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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, 2011 and 2010. Carilion does not expect that unrecognized tax benefits will materially increase within the next 12 months. 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X Rehabilitation Unit Urgent Care Carilion Medical Center- DBA- Carilion Roanoke Memorial Rehab 1 Carilion Clinic Orthopaedics 2 Carilion Clinic - Bone and Joint Center 3 CSC - Brambleton 4 Carilion Clinic Orthopaedics 5 Carilion Clinic Cardiology 6 CNRV Emergency Services 7 Carilion Breast Care Center 8 CSC - Roanoke 9 Carilion Cardiothoracic Surgery 10 Carilion Obstetrics and Gynecology Clinic 11 CES - Franklin 12 Carilion Clinic Neurology 13 Carilion Clinic Internal Medicine 14 Carilion Clinic Otolaryngology 15 CES - Bedford 16 Trauma Surgery 17 CES - Giles 18 Roanoke Athletic Club 19 Carilion Dermatology 20 Carilion Pediatric Clinic 21 CFM Roanoke Salem 22 Carilion Clinic Obstetrics and Gynecology - NRV 23 CES - Tazewell 24 Brambleton Radiology Services 25 CFM Southeast 26 Carilion Behavioral Health Radford 27 Carilion Prenatal Diagnostic Center 28 Carilion Department of Psychiatry and Behavioral Medicine 29 Carilion Clinic Ortho-Spine 30 Botetourt Athletic Center 31 Daleville Imaging 32 Carilion Center for Healthy Aging 33 CFM - Salem 34 Carilion Dentistry General Surgery 35 Department of Psychiatry & Behavioral Medicine 36 Pediatric Gastroenterology 37 Carilion Dentistry Pediatric Surgery 38 Carilion Dental Care 39 Carilion Department of Psychiatry Roanoke 40 Carilion Gynecological Oncology 41 Carilion Anticoagulation Clinic 42 CRMH Rheumatology Clinic 43 Salem Family Practice - Spartan Drive 44 Breast Mammography - North 45 Carilion Pulmonary Clinic 46 Carilion Clinic Neurological Care - Roanoke 47 Carilion Pediatric Neurology 48 Carilion Roanoke IP Psychiatry 49 Carilion Clinic Gastroenterology 50 Carilion Urgent Care Westlake 51 Carilion Child and Adolescent Psychiatry 52 Department of Psychiatry & Behavioral Medicine 53 Pediatric Cardiology Clinic 54 Pediatric Pulmonology 55 Roanoke Ambulatory Center LLC 56 Carilion Sleep Center 57 Carilion Clinic Urogynecology 58 Carilion Clinic Pediatric Surgery Clinic 59 CFM - Rocky Mount 60 Carilion Cardiac Rehab 61 Carilion ID Crystal Spring 62 Reproductive Endocrinology Clinic 63 Carilion Imaging 64 CIM Crystal Spring 65 Pediatric Developmental Clinic 66 Carilion Clinic Physiatry 67 Carilion Diabetic Education 68 Carilion Pediatric Endocrinology Clinic 69 Carilion Breast Care Center 70 Carilion Sleep Center Westlake 71 Carilion Genetics 72 CNRVMC - Neurosciences 73 Carilion Surgery Westlake 74 Northwest Internal Medicine 75 Carilion Heart Failure Clinic 76 OB-GYN Private - Roanoke 77 Carilion Imaging Professionals 78 78 Carilion Medical Center- DBA- Carilion Roanoke Memorial Rehab

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Psych Unit Outpatient Rehabilitation Carilion Clinic - Bone and Joint Center

3 Riverside Circle 1st Floor Roanoke VA 24016

Orthopaedic Services CSC - Brambleton

3707 Brambleton Avenue Roanoke VA 24018

Orthopedics Carilion Clinic Orthopaedics

3 Riverside Circle Roanoke VA 24014

Surgical Services Carilion Clinic Cardiology

127 McClanahan Street SW Roanoke VA 24014

Orthopaedic Services CNRV Emergency Services

2900 Lamb Circle Christiansburg VA 24073

Cardiology Carilion Breast Care Center

102 Highland Ave Ste 202 Roanoke VA 24014

Emergency Physicians CSC - Roanoke

213 McClanahan Suite 404 Roanoke VA 24014

Breast Care Center Carilion Cardiothoracic Surgery

2001 Crystal Spring Avenue Roanoke VA 24014

Surgical Services Carilion Obstetrics and Gynecology Clinic

902 South Jefferson Street Roanoke VA 24016

Cardiac Surgery Office CES - Franklin

180 Floyd Avenue Rocky Mount VA 24017

Obstetrics and Gynecology Carilion Clinic Neurology

3 Riverside Circle Roanoke VA 24016

Emergency Physicians Carilion Clinic Internal Medicine

3 Riverside Circle Roanoke VA 24016

Neurosciences Carilion Clinic Otolaryngology

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Internal Medicine CES - Bedford

1613 Oakwood St Bedford VA 24153

Otolaryngology Services Trauma Surgery

213 McClanahan Suite 404 Roanoke VA 24014

Emergency Physicians CES - Giles

1611 Wenonah Avenue Pearisburg VA 24134

Surgical Services Roanoke Athletic Club

4508 Starkey Road Roanoke VA 24018

Emergency Physicians Carilion Dermatology

1 Riverside Circle Suite 300M Roanoke VA 24018

Physical Therapy Services Carilion Pediatric Clinic

1030 S Jefferson Street Suite 106 Roanoke VA 24014

Dermatology CFM Roanoke Salem

1314 Peters Creek Road Roanoke VA 24014

General Pediatrics Carilion Clinic Obstetrics and Gynecology - NRV

2900 Lamb Circle Suite 202 Christiansburg VA 24073

Family Practice CES - Tazewell

141 Ben Bolt Ave Tazewell VA 24651

Obstetrics and Gynecology Brambleton Radiology Services

3707 Brambleton Avenue Roanoke VA 24016

Emergency Physicians CFM Southeast

2145 Mount Pleasant Boulevard Roanoke VA 24014

Imaging Services Carilion Behavioral Health Radford

2900 Lamb Circle Christiansburg VA 24073

Family Practice Carilion Prenatal Diagnostic Center

102 Highland Ave Ste 455 Roanoke VA 24014

Behavioral Health Carilion Department of Psychiatry and Behavioral Medicine

2900 Tyler Road Christiansburg VA 24073

Prenatal Testing Carilion Clinic Ortho-Spine

3 Riverside Circle 1st Floor Roanoke VA 24017

Behavioral Health Botetourt Athletic Center

105 Summerfield Court Roanoke VA 24019

Orthopaedic Services Daleville Imaging

46 Wesley Road Daleville VA 24073

Outpatient Therapy Services Carilion Center for Healthy Aging

2001 Crystal Spring Avenue Roanoke VA 24014

Imaging Services CFM - Salem

2102 West Main Street Salem VA 24153

Geriatrics Carilion Dentistry General Surgery

2017 S Jefferson Street 2nd Floor Roanoke VA 24014

Family Practice Department of Psychiatry & Behavioral Medicine

213 McClanahan Street Suite 310 Roanoke VA 24014

Dental Service Pediatric Gastroenterology

102 Highland Avenue Suite 305 Roanoke VA 24014

Behavioral Health Carilion Dentistry Pediatric Surgery

101 Elm Avenue 1st Floor Roanoke VA 24017

Gastroenterology Carilion Dental Care

2017 S Jefferson Street Roanoke VA 24014

Dental Service Carilion Department of Psychiatry Roanoke

2017 S Jefferson Street Roanoke VA 24014

Dental Service Carilion Gynecological Oncology

1 Riverside Circle Suite 300 Roanoke VA 24016

Behavioral Health Carilion Anticoagulation Clinic

1030 S Jefferson St Ste G101 Roanoke VA 24014

Gynecological Oncology CRMH Rheumatology Clinic

3 Riverside Circle Roanoke VA 24016

Anticoagulation Clinic Salem Family Practice - Spartan Drive

150 Spartan Drive Salem VA 24153

Rheumatology Breast Mammography - North

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Family Practice Carilion Pulmonary Clinic

2001 Crystal Spring Avenue Roanoke VA 24014

Breast Mammography Carilion Clinic Neurological Care - Roanoke

1030 S Jefferson Street Roanoke VA 24016

Pulmonary Services Carilion Pediatric Neurology

102 Highland Avenue Suite 104 Roanoke VA 24013

Neurosciences Carilion Roanoke IP Psychiatry

2017 S Jefferson Street 1st Floor Roanoke VA 24014

Neurosciences Carilion Clinic Gastroenterology

3 Riverside Circle Roanoke VA 24016

Physical Medicine and Rehab Carilion Urgent Care Westlake

35 Medical Court Hardy VA 24101

Gastroenterology Carilion Child and Adolescent Psychiatry

213 McClanahan Street Suite 310 Roanoke VA 24014

Urgent Care Department of Psychiatry & Behavioral Medicine

213 McClanahan Street Suite 310 Roanoke VA 24014

Child and Adolescent Psychiatry Services Pediatric Cardiology Clinic

102 Highland Avenue Suite 101 Roanoke VA 24013

Behavioral Health Pediatric Pulmonology

102 Highland Avenue Suite 203 Roanoke VA 24013

Cardiology Roanoke Ambulatory Center LLC

1102 Jefferson Street Roanoke VA 24016

Pulmonology Carilion Sleep Center

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Surgical Services Carilion Clinic Urogynecology

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Sleep Disorder Carilion Clinic Pediatric Surgery Clinic

102 Highland Avenue Suite 404 Roanoke VA 24013

Urogynecological Services CFM - Rocky Mount

195 Maple Avenue Rocky Mount VA 24151

Surgical Services Carilion Cardiac Rehab

127 McClanahan Street Roanoke VA 24016

Family Practice Carilion ID Crystal Spring

2001 Crystal Spring Avenue Roanoke VA 24014

Cardiac Rehab Reproductive Endocrinology Clinic

102 Highland Avenue Suite 304 Roanoke VA 24013

Infectious Disease Carilion Imaging

3 Riverside Circle Roanoke VA 24016

Reproductive Endocrinology CIM Crystal Spring

2001 Crystal Spring Avenue Roanoke VA 24014

Imaging Services Pediatric Developmental Clinic

1030 S Jefferson Street Suite 201 Roanoke VA 24016

Imaging Services Carilion Clinic Physiatry

3 Riverside Circle Roanoke VA 24016

Pediatrics Carilion Diabetic Education

1030 S Jefferson Suite G101 Roanoke VA 24016

Physical Medicine and Reahb Carilion Pediatric Endocrinology Clinic

102 Highland Avenue MOB Roanoke VA 24013

Diabetic Eduation Carilion Breast Care Center

1211 S Jefferson St Roanoke VA 24014

Endocrinology Carilion Sleep Center Westlake

35 Medical Court Hardy VA 24101

Breast Care Center Carilion Genetics

102 Highland Avenue Suite 104 Roanoke VA 24013

Sleep Disorder CNRVMC - Neurosciences

2900 Lamb Circle Christiansburg VA 24073

Genetic Counseling Carilion Surgery Westlake

35 Medical Court Hardy VA 24101

Neurosciences Northwest Internal Medicine

615 McDowell Avenue Roanoke VA 24016

Surgical Services Carilion Heart Failure Clinic

127 McClanhan St Roanoke VA 24016

Internal Medicine OB-GYN Private - Roanoke

102 Highland Avenue Suite 455 Roanoke VA 24013

Heart Failure Services Carilion Imaging Professionals

1 Taylor Avenue Pearisburg VA 24134

Obstetrics and Gynecology 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 7g N/A Part I line 7 column f Bad debt expense subtracted from total expenses for the calculation is 46,641,205. Part I line 7 Ratio of cost-to-charges was used to calculate the expense. Part III line 4 The financial statements do not include a footnote on bad debt. The audited financial statements include a provision for bad debt. The provision is calculated based on historical bad debt experience and managements evaluation of the collectibility of the accounts receivable. Balances are written off after all reasonable collection efforts have been made. Part III line 4 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 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 definitive determination of their eligibility. Part III line 4 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. Part III line 8 The Hospital does not consider a Medicare shortfall as a community benefit. Part III line 9b When an uninsured self pay patient registers for medically necessary services, the patients account is electronically marked as being potentially eligible for charity care. Carilion Clinics Eligibility Assistance Service EAS screens the patient to determine if charity care is appropriate. The patient must apply for all entitlement programs for which he or she may be eligible i.e. Medicaid, Social Security Disability, etc. EAS assists the patient with the applications. Part III line 9b If the patient does not qualify for one of the programs then the Federal Poverty Guidelines FPG are used to determine eligibility for charity care. A patient whose account balance is less than 1,500 and is at or below 100 of FPG is automatically given a 100 discount of their account. Part III line 9b For balances greater than 1,500 the patient must complete a Financial Assistance Application and provide appropriate documentation. A sliding scale of discounts is available for patients with incomes up to 400 of FPG. Part III line 9b An underinsured patient can apply for charity care. Applications are available at all Patient Access/Registration points, offices of EAS, Carilion Clinics Internet website or by calling for an application. Part V N/A Part VI Line 3 The charity care policy is posted in all patient registration areas. At the time of registration all uninsured self pay patients are given a brochure expaining the charity care policy and how to apply. Also, see comments for Part III line 9b. true VIRGINIA TECH CARILION SCHOOL OF MEDICINE 2 RIVERSIDE CIRCLE ROANOKE VA 24016 264556177 501c3 45627 Research MILL MOUNTAIN THEATRE 1 MARKET SQUARE ROANOKE VA 24011 540792067 501c3 11000 General Support RADFORD UNIVERSITY EAST MAIN ST RADFORD VA 24142 546001789 Virginia 86520 Nursing Education VIRGINIA TECH FOUNDATION 1872 PRATT DRIVE 1000 BLACKSBURG VA 24060 540721690 501c3 10000 Biomedical Institute CARILION CLINIC FOUNDATION 213 S JEFFERSON ST 807 ROANOKE VA 24011 541190773 501c3 296600 Community grants CHILD HEALTH INVESTMENT PARTNERSHIP 1201 THIRD ST SW ROANOKE VA 24016 541566451 501c3 57500 General Support CHILDREN'S TRUST FOUNDATION ROANOKE VALLEY 541 LUCK AVE STE 308 ROANOKE VA 24016 510235891 501c3 75000 General Support RONALD MCDONALD HOUSE CHARITIES 2224 S JEFFERSON ST ROANOKE VA 24014 541244769 501c3 50000 General Support 8 SCHOLARSHIPS 4 6000 1 2 As part of the Carilion Clinic system, the organization donates funds to Carilion Clinic Foundation, which provides grants to other organizations in the Hospitals service area intended to further the health and well-being of the community. Expenditure of such funds is overseen and monitored by the Foundations independent community board 1 2 The Hospital also donates funds to other 501c3 charitable organizations with a similar mission. Such organizations have community boards which oversee the expenditure of such funds. 1 2 The Hospital also has a grant program under which funds are granted to community organizations with a focus on childrens health and well-being. A committee of Carilion Medical Center employees and an independent physician reviews the applications and selects the recipients. Recipients sign a letter of agreement that delineates the terms and objectives of the project. One mid-year project report, a site visit, and a final program evaluation report on the programs services, outcomes, and budget are required for every funded project. X true true X X X X X false true false false false false false true false Cynda Johnson MD 439875 87975 -67 32511 13021 573315 William Dichtel Jr MD 335000 112000 1417 33223 12321 493961 Clifford Nottingham MD 190144 53204 -194 53627 21889 318670 Philip Shiner MD 174096 18170 1546 25415 12086 231313 Edward Murphy MD 890000 297223 100855 618095 62771 1968944 297392 Nancy Agee 436800 21491 50114 386089 13020 907514 50278 Briggs Andrews 301600 14812 17594 195902 11395 541303 Donald Lorton 436800 21491 62760 316614 16236 853901 61212 R Wayne Gandee 489250 27502 1846 40679 17231 576508 Mark Werner MD 439300 21491 57578 136230 18304 672903 54246 Hugh Thornhill 97212 16159 104304 85412 303087 Donald Halliwill 220387 10823 -8896 29782 20570 272666 G Robert Vaughan 186563 9132 6377 28287 16849 247208 Joseph Moskal MD 750453 168871 -3928 1866 22174 939436 Joseph Baker MD 524458 216298 18563 23727 20473 803519 William Arnold MD 524458 180874 20843 16778 17473 760426 Cay Mierisch MD 539813 175838 -5845 14771 23056 747633 Gary Simonds MD 550000 147014 -353 29363 16273 742297 Joan Fisher MD 94187 30139 -6690 27434 9347 154417 Rayburn Thompson 164672 51116 87627 8664 312079 51800 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 Edward Murphy MD - 273,199, Nancy Agee -192,697, Briggs Andrews - 60,550, Donald Lorton - 131,084, Mark Werner - 41,081, Rayburn Thompson - 29,648, Hugh Thornhill - 14,788. Industrial Development Authority of the City of Roanoke VA 541106038 770084EK3 2010-10-13 93754000 Redemptio fo Series 2003A-C bonds Costs of issuance false false false Industrial Development Authority of the City of Roanoke VA 541106038 770084EQ0 2005-12-14 224795000 Capital projects, Current Refunding of Series 2002 B-E bonds Costs of issuance, bond insurance false false false VA Small Business Financing Authority 541300845 928101AE4 2008-07-09 12000000 Capital projects Cost of issuance false false false 93754000 1229094 95175000 true false true true false true true false false 0.00200 0.00200 true false false false false false true true false false false false 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 Nancy Agee President/CEO 295682 Utilities false David Thompson MD Director 1665334 Anesthesiology Services false X 12 1970 Sale of comparable items X 90 Sale of comparable items X 6736 Sale of comparable items X 56 6324 Sale of comparable items X Other Auction items 652 29086 Sale of comparable items false true false Form 990 Part VI 11b A draft copy of the Form 990 was provided to the Audit and Compliance Committee of Carilion Clinic in advance of its August meeting and reviewed with Committee members at that meeting. 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 Contd. 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 2010. A similar review was last performed in October 2011. Form 990 Part VI 15a and 15b Contd. 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 Contd. 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 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 Lines 1-10 Carilion Medical Center provided in-kind support to many events and initiatives focused on children including the Southwest Virginia Alliance for Safe Babies, a multidisciplinary working to eliminate infant injury and deaths due to abusive head trauma and sudden infant death syndrome SIDS Back to School Blast, an event coordinated by the Rescue Mission of Roanoke Valley and other local non-profits and corporate sponsors to provide backpacks, school supplies and free haircuts for low-income children Better Beginnings Coalition with mission of reducing adolescent pregnancy in Virginia through the cooperative efforts of community coalitions comprised of public agencies, private organizations, community groups, and individual volunteers Form 990 Lines 1-10 Contd. Roanoke Area Youth Substance Abuse Coalition, a group of concerned citizens, parents, youth, teachers, police officers, business people, judges, and other caring individuals that strive to keep the youth of the Roanoke Valley and Southwest Virginia alcohol, tobacco and drug-free Roanoke Adolescent Health Partnership to improve the lives of teenagers by making comprehensive health care services accessible and a teen pregnancy prevention program that partners with local schools to provide educational programs and assist with administration of risk behavior assessments and presentations of results. Form 990 Lines 1-10 Contd. In-kind support was provided to the Education and Access to Healthcare Coaltion EACH, an collaboration to provide health advocacy through programs that include training of lay persons to provide basic health screenings and health resources to those in their neighborhoods and churches and Carilion Medical Center partnered with Goodwill Industries of the Roanoke Valley, the Department of Rehabilitative Services, Blue Ridge Behavioral Health, Blue Ridge Independent Living Center and local parent representatives to offer Project SEARCH, a one year high school transition program is to provide employment and educational opportunities for individuals with significant disabilities and to find long term employment in skilled positions for its participants. Form 990 Lines 1-10 Contd. Grant funding was provided for several projects including Smith Mountain Lake Good Neighbors to support a summer day camp program for children in Franklin and Bedford Counties who live near or under the poverty level Greater Roanoke Transit Company for a free trolley service for the community that operates in a continuous loop with stops that include Carilion Medical Center and Downtown Roanoke with goals of reducing the carbon footprint and enhancing the local economy by providing easier access to downtown and Rebuilding Together Roanoke for remediation of houses in lower income neighborhoods. Much in-kind support was provided for the annual United Way campaign to solicit funding from employees of Carilion Medical Center. Form 990 2 Carilion 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 Medical Center. A comprehensive community health needs assessment is scheduled for completion by September 30, 2012 along with a strategic implementation plan to address identified needs. Form 990 4 Carilion Medical Center, comprised of two hospitals, Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital, is located in Roanoke, Virginia. Roanoke is a 1,185 square mile valley located in southwest Virginia near the Blue Ridge and Allegheny Mountains. Carilion Medical Center primarily serves a little over 252,000 residents of Roanoke City and County, Salem, Botetourt County, Craig County and the Town of Vinton. Approximately 20 of adults under age 64 and 8 of children who live in the Roanoke Valley are uninsured. Additionally, 13 of residents live below the poverty level and 13 of adults 25 years of age or older did not graduate from high school. 16 Roanoke Valley residents are 65 years of age or older. Form 990 5 Carilion Medical Center includes Carilion Roanoke Memorial Hospital, one of the largest hospitals in the state of Virginia with 703 beds and an additional 60-bed Neonatal Intensive Care Unit and pediatric emergency department. With a level 1 trauma center and childrens hospital, complete with pediatric emergency room, Carilion Roanoke Memorial Hospital treats residents throughout southwest Virginia. In addition to offering high-tech services, the hospital is also home to ten residency programs and nine fellowship programs affiliated with the University of Virginia. Carilion Medical Center serves all patients regardless of their ability to pay. Form 990 5 Contd. 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 Contd. Carilion Medical Center provides support of the local EMS crews through replenishment of medications used for patient care or product with an expired use by date. Carilion Roanoke Memorial Hospitals Emergency Department has specially trained nurses who deliver immediate crisis intervention to victims of sexual assaults and/or abuse. They offer victims a unique, thorough and objective medical and legal examination, comprised of both a physical examination and forensic evidence collection and documentation. Clinical Forensic Nurse Examiners are the link between the judicial system, law enforcement, community resources, and the laboratories that process the evidence. Form 990 5 Contd. Carilion Medical Center provides financial and in-kind support annually to the Mission of Mercy Dental event in Roanoke. Approximately 1,000 residents of southwest Virginia received free dental services from volunteer dentists and Carilion Medical Center employees provided free medical screenings including health and medication histories, blood pressure, blood coagulation rates, and blood glucose levels for all patients. Carilion Medical Centers community health education department serves as host of the local chapter of the National Safe Kids Coalition and provides education on injury prevention to the community and other providers. In 2011, more than 300 individuals received car seat education or car seat safety checks during 32 events. Form 990 5 Contd. In addition, Carilion Medical Centers Safe Kids Coalition coordinator provided training, through a program offered by the Virginia Department of Health on proper car seat installation for other health and safety providers free of charge. Form 990 5 Contd. Carilion Medical Center provides education to the public about health risks and steps that can be taken to improve health. 37,464 people were touched during 786 events that include regularly scheduled health screenings such as blood pressure, blood glucose and cholesterol as well as seasonal stroke, vascular, prostate and facial sun damage detection screenings. Each Saturday morning Physicians on Foot, a program that encourages physical activity in the community, is led by a local primary care physician who walks with participants for two miles on a local greenway near the Roanoke River. Additional health improvement services include assistance with enrollment in public medical programs such as Medicaid and interpreter services for non-English speaking patients. Form 990 5 Contd. In-kind support was provided to Roanoke Adolescent Health Partnership, a unique collaboration of the Roanoke City Health Department, Roanoke City Public Schools, Roanoke Redevelopment and Housing Authority, and Blue Ridge Behavioral Healthcare, to provide clinical services at local public schools. Financial and in-kind support is provided to Child Health Investment Project CHIP of Roanoke Valley for operational expenses related to their early childhood home visiting program as they pair low-income children, ages birth to kindergarten-entry, with a community health nurse and family case manager for health care coordination help accessing needed medical services, assistance with the management of chronic conditions, and preventive services like fluoride dental varnish developmental education, kindergarten preparation and regular child assessment and monitoring. Form 990 5 Contd. Grant funding was provided to several organizations including Childrens Trust for their regional program that provides child friendly interview room and forensic interviewer to perform interviews of children to be used by multi-disciplinary team investigating alleged child abuse cases provides training for multi-disciplinary team members, and coordination of referral sources for abused children and their family Rx Partnership for operations of the public-private partnership that solicits free drugs in bulk from participating pharmaceutical companies and arranges for their distribution to licensed pharmacies serving uninsured clients and Mental Health America of Roanoke Valley to increase access to mental health services for adults with no health insurance coverage or inadequate insurance for mental health care. Form 990 5 Contd. Financial support was provided to several organizations including the American Cancer Society, Feeding America Southwest Virginia, and Virginia Health Care Foundation. More than 1,800 children learned about healthcare careers through Caring Careers, an educational program for school aged children provided onsite at local schools and community centers. Form 990 6 Carilion Medical Center is wholly owned by Carilion Clinic, a not-for-profit healthcare organization serving nearly one million people in Virginia through a physician specialty group, advanced primary care practices, hospitals and outpatient centers. Led by clinical teams with a shared philosophy that puts the patient first, Carilion is committed to improving the communitys health while advancing the quality of care through medical education and research. Carilion Clinic is based in Roanoke, Virginia and serves the residents of 18 counties and six cities in Western Virginia and southern West Virginia. Carilion Clinic employees 575 physicians representing more than 60 specialties who provide care at 160 practice sites. Form 990 6 Contd. To advance the coordination of care and quality, an electronic medical record has been implemented in all Carilion Clinic affiliated hospitals and physician practices, allowing physicians to easily and efficiently collaborate through the use of shared patient records. Form 990 6 Contd. Additional improvements in medical programs and services include a nationally certified Stroke Alert protocol that speeds lifesaving care to stroke patients hypothermia therapy for the treatment of cardiac arrest patients a neonatal pediatric mobile ICU outfitted with life-saving, state of the art medical technology certification by the National Committee for Quality Assurance NCQA of 11 Carilion Clinic Family Medicine practices as Patient-Centered Medical Homes, a new model of care designed to keep patients healthy and prevent illness and MyChart, an online tool that gives patients secure access to their health information. Form 990 6 Contd. To advance education of health professionals, Jefferson College of Health Sciences, within Carilion Medical Center, is a professional health sciences college offering the Master of Science in Nursing, Physician Assistant and Occupational Therapy and 10 baccalaureate and associate healthcare programs. As one of few private healthcare colleges in the Southern United States, the students have demonstrated excellent licensure pass rates in professional programs. Approximately 1,000 undergraduate students and 80 graduate students are enrolled annually with 87 receiving some type of financial aid. Form 990 6 Contd. Through a unique public-private partnership, in 2010 Virginia Tech and Carilion Clinic opened Virginia Tech Carilion School of Medicine and Research Institute in Roanoke. 84 students are enrolled in the first two classes and there are 421 appointed faculty members. Additionally, graduate medical education is provided for 190 residents and 16 fellows. Included are ten residency programs, eight sponsored by Carilion Clinic Emergency Medicine, Family Medicine, Internal Medicine, Neurosurgery, Obstetrics/Gynecology, Psychiatry, Surgery, and Transitional Year and two by the University of Virginia Orthopaedics and Otolaryngology. Form 990 6 Contd. Twelve fellowship programs include Addiction Psychology, Adult Joint Reconstruction, Advanced Endoscopy, Cardiovascular Disease, Child and Adolescent Psychiatry, Hospice and Palliative Care, Infectious Disease, Medical Informatics, Pulmonary Critical Care and Surgery Critical Care. Form 990 6 Contd. At the Virginia Tech Carilion VTC Research Institute, senior researchers recruited from across the country are working to unlock the secrets of the human brain as part of the Roanoke Brain Study, which examines the neural basis of human decision-making and its impact on health over a lifetime. The projects goal is to predict illnesses such as Alzheimers and other brain diseases. An additional benefit to the community is Carilion Clinics economic contribution to the region. As the areas largest employer, jobs are provided for nearly 11,000 residents of the region, with a payroll of more than 600 million in 2011. Form 990 Part III 1 Carilion Medical Center, that includes Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital, is part of Carilion Clinic, a not-for-profit healthcare organization serving nearly one million people in Virginia through hospitals, outpatient specialty centers and advanced primary care practices. Led by multi-specialty physician teams with a shared philosophy that puts the patient first, Carilion is committed to improving health outcomes for every patient while advancing the quality of care through medical education and research. Form 990 Part XI 5 Increase for transfer of propery and equipment from related organizations of 32,707,535 decrease for transfer of cash to related organizations of 23,525,000. decrease for tranfer to Carilion Clinic for effect of pension related changes of 55,829,246 decrease for unrealized losses on investments of 25,120,135 net change of 71,766,846. Form 990 Part III 4a Carilion Medical Center exists to serve the health care needs of its community and region, regardless of patient ability to pay. CMC admitted 34,908 patients and provided 172,693 days of care during the year. Hospital programs include provision of nursing care an extensive cardiac and vascular program, including cardiac surgery, implants, angioplasty and heart failure programs neurology, neurosurgery and stroke programs labor and delivery services delivering 3,300 babies the areas only neonatal intensive care unit inpatient and outpatient psychiatric services a comprehensive rehabilitation unit extensive outpatient and inpatient surgical and endoscopic services oncology services geriatric services and diagnostic imaging services including CT, MRI, PET, and mammography. Form 990 Part III 4a Contd. Housing a childrens specialty wing, CMC provides specialists in pediatric neurosurgery, cardiology, oncology, gastroenterology, pulmonology, and child development, among others. CMC is a Level I trauma center, providing full trauma services to the region and a home base for LifeGuard 10, the emergency medical air transport that serves the surrounding area. CMC provides a number of services targeting the specific health needs of the area, including diabetes management home health and hospice physical, speech, and occupational therapy programs and cardiac and respiratory rehab. CMC also provides an emergency department with 24-hour care, emergency transportation, a pediatric department, and chest pain and stroke protocol programs. Form 990 Part III 4a Contd. With 70,936 visits, CMCs 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 21 percent of ED visits. CMCs urgent care centers also provide access points for cost effective care at an appropriate level. CMC employs a number of specialty physicians to ensure an effective, integrated approach to serving its patients including pulmonologists, oncologists, obstetricians, orthopedic surgeons, cardiologists, neurosurgeons, general surgeons, and psychiatrists. As a teaching hospital with over 100 full-time faculty members, CMC hosts residency programs in family medicine, internal medicines, obstetrics and gynecology, psychiatry, general surgery, neurosurgery. Form 990 Part III 4a Contd. In addition, the Jefferson College of Health Sciences, a division of CMC, offers nursing, physician assistant, occupational therapy, and other high-need programs. CMC also supports community screenings and education on chronic disease prevention and management, sponsoring 786 events touching over 37,000 people. CMC supports a cancer registry program, and participates in a number of other research projects. In furtherance of its mission, CMC provides extensive uncompensated care. Stated at cost, charity, bad debt, and unreimbursed Medicaid costs for the year exceeded 62.3 million. Form 990 Part VI Section B Line 11b A draft copy of the Form 990 was provided to the Audit and Compliance Committee of Carilion Clinic in advance of its August meeting and reviewed with Committee members at that meeting. 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 Section B Line 12c A Conflict of Interest Questionnaire, along with a copy of the Policy, is sent out annually to all officers, directors and key employees. In addition, such individuals are instructed to inform the organization of potential conflicts which arise during the year. Answers to the Questionnaires are reviewed by the Internal Audit Department. Potential conflicts for officers and key employees are reviewed by an internal Conflict of Interest Committee, which follows up on any potential issues to ensure compliance with all policies of the organization. The answers for Directors are reviewed by the Carilion Clinic Audit and Compliance Committee. Form 990 Part VI Section B Line 12c Contd. In addition, the governing body of the organization is provided with a list of the answers annually to make all Board members aware of potential conflicts in order to ensure compliance with policies on how to handle transactions with Board members that may involve potential conflict situations. Form 990 Part VI Section B Line 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 2010. A similar review was last performed in October 2011. Form 990 Part VI Section B Line 15a and 15b Contd. 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 Section B Line 15a and 15b Contd. In addition, the Compensation Committee annually reviews the compensation plan and philosophy for all vice presidents and senior vice presidents, as well as all employed physicians and physicians in leadership roles. Form 990 Part VI Section C Line 19 The 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 Section A Line 3 Certain management and related services for the organization are provided by the management and employees of Carilion Services, Inc., a related organization and supporting organization of the organization. Form 990 Part VI Section A Line 6 The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers. Form 990 Part VI Section A Line 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 Section A Line 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 Section Schedule H, Part II Line Lines 1-10 Carilion Medical Center provided in-kind support to many events and initiatives focused on children including the Southwest Virginia Alliance for Safe Babies, a multidisciplinary working to eliminate infant injury and deaths due to abusive head trauma and sudden infant death syndrome SIDS Back to School Blast, an event coordinated by the Rescue Mission of Roanoke Valley and other local non-profits and corporate sponsors to provide backpacks, school supplies and free haircuts for low-income children Better Beginnings Coalition with mission of reducing adolescent pregnancy in Virginia through the cooperative efforts of community coalitions comprised of public agencies, private organizations, community groups, and individual volunteers Form 990 Section Schedule H, Part II Line Lines 1-10 Contd. Roanoke Area Youth Substance Abuse Coalition, a group of concerned citizens, parents, youth, teachers, police officers, business people, judges, and other caring individuals that strive to keep the youth of the Roanoke Valley and Southwest Virginia alcohol, tobacco and drug-free Roanoke Adolescent Health Partnership to improve the lives of teenagers by making comprehensive health care services accessible and a teen pregnancy prevention program that partners with local schools to provide educational programs and assist with administration of risk behavior assessments and presentations of results. Form 990 Section Schedule H, Part II Line Lines 1-10 Contd. In-kind support was provided to the Education and Access to Healthcare Coaltion EACH, an collaboration to provide health advocacy through programs that include training of lay persons to provide basic health screenings and health resources to those in their neighborhoods and churches and Carilion Medical Center partnered with Goodwill Industries of the Roanoke Valley, the Department of Rehabilitative Services, Blue Ridge Behavioral Health, Blue Ridge Independent Living Center and local parent representatives to offer Project SEARCH, a one year high school transition program is to provide employment and educational opportunities for individuals with significant disabilities and to find long term employment in skilled positions for its participants. Form 990 Section Schedule H, Part II Line Lines 1-10 Contd. Grant funding was provided for several projects including Smith Mountain Lake Good Neighbors to support a summer day camp program for children in Franklin and Bedford Counties who live near or under the poverty level Greater Roanoke Transit Company for a free trolley service for the community that operates in a continuous loop with stops that include Carilion Medical Center and Downtown Roanoke with goals of reducing the carbon footprint and enhancing the local economy by providing easier access to downtown and Rebuilding Together Roanoke for remediation of houses in lower income neighborhoods. Much in-kind support was provided for the annual United Way campaign to solicit funding from employees of Carilion Medical Center. Form 990 Section Schedule H, Part VI Line 2 Carilion 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 Medical Center. A comprehensive community health needs assessment is scheduled for completion by September 30, 2012 along with a strategic implementation plan to address identified needs. Form 990 Section Schedule H, Part VI Line 4 Carilion Medical Center, comprised of two hospitals, Car The Center For Surgical Excellence LLC PO Box 12385 Roanoke VA 24025 562595597 Surgery VA N/A Odyssey IV LLC PO Box 12385 Roanoke VA 24025 562354974 Imaging VA 659668 2766303 N/A RMH Emergency Service LLC PO Box 12385 Roanoke VA 24025 541686589 Physician billing VA N/A 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 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 Hugh Trout Memorial Foundation PO Box 12385 Roanoke VA 24025 510236357 Supporting organization VA 501c3 11 Type I N/A false Jefferson College of Health Sciences Education Foundation PO Box 12385 Roanoke VA 24025 541637118 Supporting organization VA 501c3 11 Type III N/A false false true false true true false false false true true true true false false false false true true