2013-08-15T14:06:03-00:00 2012-09-30 Deloitte Tax LLP 424 Church Street Nashville TN 37219 990 2011-10-01 546074580 Carilion Tazewell Community Hospital CARI 5402245112 PO Box 12385 Roanoke VA 24025 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 13804869 false X www.carilionclinic.org X 1968 VA 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. 10 6 132 23 0 1500 0 8885552 12654739 9951 19720 1874895 1130410 10771898 13804869 7402 9560 0 4019528 4345901 0 0 8319118 9474694 12346048 13830155 -1574150 -25286 5606511 6695725 13075731 14205299 -7469220 -7509574 X 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. false false 11037314 9560 13752257 See Schedule O 11037314 true false false true false false false false false false true false false false true true false false false false false false false false false false true true true false true false false false false false false false true false false false false false true false false false false true X 0 0 true 132 true false false false false false false false false false false X 10 6 false true false false true true true true true false false true true true true true true true true false VA X X The Organization 5402245112 213 S Jefferson Street Roanoke VA 24011 X Stephen Barrett 002.00 X 0 0 0 Charles Green 002.00 X 0 0 0 Nancye Howell 002.00 X 0 0 0 Melina Perdue 002.00 X 0 386382 266044 Peggy Riley 002.00 X 0 0 0 Stephen Rinehart MD 002.00 X 0 0 0 James Thompson 002.00 X 0 0 0 William Flattery 002.00 X X 0 235572 36621 Randal Swatzyna 002.00 X X 0 177150 47168 John Piatkowski MD 002.00 X X 0 131087 1094 Donald Lorton 002.00 X 0 680251 528400 Rachel Mabe 002.00 X 0 67991 25993 Kathren Dowdy 050.00 X 109896 0 12478 109896 1678433 917798 6 false true false MR Ramakrishnan MD PC 1745 Valley View Dr Big Stone Gap VA 24219 Physician services 264000 GJ Hopkins Inc 714 5th St NE Roanoke VA 24016 Construction Contractor 119645 Heartland Rehabilitation Services Dept L 3281 Columbus OH 432600001 Rehabilitation services 154569 Solstas Lab Partners Group LLC PO Box 751337 Charlotte NC AF 282751337 Laboratory Services 790674 4 Net Patient Revenues 900099 12654739 12654739 12654739 7320 7320 32892 32892 32892 32892 12400 12400 12400 12400 EHR Incentive Payment 900099 1081800 1081800 15718 15718 1097518 13804869 13752257 52612 9560 9560 0 0 0 0 0 3614843 3533792 81051 163340 163340 303617 285806 17811 264101 264101 1526835 320727 1206108 105 105 0 3033 3033 0 2400127 1029866 1370261 66 66 498801 485170 13631 2919 2919 0 168209 164609 3600 63908 57277 6631 0 0 134250 134250 0 576744 576744 238613 148548 90065 Medical Supplies 519103 519102 1 Bad Debt 2019062 2019062 I/C Practice Subsidy 1290150 1290150 Dues Subscriptions 13671 13014 657 19098 16178 2920 13830155 11037314 2792841 0 875 1125 29056 13254 2636641 2823575 6040 20000 56992 43186 14304429 10521248 2865502 3783181 11405 11404 5606511 6695725 1062174 2407385 15667 48247 11997890 11749667 13075731 14205299 X -7469220 -7509574 -7469220 -7509574 5606511 6695725 X -25286 -15068 X false true true X false X 0.00000 0.00000 0.00000 false false false false false false false false true 3033 3033 false II-B 1i Portion of dues paid to American Hospital Assn. and Virginia Hospital and Healthcare Assn. spent on lobbying. false 48753 48753 4889989 3638196 1251793 7818426 6774562 1043864 1547261 108490 1438771 3783181 Due to Affiliate 11699424 Qualified Pension Liability 50243 11749667 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 879443 879443 0.07450 773001 602378 170623 0.01440 1652444 602378 1050066 0.08890 4 362 3031 3031 0.00030 3 1439 1439 0.00010 7 362 4470 4470 0.00040 7 362 1656914 602378 1054536 0.08930 2 1000 1000 0.00010 6 262 3361 3361 0.00020 8 262 4361 4361 0.00030 false 623305 148660 3921291 4434931 -513640 X true true 1 1 Carilion Tazewell Community Hospital

141 Ben Bolt Avenue Tazewell VA 24651

X X X 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. Health education was provided to more 300 people during the annual Main Street Heritage Festival. Assistance with enrollment in public medical programs such as Medicaid is provided. Part I line 7 7f -- N/A Part I line 7 7g -- N/A Part I line 7 7h -- N/A Part I line 7 7i -- This line is calculated at cost. Financial support was provided to the American Cancer Society in support of research, patient services, early detection, treatment and education. In-kind support was provided during fundraising activities for the American Cancer Society and local United Way. Part I line 7 Ratio of cost-to-charges was used to calculate the expense. Part I line 7 columnf calculation -- Bad debt expense subtracted from total expenses for the calculation is 2,019,062. Part II Line 1 -- N/A Part II Line 2 -- Financial support was provided to Tazewell Area Chamber of Commerce, with mission of promoting the interests of businesses in the Tazewell area through the development of civic, commercial, agriculture, educational and cultural life of the community and Greater Bluefield Chamber of Commerce, committed to strengthen economic development, stimulate growth of area businesses and enhance the quality of life for all its citizens. Part II Line 3 -- Financial support was provided to the Four Seasons YMCA, with mission to put Christian principles into practice through programs that build healthy spirit, mind, and body for all and Tazewell Athletic Foundation, with purpose of promoting athletics at Tazewell, VA public schools in an atmosphere that is consistent with the educational philosophy of the school community. Part II Line 3 CONTINUED In-kind support was provided during several food pantry and back to school drives that assist underserved individuals in the community. Additional in-kind support was provided for Step up to the Plate, a fundraiser for the non-profit Second Chance Learning Center, a program for at-risk young adults and teenagers in the community with educational needs. 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 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 X 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. false true false false false false false true false Melina Perdue 293247 49641 43494 251092 14952 652426 William Flattery 194341 30716 10515 22990 13631 272193 Randal Swatzyna 145035 22911 9204 40223 6945 224318 Donald Lorton 486200 129425 64626 509034 19366 1208651 63526 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 250,219, Melina Perdue 121,120. Donald Lorton Assistant Treasurer 954621 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 Tazewell Community Hospital exists to serve the health care needs of its community, regardless of patient ability to pay. Tazewell hospital admitted 704 patients and provided 2,050 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. Form 990 Part III 4a CONTINUED Tazewell also provides an emergency department with 24-hour care and emergency transportation. With 10,536 visits, Tazewells 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 22 percent of ED visits. Tazewell supports community screenings and education on chronic disease management, touching more than 300 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 1.2 million. Form 990 2 -- Carilion Tazewell Community Hospital uses demographic information and data on patients treated to determine community health needs. Additionally, information from public databases compiled on the Virginia Atlas of Community Health website is reviewed for the entire geographic area served by Carilion Tazewell Community Hospital. A comprehensive community health needs assessment is scheduled for completion by September 30, 2013 along with a strategic implementation plan to address identified needs. Form 990 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 a little over 45,000. Approximately 20 of adults under age 64 and 10 of children who live in the Tazewell County are uninsured. Additionally, 18 of residents live below the poverty level and 22 of adults 25 years of age or older did not graduate from high school. 17 of residents are 65 years of age or older. Form 990 5 -- Carilion Tazewell 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 5 CONTINUED 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. Form 990 6 -- Carilion Tazewell 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 1a -- The Board is composed of two classes of directors, the Carilion Class 3 directors and the Tazewell Class 7 directors. On all matters that come before the Board for a vote, other than a small number requiring a super-majority vote, the Carilion Class has 80 of the vote and the Tazewell Class has 20 of the vote, with a majority of the class members present and voting determining the vote of the class. In the case of those matters needing a super-majority vote, a majority of the members of each class must vote in favor of the action for it to be approved. 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 is entitled to elect directors having 80 of the vote on any issue. Form 990 Part VI 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 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 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 15 a 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 VII Column B -- Directors and officers listed with less than 50 average hours per week who receive compensation from related organizations reported in column E also serve as directors and/or officers on other related organizations in the Carilion system. The difference between the hours shown in Column B and 50 hours would equal the hours worked by these individuals for related organizations. Form 990 Part XI 5 -- Other adjustments - transfer to Carilion Clinic for effect of pension-related changes 15,068. Form 990 Part III Line 4a Carilion Tazewell Community Hospital exists to serve the health care needs of its community, regardless of patient ability to pay. Tazewell hospital admitted 704 patients and provided 2,050 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. Form 990 Part III Line 4a CONTINUED Tazewell also provides an emergency department with 24-hour care and emergency transportation. With 10,536 visits, Tazewells 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 22 percent of ED visits. Tazewell supports community screenings and education on chronic disease management, touching more than 300 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 1.2 million. Form 990 Section Schedule H, Part VI Line 2 -- Carilion Tazewell Community Hospital uses demographic information and data on patients treated to determine community health needs. Additionally, information from public databases compiled on the Virginia Atlas of Community Health website is reviewed for the entire geographic area served by Carilion Tazewell Community Hospital. A comprehensive community health needs assessment is scheduled for completion by September 30, 2013 along with a strategic implementation plan to address identified needs. Form 990 Section Schedule H, 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 a little over 45,000. Approximately 20 of adults under age 64 and 10 of children who live in the Tazewell County are uninsured. Additionally, 18 of residents live below the poverty level and 22 of adults 25 years of age or older did not graduate from high school. 17 of residents are 65 years of age or older. Form 990 Section Schedule H, Part VI Line 5 -- Carilion Tazewell 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 5 CONTINUED 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. Form 990 Section Schedule H, Part VI Line 6 -- Carilion Tazewell 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 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 Section Schedule H, Part VI Line 6 CONTINUED Advanced urogynecologic 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 Giles Community Hospital PO Box 12385 Roanoke VA 24025 540549603 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 false false false false false false false false false false true true false false false false false false