CARILION TAZEWELL COMMUNITY HOSPITAL: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- CARILION TAZEWELL COMMUNITY HOSPITAL (EIN 54-6074580)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-15
- IRS object ID
- 201212289349301086
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-15T09:40:03-00:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 424 Church Street | AddressLine1 |
| City | Nashville | City |
| State | TN | State |
| ZIP Code | 37219 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 546074580 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carilion Tazewell Community Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CARI | NameControl |
| Phone | 5402245112 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 12385 | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 24025 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Don Lorton | Name |
| Title | Assistant Treasurer | Title |
| Date Signed | 2012-08-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Francis Bedard | Name |
| Phone | 6152591811 | Phone |
| Date Prepared | 2012-08-15 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Randal Swatzyna | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 12385 | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 24025 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 10771898 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.carilionclinic.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1968 | YearFormation |
| State Legal Domicile | VA | StateLegalDomicile |
| Activity Or Mission Description | Carilion Tazewell Community Hospital, part of Carilion Clinic, is a not-for-profit healthcare organization committed to improving health outcomes for every patient while advancing the quality of care in the community it serves. Carilion Tazewell Community Hospital, part of Carilion Clinic, is a not-for-profit healthcare organization committed to improving health outcomes for every patient while advancing the quality of care in the community it serves. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 200 | TotalNbrEmployees |
| Total Nbr Volunteers | 22 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 91957 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1500 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 11802230 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 8885552 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5703 | InvestmentIncomePriorYear |
| Investment Income Current Year | 9951 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 94101 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1874895 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 11993991 | TotalRevenuePriorYear |
| Total Revenue Current Year | 10771898 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 7402 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 7081191 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4019528 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10436822 | OtherExpensePriorYear |
| Other Expenses Current Year | 8319118 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 17518013 | TotalExpensesPriorYear |
| Total Expenses Current Year | 12346048 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -5524022 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1574150 | RevenuesLessExpensesCY |
| Total Assets BOY | 4779687 | TotalAssetsBOY |
| Total Assets EOY | 5606511 | TotalAssetsEOY |
| Total Liabilities BOY | 10654942 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13075731 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -5875255 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -7469220 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Carilion Tazewell Community Hospital, part of Carilion Clinic, is a not-for-profit healthcare organization committed to improving health outcomes for every patient while advancing the quality of care in the community it serves. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 9485969 | Expense |
| Grants | 7402 | Grants |
| Revenue | 10684352 | Revenue |
| Description | See Schedule O | Description |
| Total Program Service Expense | 9485969 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 200 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | VA | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | The Organization | NamePerson |
| Telephone Number | 5402245112 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 S Jefferson Street | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 24011 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Stephen Rinehart MD | ||||||||
| Director | 002.00 | X | 0 | 0 | 0 | |||
| Melina Perdue | ||||||||
| Director | 050.00 | X | 0 | 262194 | 96083 | |||
| Peggy Riley | ||||||||
| Director | 002.00 | X | 0 | 0 | 0 | |||
| William Flattery | ||||||||
| Director | 050.00 | X | 0 | 211693 | 29633 | |||
| James Thompson | ||||||||
| Chairman | 002.00 | X | 0 | 0 | 0 | X | ||
| Charles Green | ||||||||
| Vice Chairman | 002.00 | X | 0 | 0 | 0 | X | ||
| Nancye Howell | ||||||||
| Secretary | 002.00 | X | 0 | 0 | 0 | X | ||
| Stephen Barrett | ||||||||
| Treasurer | 002.00 | X | 0 | 0 | 0 | X | ||
| John Biggs III | ||||||||
| Assistant Treasurer | 002.00 | X | 0 | 0 | 0 | X | ||
| Donald Lorton | ||||||||
| Assistant Treasurer | 050.00 | 0 | 521051 | 332850 | X | |||
| Rachel Mabe | ||||||||
| Assistant Secretary | 050.00 | 0 | 70949 | 17506 | X | |||
| Randal Swatzyna | ||||||||
| Administrator | 050.00 | 0 | 156789 | 23204 | X | |||
| David Harris MD | ||||||||
| Physician | 050.00 | 173295 | 0 | -19369 | X | |||
| Charles Lambert | ||||||||
| Anesthetist | 050.00 | 119657 | 21895 | 33686 | X | |||
| Donna Valentine | ||||||||
| Anesthetist | 050.00 | 103712 | 26251 | 8449 | X | |||
| Christopher Wearmouth | ||||||||
| Former Administrator | 050.00 | 135187 | 0 | 27053 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 531851 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1270822 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 549095 | TotalOtherCompensation |
| Number Individuals GT100 K | 4 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Acute Care Inc | |||||
| 1609 N Ankeny Blvd Ste 200 | Ankeny | IA | 50021 | Physician services | 532774 |
| Vision RadiologyDr E Knapp | |||||
| 2951 West Front Street | Richlands | VA | 24641 | Radiology services | 369200 |
| Heartland Rehabilitation Services | |||||
| Dept L 3281 | Columbus | OH | 432600001 | Rehabilitation services | 307522 |
| Carilion Labs LLC | |||||
| 213 S Jefferson 1202 | Roanoke | VA | 24011 | Laboratory Services | 521079 |
| CompHealth Medical Staffing | |||||
| PO Box 972651 | Dallas | TX | 753972651 | Staffing | 281258 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| All Other Contributions | 1500 | AllOtherContributions |
| Total Contributions | 1500 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net Patient Revenues | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 8885552 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8885552 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 8885552 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9951 | TotalRevenueColumn |
| Exclusion | $9,951 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 31599 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 31599 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31599 | TotalRevenueColumn |
| Exclusion | $31,599 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| Cafeteria | 900099 | 10432 | $10,432 | |
| EHR Incentive Payment | 900099 | 1798800 | 1798800 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 34064 | TotalRevenueColumn |
| Exclusion | $34,064 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1843296 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10771898 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10684352 | RelatedOrExemptFunctionIncome |
| Exclusion | $86,046 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7402 | Total |
| Program Services | 7402 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3255927 | Total |
| Program Services | 3101823 | ProgramServices |
| Management And General | 154104 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 142310 | Total |
| Program Services | 142310 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 376438 | Total |
| Program Services | 322822 | ProgramServices |
| Management And General | 53616 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 244853 | Total |
| Program Services | 244853 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1206108 | Total |
| Management And General | 1206108 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8838 | Total |
| Management And General | 8838 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2735 | Total |
| Program Services | 2735 | ProgramServices |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees For Services Prof Fundraising | FeesForServicesProfFundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2058026 | Total |
| Program Services | 2049781 | ProgramServices |
| Management And General | 8245 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 159 | Total |
| Program Services | 159 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 810362 | Total |
| Program Services | 800462 | ProgramServices |
| Management And General | 9900 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60080 | Total |
| Program Services | 60080 | ProgramServices |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 164042 | Total |
| Program Services | 156842 | ProgramServices |
| Management And General | 7200 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49365 | Total |
| Program Services | 35016 | ProgramServices |
| Management And General | 14349 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 501292 | Total |
| Program Services | 501292 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 772053 | Total |
| Program Services | 772053 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 225641 | Total |
| Program Services | 225641 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debt | 1016740 | 1016740 | |
| Dues Subscriptions | 30125 | 13581 | 16544 |
| Special Events Items | 12448 | 12448 | |
| I/C Practice Subsidy | 1366819 | 1366819 | |
| Other | 34285 | 32377 | 1908 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12346048 | Total |
| Program Services | 9485969 | ProgramServices |
| Management And General | 2860079 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1069 | BOY |
| EOY | 875 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36633 | BOY |
| EOY | 29056 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1806382 | BOY |
| EOY | 2636641 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 93079 | BOY |
| EOY | 6040 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60280 | BOY |
| EOY | 56992 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 12862812 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 9997310 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2770839 | BOY |
| EOY | 2865502 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11405 | BOY |
| EOY | 11405 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4779687 | BOY |
| EOY | 5606511 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2294234 | BOY |
| EOY | 1062174 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8197 | BOY |
| EOY | 15667 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8352511 | BOY |
| EOY | 11997890 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10654942 | BOY |
| EOY | 13075731 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -5875255 | BOY |
| EOY | -7469220 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -5875255 | BOY |
| EOY | -7469220 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4779687 | BOY |
| EOY | 5606511 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1574150 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -19815 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| Public Support Pertcentage170 | 0.00000 | PublicSupportPertcentage170 |
| Public Support Percentage509 | 0.00000 | PublicSupportPercentage509 |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $2,735 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 2735 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | II-B | Identifier |
| Return Reference | Ij | ReturnReference |
| Explanation | Portion of dues paid to American Hospital Assn. and Virginia Hospital and Healthcare Assn. spent on lobbying. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Included On FS | false | IncludedOnFS |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 48753 | OtherCostOrOtherBasis |
| Book Value | 48753 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4773898 | OtherCostOrOtherBasis |
| Depreciation | 3439772 | Depreciation |
| Book Value | 1334126 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7775844 | OtherCostOrOtherBasis |
| Depreciation | 6469379 | Depreciation |
| Book Value | 1306465 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 264317 | OtherCostOrOtherBasis |
| Depreciation | 88159 | Depreciation |
| Book Value | 176158 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2865502 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Due to Affiliate | $11,949,824 |
| Qualified Pension Liability | $48,066 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 11997890 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | X | Identifier |
| Return Reference | 2 | ReturnReference |
| Explanation | Carilion had no material unrecognized tax benefits and no adjustments to its consolidated financial statements were required as of and for the years ended September 30, 2011 and 2010. Carilion does not expect that unrecognized tax benefits will materially increase within the next 12 months. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 751723 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 751723 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06090 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 828037 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 679806 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 148231 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01200 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1579760 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 679806 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 899954 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07290 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 35 | NumberOfActivitiesOrPrograms |
| Persons Served | 2000 | PersonsServed |
| Total Community Benefit Expense | 9420 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 9420 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 1414 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1414 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 37 | NumberOfActivitiesOrPrograms |
| Persons Served | 2000 | PersonsServed |
| Total Community Benefit Expense | 10834 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 10834 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 37 | NumberOfActivitiesOrPrograms |
| Persons Served | 2000 | PersonsServed |
| Total Community Benefit Expense | 1590594 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 679806 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 910788 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07380 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 800 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 800 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 50 | PersonsServed |
| Total Community Building Expense | 1122 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1122 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 50 | PersonsServed |
| Total Community Building Expense | 1922 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1922 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $373,685 | BadDebtExpenseAmount |
| Amount Attributable To | 157891 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 3815756 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4740326 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -924570 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carilion Tazewell Community Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 141 Ben Bolt Avenue | AddressLine1 |
| City | Tazewell | City |
| State | VA | State |
| ZIP Code | 24651 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)
| Hospital Facility NumberHospitalFacilityNumber |
|---|
| Carilion Pediatrics |
| 1 |
| Carilion Speciality Clinic |
| 2 |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Carilion Pediatrics | ||||
| 992 Ben Bolt Avenue | Tazewell | VA | 24651 | 0 |
| Carilion Speciality Clinic | ||||
| 3150 Clinch Street Suite 100 | Richlands | VA | 24641 | Pediatrics |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| 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 1,016,740. |
| 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 | Contd. 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 | Contd. 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 | Contd. 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 | Contd. 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 | Contd. 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 | Contd. 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 | Contd. 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 explaining the charity care policy and how to apply. Also, see comments for Part III line 9b. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
| No Grant More Than5000 | X | NoGrantMoreThan5000 |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | I | Identifier |
| Return Reference | 2 | ReturnReference |
| Explanation | The Hospital made donations to support other 501c3 charitable organizations in its community. Such organizations have community boards which oversee the expenditure of such funds. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Melina Perdue | ||||||||||||
| 244617 | 11787 | 5790 | 85628 | 10455 | 358277 | |||||||
| William Flattery | ||||||||||||
| 199946 | 9876 | 1871 | 14496 | 15137 | 241326 | |||||||
| Donald Lorton | ||||||||||||
| 436800 | 21491 | 62760 | 316614 | 16236 | 853901 | 61212 | ||||||
| Randal Swatzyna | ||||||||||||
| 133782 | 19367 | 3640 | 15268 | 7936 | 179993 | |||||||
| David Harris MD | ||||||||||||
| 172314 | 981 | -26899 | 7530 | 153926 | ||||||||
| Charles Lambert | ||||||||||||
| 22364 | -469 | 21895 | 122232 | -2575 | 18925 | 14761 | 153343 | |||||
| Christopher Wearmouth | ||||||||||||
| 94390 | 39111 | 17906 | 9147 | 162240 | 1686 | |||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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 - 131,084 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (26 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990 Part VI | 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 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 is entitled to elect directors having 80 of the vote on any issue. |
| Form 990 Part VI | 7a | The organization has one member. The sole member, Carilion Clinic, is entitled to elect one class of directors having 80 of the vote on any issue. The remaining class of directors, which has 20 of the vote on any issue, came from the local community and elect their own successors. Certain actions require the majority vote of both classes. |
| Form 990 Part VI | 7b | Under the laws of the Commonwealth of Virginia certain extraordinary actions require member approval, such as mergers, consolidations, liquidations and the sale of substantially all of the assets of the organization. |
| Form 990 | 1-10 | Carilion Tazewell Community Hospital provided financial for Young Life for childhood development and the Tazewell Area Chamber of Commerce. Additional in-kind support was provided for Step up to the Plate, a fundraiser for the non-profit Second Chance Learning Center, a program for at-risk young adults and teenagers in the community with educational needs. |
| Form 990 | 2 | Carilion Tazewell Community Hospital uses demographic information and data on patients treated to determine community health needs. Additionally, information from public databases compiled on the Virginia Atlas of Community Health website is reviewed for the entire geographic area served by Carilion Tazewell Community Hospital. A comprehensive community health needs assessment is scheduled for completion by September 30, 2013 along with a strategic implementation plan to address identified needs. |
| Form 990 | 4 | Carilion Tazewell Community Hospital is a 56-bed facility in Tazewell, the county seat and geographic center of this southwest Virginia County, also known as Tazewell. Tazewell County is within the valley and ridge province of the Appalachian Highlands between the Appalachian Mountains on the southeast and the Cumberland Plateau and the Allegheny mountains on the northwest. The county contains 520 square miles and a population of a little over 45,000. Approximately 20 of adults under age 64 and 10 of children who live in the Tazewell County are uninsured. Additionally, 18 of residents live below the poverty level and 22 of adults 25 years of age or older did not graduate from high school. 17 of residents are 65 years of age or older. |
| Form 990 | 5 | Carilion Tazewell Community Hospital serves all patients regardless of their ability to pay. The Hospitals governing Board is elected annually and the majority of members are neither employees nor contractors of the Hospital. Medical staff privileges are extended to qualified providers. In addition to clinical care, the hospital works to achieve its mission through the education of health professionals and the community. Any surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. This includes providing free, discounted and subsidized care as well as critical medical services that operate at a loss. |
| Form 990 | 5 Contd. | Carilion Tazewell Community Hospital provides community health education and screenings at several events annually. During fiscal year 2011, 2,000 people received health education or health screenings during 35 events, many focusing on senior health and safety. Additional health improvement services include assistance with enrollment in public medical programs such as Medicaid. Carilion Tazewell Community Hospital has been very involved in the development and implementation of a wellness center through both financial and in-kind support over several years. The Four Seasons YMCA opened on a parcel of land adjacent to the hospital and provides fitness and social activities. Financial support was also provided to the American Cancer Society for education and research. |
| Form 990 | 6 | Carilion Tazewell Community Hospital is a wholly owned hospital of 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. 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. |
| Form 990 | 6 Contd. | 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. 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 XI | 5 | Other changes- pension related adjustment of 19,006 and FAS 158 prior year adjustment of 809 for total of 19,815. |
| Form 990 Part III | 4a | Carilion Tazewell Community Hospital exists to serve the health care needs of its community, regardless of patient ability to pay. Tazewells acute hospital admitted 639 patients and provided 1,740 days of care during the year. Hospital programs include provision of nursing care outpatient and inpatient surgical and endoscopic services and diagnostic imaging services including CT, MRI, and mammography. Tazewell provides a number of services targeting the specific health needs of its population, including physical, speech, and occupational therapy programs home health services bone density testing and a cardiac rehab program. |
| Form 990 Part III | 4a Contd. | Tazewell also provides an emergency department with 24-hour care and emergency transportation. With 9,446 visits, Tazewells emergency services are a critical component of the health safety net in its service area, acting as a key health provider for a significant number of uninsured patients who comprise nearly 20 of ED visits. Tazewell supports community screenings and education on chronic disease management, sponsoring 35 events touching 2,000 people. In furtherance of its mission, Tazewell provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year of 1.1 million. |
| Form 990 Part VI Section B Line 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 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 is entitled to elect directors having 80 of the vote on any issue. Form 990 Part VI Section A Line 7a The organization has one member. The sole member, Carilion Clinic, is entitled to elect one class of directors having 80 of the vote on any issue. The remaining class of directors, which has 20 of the vote on any issue, came from the local community and elect their own successors. Certain actions require the majority vote of both classes. Form 990 Part VI Section A Line 7b Under the laws of the Commonwealth of Virginia certain extraordinary actions require member approval, such as mergers, consolidations, liquidations and the sale of substantially all of the assets of the organization. Form 990 Section Schedule H, Part II Line 1-10 Carilion Tazewell Community Hospital provided financial for Young Life for childhood development and the Tazewell Area Chamber of Commerce. Additional in-kind support was provided for Step up to the Plate, a fundraiser for the non-profit Second Chance Learning Center, a program for at-risk young adults and teenagers in the community with educational needs. Form 990 Section Schedule H, Part VI Line 2 Carilion Tazewell Community Hospital uses demographic information and data on patients treated to determine community health needs. Additionally, information from public databases compiled on the Virginia Atlas of Community Health website is reviewed for the entire geographic area served by Carilion Tazewell Community Hospital. A comprehensive community health needs assessment is scheduled for completion by September 30, 2013 along with a strategic implementation plan to address identified needs. Form 990 Section Schedule H, Part VI Line 4 Carilion Tazewell Community Hospital is a 56-bed facility in Tazewell, the county seat and geographic center of this southwest Virginia County, also known as Tazewell. Tazewell County is within the valley and ridge province of the Appalachian Highlands between the Appalachian Mountains on the southeast and the Cumberland Plateau and the Allegheny mountains on the northwest. The county contains 520 square miles and a population of a little over 45,000. Approximately 20 of adults under age 64 and 10 of children who live in the Tazewell County are uninsured. Additionally, 18 of residents live below the poverty level and 22 of adults 25 years of age or older did not graduate from high school. 17 of residents are 65 years of age or older. Form 990 Section Schedule H, Part VI Line 5 Carilion Tazewell Community Hospital serves all patients regardless of their ability to pay. The Hospitals governing Board is elected annually and the majority of members are neither employees nor contractors of the Hospital. Medical staff privileges are extended to qualified providers. In addition to clinical care, the hospital works to achieve its mission through the education of health professionals and the community. Any surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. This includes providing free, discounted and subsidized care as well as critical medical services that operate at a loss. Form 990 Section Schedule H, Part VI Line 5 Contd. Carilion Tazewell Community Hospital provides community health education and screenings at several events annually. During fiscal year 2011, 2,000 people received health education or health screenings during 35 events, many focusing on senior health and safety. Additional health improvement services include assistance with enrollment in public medical programs such as Medicaid. Carilion Tazewell Community Hospital has been very involved in the development and implementation of a wellness center through both financial and in-kind support over several years. The Four Seasons YMCA opened on a parcel of land adjacent to the hospital and provides fitness and social activities. Financial support was also provided to the American Cancer Society for education and research. Form 990 Section Schedule H, Part VI Line 6 Carilion Tazewell Community Hospital is a wholly owned hospital of Carilion Clinic, a not-for-profit healthcare organization serving 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 Section Schedule H, Part VI Line 6 Contd. To advance the coordination of care and quality, an electronic medical record h |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Carilion Clinic | ||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541190771 | Supporting organization | VA | 501c3 | 11 Type I | N/A | false |
| Carilion Clinic Foundation | ||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541190773 | Supporting organization | VA | 501c3 | 11 Type I | N/A | false |
| Carilion Franklin Memorial Hospital | ||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540480606 | Healthcare | VA | 501c3 | 3 | N/A | false |
| Carilion Giles Community Hospital | ||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540549603 | Healthcare | VA | 501c3 | 3 | N/A | false |
| Carilion Medical Center | ||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540506332 | Healthcare | VA | 501c3 | 3 | N/A | false |
| Carilion New River Valley Medical Center | ||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540553805 | Healthcare | VA | 501c3 | 3 | N/A | false |
| Carilion Services Inc | ||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 541190879 | Supporting organization | VA | 501c3 | 11 Type I | N/A | false |
| Carilion Stonewall Jackson Hospital | ||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 540568001 | Healthcare | VA | 501c3 | 3 | N/A | false |
| Hugh Trout Memorial Foundation | ||||||||||
| PO Box 12385 | Roanoke | VA | 24025 | 510236357 | Supporting organization | VA | 501c3 | 11 Type I | N/A | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |