2013-08-15T13:23:16-00:00 2012-09-30 Deloitte Tax LLP 424 Church Street Nashville TN 37219 990 2011-10-01 540549603 Carilion Giles Community Hospital CARI 5402245112 PO Box 12385 Roanoke VA 240252385 Donald Halliwill 2013-08-15 true Francis J Bedard 6152591811 2013-08-15 2011 2016-02-24 21:20:13Z John Piatkowski MD PO Box 12385 Roanoke VA 24025 27269754 false X www.carilionclinic.org X 1954 VA Carilion Giles 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. 16 12 257 44 0 68326 123862 22861557 26495958 -2362264 -657475 210883 1018028 20778502 26980373 48039 17467 0 10391832 10797435 0 0 14771675 16730758 25211546 27545660 -4433044 -565287 40300387 41473764 59850823 58015613 -19550436 -16541849 X Carilion Giles 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. false false 24303169 17467 27348287 See Schedule O 24303169 true true false true false false false false false false true true false false true true false true false false false false false false false false true true true true true true false false false false false false false false false true false false false false false true false false false false true 0 0 true 257 true false true BD CA CJ EI false false false false false false false false X 16 12 false true false false true true true true true false false true true true true true true true true false VA X X The Corporation 5402245112 213 S Jefferson Street Roanoke VA 240111713 X Richard Claus 002.00 X 0 0 0 Mark Collins 002.00 X 0 0 0 Gary Eaton 002.00 X 0 0 0 Winston Faust 002.00 X 0 0 0 James Hartley 002.00 X 0 0 0 Richard Jennell 002.00 X 0 0 0 Chris McKlarney 002.00 X 0 0 0 Michael McMahon MD 002.00 X 0 2720 12 Sue Meredith 002.00 X 0 0 0 Priscilla Morris 002.00 X 0 0 0 Melina Perdue 002.00 X 0 0 0 Kenneth Rakes 002.00 X 0 0 0 Scarlett Ratcliffe 002.00 X 0 0 0 John Tamminen MD 002.00 X 0 537173 59866 James Tyler 050.00 X X 197367 0 48891 Andrew Wagner 002.00 X 0 0 0 Donald Lorton 002.00 X 0 680251 528400 Rachel Mabe 002.00 X 0 67991 25993 Amy Westmoreland 050.00 X 140458 0 24250 Duane Blevins 050.00 X 124352 0 19198 Deborah Taylor 050.00 X 101160 0 37724 Beverley Rice 050.00 X 106527 0 36049 669864 1288135 780383 7 false true false Skanska USA Building Inc PO Box 17167 WinstonSalem NC 271167167 Construction contractor 286847 Solstas Lab Partners Group LLC PO Box 751337 Charlotte NC 282751337 Laboratory Services 1075143 GE Medical Systems PO Box 640944 Pittsburgh PA 152640944 Equipment maintenance 231042 3 4464 7001 112397 123862 Net Patient Service Revenues 900099 26495958 26495958 26495958 -501546 -501546 385 385 127647 127647 127647 127647 133067 137013 152368 -3946 -152368 -156314 -156314 EHR Incentive Income 900099 776486 776486 Cafeteria 900099 38052 38052 Court Cost Recovery 900099 13748 13748 62095 62095 890381 26980373 27348287 -491776 17467 17467 0 0 0 197422 197422 0 8355285 8175333 179952 615360 615360 1007875 952307 55568 621493 621493 2687306 2687306 2065 2065 0 3951 3951 0 3237865 3117491 120374 12906 3241 9665 653305 615996 37309 37569 37569 0 384138 383102 1036 59860 39891 19969 0 0 1410844 1410844 0 2029962 2029962 261597 149144 112453 Bad Debt 2607603 2607603 Medical Supplies 1684663 1684663 I/C Practice Subsidy 1599625 1599625 57499 40705 16794 27545660 24303169 3242491 0 1340 1560 18435 29930 3101475 3910106 4262 61551 215325 46090404 14457722 33009918 31632682 66911 1093465 2302522 4427937 1738235 158497 40300387 41473764 3244695 3738252 1677581 222055 39595554 35033092 15332993 19022214 59850823 58015613 X -19619666 -16599008 69230 57159 -19550436 -16541849 40300387 41473764 X -565287 3573874 X false true true X false X 0.00000 0.00000 0.00000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3951 3951 false II-B 1i Portion of dues paid to American Hospital Assn. and Virginia Hospital and Healthcare Assn. spent on lobbying. false 1978565 1978565 26868917 2838762 24030155 17120593 11564637 5555956 122329 54323 68006 31632682 4427937 F 4427937 Qualified Pension Liability 10129875 2005 Fixed Payor Swap Unreal L 1004494 2010 Barclays Swap Unrealized Loss -24577 2008 Swap Unrealized Losses 7887846 2010 PNC Swap Unrealized Loss -46666 2005 Swap Unrealized Losses -28486 Swap Contra 99728 19022214 X 2 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, 2012 and 2011. Carilion does not expect that unrecognized tax benefits will materially increase within the next 12 months. true true true X true X true true true false true true 1974127 1974127 0.07920 989062 897048 92014 0.00370 2963189 897048 2066141 0.08290 30 2003 99856 465 99391 0.00400 3 676 17641 17641 0.00070 33 2679 117497 465 117032 0.00470 33 2679 3080686 897513 2183173 0.08760 2 11000 11000 0.00040 2 11000 11000 0.00040 false 1015205 187761 11144232 11033893 110339 X true true 1 1 Carilion Giles Community Hospital

159 Hartley Way Pearisburg VA 24134

X X X X Adult Day Services 1 1 Adult Day Services

701 Wenonah Ave Pearisburg VA 24134

0 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 Clinics website. Part I line 7 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, in fiscal year 2012 Carilion Giles Community Hospital touched 1,028 people during 21 events offered throughout the community. Events included health fairs and screenings at various community locations. Part I line 7 7e CONTINUED Monthly blood pressure and blood glucose screenings are offered at various locations in the community. These screenings provide an opportunity to educate individuals about improving health and quality of life as well as determining ones risk of developing a chronic illness. Part I line 7 7 e CONTINUED When access to prescription drugs was determined a critical need, Carilion Giles Community Hospital established the Giles Medication Assistance Program GMAP in August 2000 to help low-income patients obtain access to prescription medications. In fiscal year 2012, GMAP served 842 patients with 9,370 prescription requests. The average cost per prescription was 562.05 and the total value of received medication AWP was 5,266,390. Part I line 7 7e CONTINUED Additional health improvement services include blood drives, assistance with enrollment in public medical programs such as Medicaid and interpreter services for non-English speaking patients. Community benefit operations includes expenses related to completion of the community health needs assessment and strategic implementation plan. Part I line 7 7F - N/A Part I line 7 7g - N/A Part I line 7 7 h - N/A Part I line 7 7i - Financial support was provided to the American Cancer Society for support of research, patient services, early detection, treatment and education. Part I line 7 Ratio of cost-to-charges was used to calculate the expense. Part I line 7 Column f - Bad debt expense subtracted from total expenses for the calculation is 2,607,603. Part II Line 1 - N/A Part II Line 2 - N/A Part II Line 3 - Financial support was provided for NRV CARESs Parenting Young Children Program that addresses child abuse prevention and family strengthening through education, advocacy, and community partnerships. Part II Line 4 - N/A Part II Line 5 - N/A Part II LIne 6 - N/A Part II Line 7 - N/A Part II Line 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 Carilions collection history. Part III line 4 CONTINUED Carilion collects substantially all of its third-party insured receivables, which include receivables from governmental agencies. Part III line 4 CONTINUED The bad debt expense reported on Line 2 was calculated using the cost-to-charges ratio applied to the provision for bad debt reported in the financial statements. Part III line 4 CONTINUED The estimated amount of bad debt expense, reported on line 3, attributable to patients eligible for charity care was determined using external credit reporting data to identify the patients that were eligible and applying the cost-to-charges ratio to the charges of the patients so identified. Sufficient information was not available to make a definite determination of their eligibility. Part III line 4 CONTINUED Patient account balances are reduced by discounts allowed and payments. 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 Carilion Clinic is committed to providing quality health care to all regardless of their ability to pay. Our Charity Care Policy is designed to allow relief of all or part of the charges that exceed a patients reasonable ability to pay. Carilion uses the Federal Poverty Guidelines FPG published and updated yearly in the Federal Register along with a Financial Needs Assessment Questionnaire FNAQ as developed by Carilion to determine eligibility. Part III line 9b CONTINUED Together, the family income, number of family members living on that income, and equity in real property are pertinent factors in determining how much, in the sole judgment of Carilion, a patient is reasonably able to pay for services. Patients with family income up to 400 percent of FPG with no more than 100,000 equity in real property are eligible for a Charity Care discount. Part III line 9b CONTINUED To apply for the Charity Care program complete a Financial Needs Assessment Questionnaire or contact our Billing Customer Service team with questions. All patients who are able will be expected to pay for their own healthcare services to avoid shifting the burden for their care to other patients and the general public. Part III line 9b CONTINUED The Charity Care Policy should have no impact on the collection policies and practices with regard to those balances that do not qualify for charity care. Failure to honor payment for amounts exceeding the charity adjustment may result in the total charity care being revoked. Part V Section B, Line 3 -- A Planning Committee consisting of Giles Free Clinic staff, project consultants, and representatives from area health and human services, including the critical access hospital, Carilion Giles Community Hospital and the Giles Health Department faith-based communities the public schools local government and the Virginia Rural Health Association led the year-long initiative. Part V Section B, Line 3 CONTINUED The majority of committee members serve the low-income, uninsured, underserved and other vulnerable populations in Giles County. Beginning in October 2011, the Planning Committee met monthly to oversee the planning grant. Meeting agendas and minutes were reviewed by the Planning Committee at each meeting. Please see the list of organizations that served on the Planning Committee below Part V Section B, Line 3 CONTINUED Free Clinic of the New River Valley and Giles Free Clinic, Giles County Administration, Giles County Christian Ministerial Assoc., Giles County Christian Services Mission, Giles County Dept. of Social Services, Giles County School Board, Giles Health Network, New River Community Action, New River Valley Agency on Aging, New River Valley Community Services, New River Valley Health District Giles Office, Newport-Mount Olivet United Methodist Church and Virginia Rural Health Resource Center. Part V Section B, Line 5a -- http//www.carilionclinic.org/cgch/giles-community-hospital http//issuu.com/carilionclinic/docs/gileschna2012 Part V Section B, Line 7 -- Mental Health Substance Abuse Services are not being addressed by Carilion Giles Community Hospital since these services will be included in a new FQHC if funding is available. The hospital does not have the expertise to effectively address the need of affordable child and adult daycare services. Part V Line 19d The maximum amount that can be charged to FAP-eligible individuals for necessary care is as follows Individuals at or below 100 of the Federal Poverty Guidelines FPG are eligible for a discount of their entire account balance. Individuals at 101 to 200 of FPG are eligible for a discount of the greater of 75 of the account balance or the discount necessary to lower their remaining balance to 10 of family income. Part V Line 19d CONTINUED Individuals at 201 to 250 of the FPG are eligible for a discount of the greater of 70 of the account balance or the discount necessary to lower their remaining balance to 15 of family income. Individuals at 251 to 300 of the FPG are eligible for a discount of the greater of 55 of the account balance or the discount necessary to lower their remaining balance to 20 of family income. Part V Line 19d CONTINUED Individuals at 301 to 350 of the FPG are eligible for a discount of the greater of 40 of the account balance or the discount necessary to lower their remaining balance to 25 of family income. Individuals at 351 to 400 of the FPG are eligible for a discount of the greater of 25 of the account balance or the discount necessary to lower their remaining balance to 30 of family income. Part V --- FOR Part VI, Lines 2, 3, 4, 5, 6 and 7 See Schedule O for the supplemental information. true Giles Life Saving and Rescue Squad Inc 175 Industrial Park Dr Pearisburg VA 24134 541064773 501c3 8540 FMV Supplies General Support 1 SCHOLARSHIPS 5 5000 1 2 The Hospital donates funds to other 501c3 charitable organizations with a similar mission. Such organizations also have community boards which oversee the expenditure of such funds. III 1 The Hospital offers scholarships to high school seniors entering a medical field. Applications are evaluated and awards made by an independent committee according to prescribed guidelines. X true true false true false false false false false true false John Tamminen MD 444374 88929 3870 44932 14934 597039 James Tyler 169339 26574 1454 41900 6991 246258 Donald Lorton 486200 129425 64626 509034 19366 1208651 63526 Amy Westmoreland 128348 9374 2736 23392 858 164708 I 7 -- The organization pays annual bonus compensation to management based on scorecard performance. While the scorecard contains a formula as a basis for determining overall performance, senior managers have discretion to include additional elements in their assessment of managers reporting to them. In addition, for top management, the actual bonus awarded is in the discretion of the Carilion Clinic Compensation Committee, although it is based on the scorecard measures. I 4b - Donald Lorton 250,129 Industrial Development Authority of the City of Roanoke VA 541106038 770084EQ0 2005-12-14 6395000 Capital projects, current refunding of Series 2002 B-E bonds Costs of issunace, bond insurance false false false VA Small Business Financing Authority 541300845 928101AD6 2008-07-09 31000000 Capital projects Cost of issuance false false false Industrial Development Authority of the City of Roanoke VA 541106038 770082mul 2012-02-09 915000 Redemption of Series 2002A bonds Cost of issunace false false false 4188000 6395000 39426 92156 6263419 true false true true 31650000 171861 31478139 2010 false false true true 63000 915000 11533 2110023 false true true true false false false false true true true true true UBS and Citigroup 0000000027.000000000000 false false true AIG 0000000000.300000000000 true false true true true true UBS and Citigroup 0000000033.000000000000 false false false false true true false false false false false X Donald Lorton Assistant Treasurer 1192927 Lab services false IV 1 Donald Lorton 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. Form 990 Part III 4a Carilion Giles Community Hospital, a critical access hospital, exists to serve the health care needs of its community, regardless of patient ability to pay. Giles hospital admitted 1,217 patients and provided 5,605 days of care during the year. Hospital programs include provision of nursing care extensive outpatient and inpatient surgical and endoscopic services and diagnostic imaging services including CT, MRI, and mammography. Giles provides a number of services targeting the specific health needs of its population, including diabetes management comprehensive physical, speech, and occupational therapy programs and participation in cardiac rehab and disease management programs. Giles also provides an emergency department with 24-hour care, emergency transportation, and a chest pain and stroke program. Form 990 Part III 4a CONTINUED With 12,956 visits, Giles emergency services are a critical component of the health safety net in its service area, acting as a primary health provider for a significant number of uninsured patients, who comprise nearly 18 percent of ED visits. Giles supports community screenings and education on chronic disease prevention and management, sponsoring 21 events touching 1,028 people, as well as providing key support and coordination for a community-based medication assistance program. In furtherance of its mission, Giles provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year exceeded 2.3 million. Form 990 2 - Carilion Giles Community Hospital partnered with community organizations to complete a community health needs assessment and develop a strategic implementation plan during fiscal year 2012. A Planning Committee consisting of Giles Free Clinic staff, project consultants, and representatives from area health and human services, including Carilion Giles Community Hospital , a critical access facility faith-based communities the public schools local government and the Virginia Rural Health Association led the year-long initiative. The project began in October 2011 with monthly meetings to oversee the project which was financially supported through a Federally Qualified Health Center Planning Grant awarded to the local free clinic. Primary data was obtained through surveys and focus groups and analyzed with information acquired through secondary data sources. Form 990 4 - Carilion Giles Community Hospital is located in the town of Pearisburg, the geographic center of Giles County. In the heart of the Appalachian Mountains of southwest Virginia, Giles County is an area of approximately 360 square miles with population of approximately 17,300. The county includes 92.4 square miles of Jefferson National Forest Giles County and borders West Virginia. Approximately 17 of adults under age 64 and 9 of children who live in the County are uninsured. Additionally, 13 of residents live below the poverty level and 23 did not graduate from high school. 18 of residents are 65 years of age or older. Form 990 4 - CONTINUED Carilion Giles Community Hospital is a 25 bed critical access hospital. A comprehensive replacement facility opened in May 2010, offering 24-hour emergency care, advanced diagnostic procedures, minimally invasive surgery, nuclear medicine studies and comprehensive rehabilitation programs. Form 990 5 - Carilion Giles Community Hospital serves all patients regardless of their ability to pay. The Hospitals governing Board is elected annually and the majority of members are neither employees nor contractors of the Hospital. Medical staff privileges are extended to qualified providers. In addition to clinical care, the hospital works to achieve its mission through the education of health professionals and the community. Any surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. This includes providing free, discounted and subsidized care as well as critical medical services that operate at a loss. Form 990 6 - Carilion Giles Community Hospital is a wholly owned hospital of Carilion Clinic, a not-for-profit healthcare organization serving approximately one million people in Western Virginia through a physician specialty group, advanced primary care practices, hospitals and outpatient centers. Carilion Clinic is based in Roanoke, Virginia and serves the residents of 18 counties and six cities in Western Virginia and southern West Virginia. Over the past six years, Carilion Clinic has gone through a dramatic and transformative change as we transitioned from a hospital system to an integrated clinic with physician leadership. At the heart of our transformation is a passion and shared purpose to meaningfully change the way healthcare is delivered and experienced, resulting in higher value and better clinical outcomes. Form 990 6 CONTINUED This has propelled a commitment to each other as providers and caregivers and working together in new and different ways. To fulfill our vision, we developed a new organizational structure for shared decision making and collaboration, implemented an enterprise-wide electronic health record, became NCQA medical homes in 27 of our primary care sites, established an accountable care organization, developed population health management infrastructure and developed the Virginia Tech Carilion School of Medicine and Research Institute. Carilion Clinic employees 592 physicians representing more than 60 specialties who provide care at 195 practice sites. During 2012, 126 students were enrolled in Virginia Tech Carilion School of Medicine and there were 549 appointed faculty members. Form 990 6 CONTINUED To advance education of health professionals, Jefferson College of Health Sciences, within Carilion Medical Center, is a professional health sciences college offering Masters of Science in Nursing, Physician Assistant and Occupational Therapy and 12 baccalaureate and associate healthcare programs. Approximately 900 undergraduate students and 190 graduate students are enrolled annually with 99 of undergraduates receiving some type of financial aid. Carilion Clinic and Virginia Tech Carilion School of Medicine provide graduate medical education to 215 residents and fellows. Residency program include Emergency Medicine, Family Medicine, Internal Medicine, Neurosurgery, Obstetrics/Gynecology, Psychiatry, Surgery, Pediatrics, Podiatry and General Hospital Dentistry inaugural class July 2013. Form 990 6 CONTINUED Additionally, the University of Virginia sponsors a residency program in Orthopaedics. Fellowship programs include Addiction Psychology, Adult Joint Reconstruction, Advanced Endoscopy, Cardiovascular Disease, Child and Adolescent Psychiatry, Gastroenterology inaugural class July 2013, Geriatric Medicine, Geriatric Psychiatry, Hospice and Palliative Care, Infectious Disease, Interventional Cardiology inaugural class July 2013, Medical Informatics, Orthopaedic-Hand and Pulmonary Critical Care. Form 990 6 CONTINUED Advanced Clinical Services in Cardiovascular and Vascular include a hybrid operating room, transcatheter aortic valve implantation TAVI, ventricular assist device VAD program using the Heartmate II, Medtronic CRYO balloon for atrial fibrillation epicardial ventricular tachycardia ablation, Heart Alert, therapeutic hypothermia, and Thoracic Oncology services with Pulmonary Medicine. In Neurosciences advanced services include Stroke Alert, an adult and pediatric Neurosurgery program, Neuro-interventional procedures, Brain Lab Navigation, Epilepsy Monitoring Inpatient Unit and Movement Disorders. Form 990 6 CONTINUED In Musculoskeletal, a joint replacement program, anterior approach hip replacements, computer-assisted knee replacements and advanced procedures for ankle replacements. Spine Center and Imaging Services include 64 slice CT and PET/CT, 3T MAGNETOM Verio MRI, MR Profusion and Enterography, advanced interventional procedures, and nationally-recognized Breast Care Center with large-format Pathology and digital mammography. Surgery services include plastic and reconstructive surgery, robotic-assisted surgery for cardiac, urology, and gynecology, and advanced laparoscopic techniques in general surgery. Form 990 6 CONTINUED In Pulmonary medicine, advanced interventional procedures are performed as well as thoracic oncology services. Carilion Clinic Cancer Center offers CyberKnife Stereotactic Radiosurgery for inoperable tumors, High Dose Radiation HDR Brachytherapy, Linear Accelerators with IMRT, Selective Internal Radiation SIR Spheres for treatment of liver cancer, Prostate Brachytherapy Radioactive Seed Implants and Mohs surgery. Advanced gynecologic oncology includes single site/port hysterectomy, minimally invasive surgery for gynecology, including the da Vinci Robotic Surgical System and in-office chemotherapy and industry-sponsored research trials as well as participation in National Cancer Institute sponsored research. Form 990 6 CONTINUED Advanced urogynecologic services include Interstim therapy for bladder incontinence and fecography for fecal incontinence. Carilion Clinic Childrens Hospital provides Sub-specialty physicians and clinics in surgery, cardiology, pulmonology, gastroenterology, dentistry, allergy immunology, rheumatology, orthopaedics, hematology oncology, neurosurgery, and developmental pediatrics. Additionally, neonatal and pediatric intensive care units are located within Carilion Roanoke Memorial Hospital. An inpatient childrens facility, pediatric emergency department and specialized transport team are included in this program. Carilion Roanoke Memorial Hospital includes a Level One Trauma Center with EMS services that include three EMS helicopters, four first-response vehicles and 50 Advanced Life Support Ambulances. Form 990 6 CONTINUED An additional benefit to the community is Carilion Clinics economic contribution to the region. As the areas largest employer, jobs are provided for more than 11,300 residents of the region. At the Virginia Tech Carilion VTC Research Institute, scientists are carrying out leading-edge research programs on autism, depression, post-traumatic stress disorder, traumatic brain injury, cerebral palsy, cardiovascular disease, Parkinsons disease, addiction, cancer, mental retardation, epilepsy, and infectious diseases, with state-of-the-art technologies and innovative interdisciplinary science. The research is characterized by computational and quantitative approaches, and modeling in conjunction with experimentation is a critical cornerstone. Form 990 6 CONTINUED The range of research going on today in the Institute includes facilities for a worldwide hub for interactive functional brain imaging, linking Roanoke to the United Kingdom, China, South Korea, Germany, and Norway as well as to other institutions throughout the United States, including Princeton, Caltech, and Emory University. This network, which includes the Institutes three research-dedicated magnetic resonance imaging scanners, is allowing Institute investigators to launch the worlds largest longitudinal study of brain function and decision-making. The Roanoke Brain Study will use functional imaging, genetic analysis, and behavior to uncover key aspects of human brain development in health and in a range of disorders. Form 990 Part VI 3 -- Certain management and related services for the organization are provided by the management and employees of Carilion Services, Inc., a related organization and supporting organization of the organization. Form 990 Part VI 6 -- The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers. Form 990 Part VI 7a -- The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the board that may occur for any reason. Form 990 Part VI 7b -- The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO, approval of borrowings, budgets and strategic plans and amendments of Articles of Incorporation and Bylaws. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia certain extraordinary actions require member approval, such as mergers, consolidations, liquidations and the sale of substantially all of the assets of the organization. Form 990 Part VI 11a and 11b -- The final Form 990 was emailed or delivered in hard copy to each member of the Board of Directors several days prior to filing and Board members were encouraged to call with any questions they might have. Form 990 Part VI 12c -- A Conflict of Interest Questionnaire, along with a copy of the Policy, is sent out annually to all officers, directors and key employees. In addition, such individuals are instructed to inform the organization of potential conflicts which arise during the year. Answers to the Questionnaires are reviewed by the Internal Audit Department. Potential conflicts for officers and key employees are reviewed by an internal Conflict of Interest Committee, which follows up on any potential issues to ensure compliance with all policies of the organization. The answers for Directors are reviewed by the Carilion Clinic Audit and Compliance Committee. Form 990 Part VI 12c CONTINUED 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 15a and 15b -- 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 President and Chief Executive Officer, Executive Vice Presidents, which include the Chief Financial Officer and the Chief Medical Officer. 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 October 2011. A similar review was last performed in October 2012. Form 990 Part VI 15a and 15b CONTINUED This review included a comprehensive report from an outside compensation consultant specializing in healthcare organizations. The report 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. Form 990 Part VI 15a and 15b CONTINUED 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 19 -- The organizations governing documents, conflict of interest statement and financial statements are not generally available to the public, but are released from time to time upon request. The Articles of Incorporation are available from the Virginia State Corporation Commission. The consolidated audited financial statements of Carilion Clinic and of the Obligated Group are released annually to the local newspaper. Limited financial information is available on our web site. Form 990 Part XI 5 -- Other adjustments - unrealized gains on investments 11,729 transfer to Carilion Clinic for effect of pension-related changes 3,037,855 and transfer from affiliate of 6,600,000 for net of 3,573,874. Form 990 Part III Line 4a Carilion Giles Community Hospital, a critical access hospital, exists to serve the health care needs of its community, regardless of patient ability to pay. Giles hospital admitted 1,217 patients and provided 5,605 days of care during the year. Hospital programs include provision of nursing care extensive outpatient and inpatient surgical and endoscopic services and diagnostic imaging services including CT, MRI, and mammography. Giles provides a number of services targeting the specific health needs of its population, including diabetes management comprehensive physical, speech, and occupational therapy programs and participation in cardiac rehab and disease management programs. Giles also provides an emergency department with 24-hour care, emergency transportation, and a chest pain and stroke program. Form 990 Part III Line 4a CONTINUED With 12,956 visits, Giles emergency services are a critical component of the health safety net in its service area, acting as a primary health provider for a significant number of uninsured patients, who comprise nearly 18 percent of ED visits. Giles supports community screenings and education on chronic disease prevention and management, sponsoring 21 events touching 1,028 people, as well as providing key support and coordination for a community-based medication assistance program. In furtherance of its mission, Giles provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year exceeded 2.3 million. Form 990 Section Schedule H, Part VI, Line 2 - Carilion Giles Community Hospital partnered with community organizations to complete a community health needs assessment and develop a strategic implementation plan during fiscal year 2012. A Planning Committee consisting of Giles Free Clinic staff, project consultants, and representatives from area health and human services, including Carilion Giles Community Hospital , a critical access facility faith-based communities the public schools local government and the Virginia Rural Health Association led the year-long initiative. The project began in October 2011 with monthly meetings to oversee the project which was financially supported through a Federally Qualified Health Center Planning Grant awarded to the local free clinic. Primary data was obtained through surveys and focus groups and analyzed with information acquired through secondary data sources. Form 990 Section Schedule H, Part VI, Line 4 - Carilion Giles Community Hospital is located in the town of Pearisburg, the geographic center of Giles County. In the heart of the Appalachian Mountains of southwest Virginia, Giles County is an area of approximately 360 square miles with population of approximately 17,300. The county includes 92.4 square miles of Jefferson National Forest Giles County and borders West Virginia. Approximately 17 of adults under age 64 and 9 of children who live in the County are uninsured. Additionally, 13 of residents live below the poverty level and 23 did not graduate from high school. 18 of residents are 65 years of age or older. Form 990 Section Schedule H, Part VI, Line 4 - CONTINUED Carilion Giles Community Hospital is a 25 bed critical access hospital. A comprehensive replacement facility opened in May 2010, offering 24-hour emergency care, advanced diagnostic procedures, minimally invasive surgery, nuclear medicine studies and comprehensive rehabilitation programs. Form 990 Section Schedule H, Part VI, Line 5 - Carilion Giles Community Hospital serves all patients regardless of their ability to pay. The Hospitals governing Board is elected annually and the majority of members are neither employees nor contractors of the Hospital. Medical staff privileges are extended to qualified providers. In addition to clinical care, the hospital works to achieve its mission through the education of health professionals and the community. Any surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. This includes providing free, discounted and subsidized care as well as critical medical services that operate at a loss. Form 990 Section Schedule H, Part VI, Line 6 - Carilion Giles Community Hospital is a wholly owned hospital of Carilion Clinic, a not-for-profit healthcare organization serving approximately one million people in Western Virginia through a physician specialty group, advanced primary care practices, hospitals and outpatient centers. Carilion Clinic is based in Roanoke, Virginia and serves the residents of 18 counties and six cities in Western Virginia and southern West Virginia. Over the past six years, Carilion Clinic has gone through a dramatic and transformative change as we transitioned from a hospital system to an integrated clinic with physician leadership. At the heart of our transformation is a passion and shared purpose to meaningfully change the way healthcare is delivered and experienced, resulting in higher value and better clinical outcomes. Form 990 Section Schedule H, Part VI, Line 6 CONTINUED This has propelled a commitment to each other as providers and caregivers and working together in new and different ways. To fulfill our vision, we developed a new organizational structure for shared decision making and collaboration, implemented an enterprise-wide electronic health record, became NCQA medical homes in 27 of our primary care sites, established an accountable care organization, developed population health management infrastructure and developed the Virginia Tech Carilion School of Medicine and Research Institute. Carilion Clinic employees 592 physicians representing more than 60 specialties who provide care at 195 practice sites. During 2012, 126 students were enrolled in Virginia Tech Carilion School of Medicine and there were 549 appointed faculty members. Form 990 Section Schedule H, Part VI, Line 6 CONTINUED To advance education of health professionals, Jefferson College of Health Sciences, within Carilion Medical Center, is a professional health sciences college offering Masters of Science in Nursing, Physician Assistant and Occupational Therapy and 12 baccalaureate and associate healthcare programs. Approximately 900 undergraduate students and 190 graduate students are enrolled annually with 99 of undergraduates receiving some type of financial aid. Carilion Clinic and Virginia Tech Carilion School of Medicine provide graduate medical education to 215 residents and fellows. Residency program include Emergency Medicine, Family Medicine, Internal Medicine, Neurosurgery, Obstetrics/Gynecology, Psychiatry, Surgery, Pediatrics, Podiatry and General Hospital Dentistry inaugural class July 2013. Form 990 Section Schedule H, Part VI, Line 6 CONTINUED Additionally, the University of Virginia sponsors a residency program in Orthopaedics. Fellowship programs include Addiction Psychology, Adult Joint Reconstruction, Advanced Endoscopy, Cardiovascular Disease, Child and Adolescent Psychiatry, Gastroenterology inaugural class July 2013, Geriatric Medicine, Geriatric Psychiatry, Hospice and Palliative Care, Infectious Disease, Interventional Cardiology inaugural class July 2013, Medical Informatics, Orthopaedic-Hand and Pulmonary Critical Care. Form 990 Section Schedule H, Part VI, Line 6 CONTINUED Advanced Clinical Services in Cardiovascular and Vascular include a hybrid operating room, transcatheter aortic valve implantation TAVI, ventricular assist device VAD program using the Heartmate II, Medtronic CRYO balloon for atrial fibrillation epicardial ventricular tachycardia ablation, Heart Alert, therapeutic hypothermia, and Thoracic Oncology services with Pulmonary Medicine. In Neurosciences advanced services include Stroke Alert, an adult and pediatric Neurosurgery program, Neuro-interventional procedures, Brain Lab Navigation, Epilepsy Monitoring Inpatient Unit and Movement Disorders. Form 990 Section Schedule H, Part VI, Line 6 CONTINUED In Musculoskeletal, a joint replacement program, anterior approach hip replacements, computer-assisted knee replacements and advanced procedures for ankle replacements. Spine Center and Imaging Services include 64 slice CT and PET/CT, 3T MAGNETOM Verio MRI, MR Profusion and Enterography, advanced interventional procedures, and nationally-recognized Breast Care Center with large-format Pathology and digital mammography. Surgery services include plastic and reconstructive surgery, robotic-assisted surgery for cardiac, urology, and gynecology, and advanced laparoscopic techniques in general surgery. Form 990 Section Schedule H, Part VI, Line 6 CONTINUED In Pulmonary medicine, advanced interventional procedures are performed as well as thoracic oncology services. Carilion Clinic Cancer Center offers CyberKnife Stereotactic Radiosurgery for inoperable tumors, High Dose Radiation HDR Brachytherapy, Linear Accelerators with IMRT, Selective Internal Radiation SIR Spheres for treat Carilion Clinic PO Box 12385 Roanoke VA 24025 541190771 Supporting organization VA 501c3 11 Type I N/A false Carilion Clinic Foundation PO Box 12385 Roanoke VA 24025 541190773 Supporting organization VA 501c3 11 Type I N/A false Carilion Franklin Memorial Hospital PO Box 12385 Roanoke VA 24025 540480606 Healthcare VA 501c3 3 N/A false Carilion Medical Center PO Box 12385 Roanoke VA 24025 540506332 Healthcare VA 501c3 3 N/A false Carilion New River Valley Medical Center PO Box 12385 Roanoke VA 24025 540553805 Healthcare VA 501c3 3 N/A false Carilion Services Inc PO Box 12385 Roanoke VA 24025 541190879 Supporting organization VA 501c3 11 Type I N/A false Carilion Stonewall Jackson Hospital PO Box 12385 Roanoke VA 24025 540568001 Healthcare VA 501c3 3 N/A false Carilion Tazewell Community Hospital PO Box 12385 Roanoke VA 24025 546074580 Healthcare VA 501c3 3 N/A false false false false true true false false false false false true true false false false false false true