CARILION TAZEWELL COMMUNITY HOSPITAL: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- CARILION TAZEWELL COMMUNITY HOSPITAL (EIN 54-6074580)
- Tax period
- 2014-10-01 to 2015-09-30
- Filed
- 2016-08-13
- IRS object ID
- 201642269349300629
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-13T11:58:05-05:00 | ReturnTs |
| Tax Period End | 2015-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 546074580 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARILION TAZEWELL COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CARI | BusinessNameControlTxt |
| Phone | 5402245112 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12385 | AddressLine1Txt |
| City | ROANOKE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 240252385 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | G Robert Vaughan Jr | PersonNm |
| Person Title | Assistant Treasurer | PersonTitleTxt |
| Phone | 5402245137 | PhoneNum |
| Signature | 2016-08-13 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Kathren R Dowdy | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12385 | AddressLine1Txt |
| City | ROANOKE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 240252385 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,539,952 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.carilionclinic.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1968 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | The Hospital is committed to better patient care, better community health, and lower cost. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 145 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $119,137 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,141 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,449,843 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,353,634 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,550 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,834 | CYInvestmentIncomeAmt |
| PY Other Revenue | $481,487 | PYOtherRevenueAmt |
| CY Other Revenue | $179,343 | CYOtherRevenueAmt |
| PY Total Revenue | $14,055,017 | PYTotalRevenueAmt |
| CY Total Revenue | $15,539,952 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $9,330 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $9,844 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,132,284 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,725,842 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,027,403 | PYOtherExpensesAmt |
| CY Other Expenses | $11,320,995 | CYOtherExpensesAmt |
| PY Total Expenses | $15,169,017 | PYTotalExpensesAmt |
| CY Total Expenses | $17,056,681 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,114,000 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,516,729 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,584,156 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,511,821 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,662,167 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,127,019 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$9,078,011 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$10,615,198 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Carilion Tazewell Community Hospital is committed to a common purpose of better patient care, better community health, and lower cost. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,741,287 | ExpenseAmt |
| Grant | $9,844 | GrantAmt |
| Revenue | $15,498,512 | RevenueAmt |
| Desc | See Schedule O.Carilion Tazewell Community 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. This 56-bed hospital primarily serves the counties of Tazewell and Russell in Virginia, and Mercer and McDowell in West Virginia.Carilion Tazewell Community Hospital (CTCH) exists to serve the health care needs of its community, regardless of patient ability to pay. CTCH's acute hospital admitted 617 patients and provided 2,462 days of care during the year. Hospital programs include provision of nursing care; outpatient and inpatient surgical and endoscopic services; and diagnostic imaging services including CT, MRI, and mammography. CTCH provides a number of services targeting the specific health needs of its population, including physical, speech, and occupational therapy programs; home health services; bone density testing; and a cardiac rehab program. CTCH also provides an emergency department with 24-hour care and emergency transportation. With 10,728 visits, CTCH's 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 nearly 18% percent of emergency department visits. CTCH supports community screenings and education on chronic disease management, sponsoring 29 events touching more than 718 people. In furtherance of its mission, CTCH provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year totaled $1 million. | Desc |
| Total Program Service Expenses | $14,741,287 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 145 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Corporation Attn J Wright | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5402245112 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 S Jefferson St | AddressLine1Txt |
| City | Roanoke | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24011 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| D Michael Hymes | ||||||||||
| Director | 1.20 | Yes (X) | $0 | $0 | $0 | |||||
| Kristie G Williams | ||||||||||
| Director/Hospital Vice President | 1.20 | Yes (X) | $0 | $107,895 | $42,974 | 48.80 | ||||
| Peggy L Riley | ||||||||||
| Director | 1.20 | Yes (X) | $0 | $0 | $0 | |||||
| Stephen R Rinehart MD | ||||||||||
| Director | 1.20 | Yes (X) | $0 | $0 | $0 | |||||
| Kathren R Dowdy RN MSN | ||||||||||
| Director/CEO | 50.00 | Yes (X) | $127,731 | $0 | $29,039 | |||||
| Antony D Roop | ||||||||||
| Director | 1.20 | Yes (X) | $0 | $0 | $0 | |||||
| Heather S Shepardson | ||||||||||
| Director | 1.20 | Yes (X) | $0 | $211,884 | $20,370 | 48.80 | ||||
| Nancye K Howell | ||||||||||
| Director/Secretary/Treasurer | 1.20 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||||
| James C Thompson | ||||||||||
| Director/Chair | 2.50 | Yes (X) | $0 | $7,325 | $0 | 2.40 | Yes (X) | |||
| Charles E Green III | ||||||||||
| Director/Vice Chair | 1.20 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||||
| William J Flattery | ||||||||||
| Director/Hospital Vice President | 2.50 | Yes (X) | $0 | $294,403 | $72,637 | 47.50 | Yes (X) | |||
| Donald B Halliwill | ||||||||||
| Assistant Treasurer/CFO/EVP | 0.30 | $0 | $499,817 | $226,399 | 49.80 | Yes (X) | ||||
| Michael D Rorrer MD | ||||||||||
| Chief of Medical Staff | 1.20 | $0 | $290,537 | $119,284 | 48.80 | Yes (X) | ||||
| Lauren J Chen | ||||||||||
| Assistant Secretary | 1.00 | $0 | $51,739 | $22,622 | 49.00 | Yes (X) | ||||
| G Robert Vaughan Jr | ||||||||||
| Assistant Treasurer/SVP | 0.30 | $0 | $277,333 | $140,269 | 49.80 | Yes (X) | ||||
| Nancy Howell Agee | ||||||||||
| CEO | 2.00 | $0 | $1,566,770 | $1,858,023 | 48.00 | Yes (X) | ||||
| Melina Perdue | ||||||||||
| EVP | 2.00 | $0 | $458,395 | $488,133 | 48.00 | Yes (X) | ||||
| David Vance | ||||||||||
| Pharmacy Manager | 50.00 | $117,584 | $0 | $17,709 | Yes (X) | |||||
| Randal Swatzyna | ||||||||||
| Former Officer | 0.00 | $0 | $143,462 | $57,238 | Yes (X) | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $245,315 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,909,560 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,094,697 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Solstas Lab Partners Group LLC | |||||
| PO Box 751337 | Charlotte | NC | 28275 | Laboratory Services | $954,036 |
| MR Ramakrishnan MD | |||||
| 1745 Valley View Drive | Big Stone Gap | VA | 24219 | Physician Services | $312,000 |
| Beck Therapy Services | |||||
| 2013 Bandy Road | Cedar Bluff | VA | 24609 | (PT) Therapy Services | $208,881 |
| Stryker Sales Corporation | |||||
| PO Box 93276 | Chicago | IL | 60673 | Equipment Services | $105,481 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,141 | GovernmentGrantsAmt |
| Total Contributions | $2,141 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Net Patient Revenue | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $15,353,634 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,353,634 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,353,634 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,834 | TotalRevenueColumnAmt |
| Exclusion | $4,834 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $34,465 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $34,465 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,465 | TotalRevenueColumnAmt |
| Exclusion | $34,465 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Affiliate Contract Revenue | 900099 | $137,600 | $137,600 |
| Court Cost Recovery | 900099 | $6,144 | $6,144 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,134 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,134 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $144,878 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,539,952 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,498,512 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $39,299 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,844 | TotalAmt |
| Program Services | $9,844 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,191 | TotalAmt |
| Management And General | $155,191 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,583,222 | TotalAmt |
| Program Services | $4,535,347 | ProgramServicesAmt |
| Management And General | $47,875 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $238,929 | TotalAmt |
| Program Services | $238,929 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $406,529 | TotalAmt |
| Program Services | $396,296 | ProgramServicesAmt |
| Management And General | $10,233 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $341,971 | TotalAmt |
| Program Services | $341,971 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,897,152 | TotalAmt |
| Management And General | $1,897,152 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50 | TotalAmt |
| Management And General | $50 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,070 | TotalAmt |
| Program Services | $1,070 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,302,439 | TotalAmt |
| Program Services | $2,195,406 | ProgramServicesAmt |
| Management And General | $107,033 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,154 | TotalAmt |
| Program Services | $1,865 | ProgramServicesAmt |
| Management And General | $1,289 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $276,038 | TotalAmt |
| Program Services | $259,334 | ProgramServicesAmt |
| Management And General | $16,704 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,443 | TotalAmt |
| Program Services | $57,443 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,882 | TotalAmt |
| Program Services | $214,882 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,245 | TotalAmt |
| Program Services | $84,558 | ProgramServicesAmt |
| Management And General | $4,687 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,439 | TotalAmt |
| Program Services | $175,439 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $670,456 | TotalAmt |
| Program Services | $670,456 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $229,672 | TotalAmt |
| Program Services | $167,750 | ProgramServicesAmt |
| Management And General | $61,922 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Bad Debt | $3,038,473 | $3,038,473 | |
| I/C Practice Subsidy | $1,685,338 | $1,685,338 | |
| Medical Supplies | $642,719 | $642,719 | |
| Dues & Subscriptions | $14,793 | $14,523 | $270 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,632 | TotalAmt |
| Program Services | $9,644 | ProgramServicesAmt |
| Management And General | $12,988 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,056,681 | TotalAmt |
| Program Services | $14,741,287 | ProgramServicesAmt |
| Management And General | $2,315,394 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $925 | BOYAmt |
| EOY | $925 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,990 | BOYAmt |
| EOY | $24,116 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,982,358 | BOYAmt |
| EOY | $1,686,466 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,664 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,932 | BOYAmt |
| EOY | $60,651 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,196,329 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,458,330 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,486,547 | BOYAmt |
| EOY | $4,737,999 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,404 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,584,156 | BOYAmt |
| EOY | $6,511,821 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,020,311 | BOYAmt |
| EOY | $991,642 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,388 | BOYAmt |
| EOY | $43,653 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,616,468 | BOYAmt |
| EOY | $16,091,724 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,662,167 | BOYAmt |
| EOY | $17,127,019 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$9,078,011 | BOYAmt |
| EOY | -$10,615,198 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$9,078,011 | BOYAmt |
| EOY | -$10,615,198 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,584,156 | BOYAmt |
| EOY | $6,511,821 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,516,729 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$20,458 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,070 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,070 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | A portion of dues paid to the American Hospital Association and Virginia Hospital and Healthcare Association is attributable to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $48,753 | OtherCostOrOtherBasisAmt |
| Book Value | $48,753 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,070,975 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,388,399 | DepreciationAmt |
| Book Value | $2,682,576 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,417,180 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,886,074 | DepreciationAmt |
| Book Value | $1,531,106 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $659,421 | OtherCostOrOtherBasisAmt |
| Depreciation | $183,857 | DepreciationAmt |
| Book Value | $475,564 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,737,999 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Affiliate | $15,986,405 |
| Pension-Qualified Liability/Accrued | $105,319 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $16,091,724 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | Carilion had no material unrecognized tax benefits and no adjustments to its consolidated financial statements were required as of and for the years ended September 30, 2015 and 2014. Carilion does not expect that unrecognized tax benefits will materially increase within the next 12 months. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $941,383 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $941,383 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06720 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $588,377 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $481,299 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $107,078 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00760 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,529,760 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $481,299 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,048,461 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07480 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 468 | PersonsServedCnt |
| Total Community Benefit Expns | $8,386 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,386 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 468 | PersonsServedCnt |
| Total Community Benefit Expns | $8,386 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,386 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 468 | PersonsServedCnt |
| Total Community Benefit Expns | $1,538,146 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $481,299 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,056,847 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07540 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 250 | PersonsServedCnt |
| Total Community Benefit Expns | $1,691 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,691 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $3,358 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,358 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $2,489 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,489 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 23 | ActivitiesOrProgramsCnt |
| Persons Served | 250 | PersonsServedCnt |
| Total Community Benefit Expns | $7,538 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,538 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,038,473 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $4,279,002 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,516,794 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$237,792 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carilion Tazewell Community Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 141 Ben Bolt Avenue | AddressLine1Txt |
| City | Tazewell | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24651 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.carilionclinic.org | WebsiteAddressTxt |
| State License | H 1907 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carilion Tazewell Community Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Section C | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | www.carilionclinic.org/about/chna | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.carilionclinic.org/about/chna | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.carilionclinic.org | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.carilionclinic.org | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.carilionclinic.org | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Carilion Tazewell Community Hospital | Part V, Section B, Line 5: Carilion Clinic's CHNAs are community-driven projects and success is highly dependent on the involvement of citizens, health and human service agencies, businesses, and community leaders. Community stakeholder collaborations known as "Community Health Assessment Teams" (CHAT) lead the CHNA projects. The CHAT consists of health and human service agency leaders, persons with special knowledge of or expertise in public health, the local health department, and leaders, representatives, or members of medically underserved populations, low-income persons, minority populations, and populations with chronic disease.The following organizations served on the CHAT for the 2013 Tazewell Community Health Needs Assessment: Appalachian Agency for Senior Citizens (AASC), Board of Supervisors, Southwest Virginia Community Health Clinic, general dentistry, Health Department, Clinch Valley Medical Center, Bluefield Regional Medical Center, family medicine, Veterans, Local Outpatient Clinic, Four Seasons YMCA, Clinch Valley Community Action, Tazewell County Schools, local pharmacy, Richlands News Press, Lillies of the Field, Department of Social Services, Carilion Tazewell Home Health, Family Crisis, Tazewell Chief of Police, TASK (Taking Action for Special Kids), Crisis Pregnancy (The Abel Crisis Center), Heritage Hall, SWVA Community College, Tazewell Library, Social Services.In addition to the CHAT, the CHNA conducted stakeholder surveys, target population focus groups, and a community health survey. Target population focus groups were conducted with Tazewell Elementary School, Student Center Vocational School (TASK Group), Tazewell Head Start, and the Four Seasons YMCA. The community health survey was made available to residents living in Tazewell. Oversampling of the target populations occurred through targeted outreach efforts. In total, 744 surveys were collected. |
| Carilion Tazewell Community Hospital | Part V, Section B, Line 6b: Appalachian Agency for Senior Citizens (AASC), Board of Supervisors, Southwest Virginia Community Health Clinic, general dentistry, Health Department, Clinch Valley Medical Center, Bluefield Regional Medical Center, family medicine, Veterans, Local Outpatient Clinic, Four Seasons YMCA, Clinch Valley Community Action, Tazewell County Schools, local pharmacy, Richlands News Press, Lillies of the Field, Department of Social Services, Carilion Tazewell Home Health, Family Crisis, Tazewell Chief of Police, TASK (Taking Action for Special Kids), Crisis Pregnancy (The Abel Crisis Center), Heritage Hall, SWVA Community College, Tazewell Library, Social Services. |
| Carilion Tazewell Community Hospital | Part V, Section B, Line 7d: 7a: www.carilionclinic.org/hospitals/carilion-tazewell-community-hospital.7d: The 2013 Tazewell CHNA was also posted to CHAT partner websites and social media. |
| Carilion Tazewell Community Hospital | Part V, Section B, Line 11: Each member of the CHAT in attendance reviewed the list of needs identified from the primary and secondary research and prioritized the top ten issues based upon the magnitude and severity of the need. Then a determination was made as to ability to focus resources on each issue, and the likelihood of improvement. These rankings were analyzed and combined into the following list:1. Substance Abuse Prevalence2. Obesity Prevalence/Lack of Exercise3. Access to Primary Care4. Mental Health Disorders/access to psychiatric services5. High cost of Services to the UninsuredThe findings clearly demonstrate the need to address substance abuse and psychiatric issues, and obesity prevalence, as well as access to primary care. The high cost of services to the uninsured is impactful to vulnerable populations and was seen by the CHAT to have high feasibility to address. To address the needs of the community, Carilion Tazewell Community Hospital will develop a multi-disciplinary team to ensure that resources are aligned with the needs identified during the Community Health Needs Assessment. The team will initially consist of CTCH employees, but add membership from community agencies as needed to ensure improvements are achieved in the identified areas of focus. In addition, the Town and County of Tazewell recently completed a workshop to kickoff a vision for economic development for the area. This project will lead to the creation of a strategic plan for the town. CTCH will actively participate in this project, in particular on the Community Health subgroup. This will provide a forum for alignment of community resources with identified community needs. Activities recommended for this group are very consistent with the CHNA findings: pilot and experiment with approaches to addressing prescription drug abuse and the Tazewell Wellness Movement.Lastly, ongoing processes will be developed to track progress of improvements.Multiple other needs were identified during the CHNA process, including dental care for children, access to vision care, transportation and access to in-home care. Dental care is being addressed via the development of a new dental school, already under development. The process used by the CHAT to prioritize needs identified access to vision, transportation and in-home care as lower priorities. The number of items was limited to the top five so that resources are focused and effective. |
| Carilion Tazewell Community Hospital | Part V, Section B, Line 20e: Prior to initiating other actions and in the absence of eligibility information (financial assistance application) provided by the patient, processes were applied to accounts to determine presumptive eligibility for financial assistance. |
| Carilion Tazewell Community Hospital | Part V, Section B, Line 22d: Carilion Tazewell Community Hospital determined the maximum amount it could charge FAP-eligible individuals using a look-back method that included information from Medicare, Medicare Advantage, and commercial payors. |
| Part V, Section B, Line 16 | Financial Assistance Policy Website Availability |
| Carilion Tazewell Community Hospital Part V, Section B, line 16a website: | www.carilionclinic.org |
| Carilion Tazewell Community Hospital Part V, Section B, line 16b website: | www.carilionclinic.org |
| Carilion Tazewell Community Hospital Part V, Section B, line 16c website: | www.carilionclinic.org |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | Patients were evaluated based on income, family size, liquid assets and real property. Patients whose income was below 200% of FPG, retirement accounts were below $10,000, remaining liquid assets were below $3,000, with no countable equity in non-residential real property were eligible for 100% adjustment.Patients whose income was above 200% of the FPG but less that 400% of the FPG and/or whose retirement accounts were above $10,000, remaining liquid assets were above $3,000 and had countable equity in non-residential real property were eligible for a discount.Uninsured patient hospital accounts received an Uninsured discount of 20% prior to billing the patient. If the patient qualified under the Financial Assistance Policy, the uninsured discount was reversed. Those patients that qualified for a discount (not 100%) were given a discount based on the amount generally billed calculation and may also receive an additional discount based on the eligibility criteria. |
| Part I, Line 6a: | Information on community benefit is reported annually through a consolidated report prepared by Carilion Clinic. Printed copies of this report are distributed throughout communities served by hospitals affiliated with Carilion Clinic. Additionally, the community benefit report is available on Carilion Clinic's website. |
| Part I, Line 7: | Ratio of cost-to-charges was used to calculate the expense.Part I, Line 7, column (f) calculation -- Bad debt expense is subtracted from total expenses for the calculation. |
| Part I, Line 7 | Part I, Line 7e:Community Health Improvement: This line is calculated at cost. As part of its mission to educate the public about health risks and steps that can be taken to improve health through health fairs and presentations offered at various community locations. These events provide an opportunity to educate individuals about improving health and quality of life. Additional health improvement services include assistance with enrollment in public medical programs such as Medicaid. Community benefit operations include the cost associated with tracking community health improvement activities. |
| Part II | Line 2: Economic DevelopmentSupport was provided to the Tazewell Area Chamber of Commerce and Business to Business event. Line 3: Community SupportSupport was provided to United Way of Southwest VA, Four Seasons YMCA, Clinch Valley Community Action, and a shoe drive. Line 6: Coalition BuildingParticipation and in-kind support provided for the Four Season YMCA, Special Needs in Disaster meetings, Children's Day and TRIAD meetings. |
| Part III, Line 2: | Carilion Tazewell Community Hospital estimates bad debt expense by reserving a percentage of all self-pay accounts receivable by aging category, based on collection history, adjusted for expected recoveries and, if present, anticipated changes in trends. The percentage used to reserve for all self-pay accounts is based on Carilion's collection history. |
| Part III, Line 4: | Accounts receivable are reduced by an allowance for amounts that could become uncollectible in the future. Carilion Tazewell Community Hospital estimates the allowance for doubtful accounts by reserving a percentage of all self-pay accounts receivable by aging category, based on collection history, adjusted for expected recoveries and, if present, anticipated changes in trends. Carilion Tazewell Community Hospital collects substantially all of its third-party insured receivables, which include receivables from governmental agencies. |
| Part III, Line 8: | Medicare allowable costs are determined from the Medicare cost report using the cost-to-charges ratio. The Hospital does not consider a Medicare shortfall as a community benefit. |
| Part III, Line 9b: | Patient accounts not identified as qualifying for financial assistance under the Financial Assistance Policy and procedures are evaluated against Presumptive eligibility criteria using a third party vendor software prior to moving the accounts to collections at 120 days. Those that qualify as "presumed charity" are adjusted.Patient accounts that are not adjusted to "presumed charity" are sent to the collection agency. The agency delays any extraordinary collections practices for an additional 120 days from the first billing statement. Patients may apply for financial assistance at any time during the 240 day application period. |
| Part VI, Line 2: | Needs Assessment:Carilion Clinic's community health improvement process was adapted from Associates in Process Improvement's the Model for Improvement and the Plan-Do-Study-Act (PDSA) cycle developed by Walter Shewhart. It consists of five distinct 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 to comply with IRS requirements. Carilion Clinic fosters community development in its CHNA process and community health improvement process by using the Strive Collective Impact Model for the CHAT. 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) and has been proven to lead to large-scale changes. It focuses on relationship building between organizations and the progress towards shared strategies. Carilion also addresses community health needs through health safety-net partnerships, including financial and in-kind assistance through community grants and sponsorships. |
| Part VI, Line 3: | Eligibility Assistance:Education of the Financial Assistance Policy is provided to patients at all hospital admission and ambulatory areas in the form of signage, a summary of the policy which includes contact information, available financial assistance applications and is included in the inpatient handbook. Hospital social workers and customer service representatives provide patients with verbal information on availability of assistance. Each patient statement and letters regarding patient financial responsibility includes information on the Financial Assistance Policy and who to contact for additional information. Applications, the Policy and a Plain Language summary are available free of charge to the patient. These items will be mailed to the patient if the patient failed to obtain the documents at the time of service. The Financial Assistance Policy as well as the Plain Language summary and application is available on the web site.Carilion also employs an Eligibility staff that counsel patients on federal and state programs. The staff completes applications for Medicaid, Social Security, Social Security Disability, and Medicare and provides support services in ensuring the applications are processed correctly based on federal and state policy. In addition, the Eligibility staff is Certified Application Counsels and will assist patients in enrollment in the Marketplace. Eligibility staff will also complete Carilion's financial assistance and counsel patients on the requirements for financial assistance. |
| Part VI, Line 4: | Community Information:Carilion Tazewell Community Hospital is a 56-bed facility in Tazewell, the county seat and geographic center of this southwest Virginia County, also known as Tazewell. Tazewell County is within the valley and ridge province of the Appalachian Highlands between the Appalachian Mountains on the southeast and the Cumberland Plateau and the Allegheny mountains on the northwest. The county contains 520 square miles and a population of 43,452. Approximately 21.8% of adults under age 64 and 8.7% of children who live in the Tazewell County are uninsured. Additionally, 18.3% of residents live below the poverty level and 23% of adults 25 years of age or older did not graduate from high school. 18.5% of residents are 65 years of age or older. |
| Part VI, Line 5: | Promotion of Community Health:Carilion Tazewell Community Hospital serves all patients regardless of their ability to pay. The Hospital's 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 Tazewell Community Hospital has been very involved in the development and implementation of a wellness center through both financial and in-kind support over several years. The Four Seasons YMCA, located on a parcel of land adjacent to the hospital, provides fitness and social activities. |
| Part VI, Line 6: | Affiliated System:Carilion Tazewell Community Hospital is wholly owned and operated by Carilion Clinic, a not-for-profit healthcare organization based in Roanoke, Virginia. Through a comprehensive network of hospitals, primary and specialty physician practices and other complementary services, quality care is provided close to home for more than 870,000 Virginians. With an enduring commitment to the health of the region, care is advanced through medical education and research and assistance is provided to help the community stay healthy. Carilion Clinic employs 685 physicians representing more than 70 specialties who provide care at 241 practice sites. To advance education of health professionals, Jefferson College of Health Sciences, within Carilion Medical Center, is a professional health sciences college offering Associate's, Bachelor's, and Master's degree programs. During fiscal year 2015, 800 undergraduate and 262 graduate students were enrolled. Carilion Clinic, through Carilion Medical Center, works in cooperation with Virginia Tech Carilion School of Medicine to provide medical education opportunities to the community. There are 13 accredited residency programs (Carilion / OMNEE Emergency Medicine Dermatology, General Hospital Dentistry, Emergency Medicine, Family Medicine, Internal Medicine, Neurosurgery, Obstetrics/Gynecology, Pediatrics, Plastic Surgery, Podiatry, Psychiatry and Surgery) and 11 accredited fellowship programs (Addiction Psychology, Adult Joint Reconstruction, Cardiovascular Disease, Child and Adolescent Psychiatry, Gastroenterology, Geriatric Medicine, Geriatric Psychiatry, Hospice and Palliative Care, Infectious Disease, Interventional Cardiology, and Pulmonary Critical Care). Advanced clinical technology and programs include CyberKnife Stereotactic Radiosurgery, DaVinci Robotic Surgical System, 60 bed neonatal intensive care unit, hybrid operating room, Carilion Clinic Children's Hospital, Cancer Center, Spine Center, and comprehensive cardiothoracic, vascular and orthopedic surgery programs. Carilion Roanoke Memorial Hospital serves as a Level One Trauma Center with EMS services that include three EMS helicopters, six first-response vehicles and 38 Advanced Life Support Ambulances. An additional benefit to the community is Carilion Clinic's economic contribution to the region. As the area's largest employer, jobs are provided for more than 12,100 residents of the region. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kristie G Williams | ||||||||||||||
| Director/Hospital Vice President | $0 | $99,128 | $0 | $2,500 | $0 | $6,267 | $0 | $23,483 | $0 | $19,491 | $0 | $150,869 | $0 | $0 |
| Kathren R Dowdy RN MSN | ||||||||||||||
| Director/CEO | $117,479 | $0 | $2,500 | $0 | $7,752 | $0 | $28,266 | $0 | $773 | $0 | $156,770 | $0 | $0 | $0 |
| Heather S Shepardson | ||||||||||||||
| Director | $0 | $177,241 | $0 | $34,398 | $0 | $245 | $0 | $18,160 | $0 | $2,210 | $0 | $232,254 | $0 | $0 |
| William J Flattery | ||||||||||||||
| Director/Hospital Vice President | $0 | $217,782 | $0 | $67,000 | $0 | $9,621 | $0 | $57,819 | $0 | $14,818 | $0 | $367,040 | $0 | $0 |
| Donald B Halliwill | ||||||||||||||
| Assistant Treasurer/CFO/EVP | $0 | $374,141 | $0 | $72,188 | $0 | $53,488 | $0 | $204,059 | $0 | $22,340 | $0 | $726,216 | $0 | $0 |
| Michael D Rorrer MD | ||||||||||||||
| Chief of Medical Staff | $0 | $272,754 | $0 | $12,216 | $0 | $5,567 | $0 | $102,789 | $0 | $16,495 | $0 | $409,821 | $0 | $0 |
| G Robert Vaughan Jr | ||||||||||||||
| Assistant Treasurer/SVP | $0 | $227,155 | $0 | $44,697 | $0 | $5,481 | $0 | $119,382 | $0 | $20,887 | $0 | $417,602 | $0 | $0 |
| Nancy Howell Agee | ||||||||||||||
| CEO | $0 | $936,377 | $0 | $281,435 | $0 | $348,958 | $0 | $1,840,194 | $0 | $17,829 | $0 | $3,424,793 | $0 | $341,789 |
| Melina Perdue | ||||||||||||||
| EVP | $0 | $379,288 | $0 | $72,188 | $0 | $6,919 | $0 | $470,677 | $0 | $17,456 | $0 | $946,528 | $0 | $0 |
| David Vance | ||||||||||||||
| Pharmacy Manager | $115,988 | $0 | $1,500 | $0 | $96 | $0 | $3,968 | $0 | $13,741 | $0 | $135,293 | $0 | $0 | $0 |
| Randal Swatzyna | ||||||||||||||
| Former Officer | $0 | $85,211 | $0 | $7,500 | $0 | $50,751 | $0 | $52,715 | $0 | $4,523 | $0 | $200,700 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | Executive compensation, including that of the organization's Chief Executive Officer, is reviewed annually by the Carilion Clinic Compensation Committee. This committee is made up of Board members of Carilion Clinic, a related organization, who do not have a conflict of interest with any of the executives being reviewed. This review was performed in September and October 2014. A similar review was last performed in October 2015. This review included review of a comprehensive report from an 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 detailed comparison of total compensation and each element thereof, including base salary, bonuses and other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to a peer group of organizations similar in size and structure to the organization, which was reviewed by the Compensation Committee. Detailed minutes of the meetings of the Compensation Committee are kept and approved at the next meeting of the Committee, setting forth the deliberations and decisions regarding executive compensation. |
| Part I, Line 4b | Select members of management participate in a Pension Restoration Plan. This plan provides a benefit equal to the normal retirement benefit that would be payable to the participant were it not for the Qualified plan's legislative restrictions on compensation and payable benefits, less the actual benefits under the Qualified plan. Entitlement to benefits and consequent lump sum payment occurs upon the earliest of (i) attaining age 65 while employed by Carilion Clinic, (ii) 24 months following involuntary separation from service without reasonable cause, (iii) disability, or (iv) voluntary separation or involuntary separation with reasonable cause prior to attaining age 65 if the participant does not enter into competition with Carilion Clinic during the 24-month period following the participant's separation from service. Upon the death of the participant, the plan shall pay the participant's beneficiary according to plan terms. Select members of management participate in an Executive Flexible Benefit Plan, in which an allowance is provided to the participant for use in obtaining certain insurance benefits. The allowance is determined annually as a percentage of salary at Carilion Clinic's discretion. The amount of allowance in excess of elected benefits is credited to a capital accumulation account (CAA) with a deferred vesting date of at least two years from the first day of the plan year. The CAA shall be distributed in a lump sum upon the earliest of (i) remaining employed by Carilion until the deferred vesting date for such account; (ii)disability; (iii) 24 months following involuntary separation from service without reasonable cause, except that Carilion at its discretion may make a partial tax distribution upon separation; or (iv) 24 months following voluntary or involuntary separation from service with reasonable cause if the participant does not enter into competition with Carilion Clinic during the 24-month period following separation from service. Upon the death of the participant, the plan shall pay the participant's beneficiary according to plan terms. Select members of management participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP) in which the employer at the discretion of Carilion Clinic's Compensation Committee makes a contribution to an account established on its books for each eligible participant. If a participant ceases to be a participant prior to the vesting date, the account shall be forfeited. A lump sum distribution shall be made upon the participant's vesting date, death, or disability. Payments during the calendar year under these plans included the following: Nancy Howell Agee $341,789 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part I, Line 6 | Volunteers staff the gift shop and volunteer in various departments doing clerical work, supporting community events, and service related tasks. |
| Form 990, Part V, Line 1a | 1099s are issued on Carilion Tazewell Community Hospital's behalf by Carilion Services, Inc., a related organization providing management and administrative services, including payment processing. |
| Form 990, Part VI, Section A, line 1 | The organization has one member. The sole member, Carilion Clinic, is entitled to elect one class of directors having 80% of the vote on any issue. The remaining class of directors, which has 20% of the vote on any issue, come from the local community and elect their own successors. Certain actions require the majority vote of both classes. |
| Form 990, Part VI, Section A, line 2 | 1. Nancy Howell Agee, Lauren J. Chen, Donald B. Halliwill, Melina D. Perdue, Heather S. Shepardson, G. Robert Vaughan, Jr., William J. Flattery, and Kristie G. Williams - Business relationship due to each serving as officers, directors, and/or employees of the same related organizations. |
| Form 990, Part VI, Section A, line 3 | 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. |
| Form 990, Part VI, Section A, line 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 is entitled to elect directors having 80% of the vote on any issue. |
| Form 990, Part VI, Section A, line 7a | The organization has one member. The sole member, Carilion Clinic, is entitled to elect one class of directors having 80% of the vote on any issue. The remaining class of directors, which has 20% of the vote on any issue, come from the local community and elect their own successors. |
| Form 990, Part VI, Section A, line 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, Part VI, Section B, line 11 | The Form 990 is prepared by Carilion's internal Tax Department and reviewed by internal Accounting management. Several days prior to filing, all Board Members are notified by email of its availability on Carilion's Board portal and encouraged to call with any questions they might have. |
| Form 990, Part VI, Section B, line 12c | Our organization monitors and reviews proposed and current transactions for conflicts on 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 Organizational Integrity & 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 Audit & Compliance Committee of the Carilion Clinic Board and are 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 Organizational Integrity & 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, Section B, line 15 | Executive compensation is reviewed annually by the Carilion Clinic Compensation Committee. This committee is made up of Board members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. With respect to Carilion Clinic, the Compensation Committee reviews the compensation of the Board of Governors which includes the President and Chief Executive Officer, Executive Vice Presidents, Chief Financial Officer, Chief Medical Officer, and 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. This review was performed in September and October 2014. A similar review was last performed in October 2015. This review included review of a comprehensive report from an 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 detailed comparison of total compensation and each element thereof, including base salary, bonuses and other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to a peer group of organizations similar in size and structure to the organization, which list was reviewed by the Compensation Committee. Detailed minutes of the meetings of the Compensation Committee are kept and approved at the next meeting of the Committee, setting forth the deliberations and decisions regarding the compensation of these executives. In addition, the Compensation Committee annually reviews the compensation plan and philosophy for all vice presidents and senior vice presidents, as well as all employed physicians and physicians in leadership roles. |
| Form 990, Part VI, Section C, line 19 | The organization's 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 website. |
| Form 990, Part IX, Line 11g Column B | Professional/ Physcian Services: $1,548,655 Purchase Services: $267,372 Contract Fees/Consulting: $34,629 Patient Transportation: $1,240 Repairs and Maintenance: $343,510 Total Other Fees Column B: $2,195,406 |
| Form 990, Part IX, Line 11g Column C | Purchase Services: $107,033 Total Other Fees Column C: $107,033 |
| Form 990, Part XI, line 9: | Pension-Related Changes -20,458. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Carilion Clinic | |||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541190771 | Supporting organization | VA | 501(c)(3) | Line 11a, I | N/A | 0 | |
| Carilion Clinic Foundation | |||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541190773 | Supporting organization | VA | 501(c)(3) | Line 11b, II | Yes (1) | Carilion Clinic | |
| Carilion Franklin Memorial Hospital | |||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540480606 | Healthcare | VA | 501(c)(3) | Line 3 | Yes (1) | Carilion Clinic | |
| Carilion Giles Community Hospital | |||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540549603 | Healthcare | VA | 501(c)(3) | Line 3 | Yes (1) | Carilion Clinic | |
| Carilion Medical Center | |||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540506332 | Healthcare | VA | 501(c)(3) | Line 3 | Yes (1) | Carilion Clinic | |
| Carilion New River Valley Medical Center | |||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540553805 | Healthcare | VA | 501(c)(3) | Line 3 | Yes (1) | Carilion Clinic | |
| Carilion Services Inc | |||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541190879 | Supporting organization | VA | 501(c)(3) | Line 11a, I | Yes (1) | Carilion Clinic | |
| Carilion Stonewall Jackson Hospital | |||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540568001 | Healthcare | VA | 501(c)(3) | Line 3 | Yes (1) | Carilion Clinic | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|
| Carilion Clinic Medicare Shared Savings Company LLC | ||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 455235473 | Medicare HMO | VA | 0 | 0 |
| Franklin County Ventures LLC | ||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 474365316 | Real estate | VA | 0 | 0 |
| Community Medical Associates LLP | ||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541517662 | Real estate | VA | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|
| Carilion Clinic Medicare Resources LLC | ||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 263729975 | Medicare HMO | VA | C | Yes (1) |
| CHS Inc | ||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541725732 | Services | VA | C | Yes (1) |
| Carilion Behavioral Health Inc | ||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 203136891 | Healthcare | VA | C | Yes (1) |
| Carilion Emergency Services Inc | ||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 542033006 | Healthcare | VA | C | Yes (1) |
| SCA Credit Services Inc | ||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541180398 | Collection agency | VA | C | Yes (1) |
| Carilion Healthcare Corporation | ||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541586601 | Healthcare | VA | C | Yes (1) |
| MedKey Inc | ||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541645357 | Financing services | VA | C | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CHS Inc | ||
| E | $1,477,164 | Cash |
| Carilion Medical Center | ||
| L | $137,600 | Cost |
| Carilion Medical Center | ||
| M | $1,792,185 | Cost |
| Carilion Services Inc | ||
| M | $2,118,901 | Cost |
| CHS Inc | ||
| M | $248,921 | Cost |