2013-08-15T13:10:34-00:00 2012-09-30 Deloitte Tax LLP 424 Church Street Nashville TN 37219 990 2011-10-01 540553805 Carilion New River Valley Medical Center CARI 5402245112 PO Box 12385 Roanoke VA 24025 Donald Halliwill 5402245112 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 294618618 false X www.carilionclinic.org X 1941 VA Carilion New River Valley Medical Center, 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. 15 11 1083 121 0 98753 132731 143183258 154764098 5268794 -622103 4376493 4757234 152927298 159031960 135383 21817 0 49926473 53037030 0 0 84701060 85180458 134762916 138239305 18164382 20792655 190142332 218573426 107140870 111649582 83001462 106923844 X Carilion New River Valley Medical Center, 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 119594015 21817 158277025 See Schedule O 119594015 true true false true false false false false false false true false false false true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true false false false false true 0 0 true 1083 true false true false false false false false false false false X 15 11 true true false false true true true true true false false true true true true true true true true true true VA X X The Organization 5402245112 213 S Jefferson Street - Suite 827 Roanoke VA 24011 X Leslie Badillo MD 002.00 X 0 252494 86326 Charles Bissell MD 002.00 X 0 602726 38786 Carolyn Brown 002.00 X 0 0 0 Howard Conduff DDS 002.00 X 0 0 0 Larry Hincker 002.00 X 0 0 0 Todd Murray 002.00 X X 0 0 0 Jeffrey Reed 002.00 X 0 0 0 Joseph Scartelli PhD 002.00 X 0 0 0 Joseph Sheffey 002.00 X 0 0 0 Stephanie Shortt 002.00 X X 0 0 0 Thomas Starnes 002.00 X 0 0 0 Barbara Turk 002.00 X 0 0 0 Cris Whitaker 002.00 X 0 0 0 James Williams OD 002.00 X 0 0 0 John Piatkowski MD 050.00 X X 131087 0 1094 Donald Lorton 002.00 X 0 680251 528400 Rachel Mabe 002.00 X 0 67991 25993 Dennis Means 050.00 X 284769 0 44156 Ralph Brown 050.00 X 268147 0 50373 Charlotte Ramsey 050.00 X 174052 0 39092 Corwin Brower 050.00 X 150054 0 123029 Dale Bryant 050.00 X 144478 0 77997 Don Halliwill 000.00 X 0 244181 65903 1152587 1847643 1081149 10 true true false Anesthesiology Associates PO Box 3605 Radford VA 24143 Anesthesiology Services 2458567 Soltax Lab Partners Group PO Box 751337 Charlotte NC 282751337 Laboratory Services 5357979 Avis Construction Co Inc PO Box 11985 Roanoke VA 24022 Construction Contractor 1915082 Siemens Medical Solutions 51 Valley Stream Parkway Malvern PA 19355 Equipment and Software Materials 728143 Foodservice Partners of VA 2823 Franklin Road Building B Roanoke VA 24016 Food Service 490790 5 38000 23505 71226 132731 Ner Patient Revenues 900099 154599194 154599194 Program-Related Investments 900099 164904 164904 154764098 3171113 3171113 9 9 1009388 1009388 1009388 1009388 127997822 3795611 131793433 3793225 -3795611 2386 -3793225 -3793225 EHR Incentive Payment 900099 2098095 2098095 Cafeteria 900099 234919 234919 Court Cost Recovery 900099 54359 54359 1360473 1360473 3747846 159031960 158277025 622204 21817 21817 0 0 0 261937 261937 0 41707275 41281914 425361 2976340 2976340 5143279 5077413 65866 2948199 2948199 16403901 16403901 2423 2423 0 14294 14294 168545 168545 16155935 15284468 871467 42 42 4626577 4543660 82917 249221 249221 0 1892418 1852764 39654 517841 490333 27508 0 0 3873344 3873344 0 5903779 5903779 1237156 718204 518952 Medical Supplies 15785066 15784428 638 Bad Debt 9636832 9636832 I/C Practice Subsidy 8427465 8413298 14167 Dues Subscriptions 91032 83046 7986 194587 178682 15905 138239305 119594015 18645290 0 6447 6447 278811 282827 18264048 19365857 1571081 1124438 537464 1033972 148604360 86853051 60585167 61751309 59083341 125199137 48571429 8559401 1244544 1250038 190142332 218573426 11156150 12860820 182468 213117 70977440 67945847 24824812 30629798 107140870 111649582 83000892 106915364 570 8480 83001462 106923844 190142332 218573426 X 20792655 3129727 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 14294 14294 false II-B 1i Portion of dues paid to American Hospital Assn. and Virginia Hospital and Healthcare Assn. spent on lobbying. false 1507465 1507465 84572771 35256791 49315980 247117 172010 75107 59457627 50530167 8927460 2819380 894083 1925297 61751309 Qualified Pension Liability 15903664 2005 Fixed Payor Swap Unrealized 9763688 2008 Fixed Swap Unrealized Losses 4962447 2010 Barclays Swap Unrealized Losses -214863 2010 PNC Swap Unrealized Losses -407972 Swap Contra 622834 30629798 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 9456592 9456592 0.07350 9616138 7262653 2353485 0.01830 19072730 7262653 11810077 0.09180 196 30190 212506 212506 0.00170 1 285 14967 14967 0.00010 5 826 54634 54634 0.00040 202 31301 282107 282107 0.00220 202 31301 19354837 7262653 12092184 0.09400 3 11670 11670 0.00010 3 28 1138 1138 11 106 1048 1048 17 134 13856 13856 0.00010 false 3206836 484914 34171115 37364144 -3193029 X true true New River Valley Surgery Center LLC Ambulatory surgery 0.50000 0.32670 1 1 Carilion New River Valley Medical Center

2900 Lamb Circle Christiansburg VA 24073

X X X Carilion New River Valley Medical Center 1 Carilion New River Valley Medical Center Rehabilitation 2 Carilion New River Valley Medical Center Home Health and Hospice 3 New River Valley Surgery Center LLC 4 Orthopedic Spine PT Clinic 5 Orthopedic Spine PT Clinic 6 6 Carilion New River Valley Medical Center

2900 Lamb Circle Christiansburg VA 24073

0 Carilion New River Valley Medical Center Rehabilitation

118 Broad Street Dublin VA 24084

Psychiatric Unit Carilion New River Valley Medical Center Home Health and Hospice

707 Randolph Street Suite 251 Radford VA 24141

Outpatient therapy New River Valley Surgery Center LLC

2901 Lamb Circle Christiansburg VA 24073

Home Health and Hospice Orthopedic Spine PT Clinic

51 West Main Street Radford VA 24141

Ambulatory surgery Orthopedic Spine PT Clinic

178 West Main Street Wytheville VA 24382

Orthopedic spine- PT Part I line 3c n/a 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 actual cost. Carilion New River Valley Medical Center educates the public about health risks and steps that can be taken to improve health. During fiscal year 2012, 28,684 people received health education information provided during 183 events that included screenings, presentations and health fairs. Regularly scheduled health screenings such as blood pressure, blood glucose and cholesterol are offered at various locations throughout the year. Part I line 7 7e CONTINUED In addition, Red Hot Mommas features speakers focusing on womens health issues. The national SafeKids program is coordinated by Carilion New River Valley Medical Center with education on injury prevention for children. Car seat education and regularly scheduled car seat safety checks are provided. Part I line 7 7e CONTINUED Carilion New River Valley Medical Centers Medication Assistance Program assists uninsured clients obtain medications necessary for disease management and therapeutic outcomes and enrolls eligible individuals into state and federal insurance programs. During fiscal year 2012, needed prescription medication was provided to 638 individuals. 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. Part I line 7 7f - This line is calculated at actual cost. In-kind support was provided to Virginia College of Osteopathic Medicine toward education of medical students. Part I line 7 7g - N/A Part I line 7 7h - This line is calculated at actual cost. Carilion New River Valley Medical Center provides data through a cancer registry to assist public health professionals in understanding and addressing the cancer burden more effectively. Information obtained is used in development of programs on cancer prevention, early detection, and successful treatment and care. Part I line 7 7i - This line is calculated at actual cost. Financial contributions were made to the local chapter of the National Multiple Sclerosis Society as they work to assist people affected by MS by funding cutting-edge research, driving change through advocacy, facilitating professional education, and providing programs and services that help people with MS and their families move their lives forward and the Free Clinic of the New River Valley. Part I line 7 7i CONTINUED In-kind support was provided to the United Way during their local fundraising campaign. A grant was provided to the Free Clinic of the New River Valley for staffing and supplies of the dental program that serves uninsured, low-income residents. Additionally, Carilion New River Valley Medical Centers Emergency Department replenishes medical supplies on ambulances owned by local Emergency Medical Services organizations. 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 9,694,328. Part II Line 1 - N/A Part II Line 2 - Financial support was provided to Montgomery County Chamber of Commerce toward their mission of promoting and developing a positive environment for the operation and growth of business in Montgomery County and the New River Valley New River Valley Economic Development New River Valley Economic Development Council whose mission is to market the New River Valley, to foster job creation, to facilitate new investment, Part II Line 2 CONTINUED and to nurture and improve quality of life in the Valley and New Century Technology Council, a non-profit member-driven association of businesses and organizations in the greater Roanoke-Blacksburg region focused on building a technology community that is a catalyst for innovation, inspiration, success, and leadership within the region. Part II Line 3 - Financial support was provided to NRV CARES, a private, non-profit organization dedicated to protecting children from abuse and strengthening families through education, advocacy and community partnerships. In-kind support was provided for dental care education at the Free Clinic and NAACP for Project HELP, the Health and Wellness initiative to improve the overall quality of life for African Americans through health education. Part II Line 4 - N/A Part II Line 5 - N/A Part II Line 6 - In-kind support was provided to the Retired Senior Volunteer Program for their Walkathon Advisory Committee representation on the Area Agency on Aging Advisory Council New River Valley Safe Kids initiatives Chamber of Commerce events and presenting educational information to Virginia Techs employee wellness committee. 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 New River Valley Economic Development Alliance 6226 University Park Dr Radford VA 24141 541545804 501c6 10000 General Support 1 1 2 The Hospital donates funds to other tax-exempt organizations with a similar community improvement mission. Such organizations also have community boards which oversee the expenditure of such funds. X true true false true false false false false false true false Leslie Badillo MD 167144 84571 779 65909 20417 338820 Charles Bissell MD 378877 222499 1350 35842 2944 641512 Donald Lorton 486200 129425 64626 509034 19366 1208651 63526 Dennis Means 266096 1040 17633 42912 1244 328925 Ralph Brown 214831 52417 899 39286 11087 318520 Charlotte Ramsey 155302 17230 1520 31186 7906 213144 Corwin Brower 146479 174 3401 115850 7179 273083 Dale Bryant 117408 19282 7788 67033 10964 222475 Don Halliwill 210112 33722 347 54139 11764 310084 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 Industrial Development Authority of the City of Roanoke VA 541106038 770084ES6 2005-12-14 65880000 Capital projects, Current Refunding of Series 2002 B-E bonds Costs of issuance, bond insurance false false false VA Small Business Financing Authority 541300845 928101AD6 2008-07-09 20000000 Capital projects, Costs of issuance false false false 20595000 65880000 406156 949368 64524476 true false true true 20050000 137743 19912257 2008 false false true true false false false false true true true true UBS & Citigroup 0000000027.000000000000 false false true AIG 0000000000.300000000000 true false true true true true UBS & Citigroup 0000000033.000000000000 false false false false true X Donald Lorton Assistant Treasurer 6698891 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 New River Valley Medical Center exists to serve the health care needs of its community, regardless of patient ability to pay. New River admitted 7,915 patients and provided 29,829 days of care during the year New River also delivered 1,235 babies. Hospital programs include provision of nursing care extensive outpatient and inpatient surgical and endoscopic services comprehensive cardiac treatment, diagnostic, and rehab solutions and diagnostic imaging services including CT, MRI, and mammography. Form 990 Part III 4a CONTINUED With almost 22 of its inpatient admissions representing psychiatric admissions, and a significant outpatient presence in behavioral medicine, New River plays a critical role in providing mental health services for the region. New River is a Level III trauma center, and provides a home base for Lifeguard 11, the emergency medical air transport that serves the surrounding area. New River provides a number of inpatient and outpatient services targeting the specific health needs of its population, including diabetes management home health and hospice physical, speech, and occupational therapy programs and cardiac and respiratory rehab. Form 990 Part III 4a CONTINUED New River also provides an emergency department with 24-hour care, emergency transportation, and a chest pain and stroke program. With 32,375 visits, New Rivers emergency services are a critical component of the health safety net in its service area, acting as the primary health provider for a significant number of uninsured patients, who comprise 19 percent of ED visits. New River supports community screenings and education on chronic disease prevention and management sponsoring 183 events touching more than 28,000 people. New River also champions and supports a Medication Assistance Program in partnership with community-based social services. In furtherance of its mission, New River provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year of 12.2 million. Form 990 2 - Carilion New River Valley Medical Center 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 New River Valley Medical Center. 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 New River Valley Medical Center serves approximately 145,000 residents living in the counties of Montgomery, Floyd and Pulaski and the city of Radford. The New River Valley is a 1,471 square mile region in southwest Virginia between the Blue Ridge and Allegheny Mountains. Approximately 18 of adults under age 64 and 8 of children who live in the New River Valley are uninsured. Additionally, 18 of residents live below the poverty level and 13 of adults 25 years of age or older did not graduate from high school. 12 of residents are 65 years of age or older. Form 990 5 - Carilion New River Valley Medical Center is a modern hospital facility hosting both medical and psychiatric services. The 146-bed facility offers comprehensive healthcare services with access to 50 specialists and 24-hour emergency care facilities including a Level III Trauma Center with medical air transport. Carilion New River Valley Medical Center serves all patients regardless of their ability to pay. The Centers 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. Form 990 5 CONTINUED In addition to clinical care, the center 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 New River Valley Medical Center is wholly owned by 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 COINTINUED 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 2 -- 1. Todd Murray and Jeffery Reed - business relationship. 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 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 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 - unrealized gains on investments 9,464,515 transfer to Carilion Clinic for effect of pension-related changes 4,684,794 and transfer to affiliate of 1,650,000 for net of 3,129,727. Form 990 Part III Line 4a Carilion New River Valley Medical Center exists to serve the health care needs of its community, regardless of patient ability to pay. New River admitted 7,915 patients and provided 29,829 days of care during the year New River also delivered 1,235 babies. Hospital programs include provision of nursing care extensive outpatient and inpatient surgical and endoscopic services comprehensive cardiac treatment, diagnostic, and rehab solutions and diagnostic imaging services including CT, MRI, and mammography. Form 990 Part III Line 4a CONTINUED With almost 22 of its inpatient admissions representing psychiatric admissions, and a significant outpatient presence in behavioral medicine, New River plays a critical role in providing mental health services for the region. New River is a Level III trauma center, and provides a home base for Lifeguard 11, the emergency medical air transport that serves the surrounding area. New River provides a number of inpatient and outpatient services targeting the specific health needs of its population, including diabetes management home health and hospice physical, speech, and occupational therapy programs and cardiac and respiratory rehab. Form 990 Part III Line 4a CONTINUED New River also provides an emergency department with 24-hour care, emergency transportation, and a chest pain and stroke program. With 32,375 visits, New Rivers emergency services are a critical component of the health safety net in its service area, acting as the primary health provider for a significant number of uninsured patients, who comprise 19 percent of ED visits. New River supports community screenings and education on chronic disease prevention and management sponsoring 183 events touching more than 28,000 people. New River also champions and supports a Medication Assistance Program in partnership with community-based social services. In furtherance of its mission, New River provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year of 12.2 million. Form 990 Section Schedule H, Part VI, Line 2 - Carilion New River Valley Medical Center 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 New River Valley Medical Center. 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 New River Valley Medical Center serves approximately 145,000 residents living in the counties of Montgomery, Floyd and Pulaski and the city of Radford. The New River Valley is a 1,471 square mile region in southwest Virginia between the Blue Ridge and Allegheny Mountains. Approximately 18 of adults under age 64 and 8 of children who live in the New River Valley are uninsured. Additionally, 18 of residents live below the poverty level and 13 of adults 25 years of age or older did not graduate from high school. 12 of residents are 65 years of age or older. Form 990 Section Schedule H, Part VI, Line 5 - Carilion New River Valley Medical Center is a modern hospital facility hosting both medical and psychiatric services. The 146-bed facility offers comprehensive healthcare services with access to 50 specialists and 24-hour emergency care facilities including a Level III Trauma Center with medical air transport. Carilion New River Valley Medical Center serves all patients regardless of their ability to pay. The Centers 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. Form 990 Section Schedule H, Part VI, Line 5 CONTINUED In addition to clinical care, the center 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 New River Valley Medical Center is wholly owned by 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 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 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 true true true true false false false false true false