2024-08-15T20:14:00+00:00 2023-09-30 990 2022-10-01 540480606 Carilion Franklin Memorial Hospital CARI 5402245102 PO BOX 12385 Roanoke VA 24025 G ROBERT VAUGHAN JR TREASURER 5402245102 2024-08-16 true 2022 2024-08-08 14:25:15Z Carl Cline PO BOX 12385 Roanoke VA 24025 82367079 false X WWW.CARILIONCLINIC.ORG X 1956 VA Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost. 12 5 603 20 0 0 2936052 510297 66480215 81320995 365624 180347 252410 249085 70034301 82260724 71598 86946 0 27089348 27723123 0 0 39718670 44715199 66879616 72525268 3154685 9735456 45660792 52574219 21624935 18637420 24035857 33936799 Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost. false false 60597804 86946 81351478 See Schedule O. 60597804 true true false true false false false false false true true false false true false false true false false false false false false false false true true true false true false false false false false false true false false false false false false true true true false false true X 0 0 603 true false false false false false false false false false false false false X 12 5 true true false false true true true true true false false true true true true true true true true false VA X MATTHEW BARR 5402245021 213 S JEFFERSON ST ROANOKE VA 24011 Carl Cline Jr Dir./Sec./Treas./Hospital VP 50.0 0 X X 203341 0 -55670 Victoria Gardner Director/Vice President 1.2 0.0 X X 0 768 0 William Kingery Jr Director / President 2.5 2.9 X X 0 11825 0 Barbara Jackman Director 1.2 0 X 0 0 0 Craig L Bookout MD Director 1.2 48.8 X 0 351583 -54279 Dave Peters Director 1.2 0.0 X 0 768 0 Katherine Goff PhD Director 1.2 0 X 0 0 0 Sarah Stubbs MD Director 1.2 48.8 X 0 196145 -123301 Shannon Moore Director 1.2 7.7 X 0 40237 20749 Stephanie Lareau MD Director 1.2 48.8 X 0 375677 -95161 Steven Arner Director/COO, Carilion Clinic 2.0 48.0 X 0 1120207 -113754 W Mark Church PhD Director 1.2 0 X 0 480 0 David Hagadorn Asst. Treasurer 0.5 49.5 X 0 160104 -121301 Donald Halliwill Asst. Treasurer 0.5 49.5 X 0 988973 -138321 G Robert Vaughan Jr Asst. Treasurer 0.5 49.5 X 0 409821 -254014 J Harrison Lapuasa Asst. Treasurer 0.5 3.0 X 0 0 0 Julie Smith-Hamilton Asst. Secretary 0.5 49.5 X 0 61128 12403 Nicholas Conte Asst. Secretary 1.0 49.0 X 0 817822 83882 Nancy Howell Agee CEO, Carilion Clinic 2.0 48.0 X 0 2186283 1001688 Carole Robertson Physical Therapist 50.0 0 X 123563 0 -75772 Donn Bergman Physical Therapist 50.0 0 X 131936 0 7184 Ian Stanaway Physical Therapist 50.0 0 X 122106 0 23586 Lori McClure Pharmacy Manager 50.0 0 X 179791 0 -204550 Shirley Landon-King Occupational Therapist 49.0 1.0 X 128720 1286 -109759 889457 6723107 -196390 18 false true false SKANSKA USA BUILDING INC 4309 EMPEROR BLVD SUITE 200 DURHAM NC 27703 CONSTRUCTION SERVICES 6949145 QUALIVIS LLC 1601 ASSEMBLY ST UNIT 1439 COLUMBIA SC 29201 TEMPORARY STAFFING 4058132 QUEST DIAGNOSTICS 500 PLAZA DRIVE SECAUCUS NJ 07094 LABORATORY SERVICES 1875396 AVANT HEALTHCARE PROFESSIONALS 1211 SEMORAN BLVD CASSELBERRY FL 32707 TEMPORARY STAFFING 194622 CROTHALL HEALTHCARE INC 13028 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 HOUSEKEEPING SERVICES 193112 9 23148 245324 241825 510297 Net Patient Revenue 622110 80940671 80940671 Rent From Affiliates 531120 380324 380324 0 0 0 0 81320995 182720 182720 111967 111967 0 111967 111967 103982 106355 -2373 0 -2373 -2373 Cafeteria and Vending Revenue 722514 106635 106635 Affiliate income 900099 21994 21994 900099 8489 8489 0 0 0 0 137118 82260724 81351478 0 398949 X 86946 86946 248747 248747 110585 110585 21711503 21667772 43731 666265 665691 574 3420954 3373403 47551 1565069 1547733 17336 11088644 11088644 56 56 6315 6315 35551 35551 8631496 8463494 168002 0 5125 5125 1198030 1149750 48280 151776 151618 158 1219276 1219276 546829 542366 4463 143945 143945 2302560 2302560 457116 240573 216543 Medical Supplies 7467747 7467747 Bad Debt 5755388 5755388 Assessment Fees 2945578 2945578 Affiliate Practice Subsidy 2679158 2679158 80609 72781 7828 0 72525268 60597804 11927464 0 717 717 961 326 12420714 12996796 0 0 0 0 427041 590055 62156774 34893472 22109538 27263302 4007838 3345603 6682732 8364825 0 11251 12595 45660792 52574219 7136524 8115724 400493 127435 5423841 5342420 0 0 8664077 5051841 21624935 18637420 24035857 33936799 24035857 33936799 45660792 52574219 X 9735456 963104 -797618 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 6315 6315 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY A portion of dues paid to various healthcare industry associations is attributable to lobbying activities. 408022 408022 36999032 17297483 19701549 9300 930 8370 21634505 16670768 4963737 3105915 924291 2181624 27263302 247992 F Alternative Investments 8116833 F 8364825 Pension Liability 2516223 Interest Rate Swap Liability 132280 Lease Liability 678063 Due to Affiliate 1725275 5051841 true true X true X 300 true X 500 false true false true true 967448 967448 0.0145 16682699 16963429 0 0.0 0 0.0 0 0 17650147 16963429 967448 0.0145 231547 23778 207769 0.0031 114 114 0.0000 0 0.0 0 0.0 105481 105481 0.0016 0 0 337142 23778 313364 0.0047 0 0 17987289 16987207 1280812 0.0192 0 0.0 3827 3827 0.0001 9014 9014 0.0001 0 0.0 0 0.0 10287 10287 0.0002 113 113 0.0000 321 321 0.0000 0 0.0 0 0 23562 0 23562 0.0004 true 5755388 16322313 17037950 -715637 X true true 1 1 CARILION FRANKLIN MEMORIAL HOSPITAL 390 South Main Street ROCKY MOUNT VA 24151 https://carilionclinic.org/locations/carilion-franklin-memorial-hospital H 1836 X X X CARILION FRANKLIN MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 20 true false true true X https://www.carilionclinic.org/cho-community-health-assessments#reports X https://issuu.com/carilionclinic/docs/2021_franklin_chna_report_final X X true 21 true https://www.carilionclinic.org/cho-community-health-assessments#reports false true X 300.0 500.0 X X X true true X X X true X https://www.carilionclinic.org/billing/financial-assistance X https://www.carilionclinic.org/billing/financial-assistance X https://www.carilionclinic.org/billing/financial-assistance X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E The publicly available community health needs assessment report details the prioritization process for the community's significant health needs as identified through the CHNA. The Community Health Assessment Team (CHAT), made up of community stakeholders, reviews all data and completes a prioritization survey. Through the survey, each CHAT member selects and ranks the most pertinent community needs. The data are combined and priorities are selected based on the highest weighted score of each need. Through this process, CHAT members prioritize needs according to the need's perceived burden, scope, severity or urgency; the importance the community places on addressing the need through survey responses and other interactions; and each member's unique perspective on community health. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - CARILION FRANKLIN MEMORIAL HOSPITAL. Carilion Clinic's Community Health Needs Assessments (CHNAs) are community-driven projects. Their success is highly dependent on engaging citizens, health and human service agencies, businesses and community leaders. Stakeholder collaborations known as Community Health Assessment Teams (CHATs) lead the CHNAs. The CHATs are a dynamic group that includes health and human service agency leaders, people with exceptional knowledge of, or expertise in, public health, and local health department officials. The CHATs obtain input from leaders, representatives or members of medically underserved populations who report low-income, are minorities and suffer from chronic diseases. The following organizations served on the CHAT for the 2021 Franklin County Area Community Health Needs Assessment (FCACHNA): Franklin County Public Safety, Friends of Pigg River, Disability Rights and Resource Center, Rocky Mount Health and Rehab, Smith Mountain Lake Regional Chamber of Commerce, Department of Social Services, Ferrum College, Franklin County Public Schools, Bernard Healthcare Center & Free Clinic, Franklin Center, Piedmont Community Services, Tri-Area Community Health Center-Ferrum, Southern Virginia Child Advocacy Center, West Piedmont Health District, United Way of Roanoke Valley/Healthy Franklin County, Franklin County Parks and Recreation, Piedmont Community Services, and Habitat for Humanity, in addition to representatives from multiple Carilion Clinic departments. To obtain input from the community, the FCACHNA conducted a focus group among CHAT stakeholders and administered a 40-question community health survey broadly across the service area. This occurred from October 1, 2020, through January 31, 2021. The community health survey was developed (in English and Spanish) with questions about socioeconomic factors; access to medical, dental and mental health care; health behaviors; physical environment; health outcomes; and demographics. The survey included commonly used questions and metrics from previously validated community surveys conducted by organizations such as the National Association of County and City Health Officials and Centers for Disease Control and Prevention. During the CHNA process, community stakeholders, leaders and providers were encouraged to complete a stakeholder survey electronically to provide additional perspectives about our community's health needs and barriers. A focus group was held with the CHAT stakeholders to further discuss the data collected through the stakeholder survey. The CHAT assisted with survey distribution in an effort to reach particular target populations. The survey focused on Franklin County and Henry County residents 18 years of age and older. Special efforts were made to include underserved/vulnerable populations disproportionately impacted by social determinants of health such as income, race/ethnicity, education and insurance status. Specific populations served by CHAT representatives include the un- or underinsured, the homeless, the food insecure, small business owners, and low-income individuals and families with young children, among others. Due to the COVID-19 pandemic, most responses were collected electronically, though the survey was also available by phone and on paper. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - CARILION FRANKLIN MEMORIAL HOSPITAL. The 2021 Franklin County Area Community Health Needs Assessment was conducted with: Franklin County Public Safety, Friends of Pigg River, Disability Rights and Resource Center, Rocky Mount Health and Rehab, Smith Mountain Lake Regional Chamber of Commerce, Department of Social Services, Ferrum College, Franklin County Public Schools, Bernard Healthcare Center & Free Clinic, Franklin Center, Piedmont Community Services, Tri-Area Community Health Center-Ferrum, Southern Virginia Child Advocacy Center, West Piedmont Health District, United Way of Roanoke Valley/Healthy Franklin County, Franklin County Parks and Recreation, Piedmont Community Services, and Habitat for Humanity. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - CARILION FRANKLIN MEMORIAL HOSPITAL. The Community Health Assessment Team shared the 2021 Franklin County Area Community Health Needs Assessment on partner websites and social media, as well as a presentation to the Chamber of Commerce. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - CARILION FRANKLIN MEMORIAL HOSPITAL. The following information describes the implementation strategy used by Carilion Franklin Memorial Hospital (CFMH) to address the community health needs identified in the 2021 Franklin County Area Community Health Needs Assessment (FCACHNA). The complete implementation strategy is available online at https://www.carilionclinic.org/sites/default/files/2022-02/2021%20CFMH%20Implementation%20Strategy_FINAL%20APPROVED.pdf. The top prioritized needs for the 2021 FCACHNA were grouped into four overarching categories: mental health, access to care, health behaviors and access to services. We have been addressing prioritized needs with the following strategies and a commitment of financial resources, staff time and leadership. Strategies to address mental health include supporting ongoing work of other organizations in addressing recovery and transitional housing with a Carilion physician providing regular educational sessions with women at the Pearl House, a transitional home for mothers and children; providing community grants to mental health safety net providers; expanding the PACE (partnership-access-care-empowerment) program; supporting the Franklin County Opioid Task force and the Martinsville and Henry County Task Force in creating a new regional awareness campaign for medication drop boxes; continuing to provide a permanent medication drop box in CFMH emergency department waiting area; continuing to facilitate and promote drug takeback events every spring and fall; continuing to monitor physician prescription ordering for opioids; and continuing participation in the local prevention coalition (FRESH - Focus on Response and Education to Stay Healthy). Strategies to address access to care include providing support for the Free Clinic of Franklin County through grants and board representation; launching Carilion Now platform for virtual visits; converting a 0.6 FTE physician to 1.0 FTE at the Westlake Family and Internal Medicine practice; and opening a new dental practice located at the Tanglewood Center in Roanoke. We also continue to work towards making prevention services available in neighborhoods and easy-to-access community locations. Strategies to address health behaviors include supporting work to address chronic disease, obesity and poor eating habits through food access and increased physical activity; providing grant funding to Stepping Stone Mission to support their soup kitchen; and providing community health education and participating in community events such as health fairs, immunizations and health screenings. A new health educator was hired in FY22 who is serving the Franklin County area. Strategies to address access to services include hiring a community health worker to serve the Franklin area; and promoting an external community resource referral resource, Unite Us. Additional strategies to more broadly address a culture of community health and its ties to each of the priority needs include developing a system-wide community health investment plan; further developing community health infrastructure; engaging employees in supporting community partnerships through Board representation with Franklin County Non-Emergent Transportation Services and the Free Clinic of Franklin County; and leveraging internal data to assess health disparities. Progress made in 2023 to further develop a culture of community health continued to build upon increasing infrastructure and strategic impact. Community Health and Outreach services have been integrated into the electronic medical record system, increasing provider knowledge of and capacity for referrals to health education, community health nursing, and community health worker services. The Community Health and Development division continues working closely with the Clinical Advancement and Patient Safety department, the office of Diversity, Equity, and Inclusion, Health Analytics, and others on a health equity steering committee to identify and address health disparities in the communities we serve. 0 Schedule H, Part I, Line 3c OTHER FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA Financial assistance policy in effect for fiscal year 2023: families with family income equal or below 300% of the Federal Poverty Guidelines and countable assets equal or below $25,000 receive 100% adjustment under FAP. Families with family income greater than 300% of the Federal Poverty Guidelines but less than or equal to 500% of the Federal Poverty Guidelines or countable assets above $25,000 and less than or equal to $100,000 receive a partial adjustment under FAP. The partial adjustment matches the highest AGB percentage determined for all facilities. Schedule H, Part I, Line 6a PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT Information about community benefit is reported annually through a consolidated report prepared by Carilion Clinic (EIN 54-1190771). Printed copies of this report are distributed throughout communities served by hospitals affiliated with Carilion Clinic. Additionally, the community benefit report is available on Carilion Clinic's website: https://www.carilionclinic.org/cho-community-health-assessments#community-benefit-reports Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 5755388 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Line 7a and 7b: For activities reported on the Medicaid Cost Report, a cost-to-charge ratio as determined from the Medicaid Cost Report was used. For all other activities, a cost to charge ratio derived from Worksheet 2 of the 990 instructions was used. Line 7e through 7i are reported at actual cost. Schedule H, Part II Community Building Activities Line 2 - Economic development: As the largest employer in Southwest Virginia, Carilion impacts economic development by investing in jobs, increased wages for employees and various capital building projects. In addition, Carilion had in-kind expenses from support of the Smith Mountain Lake Chamber of Commerce, and direct economic development expense support of Cruisin' Rocky Mount, an event which benefits local businesses and builds a vibrant community. Support was also provided to the Community Partnership, promoting economic strength and development of Rocky Mount and Franklin County. Line 3 - Community support: Research demonstrates the strong connection between social determinants of health-such as transportation and education-and communities' overall health and well-being. Carilion supports nonprofit organizations addressing barriers to good health arising from these social determinants in various ways. Carilion also collaborates with local partners to support better education and opportunities for children and families and improved housing, better nutrition and additional resources for our neighbors in need. These efforts help to remove a range of obstacles to good health for our region's residents. CFMH is involved with various health and social determinant-related initiatives, providing organizational support and monetary donations. For example, Carilion supported Virginia Cooperative Extension, local Parks and Recreation, the agricultural fair, and Ferrum College. Line 6 - Coalition building: Carilion believes in the power of collaboration and understands that we must address our most significant health issues in concert with the community. To ensure lasting impact from the health assessment and community health improvement process, Carilion participates in coalitions that address health, safety and social determinant needs in the Franklin County area. We also partner with multiple community and business organizations on initiatives to improve health and wellness for everyone living in the Franklin County area. An example is Carilion's representation on the Rocky Mount Rotary Club-a group working together to advance goodwill in the area. Carilion also participated on the local Red Cross board, Healthy Franklin County, the Roanoke Valley Hearing and Speech Center board, and participated with the local NAACP, CASA, and Local Emergency Planning Committee. Line 7 - Community health improvement advocacy: Carilion's mission of community health improvement focuses not only on what the organization does directly but also on supporting the advocacy efforts of other organizations. Carilion participated in the Franklin County strategic planning process in order to ensure community health improvement continued to be a priority for the local government. Line 8 - Workforce development: With the understanding that employment is directly linked to health and wellness, Carilion partners to provide workforce development and training for community members. Carilion supported the STEM Health and Applied Program Advisory Board and the Franklin County High School Auxiliary. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Carilion Franklin Memorial Hospital estimates bad debt expense by reserving a percentage of all self-pay patient accounts receivable by aging category, based on collection history, adjusted for expected recoveries and, if present, anticipated changes in trends Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Patient accounts receivable are stated at net realizable amounts due from patients, third-party payors, and other insurers for which Carilion Franklin Memorial Hospital expects to be entitled in exchange for providing patient care. In accordance with Accounting Standards Update (ASU) No. 2014-09, Revenue from Contracts with Customers (Topic 606) (ASU 2014-09), the estimated uncollectible amounts are generally considered implicit price concessions that are a direct reduction to patient accounts receivable. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Medicare allowable costs are determined from the Medicare cost report using the cost-to-charge ratio. The hospital believes our Medicare shortfall is a cost we incur as a benefit to the community. IRS REV. RUL. 69-545 provides that one of the factors demonstrating community benefit is caring for patients who pay their bills through public programs such as Medicare. In order to operate for the benefit of the broad community that we serve we must include our significant Medicare population, even if we are required to subsidize care to our Medicare patients due to being reimbursed at less than cost by Medicare's nonnegotiable rates. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance When accounts receivable efforts are exhausted, the account may be placed with a collection agency and extraordinary collection actions (ECAs) may be considered. Accounts will not be placed with a collection agency prior to 120 days from the date the first post-discharge billing statement is provided except when mailings are returned with no forwarding address and combining multiple accounts of varying age with those already transferred or for legal verification regarding other liabilities. Reasonable efforts will be made to identify appropriate forwarding addresses. When a financial assistance application (FAA) is received during the application period (within 240 days after the date the first post-discharge billing statement is provided), but after initiation of ECAs, all ECAs will be suspended. Best efforts will be made to process completed applications within 30 days of receipt of the application; financial assistance eligibility will be determined and communicated to the individual. Incomplete applications must be completed within 30 days of the initial notification of additional items required; otherwise, the application will be deemed incomplete and closed. If an individual is eligible for financial assistance, ECAs, other than the sale of debt, will be reversed and any payments related to eligible care refunded to the extent no longer owed. ECAs will be reinstated if the individual is not eligible for financial assistance or does not complete the FAA by the deadline. At least 30 days before initiating an ECA, Carilion will send the patient written notice of intended ECA(s), a plain language summary explaining financial assistance available and the process for determining eligibility, and the deadline for applying for assistance. Carilion will also attempt to call individuals at least 30 days before initiating an ECA to make them aware of the financial assistance available and how to obtain assistance with the application process. Carilion shall enter into a written contract with any collection agency to which it refers bad debt. The contract will obligate the collection agency to observe and comply with Carilion's obligations under this policy and the Financial Assistance Policy. A collection agency to which bad debt is referred for collection may not engage in any ECAs without the prior written consent of Carilion. After making reasonable efforts to determine if a patient qualifies for financial assistance and the patient either does not qualify for financial assistance or fails to submit an application as requested, within 240 days from the date the first post-discharge billing statement is provided, Carilion may engage in one or more of the following ECAs: 1. Place a lien on an individual's property; 2. Attach or seize an individual's bank account or any other personal property; 3. Commence a civil action against an individual; 4. Garnish an individual's wages; 5. Sell an individual's debt to another party; or 6. Report the account to credit agencies. Individual account balances greater than $5,000 are not sent to a collection agency. These are handled through the Debt Recovery Department (DRD) for verification of financial assistance status before further collection activity occurs. DRD will also investigate any accounts that require special handling. For example, in cases of a deceased patient, auto accident, or any other unique circumstances requiring special handling, the accounts are placed with the DRD. When all collection efforts have been exhausted, all hospital accounts will be returned and closed as uncollectible. No further collection activity is taken at that time. Accounts with satisfactory payment arrangements, legal activity or accounts with pending payment will be considered active and are not returned. Schedule H, Part V, Section B, Line 16a FAP website - CARILION FRANKLIN MEMORIAL HOSPITAL: Line 16a URL: https://www.carilionclinic.org/billing/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - CARILION FRANKLIN MEMORIAL HOSPITAL: Line 16b URL: https://www.carilionclinic.org/billing/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - CARILION FRANKLIN MEMORIAL HOSPITAL: Line 16c URL: https://www.carilionclinic.org/billing/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment In addition to conducting regular Community Health Needs Assessments (CHNAs), Carilion Clinic closely monitors community health indicators and responds to needs as they arise. Each year, Carilion updates scorecards with refreshed County Health Rankings indicators provided by the Robert Wood Johnson Foundation and incorporates health data from other secondary data sources. Carilion is also responsive to needs identified through clinical data and internal departments. Carilion's call center, Carilion Direct, is available for community members to ask questions and connect with community resources. Carilion is also in the process of hiring a community health worker (CHW) to help address needs, and data will be reviewed periodically to identify trends in health care needs of patients served by CHWs. Unite Virginia data on referrals to community-based resources is also monitored regularly in order to understand the social determinant of health needs across our region. Needs are also identified through current collaborative relationships and community partnerships. Ongoing collaboration with stakeholders allows for regular communication of needs and gives our partners opportunities to respond cohesively. Carilion has adapted its community health improvement process from Associates in Process Improvement's Model for Improvement and the Plan-Do-Study-Act cycle developed by Walter Shewhart. It consists of five steps: (1) conducting the CHNA, (2) strategic planning, (3) creating the implementation strategy, (4) program implementation and (5) evaluation. This cycle is repeated every three years. Carilion fosters community development in its CHNA and community health improvement processes through the Strive Collective Impact Model for the Community Health Assessment Team. This evidence-based model focuses on "the commitment of a group of important players from different sectors to a common agenda for solving a specific social problem(s) has been proven to lead to large-scale changes. It focuses on relationship-building between organizations and the progress toward shared strategies. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Information on Financial Assistance is provided to the patient at hospital admission and ambulatory areas in the form of signage, a plain language summary which includes contact information, financial assistance application and documentation in the inpatient handbook. Patient Access staff, Hospital social workers and customer service representatives verbally inform patients on availability of assistance. Each patient statement and patient financial responsibility letter includes information on the Financial Assistance policy including who to contact for additional information and location of in-person assisters. The Application, the Policy, and the plain language summary are available free of charge to the patient. They are available by mail and on the web site if the patient did not receive written information at the time of service. Financial Assistance policy and application are also distributed to community partners through electronic mailing groups. Carilion Clinic employs an Eligibility staff that counsel patients on federal and state programs. The staff completes applications for Medicaid and provides information on Social Security, Social Security Disability and Medicare. The staff provides support services ensuring the applications are processed correctly based on federal and state policy. In addition, Eligibility staff are trained as Certified Application Counselors and will assist patients in enrollment in the Marketplace. Eligibility staff will also complete Carilion's financial assistance application and counsel patients on the requirements for financial assistance. Schedule H, Part VI, Line 4 Community information Franklin County is part of the Roanoke Valley metropolitan statistical area, a region flush with resources including food, health and human services, arts and culture, and outdoor amenities. Additionally, within the service area, resources are accessible to residents in the city of Martinsville, the town of Rocky Mount, the Smith Mountain Lake area, and other smaller communities. Health and human service organizations work to reduce the disparities in access to care and access to resources for many residents of the region. The Franklin County Area is comprised of distinct communities with disparities in size, population, and social determinants of health. The 2018-2022 American Community Survey (ACS) found the total population of the counties of Franklin and Henry to be 54,838 and 50,760 respectively. Median age is similar at 48.4 in Franklin County and 48.3 in Henry County. The Weldon Cooper Center of Public Service predicts positive future population change for Franklin County and negative population change for Henry County by 2040. The ACS finds that both Franklin and Henry Counties have a more significant percentage of the population that is White (86.68% and 67.74%) than in the Commonwealth of Virginia (59.97%) as a whole. Henry County also has a larger percentage of the population that is Black (23.67%) than in the Commonwealth of Virginia (21.29%) (US Census Bureau, ACS, 2018-2022). Franklin and Henry Counties are designated as Health Professional Shortage Areas for primary care, mental health, and dental health for low-income residents, and Medically Underserved Areas for primary care. There is another hospital in Henry County owned by Sovah Health. CFMH is the only hospital in Franklin County. (https://data.hrsa.gov/tools/shortage-area) The 2018-2022 ACS states that the average household income in Franklin County is $89,849 and in Henry County is $58,729. Franklin County has 5.44% of the population living at or below the Federal Poverty Level. In Henry County that number is 5.62%. Both counties have higher poverty rates than Virginia (4.88%) (US Census Bureau, ACS, 2018-2022). The ACS shows that 21.08% of the population in Franklin County are receiving Medicaid and 7.19% have no insurance coverage. In Henry County, 29.98% are receiving Medicaid and 8.10% have no insurance. Of the patients receiving care at CFMH in FY23, 25.63% have Medicaid coverage and 4.55% are self-pay (Strata internal data). Schedule H, Part VI, Line 5 Promotion of community health Carilion Franklin Memorial Hospital is part of the non-profit Carilion Clinic integrated health care system located among the Blue Ridge Mountains. Carilion provides quality care for nearly one million individuals through a comprehensive network of hospitals, primary and specialty physician practices, wellness centers and other complementary services. Carilion's roots go back more than a century when a group of dedicated citizens came together and built a hospital to meet the community's health care needs. Today, Carilion is a vital anchor institution focused on health care and dedicated to our mission of improving the health of the communities we serve. With an enduring commitment to our region's health, care is advanced through clinical services, medical education, research and community health investments. Carilion believes in service, collaboration and caring for all. Carilion invests in discovering and responding to local and regional health needs, understanding that we must involve additional stakeholders to address community health issues and create change effectively. Carilion recognizes the impact the environment has on the health of our communities. Efforts continue to make our hospitals and other facilities more energy-efficient, increase recycling and use of recyclable or bio-degradable materials, reduce waste materials and serve local, sustainable foods to patients and in our cafeterias. Carilion has an office of sustainability which leads these efforts and empowers employees to be involved in environmental health related projects. Carilion Franklin Memorial Hospital (CFMH) provides a full range of top-quality inpatient and outpatient care for Franklin County area residents. The facility includes an inpatient hospital and medical offices for acute and specialty care. CFMH's health care professionals provide patients with reliable, safe care to get them on the road to recovery, close to home. For inpatient care, CFMH physicians diagnose and treat illnesses, anticipate problems and rapidly respond to changes in patient conditions. Emergency services are onsite 24/7 and CFMH offers direct access to Carilion's Level 1 Trauma Center if an advanced level of care is needed. Other onsite services include imaging services, inpatient and outpatient surgical services, therapy services (PT, OT, ST, RT), and laboratory. CFMH serves all patients regardless of their ability to pay. The hospital's governing board members are elected annually and reside in the region. The majority of members are neither hospital employees nor contractors. Medical staff privileges are extended to qualified providers. Surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. Reinvestments include providing free, discounted and subsidized care and critical medical services not otherwise offered in our region. Schedule H, Part VI, Line 6 Affiliated health care system Carilion Franklin Memorial Hospital is wholly owned by Carilion Clinic, a not-for-profit health care organization based in Roanoke, Virginia. Carilion Clinic includes a comprehensive network of hospitals, primary and specialty physician practices, and complementary services consisting of six hospital entities, 81 specialties, and 248 practice sites across Southwest Virginia. All of these are centered on a common mission and shared values. In the mid-2000s, Carilion made the strategic decision to transform from a collection of hospitals to a physician-led, integrated health care system. Advances include developing a multi-specialty physician group, transforming our primary care practices into patient-centered medical homes, implementing electronic health records system-wide, creating a robust partnership with Virginia Tech, including developing the Virginia Tech Carilion (VTC) School of Medicine and the Fralin Biomedical Research Institute at VTC. Each decision and adaptation have fundamentally changed the way Carilion collaborates and provides care (https://www.carilionclinic.org/about-carilion-clinic). Carilion's community and population health infrastructure is the health system's engine for providing collaborative opportunities to improve and promote the community's health. Carilion's Community Health Assessments process helps identify the strengths and barriers impacting health. Our community-based programs reflect the Robert Wood Johnson Foundation's framework of four main influences of health: health behaviors, social and economic factors, clinical care access and quality, and physical environment. Our many partnerships with cross-sector organizations create a collaborative culture of health and wellness. Carilion has a long history of working with Radford University and Jefferson College to advance health professionals' education. Founded in 1914 as the Jefferson Hospital School of Nursing, what became known as the Jefferson College of Health Sciences merged with Radford University in early 2018 to form Radford University Carilion (RUC). Located on the campus of Carilion Roanoke Community Hospital, this higher education institution "prepares, within a scholarly environment, ethical, knowledgeable, competent and caring healthcare professionals." Today, RUC provides more than 1,100 students with opportunities to become part of the health care profession, serving communities ranging from Southwest Virginia to the Shenandoah Valley and beyond. The school's graduates are building healthier tomorrows in our region and across the country every day. true Children's Advocacy Prog of Blue Ridge 300 S Main St Rocky Mount VA 24151 541950268 501(c)(3) 12000 Operations support Free Clinic of Franklin County 1171 Franklin St Rocky Mount VA 24151 541634138 501(c)(3) 21000 Primary care access via NP Habitat for Humanity of Franklin Co VA 1145 Franklin St Rocky Mount VA 24151 541723239 501(c)(3) 10000 Critical home repair Healing Strides of Virginia PO Box 456 Boones Mill VA 24065 541594325 501(c)(3) 6944 Parenting courses 4 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. The hospital donates funds to other charitable organizations in support of health and community improvement. Such organizations also have community boards which oversee the expenditure of such funds. Carilion Clinic is committed to improving the health of the communities that we serve by addressing key health priorities identified through our triennial Community Health Assessments. Carilion fulfills this commitment in many ways, one of which is through targeted grants for community health improvement programs, and those that impact the social determinants of health. For Carilion Clinic's Community Grant Program, each grantee must sign a letter of agreement with Carilion Clinic that delineates the terms and specific objectives of the project. By accepting a Carilion award, grantees are asked to acknowledge the support of Carilion Clinic in all materials and/or related special events or fundraisers throughout the award cycle where other donors are publicly recognized. One mid-cycle progress report and a final program evaluation are required for each funded project. Site visits may be made to grantees. Program evaluation includes alignment with Community Health Assessment priorities, program impact, organizational effectiveness and community benefit through collection of data including clients served, cost effectiveness of the program (cost per client or service), tangible community or client outcomes, collaboration with other organizations, and specific efforts to cultivate diverse funding sources for program sustainability. Each grantee must agree to submit requested data and reports on a timely basis and to complete the evaluation process as requested. false true false false false false false true false Carl Cline Jr Dir./Sec./Treas./Hospital VP 182203 0 19663 0 1475 0 -69986 0 14316 0 147671 0 0 0 Steven Arner Director/COO, Carilion Clinic 0 892203 0 149632 0 78372 0 -135050 0 21296 0 1006453 0 73054 Craig L Bookout MD Director 0 337425 0 7432 0 6726 0 -62360 0 8081 0 297304 0 0 Stephanie Lareau MD Director 0 348757 0 24595 0 2325 0 -103274 0 8113 0 280516 0 0 Sarah Stubbs MD Director 0 173324 0 21340 0 1481 0 -143194 0 19893 0 72844 0 0 Nicholas Conte Asst. Secretary 0 642289 0 107354 0 68179 0 68334 0 15548 0 901704 0 60115 David Hagadorn Asst. Treasurer 0 150264 0 2700 0 7140 0 -127993 0 6692 0 38803 0 0 Donald Halliwill Asst. Treasurer 0 745723 0 125641 0 117609 0 -159617 0 21296 0 850652 0 113415 G Robert Vaughan Jr Asst. Treasurer 0 341967 0 44219 0 23635 0 -275310 0 21296 0 155807 0 19258 Nancy Howell Agee CEO, Carilion Clinic 0 1567773 0 358583 0 259927 0 987742 0 13946 0 3187971 0 0 Donn Bergman Physical Therapist 130138 0 1000 0 798 0 -13496 0 20680 0 139120 0 0 0 Lori McClure Pharmacy Manager 176659 0 2000 0 1132 0 -205512 0 962 0 -24759 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation, including that of the Hospital Vice President, is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of independent Board members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, the list of which was reviewed by the Compensation Committee. The Compensation Committee maintained minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Mr. Arner, Mr. Conte, Mr. Halliwill, and Mr. Vaughan, participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP). Contributions to the plan are at the discretion of Carilion Clinic's Compensation Committee. Amounts vest and become non-forfeitable and payable upon the first of the following (1) attainment of scheduled vesting date (2) attainment of age and years of service requirements (3) disability or death while an eligible employee or (4) entitlement to severance benefits from an involuntary termination without reasonable cause or resignation with good reason. Unvested contributions made to the DC SERP in the reporting period are included in Part II, Column C of this schedule with "retirement and other deferred compensation," while vested contributions paid out during the year are included in Part II, Column B(iii). The following distributions were made to these individuals under this plan in the reporting year. Deferred in prior year and paid out in current year: $113,415 - Donald Halliwill $73,054 - Steven Arner $19,258 - G. Robert Vaughan, Jr. $60,115 - Nicholas Conte Ms. Agee participates in an Executive Flexible Benefit Plan, under which she receives an allowance which can be used to obtain certain benefits, with the excess deferred until the applicable vesting date. Amounts now received under this plan vest immediately and thus are no longer deferred. $245,365 was distributed under this plan in the reporting year. Schedule J, Part I, Line 7 Non-fixed payments The organization pays annual "at-risk" compensation to certain members of management based on performance of an applicable scorecard. While the scorecard contains a formula as a basis for determining overall performance, in certain cases, senior managers have discretion to include additional elements in their assessment of managers reporting to them. In addition, for top management, the actual non-fixed payment awarded is in the discretion of the Carilion Clinic Board of Directors and its Compensation Committee. LETTITIA FURROW FAMILY MEMBER OF WILLIAM KINGERY, DIRECTOR 110585 EMPLOYEE false Form 990, Part I, Line 6 VOLUNTEERS At the end of 2022 our Auxiliary disbanded, and we have been working on growing our new volunteer program. The volunteers helped in many different ways this year. They assisted our pharmacy with installing and assembling new equipment, delivering items to patient rooms, greeting and escorting patients to their appointments or various hospital departments. Our volunteers truly exemplify our hospital's dedication to exceptional patient service. Hospice volunteers crafted handmade cards for patients to receive on birthdays, holidays, and for Veteran Pinning Ceremonies. Volunteers also conducted Veteran Pinning Ceremonies for Hospice Veteran patients. This consists of providing a patient with a handmade quilt, handmade card, certificate of recognition, USA flag pin, and a fabric star from a retired flag that is presented to the caregiver/spouse. Respite for caregivers was also provided by volunteers. Local volunteer quilting groups provide quilts for patient birthdays and Veteran Pinning Ceremonies. Volunteers help with Grief Support Group, delivering birthday bags to patients, and office administrative support. Form 990, Part III, Line 4a Program Service Accomplishments Carilion Franklin Memorial Hospital (CFMH), 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. Located in Rocky Mount, VA, this 37-bed hospital offers a wide range of medical and surgical services, including convenient outpatient and emergency department services. Carilion Franklin Memorial Hospital exists to serve the health care needs of its community, regardless of a patient's ability to pay. CFMH's acute hospital admitted 1,702 patients and provided 6,821 days of care during the year. Hospital programs include the provision of nursing care, extensive outpatient and inpatient surgical and endoscopic services, and diagnostic imaging services including CT, MRI, and mammography. CFMH provides several services targeting the specific health needs of its population, including diabetes management, home health and hospice, physical, speech, and occupational therapy programs, plastics & reconstructive, ENT, and cardiac and respiratory rehab. A desk area at the hospital's medical office building is staffed by volunteers who welcome patients and visitors. CFMH also provides an emergency department with 24-hour care, emergency transportation, and STEMI and stroke programs. With 21,036 visits, CFMH's emergency services are a critical component of the health safety net in its service area. It acts as a primary health provider for a significant number of uninsured patients, who comprise 6 percent of ED visits. CFMH also supports community screenings and education on chronic disease prevention and management. In furtherance of its mission, CFMH provides extensive uncompensated care and community support. Stated at cost, financial assistance and other community benefits for the year exceeded $1.2 million. Form 990, Part IV, Line 11f Disclosure of Uncertain Tax Positions Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. Form 990, Part V, Line 1a FORMS 1099 1099's are issued on Carilion Franklin Memorial Hospital's behalf by Carilion Services, Inc., a related organization providing management and administrative services, including payment processing. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons Nancy Howell Agee, Steven Arner, Nicholas Conte, David Hagadorn, Donald Halliwill, G. Robert Vaughan Jr., Julie Smith-Hamilton, J. Harrison Lapuasa, Craig Bookout, Sarah Stubbs, Stephanie Lareau and Shannon Moore - Business relationship Form 990, Part VI, Line 3 Delegation of management duties Certain management and related services for the organization are provided by the management and employees of Carilion Services, Inc., a related and supporting organization of the filing organization. Some or all of the compensation of the following individuals listed in Part VII, Section A was provided by Carilion Services Inc.: Nancy Howell Agee, Steven Arner, Nicholas Conte, David Hagadorn, Donald Halliwill, Julie Smith-Hamilton, Shannon Moore, and G. Robert Vaughan, Jr. Form 990, Part VI, Line 6 Classes of members or stockholders The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the board that may occur for any reason. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders 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, among others. 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. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a. Form 990, Part VI, Line 11b Review of form 990 by governing body The Form 990 was prepared by Carilion's internal Tax Department with input from various Carilion departments as applicable, and reviewed by internal management. Several days prior to filing, all Board Members were notified via email that the final Form 990 was posted on the organization's Board portal, which is the mechanism used to disseminate meeting materials to the directors, and were encouraged to call with any questions they might have. Form 990, Part VI, Line 12c Conflict of interest policy Our organization monitors and reviews proposed and current transactions for conflicts of interest in a variety of ways. At the governing board level, we have board members complete an initial (upon appointment) and annual conflict of interest questionnaire to disclose actual or potential conflicts. Board members are required to update their disclosure as needed in between questionnaires. All disclosures are reviewed by the Compliance Office and as needed escalated to the appropriate leaders/board members for further discussion/review. If a disclosure is viewed as an actual or potential conflict, an action is recommended to the Compliance Committee of the Carilion Clinic Board and implemented as approved. Actions can include recusal in discussion/voting at board meetings, limitation/termination of the transaction, removal from board appointment or other appropriate controls. In addition, at any time, board members are encouraged to disclose any potential conflicts as they arise at a board meeting and to recuse themselves as deemed appropriate. The same process takes place as described above for key employees (upon hire and annually thereafter), including all officers, members of the management team, physicians/mid-level practitioners, pharmacists and key supply chain buyers. After review and further discussion as needed, action may be required to manage an actual conflict or to reduce the appearance of such as approved by the Compliance Office and other key management team members. As needed, the governing board leaders are notified of any conflicts which may impact board proceedings. Form 990, Part VI, Line 15a Process to establish compensation of top management official The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of independent Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. With respect to Carilion Clinic, the Compensation Committee reviews the compensation of the Board of Governors annually, which includes the President and Chief Executive Officer, the Executive Vice Presidents (Chief Financial Officer, Chief Medical Officer, Chief Operating Officer, Chief Administrative Officer and Chief Legal Officer), and select Senior Vice Presidents who are the physician Chairs of the Clinical Departments. For the fiscal year covered by this return, the Compensation Committee also used the same process to review the compensation of other Disqualified Individuals, including the Hospital Vice Presidents. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders, which includes Vice Presidents, Senior Vice Presidents, Executive Vice Presidents, and the CEO, as well as the compensation philosophy for employed physicians. Some officers of the organization who are not compensated in their capacity as an officer but rather in their role as employee in a position not mentioned above are not subject to Committee review. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for certain select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, the list of which was reviewed by the Compensation Committee. The Compensation Committee maintained minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives. Form 990, Part VI, Line 15b Process to establish compensation of other employees See Response to Line 15A. Form 990, Part VI, Line 19 Required documents available to the public The organization's governing documents, conflict of interest statement, and financial statements are released from time to time during the tax year upon request. The conflict of interest policy is included in our Code of Excellence which is available to the public on our website. The Articles of Incorporation are available from the Virginia State Corporation Commission. Limited financial information is available on our website. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees Physician/Professional Services - Total Expense: 821362, Program Service Expense: 821362, Management and General Expenses: , Fundraising Expenses: ; Purchased Services - Total Expense: 897514, Program Service Expense: 893716, Management and General Expenses: 3798, Fundraising Expenses: ; Contract Fees/Consulting - Total Expense: 702988, Program Service Expense: 643795, Management and General Expenses: 59193, Fundraising Expenses: ; Repairs and Maintenance - Total Expense: 598489, Program Service Expense: 595527, Management and General Expenses: 2962, Fundraising Expenses: ; Temporary Employment - Total Expense: 2713985, Program Service Expense: 2713985, Management and General Expenses: , Fundraising Expenses: ; Reference Labs - Total Expense: 2223182, Program Service Expense: 2223182, Management and General Expenses: , Fundraising Expenses: ; Laundry/Housekeeping - Total Expense: 571927, Program Service Expense: 571927, Management and General Expenses: , Fundraising Expenses: ; Billing/Collection Fees - Total Expense: 102049, Program Service Expense: , Management and General Expenses: 102049, Fundraising Expenses: ; Form 990, Part X, Line 20 Tax Exempt Bond Liabilities The amount reported as Tax-Exempt Bonds is the portion of Carilion Clinic Bonds allocated to Carilion Franklin Memorial Hospital. Required information for the Bonds, including Schedule K, is reported in the Carilion Clinic (EIN: 54-1190771) IRS Form 990. 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