CARILION ROCKBRIDGE COMMUNITY HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- CARILION ROCKBRIDGE COMMUNITY HOSPITAL (EIN 54-0568001)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-08-15
- IRS object ID
- 201102279349302710
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-08-15T14:35:57-00:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 424 Church Street | AddressLine1 |
| City | Nashville | City |
| State | TN | State |
| ZIP Code | 37027 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540568001 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carilion Stonewall Jackson Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CARI | NameControl |
| Phone | 5402245112 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 12385 | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 240252385 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Donald Lorton | Name |
| Title | Assistant Treasurer | Title |
| Date Signed | 2011-08-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6152591811 | Phone |
| Date Prepared | 2011-08-15 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Thomas McNamara DO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 12385 | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 24025 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 38210864 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.carilion.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1955 | YearFormation |
| State Legal Domicile | VA | StateLegalDomicile |
| Activity Or Mission Description | See Schedule O | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 331 | TotalNbrEmployees |
| Total Nbr Volunteers | 100 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 274861 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 28663 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 34691452 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 30156957 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -1442880 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1203578 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 373482 | OtherRevenuePriorYear |
| Other Revenue Current Year | 627997 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 33896915 | TotalRevenuePriorYear |
| Total Revenue Current Year | 32017195 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 13270077 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 13335030 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 21676062 | OtherExpensePriorYear |
| Other Expenses Current Year | 19729338 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 34946139 | TotalExpensesPriorYear |
| Total Expenses Current Year | 33064368 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1049224 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1047173 | RevenuesLessExpensesCY |
| Total Assets BOY | 49080444 | TotalAssetsBOY |
| Total Assets EOY | 46491260 | TotalAssetsEOY |
| Total Liabilities BOY | 36743537 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 35066815 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 12336907 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 11424445 | NetAssetsOrFundBalancesEOY |
| Mission Description | See Schedule O. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 28512732 | Expense |
| Revenue | 30431716 | Revenue |
| Description | See Schedule O. | Description |
| Total Program Service Expense | 28512732 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 331 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | true | ForeignFinancialAccount |
| Name Of Foreign Country | CA | NameOfForeignCountry |
| Name Of Foreign Country | CJ | NameOfForeignCountry |
| Name Of Foreign Country | EI | NameOfForeignCountry |
| Name Of Foreign Country | UK | NameOfForeignCountry |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | VA | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | The Organization | NamePerson |
| Telephone Number | 5402245112 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 S Jefferson Street | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 240111331 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Charles Carr | |||||||
| Director | 002.00 | X | 0 | 0 | 0 | ||
| Donald Halliwill | |||||||
| Director | 040.00 | X | 0 | 238576 | 63838 | ||
| Laurent Boetsch | |||||||
| Director | 002.00 | X | 0 | 0 | 0 | ||
| Melina Perdue | |||||||
| Director | 040.00 | X | 0 | 265630 | 154608 | ||
| Joseph Troise MD | |||||||
| Director | 002.00 | X | 0 | 0 | 0 | ||
| Rebecca Gates | |||||||
| Director | 002.00 | X | 0 | 0 | 0 | ||
| John Sheridan DO | |||||||
| Director | 002.00 | X | 0 | 0 | 0 | ||
| Thomas McNamara DO | |||||||
| CEO/President | 040.00 | X | 307643 | 0 | 98677 | X | |
| Kermit Rockett | |||||||
| Treasurer | 002.00 | X | 0 | 0 | 0 | X | |
| Richard Teaff | |||||||
| Vice Chairman | 002.00 | X | 0 | 0 | 0 | X | |
| H E Derrick Jr | |||||||
| Chairman | 002.00 | X | 0 | 0 | 0 | X | |
| Donald Lorton | |||||||
| Asst. Treasurer | 040.00 | X | 0 | 545546 | 565924 | X | |
| Farris Hotchkiss | |||||||
| Secretary | 002.00 | X | 0 | 0 | 0 | X | |
| Briggs Andrews | |||||||
| Asst. Secretary | 040.00 | X | 0 | 336244 | 250796 | X | |
| John Sedovy MD | |||||||
| Chief of Staff | 040.00 | X | 0 | 0 | 0 | ||
| Jay Sailer MD | |||||||
| Chief of Staff | 040.00 | X | 0 | 0 | 0 | ||
| Sheila Hatmaker | |||||||
| Sr. Director | 040.00 | 131666 | 0 | 33923 | X | ||
| Regina Donald | |||||||
| Pharmacy Manager | 040.00 | 130436 | 0 | 44129 | X | ||
| Tonia McFaddin | |||||||
| Nursing Supervisor | 040.00 | 108734 | 0 | 4218 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 678479 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1385996 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1216113 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Lexington VA Emergency Physicians | |||||
| PO Box 793 | Traverse City | MI | 496850793 | Physician services | 403541 |
| Anesthesia Healthcare Partners | |||||
| 3079 Peachtree Industrial Blvd | Duluth | GA | 30097 | Anesthesia services | 189021 |
| Trane | |||||
| 3600 Pammel Creek Rd | La Crosse | WI | 54601 | Equipment maintenance | 129625 |
| GE Medical Systems | |||||
| 5517 Collections Center Dr | Chicago | IL | 60693 | Equipment maintenance | 129504 |
| Computer Programs and Systems | |||||
| 6600 Wall St | Mobile | AL | 36695 | Software maintenance | 117548 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Government Grants | 8718 | GovernmentGrants |
| All Other Contributions | 19945 | AllOtherContributions |
| Total Contributions | 28663 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net Patient Service Revenues | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 30156957 | TotalRevenueColumn |
| Related Or Exempt Function Income | 30156957 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 30156957 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -43052 | TotalRevenueColumn |
| Exclusion | -$43,052 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 302962 | TotalRevenueColumn |
| Exclusion | $302,962 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 261596 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 261596 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 261596 | TotalRevenueColumn |
| Exclusion | $261,596 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6989036 | Securities |
| Other | 148301 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6178882 | Securities |
| Other | 14787 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 810154 | Securities |
| Other | 133514 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 943668 | TotalRevenueColumn |
| Exclusion | $943,668 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| Contract Revenue | 900099 | 190113 | 190113 | |
| Cafeteria | 900099 | 91642 | $91,642 | |
| Other Revenue | 900099 | 75488 | 75488 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9158 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9158 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 366401 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 32017195 | TotalRevenueColumn |
| Related Or Exempt Function Income | 30431716 | RelatedOrExemptFunctionIncome |
| Exclusion | $1,556,816 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 305358 | Total |
| Program Services | 305358 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10408963 | Total |
| Program Services | 10131264 | ProgramServices |
| Management And General | 277699 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 462697 | Total |
| Program Services | 462697 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1376778 | Total |
| Program Services | 1317266 | ProgramServices |
| Management And General | 59512 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 781234 | Total |
| Program Services | 781234 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3649126 | Total |
| Management And General | 3649126 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 153004 | Total |
| Management And General | 153004 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32000 | Total |
| Management And General | 32000 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5220 | Total |
| Program Services | 5220 | ProgramServices |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees For Services Prof Fundraising | FeesForServicesProfFundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39285 | Total |
| Management And General | 39285 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2982979 | Total |
| Program Services | 2837771 | ProgramServices |
| Management And General | 145208 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2575 | Total |
| Program Services | 2575 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3130183 | Total |
| Program Services | 3119320 | ProgramServices |
| Management And General | 10863 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 201543 | Total |
| Program Services | 201543 | ProgramServices |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 480629 | Total |
| Program Services | 480629 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 135776 | Total |
| Program Services | 130475 | ProgramServices |
| Management And General | 5301 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2060361 | Total |
| Program Services | 2060361 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2196843 | Total |
| Program Services | 2196843 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 295775 | Total |
| Program Services | 164226 | ProgramServices |
| Management And General | 131549 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debt | 3513793 | 3513793 | |
| I/C Pracrice subsidy | 720001 | 720001 | |
| Dues Subscriptions | 58740 | 58740 | |
| Donations Sponsorships | 28003 | 5500 | 22503 |
| Miscellaneous | 43502 | 17916 | 25586 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33064368 | Total |
| Program Services | 28512732 | ProgramServices |
| Management And General | 4551636 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1135 | BOY |
| EOY | 1135 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1736191 | BOY |
| EOY | 24076 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4620742 | BOY |
| EOY | 3502179 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 220939 | BOY |
| EOY | 230266 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 197301 | BOY |
| EOY | 187696 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 43297608 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 25019703 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20183571 | BOY |
| EOY | 18277905 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11476511 | BOY |
| EOY | 12660926 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6579351 | BOY |
| EOY | 7555384 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4064703 | BOY |
| EOY | 4051693 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49080444 | BOY |
| EOY | 46491260 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4679496 | BOY |
| EOY | 4144361 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34821 | BOY |
| EOY | 42735 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28092492 | BOY |
| EOY | 27453343 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3057900 | BOY |
| EOY | 2891450 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 878828 | BOY |
| EOY | 534926 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36743537 | BOY |
| EOY | 35066815 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12336907 | BOY |
| EOY | 11424445 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12336907 | BOY |
| EOY | 11424445 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49080444 | BOY |
| EOY | 46491260 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| Public Support Pertcentage170 | 0.00000 | PublicSupportPertcentage170 |
| Public Support Percentage509 | 0.00000 | PublicSupportPercentage509 |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $5,220 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 5220 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | II-B | Identifier |
| Return Reference | 1i | ReturnReference |
| Explanation | Portion of dues paid to American Hospital Assn., Vrginia Hospital and Healthcare Assn. and other healthcare related organizations spent on lobbying. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Included On FS | false | IncludedOnFS |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 707453 | OtherCostOrOtherBasis |
| Book Value | 707453 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 25143251 | OtherCostOrOtherBasis |
| Depreciation | 10739994 | Depreciation |
| Book Value | 14403257 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16384292 | OtherCostOrOtherBasis |
| Depreciation | 13301638 | Depreciation |
| Book Value | 3082654 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1062612 | OtherCostOrOtherBasis |
| Depreciation | 978071 | Depreciation |
| Book Value | 84541 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 18277905 | TotalOfBookValueLandBuildings |
Closely Held Equity Interests CloselyHeldEquityInterests
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 7555384 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 7555384 | TotalOfBookValueSecurities |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| 2002 Bond Principal Fund | 3275643 |
| Bond Issue Costs | 776050 |
| Other Long Term Assets |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 4051693 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Deferred Physicians Payable | $426,649 |
| Due to Restricted Fund | |
| Due to Caril Enterprises | $29,000 |
| Qualified Pension Liability | $79,277 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 534926 | TotalOfAmounts |
| Total Revenue | 32017195 | TotalRevenue |
| Total Expenses | 33064368 | TotalExpenses |
| Excess Or Deficit For Year | -1047173 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 139422 | NetUnrealizedGLOnInvestments |
| Other | -$4,711 | OtherAmount |
| Total Adjustments | 134711 | TotalAdjustments |
| Excess Or Deficit Per FS | -912462 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 32156617 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 139422 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 139422 | RevenueNotRptdF990 |
| Revenue Subtotal | 32017195 | RevenueSubtotal |
| Total Revenue Per Form990 | 32017195 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 33064368 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 33064368 | ExpensesSubtotal |
| Total Expenses Per Form990 | 33064368 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| XI | 8 | Adjustment for Pension of 4,712 |
| XI | 8 | Rounding 1 |
| XII | 8 | Total 4.711 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1595826 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1595826 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05410 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1891664 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1186835 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 704829 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02390 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3487490 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1186835 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2300655 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07800 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 163 | NumberOfActivitiesOrPrograms |
| Persons Served | 9194 | PersonsServed |
| Total Community Benefit Expense | 60662 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2310 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 58352 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00200 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 866 | PersonsServed |
| Total Community Benefit Expense | 26118 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 26118 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 168 | NumberOfActivitiesOrPrograms |
| Persons Served | 10060 | PersonsServed |
| Total Community Benefit Expense | 86780 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2310 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 84470 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 168 | NumberOfActivitiesOrPrograms |
| Persons Served | 10060 | PersonsServed |
| Total Community Benefit Expense | 3574270 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1189145 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2385125 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08090 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 2795 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2795 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 2795 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2795 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $1,494,131 | BadDebtExpenseAmount |
| Amount Attributable To | 717525 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 11551362 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 11793857 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -242495 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|
| Carilion Stonewall Jackson Hospital | ||||||||
| 1 Health Circle | Lexington | VA | 24450 | X | X | X | X | |
| Lexington Medical Building West | ||||||||
| 108 Houston Street | Lexington | VA | 24450 | Physician offices | ||||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | N/A | IncomeBasedCriteria |
| Annual Community Benefit Expln | Carilion Clinic, an 80 member of the Hospital, includes the community benefit report for the Hospital in a system-wide annual report. | AnnualCommunityBenefitExpln |
| Costing Method Used | Ratio of cost-to-charges was used to calculate the expense. | CostingMethodUsed |
| Subsidized Health Services Expln | N/A | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | Bad debt expense subtracted from total expenses for the calculation is 3,513,793. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | The 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 Benefit | 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. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | When 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 Service 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 Poverty Guidelines FPG are used to determine eligibility for charity care. A patient whose account balance is less than 1,500 and is at or below 100 of FPG is automatically 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 Expln | N/A | NumberOfFacilityTypeExpln |
| Needs Assessment | Carilion Stonewall Jackson 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 Stonewall Jackson Hospital. A community health needs assessment is scheduled for completion in compliance with recent guidelines related to quantifying community benefit. | NeedsAssessment |
| Patient Education Assistance | The charity care policy is posted in all patient 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 Information | Carilion Stonewall Jackson Hospital is a 25-bed critical access facility serving the more than 35,000 residents of the Rockbridge County community. Rockbridge County is centrally located in the historic and scenic Shenandoah Valley in west-central Virginia. The County is bordered on the west by the lower elevations of the Allegheny Mountains and on the east by the crest of the Blue Ridge Mountains. With 610 square miles of diverse, rolling terrain, Rockbridge County includes the cities of Lexington and Buena Vista and incorporated towns of Glasgow and Goshen. Approximately 22 of adults under age 64 and 12 of children who live in the Rockbridge County are uninsured. Additionally, 12 of residents live below the poverty level. | CommunityInformation |
| Community Building Activities | Carilion Stonewall Jackson Hospital provided support of economic and workforce development in Rockbridge County through financial and in-kind support of the Shenandoah Valley Partnership and Lexington-Rockbridge County Chamber of Commerce. | CommunityBuildingActivities |
| Other Information | Carilion Stonewall Jackson 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. The dangers of obesity and diabetes are a concern in Rockbridge County, particularly for our youngsters so Carilion Stonewall Jackson Hospitals community health educator provided sessions on nutrition, diet, and exercise. Five programs were offered to 125 children attending summer camp and after school programs at the YMCA. As a member of the Rockbridge County School Health Advisory Board, nutrition education was developed and provided to all students from elementary, middle, and high school in the form of materials and assemblies. Additionally, food slide guides were distributed to more than 700 elementary students. A diabetes task force identified support of diabetics as an opportunity for improving health status. As a result, a diabetes support group was created with monthly meetings featuring important health topics such as eye care, foot care, and sleep apnea. With a focus on teen wellness and suicide prevention, presentations and activities were developed and provided to more than 400 teens during nine events. Overall, during 2010 almost 9,000 residents received health education by attending one of more than 160 community health outreach events including screenings, health fairs and presentations. Carilion Stonewall Jackson Hospital provided financial support to Rockbridge Area Hospice and the Free Clinic of Rockbridge County to assist with operational expenses related to the increased demand for health services of the uninsured. | OtherInformation |
| Affiliated Health Care System | Carilion Stonewall Jackson Hospital is an affiliate of 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Donald Halliwill | ||||||||||||
| 220387 | 25036 | -6847 | 48938 | 14900 | 302414 | |||||||
| Melina Perdue | ||||||||||||
| 240000 | 27360 | -1730 | 143483 | 11125 | 420238 | |||||||
| Thomas McNamara DO | ||||||||||||
| 273050 | 35604 | -1011 | 80053 | 18624 | 406320 | |||||||
| Donald Lorton | ||||||||||||
| 436800 | 49620 | 59126 | 548892 | 17032 | 1111470 | 55087 | ||||||
| Briggs Andrews | ||||||||||||
| 301600 | 34262 | 382 | 239565 | 11231 | 587040 | |||||||
| Sheila Hatmaker | ||||||||||||
| 112592 | 18238 | 836 | 28663 | 5260 | 165589 | |||||||
| Regina Donald | ||||||||||||
| 124533 | 5903 | 30138 | 13991 | 174565 | ||||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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 - 308,492, Briggs Andrews - 82,342 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990 I | 1 | Carilion Stonewall Jackson Hospital, part of Carilion Clinic, is a not-for-profit healthcare organization committed to improving health outcomes for every patient while advancing the quality of care in the community it serves. |
| Form 990 III | 1 | Carilion Stonewall Jackson Hospital, part of Carilion Clinic, is a not-for-profit healthcare organization committed to improving health outcomes for every patient while advancing the quality of care in the community it serves. |
| Form 990 VI | 6 | The organization has two classes of members. Carilion Clinic, a charitable tax-exempt healthcare organization, has an 80 membership interest and is entitled to elect directors having 80 of the vote on any issue. The Stonewall Jackson Community Foundation, a tax-exempt community foundation which supports healthcare within the local community, has a 20 membership interest and is entitled to elect directors having 20 of the vote on any issue. |
| Form 990 VI | 7a | The organization has two classes of members. Carilion Clinic, a charitable tax-exempt healthcare organization, has an 80 membership interest and is entitled to elect one class of directors having 80 of the vote on any issue. The Stonewall Jackson Community Foundation, a tax-exempt community foundation which supports healthcare within the local community, has a 20 membership interest but is not entitled to elect directors. The remaining class of directors, which has 20 of the vote on any issue, came from the local community and those directors elect their own successors. |
| Form 990 VI | 7b | 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 VI | 11 | 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 VI | 12c | A Conflict of Interest Questionnaire, along with a copy of the Policy, is sent out annually to all officers, directors and key employees. In addition, such individuals are instructed to inform the organization of potential conflicts which arise during the year. Answers to the Questionnaires are reviewed by the Internal Audit Department. Potential conflicts for officers and key employees are reviewed by an internal Conflict of Interest Committee, which follows up on any potential issues to ensure compliance with all policies of the organization. The answers for Directors are reviewed by the Carilion Clinic Audit and Compliance Committee. |
| Form 990 VI | 12c contd | 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 VI | 15a and b | This 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 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 XI | 2 | The organizations financial statements were audited on a consolidated basis as part of Carilion Clinic as well as on a separate basis. |
| Form 990 III | 4a | Carilion Stonewall Jackson Hospital, a critical access hospital, exists to serve the health care needs of its community, regardless of patient ability to pay. Stonewalls acute hospital admitted 1,506 patients and provided 5,365 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. Stonewall provides a number of services targeting the specific health needs of its population, including diabetes management home health physical, speech, and occupational therapy programs and cardiac and respiratory rehab. Stonewall also provides an emergency department with 24-hour care, emergency transportation, and a chest pain and stroke program. |
| Form 990 III | 4a contd | With 16,131 visits, Stonewalls emergency 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. Stonewall supports community screenings and education on chronic disease prevention and management, sponsoring 163 events touching 9,200 people. In furtherance of its mission, Stonewall provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year exceeded 3 million. |
| Form 990 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. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stonewall Jackson Ambulatory Health LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 12385 | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 24025 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 203842434 | EIN |
| Primary Activities | Inactive | PrimaryActivities |
| Legal Domicile State | VA | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| Carilion Clinic | |||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541190771 | Supporting organization | VA | 501c3 | 11 Type I | N/A |
| Carilion Clinic Foundation | |||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541190773 | Supporting organization | VA | 501c3 | 11 Type I | N/A |
| Carilion Franklin Memorial Hospital | |||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540480606 | Healthcare | VA | 501c3 | 3 | N/A |
| Carilion Giles Community Hospital | |||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540549603 | Healthcare | VA | 501c3 | 3 | N/A |
| Carilion Medical Center | |||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540506332 | Healthcare | VA | 501c3 | 3 | N/A |
| Carilion New River Valley Medical Center | |||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540553805 | Healthcare | VA | 501c3 | 3 | N/A |
| Carilion Services Inc | |||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541190879 | Supporting organization | VA | 501c3 | 11 Type I | N/A |
| Carilion Tazewell Community Hospital | |||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 546074580 | Healthcare | VA | 501c3 | 3 | N/A |
| Hugh Trout Memorial Foundation | |||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 510236357 | Supporting organization | VA | 501c3 | 11 Type I | N/A |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |