommunityBuildingExpense
Net Community Building Expense14392NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$1,610,713BadDebtExpenseAmount
Amount Attributable To642204AmountAttributableTo
Amount Reimbursed By Medicare8646685AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare8386770CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall259915MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (5 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursOtherOther
Bedford Memorial Hospital
1613 Oakwood StreetBedfordVA24523XXX
Oakwood manor
1613 Oakwood StreetBedfordVA24523Nuirsing home
Bedford Adult Day Center
1617 Oakwood StreetBedfordVA24523Adult day care
Blue Ridge Cardiovascular
37 Laymantown RoadTroutvilleVA24175Cardiovascular testing
Huddleston Cardiovascular
10102 Leesville RoadLynch StationVA24571Cardiovascular testing

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaN/AIncomeBasedCriteria
Annual Community Benefit ExplnCarilion Clinic, a 50 member of the Hospital, includes the community benefit report for the Hospital in a system-wide report.AnnualCommunityBenefitExpln
Costing Method UsedRatio of cost-to-charges was used to calculate the expense.CostingMethodUsed
Subsidized Health Services ExplnN/ASubsidizedHealthServicesExpln
Percent Of Total Expense ExplnBad debt expense substracted from total expenses for the calculation is 4,721,211.PercentOfTotalExpenseExpln
Bad Debt FootnoteThe audited financial statements footnote on bad debt states an allowance of uncollectible accounts is recorded based on historical bad debt experience and managements evaluation of the collectibility of the accounts receivable. Balances are written off after all reasonable collection efforts have been made. 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. 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 definitive determination of their eligibility. Patient account balances are reduced by discounts allowed and payments.BadDebtFootnote
Shortfall As Community BenefitMedicare 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.ShortfallAsCommunityBenefit
Debt Collection PolicyWhen an uninsured self pay patient registers for medically necessary services, the patients account is electronically marked as being potentially eligible for charity care. Carilion Clinics Eligibility Assistance Services EAS screens the patient to determine if charity care is appropriate. The patient must apply for all entitlement programs for which he or she may be eligible i.e. Medicaid, Social Security Disability, etc. EAS assists the patient with the applications. If the patient does not qualify for one of the programs then the Federal Proverty Guidelines FPG are used to determine eligibility for charity care. A patient whose account is less than 1,500 and is at or below 100 of FPG is automically given a 100 discount of their account. For balances greater than 1,500 the patient must complete a Financial Assistance Application and provide appropriate documentation. a sliding scale of discounts is available for patients with incomes up to 400 of FPG. An underinsured patient can apply for charity care. Applications are available at all Patient Access/Registration points, offices of EAS, Carilion Clinics Internet website or by calling for an application.DebtCollectionPolicy
Number Of Facility Type ExplnFacilities operated that are not required to be licensed or registered include two cardiovascular testing sites.NumberOfFacilityTypeExpln
Needs AssessmentBedford 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 formal community health needs assessment is scheduled for completion in compliance with recent guidelines related to quantifying community benefit.NeedsAssessment
Patient Education AssistanceThe charity care policy is posted in all registration areas. At the time of registration all uninsured self pay patients are given a brochure explaining the charity care policy and how to apply. Also, see comments for Part III line 9b.PatientEducationAssistance
Community InformationBedford Memorial Hospital primarily serves approximately 74,000 residents of Bedford City and County. Bedford encompasses 764 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 4200 feet above sea level. Bedford Memorial Hospital is a 50-bed hospital that also has 110 long term care and skilled beds. Approximately 10 of children and 20 of adults under age 64 who live in the area served by Bedford Memorial Hospital are uninsured. More than 74 of patients treated at Bedford Memorial Hospital are Medicare or Medicaid beneficiaries.CommunityInformation
Community Building ActivitiesBedford Memorial Hospital partners with the Bedford Community Health Foundation to support an adult day care center. The Hospital helps with managing this center for the elderly and mentally retarded in a facility adjacent to the hospital. The Center serves Bedford City, Bedford County, and several surrounding counties, and strives to meet the needs of a diverse population. The overall mission is to prevent the premature or unnecessary institutional placement of our elderly and mentally retarded. Bedford Memorial Hospital provides office space for the Bedford Parish Nurse Ministry. This program began as a grass-roots response and is now a nondenominational, independent agency addressing the needs of all senior citizens. Bedford Parish Nurse Ministry is an efficient and cost effective means of improving low income seniors health awareness, healthcare, and access to prescription drugs through professional nurse counsel. Office space is also provided for Bedford Ride, an organization focused on improving the quality of life for Bedford City and County citizens by providing better access to non-emergency medical services through transportation services. Additionally in-kind support was provided to Healthy Bedford, a program of the Bedford Community Health Foundation that provides mammography screening for the poor, school nurses in every public school, therapy for the mentally and physically challenged, care for the elderly, emergency medical services and equipment for the local hospital and in-kind support of Virginia Heart Attack Coalition, a volunteer collaborative organization dedicated to improving care for heart attack patients in Virginia by implementing the American Heart Associations AHA Mission Lifeline guidelines and fostering cooperation and coordination among the Commonwealths STEMI care providers. Guidance and clinical expertise is provided through community Board membership of the following organizations Bedford Christian Free Clinic, a local non-profit providing medical treatment and prescription assistance to residents of Bedford city and Bedford County who are otherwise ineligible to be seen at the local health department Bedford EMS Bedford Hospice House, opening in the summer of 2011 to provide a place where the terminally ill can die peacefully with support and dignity Bedford County Domestic Violence Services, providing access to shelter, information and referral, counseling, and court accompaniment free of charge and Bedford Area Chamber of Commerce, 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.CommunityBuildingActivities
Other InformationBedford 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. Bedford Memorial Hospitals Emergency Department has specially trained nurses who deliver immediate crisis intervention to victims of sexual assaults and/or abuse. They offer victims a unique, thorough and objective medical and legal examination, comprised of both a physical examination and forensic evidence collection and documentation. Clinical Forensic Nurse Examiners are the link between the judicial system, law enforcement, community resources, and the laboratories that process the evidence. In addition, they educate colleagues and the community regarding issues and treatment of violence while upholding the mission of their facility. As part of its mission to educate the public about health risks and steps that can be taken to improve health, in 2010 Bedford Memorial Hospital touched more than 6,700 people during 224 events offered throughout the community. 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.OtherInformation
Affiliated Health Care SystemBedford Memorial Hospital is jointly owned by Carilion Clinic and Centra Health. Management is provided by Carilion Clinic, a not-for-profit healthcare organization serving nearly one million people in Virginia through hospitals, outpatient specialty centers and advanced primary care practices. Led by multi-specialty physician teams with a shared philosophy that puts the patient first, Carilion is committed to improving health outcomes for every patient while advancing the quality of care through medical education and research. To advance the coordination of care and quality, an electronic medical record has been implemented in all Carilion Clinic affiliated hospitals and physician practices, allowing physicians to easily and efficiently collaborate through the use of shared patient records. Additional improvements in medical programs and services include a new nationally certified Stroke Alert protocol that speeds lifesaving care to stroke patients the introduction of hypothermia therapy to southwest Virginia for the treatment of cardiac arrest patients certification by the National Committee for Quality Assurance NCQA of 11 Carilion Clinic Family Medicine practices as Patient-Centered Medical Homes, a new model of care designed to keep patients healthy and prevent illness and the introduction of MyChart, an online tool that gives patients secure access to their health information. To advance education of health professionals, Jefferson College of Health Sciences, within Carilion Medical Center, is a professional health sciences college offering the Master of Science in Nursing, Physician Assistant and Occupational Therapy and 10 baccalaureate and associate healthcare programs. As one of few private healthcare colleges in the Southern United States, the students have demonstrated excellent licensure pass rates in professional programs. Approximately 1,000 undergraduate students and 80 graduate students are enrolled annually with 87 receiving some type of financial aid. Through a unique public-private partnership, Virginia Tech and Carilion Clinic recently opened the Virginia Tech Carilion School of Medicine and Research Institute in Roanoke. The School welcomed an inaugural class of 42 students in August 2010. The Research Institute opened in September 2010 with a mission to advance the health of the nation and the world by making major scientific advances in understanding human health and developing new diagnostics, treatments and cures for disorders that limit the quality of life and the realization of full human potential. This is done through biomedical and behavioral research. An additional benefit to the community is Carilion Clinics economic contribution to the region. As the areas largest employer, jobs are provided for nearly 11,000 residents of the region, with a payroll of more than 625 million in 2010.AffiliatedHealthCareSystem

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
Eugene Lowe MD
16001419312-27811834820776215669
Donna Littlepage
20605023407112411087237273356694
Curtis Mills Jr
225563256249269260314102625310327364
Edward Murphy MD
89000034482593263717538876482133274219561
Melina Perdue
24000027360-173014348311125420238
Rayburn Thompson
35053039820488411621202096962228049804
Donald Creech
25500028968-623585457744349634
Paul Davenport
1139256589314501843153807
William Flattery
1911002170935913069310913258006
Donald Lorton
436800496205912654889217032111147055087
Phillip Gruber
108442191074476612279184594
Georgiann Watts
109936-1110707685182184776

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
I7The 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.
I4bCurtis Mills - 46,960, Edward Murphy, MD - 360,623, Rayburn Thompson - 85,182, Donald Lorton - 308,492

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Industrial Development Authority of the City of Roanoke VABusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN541106038IssuerEIN
CUSIP Number770084ES6CUSIPNumber
Date Issued2005-12-12DateIssued
Issue Price5790000IssuePrice
Description Of PurposeCapital Projects , Refunding Series 2002, Cost of Issuance, Bond Insur.DescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds5790187TotalProceeds
Issuance Costs From Proceeds119133IssuanceCostsFromProceeds
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledtrueForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdstrueHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1UBS & CitigroupBusinessNameLine1
FieldValueIRS element (for citing)
Term Of Hedge0000000027.000000000000TermOfHedge
Gross Proceeds Invested In GICtrueGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line1AIGBusinessNameLine1
FieldValueIRS element (for citing)
Term Of GIC0000000000.300000000000TermOfGIC
Regulatory Safe Harbor SatisfiedtrueRegulatorySafeHarborSatisfied
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatetrueExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990 VI6The 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 VI7aEach 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 VI7bThe 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 VI11The 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 VI12cA 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. 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
Form 990 VI15a and bThis organizations CEO is an employee of Carilion Services, Inc. The CEOs compensation is determined by the Human Resources Department of Carilion Clinic based on the job description, experience of the individual and the results of comparisons to 6 to 8 nationwide third party surveys of compensation. The Board of Directors of the organization and the Board of Directors of Carilion Clinic have to approve the appointment of the CEO.
Form 990 VI19The 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 XI2The organizations financial statements were audited on a consolidated basis as part of Carilion Clinic as well as on a separate basis..
Form 990 I1The mission of Bedford Memorial Hospital, a partnership between Centra and Carilion Clinic, is to improve the health of the community it serves. The hospital provides inpatient and outpatient surgery, and emergency, geriatric and rehabilitative services
Form 990 III1The mission of Bedford Memorial Hospital, a partnership between Centra and Carilion Clinic, is to improve the health of the community it serves. The hospital provides inpatient and outpatient surgery, and emergency, geriatric and rehabilitative services. In addition to clinical care, the hospital works to achieve it mission through the education of health professionals and the community.
Form 990 III4aBedford Memorial Hospital exists to serve the health care needs of its community, regardless of patient ability to pay. Bedfords acute hospital admitted 1,655 patients and provided 5,295 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 37,340 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 III4a contdBedford also provides an emergency department with 24-hour care, emergency transportation, and a chest pain and stroke program. With 15,517 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 224 events touching over 6,700 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 2.8 million.
Form 990 VI3Certain 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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
Carilion Clinic Foundation
PO Box 12385RoanokeVA24025541190773Supporting organizationVA501c311 Type IN/A
Carilion Services Inc
PO Box 12385RoanokeVA24025541190879Supporting organizationVA501c311 Type IN/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg