2011-08-15T14:02:55-00:00 2010-09-30 Deloitte Tax LLP 424 Church Street Nashville TN 37027 990 2009-10-01 540480606 Carilion Franklin Memorial Hospital CARI 5402245112 PO Box 12385 Roanoke VA 240252385 Donald Lorton 2011-08-15 true Francis Bedard 6152591811 2011-08-15 2009 2016-02-24 21:20:13Z William Jacobsen PO Box 12385 Roanoke VA 24025 37461736 false X www.carilion.com X 1956 VA See Schedule O 11 7 378 113 0 83560 180661 40245634 36669870 -740920 -192213 407837 407084 39996111 37065402 0 0 16859100 16260451 0 0 25739750 23664517 42598850 39924968 -2602739 -2859566 21476755 19013083 19191976 19427010 2284779 -413927 See Schedule O. false false 32559871 36674188 See Schedule O 32559871 true true false true false false false false false true false true false false false false false false false false true false false true true false false false false false false false false false false false false false false false true false false false true 0 0 true 378 true false true CA CJ EI UK false false false false false false false 11 7 false true false false true true true true true false false true true true true true true true true false VA X X The Organization 5402245112 213 S Jefferson Street Roanoke VA 240111331 Lyne Aigner MD 002.00 X 0 0 0 Florella Johnson 002.00 X 0 0 0 Billy Kingery 002.00 X 0 0 0 Dave Peters 002.00 X 0 0 0 Susan Kirby MD 002.00 X 0 0 0 Mack Longmire III MD 040.00 X 0 153038 47761 Jeff Powell 002.00 X 0 0 0 Chris Aylesworth 002.00 X 0 0 0 Ronald Evans 002.00 X X 0 0 0 Victoria Gardner 002.00 X 0 0 0 William Jacobsen 040.00 X X 177725 0 56294 Donald Lorton 040.00 X 0 545546 565924 Rachel Mabe 040.00 X 0 68552 28346 Charles Lane MD 040.00 X X 0 279098 67185 Lori McClure 040.00 X 129405 0 50635 Sharon Scott 040.00 X 128239 0 53431 Darrell Van Ness 040.00 X 116260 0 48950 551629 1046234 918526 3 false true false JM Turner & Co Inc 130 Church Ave Roanoke VA 24011 Construction contractor 1836084 Siemens Medical Solutions 51 Valley Stream Pkwy Malvern PA 19355 Equipment and software maintenance 329461 Health Information Associates PO Box 3787 Pawleys Island SC 29585 Medical billing services 128348 Richard Bailey 1961 Merriman Way Road Moneta VA 24121 Construction contractor 110778 4 24666 154495 1500 180661 Net Patient Service Revenues 900099 36650366 36650366 Program-Related Revenues 900099 19504 19504 36669870 -232670 -232670 2 2 311793 311793 311793 311793 436789 396334 40455 40455 40455 Miscellaneous 900099 4318 4318 90973 90973 95291 37065402 36674188 210553 0 0 0 0 177086 177086 0 12849177 12570161 279016 516784 516784 1772715 1700976 71739 944689 944664 25 5517069 5517069 0 0 5834 5834 5480 5480 4420188 4363282 56906 374 374 3351055 3319533 31522 240428 237932 2496 0 624930 624882 48 205161 190202 14959 0 0 469394 469394 0 1551581 1551581 343996 222244 121752 Bad Debt 4353161 4353161 Practice Subsidy 2328423 1113464 1214959 Donations 74478 65153 9325 Dues Subscriptions 96074 66909 29165 Education 12571 4082 8489 64320 62173 2147 39924968 32559871 7365097 0 1360 1360 23660 10619 5032928 4948062 265855 73942 34341134 22787689 15652561 11553445 96003 1030363 152405 653897 251983 741395 21476755 19013083 3128252 3280145 66222 68252 12030451 11674519 3967051 4404094 19191976 19427010 X 2230699 -459135 54080 45208 2284779 -413927 21476755 19013083 X false true true X X 0.00000 0.00000 0.00000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 5834 5834 false II-B 1i Portion of dues paid to American Hospital Assn., Virginia Hospital and Healthcare Assn. and other healthcare related organizations spent on lobbying. false 226092 226092 18035849 9522722 8513127 16939 16939 15275949 12609027 2666922 786305 639001 147304 11553445 Qualifed Pension Liability 3617906 2001 Swap Unrealized Losses 172711 2005 Fixed Payor Swap Unreal 613477 2005 Basis Swap Unreal Losses 4404094 true true X true X true X true true false true true 3892773 3892773 0.10950 3925640 3199580 726060 0.02040 7818413 3199580 4618833 0.12990 164 16581 159176 749 158427 0.00450 2 14 774 774 11 2371 58179 58179 0.00160 177 18966 218129 749 217380 0.00610 177 18966 8036542 3200329 4836213 0.13600 1 21 85 85 1 425 618 618 2 446 703 703 false 1530511 1056721 9273847 10190671 -916824 X true true Carilion Franklin Memorial Hospital

180 Floyd Avenue Rocky Mount VA 24151

X X X Imaging Services

35 Medical Court Hardy VA 24101

CT and Radiology services N/A Carilion Clinic, the sole member of the Hospital, includes the community benefit report for the Hospital in a system-wide annual report Ratio of cost-to-charges was used to calculate the expense. N/A Bad debt expense subtracted from total expenses for the calculation is 4,353,161. The financial statements do not include a footnote on bad debt. The audited financial statements include a provision for bad debt. The provision is calculated 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 Medicare allowable costs are determined from the Medicare cost report using the cost-to-charges ratio. The Hospital doe not consider a Medicare shortfall as a community benefit. 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. One facility offers CT and Radiology services Carilion Franklin Memorial Hospital uses demographic information and data on patients treated to determine community health needs. Additionally, information from public databases compiled on the Virginia Atlas of Community Health website is reviewed for the entire geographic area served by Carilion Franklin Memorial Hospital. With the large growth of uninsured seeking primary care through the hospital Emergency Room, Carilion Franklin Memorial Hospital contracted with the Virginia Tech Center for Public Health Practice and Research Institute for Society, Culture and Environment to provide an independent baseline assessment for coordinated care that was completed in January 2011. Additionally, a community health needs assessment is scheduled for completion in compliance with recent guidelines related to quantifying community benefit. 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. Carilion Franklin Memorial Hospital, located in Rocky Mount, Virginia, primarily serves the 52,238 residents of Franklin County. The County is 712 square miles and situated in the foothills of the Blue Ridge Mountains of Central Virginia. While much of the County is rural, recreational interests are met with more than 24,000 acres comprised of public lakes. Approximately 22 of adults under age 64 and 11 of children who live in the County are uninsured. Additionally, 13 of residents live below the poverty level and 19 did not graduate from high school. Carilion Franklin Memorial Hospital is a 37 bed hospital with an extremely busy Emergency Room, treating approximately 23,500 patients in 2010. Carilion Franklin Memorial Hospital provides financial and in-kind support to the Free Clinic of Franklin County that included an unexpected move and renovation project during 2010. Carilion Franklin Memorial Hospital has been working to reduce the overall carbon footprint through its recycling effort that includes light bulbs, batteries, printer cartridges, mixed paper and even cooking grease. More than 425 children learned about healthcare careers through Caring Careers, an educational program for school aged children provided onsite at local schools and community centers. Carilion Franklin Memorial Hospital provides support of the local EMS crews through replenishment of medications used for patient care or product with an expired use by date. Additionally financial and in-kind support was provided to the American Cancer Society, Special Olympics, Rotary Club in Rocky Mount and United Way Carilion Franklin Memorial Hospital serves all patients regardless of their ability to pay. The Hospitals governing Board is elected annually and the majority of members are neither employees nor contractors of the Hospital. Medical staff privileges are extended to qualified providers. In addition to clinical care, the hospital works to achieve its mission through the education of health professionals and the community. Any surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. This includes providing free, discounted and subsidized care as well as critical medical services that operate at a loss. Carilion Franklin 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 Carilion Franklin Memorial Hospital touched 16,581 people during the more than 164 events offered throughout the community. Individualized health information is provided through community screenings at several public locations, many in localities experiencing high unemployment such as Ferrum. Additionally health fairs and presentations are offered at various locations throughout the County. Another way that Carilion Franklin Memorial Hospital touches the community is through Med Talk, a weekly radio program, providing listeners with an opportunity to learn more about a variety of health topics through a call in show that provides answers to their specific questions. Coordinated by local health educator, guests of the show include health professionals as well as representatives of local community service organizations. Carilion Franklin Memorial Hospital is a wholly owned hospital 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. X X true true X X X X X false true false false false false false true false Mack Longmire III MD 135390 22382 -4734 28193 19568 200799 William Jacobsen 164727 18713 -5715 40621 15673 234019 Donald Lorton 436800 49620 59126 548892 17032 1111470 55087 Charles Lane MD 256616 15919 6563 55898 11287 346283 Lori McClure 124669 4736 36952 13683 180040 Sharon Scott 128199 40 51619 1812 181670 Darrell Van Ness 113065 3195 36116 12834 165210 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 Industrial Development Authority of the City of Roanoke VA 541106038 770084EK3 2003-08-19 2075000 Capital projects, Redemptioof Series 1993A bonds Costs of issuance, bond insurance false false Industrial Development Authority of the City of Roanoke VA 541106038 770084EQ0 2005-12-12 5605000 Capital projects, current refunding of Series 2002 B-E bonds Costs of issuance, bond insurance false false 2075016 75105 true false true true 5605181 115326 true false true true true true false false false true true true true UBS & Citicorp 0000000027.000000000000 true AIG 0000000000.300000000000 true false true Form 990 I 1 Carilion Franklin Memorial Hospital, part of Carilion Clinic, is a not-for-profit healthcare organization committed to improving health outcomes for every patient while advancing the quality of care in the community it serves. Form 990 III 1 Carilion Franklin Memorial Hospital, part of Carilion Clinic, is a not-for-profit healthcare organization committed to improving health outcomes for every patient while advancing the quality of care in the community it serves. Form 990 VI 6 The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers. Form 990 VI 7a The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the board that may occur for any reason. Form 990 VI 7b The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO, approval of borrowings, budgets and strategic plans and amendments of Articles of Incorporation and Bylaws. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia certain extraordinary actions require member approval, such as mergers, consolidations, liquidations and the sale of substantially all of the assets of the organization. Form 990 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. Form 990 III 4a Carilion Franklin Memorial Hospital exists to serve the health care needs of its community, regardless of patient ability to pay. Franklins acute hospital admitted 1,858 patients and provided 5,791 days of care during the year. Hospital programs include provision of nursing care extensive outpatient and inpatient surgical and endoscopic services and diagnostic imaging services including CT, MRI, and mammography. Franklin provides a number of services targeting the specific health needs of its population, including diabetes management home health and hospice physical, speech, and occupational therapy programs and cardiac and respiratory rehab. Franklin also provides an emergency department with 24-hour care, emergency transportation, and a chest pain and stroke program. Form 990 III 4a contd With 23,478 visits, Franklins emergency services are a critical component of the health safety net in its service area, acting as a primary health provider for a significant number of uninsured patients, who comprise 21 percent of ED visits. Franklin also supports community screenings and education on chronic disease prevention and management, sponsoring 164 events touching over 16,500 people. In furtherance of its mission, Franklin provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year exceeded 5.6 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. 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 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 Stonewall Jackson Hospital PO Box 12385 Roanoke VA 24025 540568001 Healthcare VA 501c3 3 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 false true false false false false false false true false false true false false false false false true