CARILION TAZEWELL COMMUNITY HOSPITAL: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- CARILION TAZEWELL COMMUNITY HOSPITAL (EIN 54-6074580)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-08-15
- IRS object ID
- 201522279349300237
- Schema version
- 2013v4.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-08-15T13:16:52-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | 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 | BusinessNameLine1 |
| 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 | AddressLine1 |
| City | ROANOKE | City |
| State | VA | State |
| ZIP Code | 240252385 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Donald Halliwill | PersonNm |
| Person Title | Chief Financial Officer | PersonTitleTxt |
| Phone | 5402245112 | PhoneNum |
| Signature | 2015-08-15 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | William J Flattery | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12385 | AddressLine1 |
| City | ROANOKE | City |
| State | VA | State |
| ZIP Code | 240252385 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,055,017 | 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 | See Schedule O.Carilion Tazewell Community Hospital is committed to a common purpose of better patient care, better community health, and lower cost. This 56-bed hospital primarily serves the counties of Tazewell and Russell in Virginia, and Mercer and McDowell in West Virginia. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 139 | TotalEmployeeCnt |
| Total Volunteers | 26 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,112 | PYContributionsGrantsAmt |
| CY Contributions Grants | $119,137 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,879,009 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,449,843 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,445 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,550 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,134,086 | PYOtherRevenueAmt |
| CY Other Revenue | $481,487 | CYOtherRevenueAmt |
| PY Total Revenue | $15,027,652 | PYTotalRevenueAmt |
| CY Total Revenue | $14,055,017 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,598 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $9,330 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,876,049 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,132,284 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,617,381 | PYOtherExpensesAmt |
| CY Other Expenses | $10,027,403 | CYOtherExpensesAmt |
| PY Total Expenses | $15,496,028 | PYTotalExpensesAmt |
| CY Total Expenses | $15,169,017 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$468,376 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,114,000 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,631,121 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,584,156 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,557,460 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,662,167 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$7,926,339 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$9,078,011 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | 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.Our mission is to improve the health of the communities we serve. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,236,521 | ExpenseAmt |
| Grant | $9,330 | GrantAmt |
| Revenue | $13,897,163 | RevenueAmt |
| Desc | See Schedule O.Carilion Tazewell Community Hospital exists to serve the health care needs of its community, regardless of patient ability to pay. Tazewell's acute hospital admitted 580 patients and provided 2,148 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. Tazewell 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. Tazewell also provides an emergency department with 24-hour care and emergency transportation. With 9,800 visits, Tazewell'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 ED visits. Tazewell supports community screenings and education on chronic disease management, sponsoring 41 events touching more than 9,333 people. In furtherance of its mission, Tazewell provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year of $900 thousand. | Desc |
| Total Program Service Expenses | $13,236,521 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | Yes (1) | 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 |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 139 | 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 | 11 | 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 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5402245112 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 S Jefferson St | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 24011 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| D Michael Hymes | |||||||||
| Director | 1.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Peggy Riley | |||||||||
| Director | 1.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Stephen Rinehart MD | |||||||||
| Director | 1.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Kathren R Dowdy RN MSN | |||||||||
| Director/Nursing Director | 50.00 | 0.00 | Yes (X) | $122,830 | $0 | $9,182 | |||
| Antony D Roop | |||||||||
| Director | 1.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Heather S Shepardson | |||||||||
| Director | 1.20 | 48.80 | Yes (X) | $0 | $153,236 | $2,465 | |||
| Nancye Howell | |||||||||
| Director/Secretary | 1.20 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| James C Thompson | |||||||||
| Director//Chair | 2.50 | 2.40 | Yes (X) | $0 | $7,700 | $0 | Yes (X) | ||
| Charles E Green | |||||||||
| Director/Vice Chair | 1.20 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| John Piatkowshi MD | |||||||||
| Director/CEO | 2.50 | 47.50 | Yes (X) | $0 | $277,683 | $10,360 | Yes (X) | ||
| William J Flattery | |||||||||
| Director/CEO | 2.50 | 47.50 | Yes (X) | $0 | $249,555 | $21,386 | Yes (X) | ||
| Michael D Rorrer MD | |||||||||
| Director/Chief of Medical Staff | 1.20 | 48.80 | Yes (X) | $0 | $308,519 | $20,607 | Yes (X) | ||
| Donald B Halliwill | |||||||||
| Assistant Treasurer | 0.20 | 49.80 | $0 | $343,160 | -$13,889 | Yes (X) | |||
| Rachel Mabe | |||||||||
| Asstistant Secretary | 0.10 | 49.90 | $0 | $69,609 | $89 | Yes (X) | |||
| Lauren J Chen | |||||||||
| Assistant Secretary | 1.00 | 49.00 | $0 | $68,855 | $7,219 | Yes (X) | |||
| G Robert Vaughan Jr | |||||||||
| Assistant Treasurer | 0.20 | 49.80 | $0 | $255,568 | -$13,062 | Yes (X) | |||
| David Vance | |||||||||
| Pharmacy Manager | 50.00 | 0.00 | $112,205 | $0 | $10,761 | Yes (X) | |||
| Donald Lorton | |||||||||
| Former Officer | 0.00 | 50.00 | $0 | $3,772,316 | -$29,521 | Yes (X) | |||
| Randal Swatzyna | |||||||||
| Former Officer | 0.00 | 50.00 | $0 | $104,635 | $8,566 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $235,035 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,610,836 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $34,163 | 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 (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Soltas Lab Partners Group LLC | |||||
| PO Box 751337 | Charlotte | NC | 28275 | Laboratory Services | $900,275 |
| Allied Health Services | |||||
| PO Box 97 | Tazewell | VA | 24651 | Professional Fees | $370,793 |
| MR Ramakrishnan MD | |||||
| 1745 Valley View Drive | Big Stone Gap | VA | 24219 | Physician Services | $312,000 |
| Nickels Inc | |||||
| PO Box 347 | Tazewell | VA | 24651 | Construction Services | $200,047 |
| GJ Hopkins Inc | |||||
| 714 5th Street NE | Roanoke | VA | 24016 | Construction Services | $163,241 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $119,137 | GovernmentGrantsAmt |
| Total Contributions | $119,137 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Net Patient Revenue | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $13,449,843 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,449,843 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,449,843 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,550 | TotalRevenueColumnAmt |
| Exclusion | $4,550 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $34,167 | 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 | $34,167 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,167 | TotalRevenueColumnAmt |
| Exclusion | $34,167 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EHR Incentive Income | 900099 | $442,274 | $442,274 |
| Court Cost Recovery | 900099 | $5,750 | $5,750 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$704 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$704 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $447,320 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,055,017 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,897,163 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $38,717 | 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 | $9,330 | TotalAmt |
| Program Services | $9,330 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,495 | TotalAmt |
| Program Services | $127,495 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,206,483 | TotalAmt |
| Program Services | $4,162,187 | ProgramServicesAmt |
| Management And General | $44,296 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,951 | TotalAmt |
| Program Services | $187,951 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,992 | TotalAmt |
| Program Services | $284,691 | ProgramServicesAmt |
| Management And General | $9,301 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,363 | TotalAmt |
| Program Services | $316,363 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,751,622 | TotalAmt |
| Management And General | $1,751,622 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $508 | TotalAmt |
| Management And General | $508 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,310 | TotalAmt |
| Program Services | $2,310 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,495,465 | TotalAmt |
| Program Services | $2,467,205 | ProgramServicesAmt |
| Management And General | $28,260 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10 | TotalAmt |
| Program Services | $10 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $330,450 | TotalAmt |
| Program Services | $313,811 | ProgramServicesAmt |
| Management And General | $16,639 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,633 | TotalAmt |
| Program Services | $40,633 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $209,924 | TotalAmt |
| Program Services | $209,924 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,502 | TotalAmt |
| Program Services | $67,737 | ProgramServicesAmt |
| Management And General | $2,765 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,037 | TotalAmt |
| Program Services | $167,037 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $642,903 | TotalAmt |
| Program Services | $642,903 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,467 | TotalAmt |
| Program Services | $158,999 | ProgramServicesAmt |
| Management And General | $60,468 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Bad Debt | $2,144,616 | $2,144,616 | |
| I/C Practice Subsidy | $1,349,078 | $1,349,078 | |
| Medical Supplies | $545,927 | $545,927 | |
| Dues & Subscriptions | $18,724 | $16,924 | $1,800 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,227 | TotalAmt |
| Program Services | $21,390 | ProgramServicesAmt |
| Management And General | $16,837 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,169,017 | TotalAmt |
| Program Services | $13,236,521 | ProgramServicesAmt |
| Management And General | $1,932,496 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $926 | BOYAmt |
| EOY | $925 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,507 | BOYAmt |
| EOY | $25,990 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,695,727 | BOYAmt |
| EOY | $1,982,358 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,278 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,494 | BOYAmt |
| EOY | $76,932 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,274,420 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,787,873 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,770,785 | BOYAmt |
| EOY | $4,486,547 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,404 | BOYAmt |
| EOY | $11,404 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,631,121 | BOYAmt |
| EOY | $6,584,156 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,163,817 | BOYAmt |
| EOY | $1,020,311 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,609 | BOYAmt |
| EOY | $25,388 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,331,034 | BOYAmt |
| EOY | $14,616,468 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,557,460 | BOYAmt |
| EOY | $15,662,167 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$7,926,339 | BOYAmt |
| EOY | -$9,078,011 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$7,926,339 | BOYAmt |
| EOY | -$9,078,011 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,631,121 | BOYAmt |
| EOY | $6,584,156 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,114,000 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$37,672 | 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
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 | $2,310 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,310 | 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 | Portion of dues paid to American Hospital Association and Virginia Hospital and Healthcare Association spent on lobbying. | 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 | $7,036,260 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,140,009 | DepreciationAmt |
| Book Value | $2,896,251 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,845,131 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,495,242 | DepreciationAmt |
| Book Value | $1,349,889 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $344,276 | OtherCostOrOtherBasisAmt |
| Depreciation | $152,622 | DepreciationAmt |
| Book Value | $191,654 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,486,547 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Affiliate | $14,509,241 |
| Qualified Pension Liability | $92,227 |
| Accrued Pension | $15,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $14,616,468 | 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, 2014 and 2013. 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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 133.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| 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 | $831,811 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $831,811 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06390 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $746,327 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $651,109 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $95,218 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00730 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,578,138 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $651,109 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $927,029 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07120 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Persons Served | 7283 | PersonsServedCnt |
| Total Community Benefit Expns | $11,984 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,984 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $199 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $199 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 16 | ActivitiesOrProgramsCnt |
| Persons Served | 7283 | PersonsServedCnt |
| Total Community Benefit Expns | $12,183 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,183 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 16 | ActivitiesOrProgramsCnt |
| Persons Served | 7283 | PersonsServedCnt |
| Total Community Benefit Expns | $1,590,321 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $651,109 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $939,212 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07210 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 250 | PersonsServedCnt |
| Total Community Benefit Expns | $1,401 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,401 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 21 | ActivitiesOrProgramsCnt |
| Persons Served | 1800 | PersonsServedCnt |
| Total Community Benefit Expns | $4,268 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,268 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $150 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $150 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 25 | ActivitiesOrProgramsCnt |
| Persons Served | 2050 | PersonsServedCnt |
| Total Community Benefit Expns | $5,819 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,819 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,144,616 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $159,365 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,581,573 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,815,255 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$233,682 | 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 | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 141 Ben Bolt Avenue | AddressLine1 |
| City | Tazewell | City |
| State | VA | State |
| ZIP Code | 24651 | ZIPCode |
| 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 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| 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 |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 133.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | Yes (1) | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Carilion Tazewell Community Hospital | Part V, Section B, Line 3: In January 2013, Carilion Tazewell Community Hospital began its seven-month Community Health Needs Assessment process. A Community Health Assessment Team (CHAT) was formed, inviting stakeholder agencies across Tazewell County involved in the health of the community, to advise and oversee the process. A total of about 30 participated in the CHAT meetings. The process was led and informed by Carilion Clinic's Planning Team. Primary data collection took place in the spring of 2013. Primary data collection included the implementation of a broad-based Community Health Survey, four Focus Group meetings with the target populations and a Stakeholder Survey given to individuals working in health-related areas.CHAT members represented the following organizations and groups:Carilion Tazewell Community Hospital and Carilion Clinic, 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, and Tazewell Library. |
| Carilion Tazewell Community Hospital | Part V, Section B, Line 5d: 5a: www.carilionclinic.org/hospitals/carilion-tazewell-community-hospital. |
| Carilion Tazewell Community Hospital | Part V, Section B, Line 7: 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 12i: Liquid assets and equity in real property. |
| Carilion Tazewell Community Hospital | Part V, Section B, Line 20d: FAP eligible uninsured patients are charged gross charges less an uninsured discount. FAP eligible insured patients are charged under terms of their insurance contract (never gross charges) and are also eligible for financial assistance. The discount rate is based on the system's dominant negotiated commercial insurance rate. |
| Carilion Tazewell Community Hospital | Part V, Section B, Line 21: The discount rate is based on the system's dominant negotiated commercial insurance rate. |
| Carilion Tazewell Community Hospital | Part V, Section B, Line 22: FAP eligible uninsured patients are charged gross charges less an uninsured discount for the hospital's services. Certain physician services may be stated at gross charges. |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | Asset test is used to determine free/discounted care. Equity value in real property is required for review/outcome. |
| 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 subtracted from total expenses for the calculation is $2,144,616. |
| Part I, Line 1- | Part I, Line 7e-7i:7e - 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, the hospital provides health fairs, screenings, and presentations offered at various community locations. These events provide an opportunity to educate individuals about improving health and quality of life as well as determining one's risk of developing a chronic illness. Additional health improvement services include blood drives and assistance with enrollment in public medical programs such as Medicaid. Community benefit operations include the cost associated with tracking community health improvement activities.7f - n/a.7g - n/a.7h - n/a.7i - This line is calculated at cost. Financial support was provided to Legacy Hospice and in-kind during the local United Way annual campaign. |
| 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 3: | The estimated amount of bad debt expense, reported on line 3, attributable to patients eligible for charity care was determined as the amount of unprocessed financial assistance at September 30, 2014 that was subsequently granted to patients. |
| Part II, Line 1: | 1 - n/a.2 - Support was provided to the Greater Bluefield Chamber of Commerce, Princeton-Mercer County Chamber of Commerce and Business to Business event. 3 - Support was provided to Relay for Life, Rotary Club of Tazewell, Four Season YMCA, National Child Safety Council, Feeding America Southwest Virginia, and Clinch Valley Community Action.4 - n/a.5 - Support was provided to the Virginia Future Business Leaders Association.6 - n/a.7 - n/a.8 - n/a. |
| Part III, Line 4: | Accounts receivable are reduced by an allowance for amounts that could become uncollectible in the future. Carilion 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. The percentage used to reserve for all self-pay accounts is based on Carilion's collection history. Carilion 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: | Patients are actively screened through a "Presumptive" eligibility process before moving accounts through Extraordinary Collection Actions as defined under the 501r regulations. In addition, individuals have been allowed to apply for financial assistance throughout the collection process. |
| Part VI, Line 3: | The organization informs and educates patients and persons who may be billed for patient care through an in-house eligibility assistance program (EAS) and will evaluate according to our organization's financial assistance policy when patients are eligible for the program. We inform the public through our Internet site, EAS Representatives and other Financial Representatives (Customer Service/Patient Access), and provide information regarding the programs above when patients ask. In addition, our statements comment regarding financial assistance availability. |
| Part VI, Line 4: | 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: | 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: | Carilion Tazewell Community Hospital is a wholly owned hospital of 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, assistance is provided to help the community to stay healthy, and inspiration for the region to grow stronger. Carilion Clinic employees 650 physicians representing more than 70 specialties who provide care at 220 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, baccalaureate, and master's degree programs. During fiscal year 2014, 876 undergraduate and 255 graduate students were enrolled. The Virginia Tech Carilion School of Medicine enrolled 167 students and there were 649 appointed faculty members during fiscal year 2014. Carilion Clinic and Virginia Tech Carilion School of Medicine provide graduate medical education to 250 medical residents and fellows. There are 12 accredited residency programs (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, four first-response vehicles and 50 Advanced Life Support Ambulances. An additional benefit to the community is Carilion Clinic's economic contribution to the region. As the areas largest employer, jobs are provided for more than 11,700 residents of the region. Research conducted at the Virginia Tech Carilion Research Institute (VTCRI) creates a bridge between basic science research at Virginia Tech and clinical expertise at Carilion Clinic and increases translational research opportunities for both partners. Research conducted by scientists at the institute is aimed at understanding the molecular basis for health and disease, and development of diagnostic tools, treatments, and therapies that will contribute to the prevention and solution of existing and emerging problems in contemporary medicine. Research areas of emphasis which presently align with areas of strength and active research at Virginia Tech include inflammation, infectious disease, neuroscience, and cardiovascular science and cardiology. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Heather S Shepardson | ||||||||||||||
| Director | $0 | $144,213 | $0 | $2,500 | $0 | $6,523 | $0 | $1,367 | $0 | $1,098 | $0 | $155,701 | $0 | $0 |
| John Piatkowshi MD | ||||||||||||||
| Director/CEO | $0 | $219,511 | $0 | $45,500 | $0 | $12,672 | $0 | $8,338 | $0 | $2,022 | $0 | $288,043 | $0 | $0 |
| William J Flattery | ||||||||||||||
| Director/CEO | $0 | $201,544 | $0 | $39,200 | $0 | $8,811 | $0 | $3,718 | $0 | $17,668 | $0 | $270,941 | $0 | $0 |
| Michael D Rorrer MD | ||||||||||||||
| Director/Chief of Medical Staff | $0 | $276,554 | $0 | $24,820 | $0 | $7,145 | $0 | $9,588 | $0 | $11,019 | $0 | $329,126 | $0 | $0 |
| Donald B Halliwill | ||||||||||||||
| Assistant Treasurer | $0 | $284,640 | $0 | $52,500 | $0 | $6,020 | $0 | -$27,463 | $0 | $13,574 | $0 | $329,271 | $0 | $0 |
| G Robert Vaughan Jr | ||||||||||||||
| Assistant Treasurer | $0 | $211,713 | $0 | $38,988 | $0 | $4,867 | $0 | -$27,255 | $0 | $14,193 | $0 | $242,506 | $0 | $0 |
| Donald Lorton | ||||||||||||||
| Former Officer | $0 | $314,369 | $0 | $67,943 | $0 | $3,390,004 | $0 | -$34,833 | $0 | $5,312 | $0 | $3,742,795 | $0 | $3,389,344 |
| Randal Swatzyna | ||||||||||||||
| Former Officer | $0 | $103,729 | $0 | $300 | $0 | $606 | $0 | $1,919 | $0 | $6,647 | $0 | $113,201 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | David Vance and Kathren Dowdy each received $150 gift certificates grossed up for taxes and included in taxable compensation. |
| Part I, Line 1b | The organization has written policies regarding the inclusion of gift cards, prizes and awards in taxable compensation. Management at its discretion may choose to gross up awards, gifts and prizes for taxes so that the employee receives the full amount of the award, gift, or prize on an after-tax basis. |
| Part I, Line 3 | See Schedule O disclosure for Form 990, Part VI, Section B, Line 15 |
| Part I, Line 4b | Select members of management participate in a split-dollar life insurance benefit. Under the program, participants purchase a life insurance policy. The Company pays the premium on the policy as an interest-bearing loan to the participant. The policy is collaterally assigned to the Company as security for the payment of the loan. Upon any payout from the policy, either at the death of the participant or some earlier terminating event, the Company is repaid its loan first, with the remainder of policy proceeds, if any, then payable to the participant or his or her beneficiaries. 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 to 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. Payments during the calendar year under these plans included the following: Donald Lorton $3,389,344 |
| Part I, Line 7 | The organization pays annual bonus compensation to management based on scorecard performance. While the scorecard contains a formula as a basis for determining overall performance, senior managers have discretion to include additional elements in their assessment of managers reporting to them. In addition, for top management, the actual bonus awarded is in the discretion of the Carilion Clinic Compensation Committee, although it is based on the scorecard measures. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Solstas Lab Partners LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Service Provider | RelationshipDescriptionTxt |
| Transaction | $900,275 | TransactionAmt |
| Transaction | Lab services | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part IV, Line (1): | FormAndLineReferenceDesc |
| Explanation | G. Robert Vaughan, Jr., an officer, serves on the Board of Solstas Lab Partners, LLC, of which Carilion has a minority financial interest, and from whom the organization purchases lab services. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, came 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. Charles E. Green, III, and Stephen Rinehart, MD - Business relationship. 2. Lauren J. Chen, Donald B. Halliwill, Rachel L. Mabe, Heather S. Shepardson, and G. Robert Vaughan, Jr. - Business relationship. 3. Lauren J. Chen, Donald B. Halliwill, Rachel L. Mabe, Michael D. Rorrer, M.D., and G. Robert Vaughan, Jr.- Business relationship. 4. Lauren J. Chen, William J. Flattery, Donald B. Halliwill, Rachel L. Mabe, and G. Robert Vaughan, Jr. - Business relationship. |
| 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 organization and supporting organization of the 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, came 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 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 | All Board Members were notified that the final Form 990 was posted on our Board portal several days prior to filing and were encouraged to call with any questions they might have. |
| Form 990, Part VI, Section B, line 12c | A Conflict of Interest Questionnaire, along with a copy of the Policy, is sent out annually to all officers, directors and key employees. In addition, such individuals are instructed to inform the organization of potential conflicts which arise during the year. Answers to the Questionnaires are reviewed by the Internal Audit Department. Potential conflicts for officers and key employees are reviewed by an internal Conflict of Interest Committee, which follows up on any potential issues to ensure compliance with all policies of the organization. The answers for Directors are reviewed by the Carilion Clinic Audit and Compliance Committee. In addition, the governing body of the organization is provided with a list of the answers annually to make all Board members aware of potential conflicts in order to ensure compliance with policies on how to handle transactions with Board members that may involve potential conflict situations. |
| Form 990, 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 CEOs. This review was performed in September and October 2013. A similar review was last performed in October 2014. This review included a 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 web site and in our annual report to the community. |
| Form 990, Part IX, line 11g | Other Services: Program service expenses 2,467,205. Management and general expenses 28,260. Fundraising expenses 0. Total expenses 2,495,465. |
| Form 990, Part XI, line 9: | Pension-Related Changes -37,672. |
| 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | |
| 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 | 0 | 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 (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CHS Incand Subsidiaries | ||
| E | $248,417 | Cash |
| Carilion Medical Center | ||
| M | $1,371,571 | Cost |
| Carilion Services Inc | ||
| M | $2,019,279 | Cost |
| CHS Incand Subsidiaries | ||
| M | $303,137 | Cost |