2011-08-15T14:35:57-00:00 2010-09-30 Deloitte Tax LLP 424 Church Street Nashville TN 37027 990 2009-10-01 540568001 Carilion Stonewall Jackson Hospital CARI 5402245112 PO Box 12385 Roanoke VA 240252385 Donald Lorton 2011-08-15 true 6152591811 2011-08-15 2009 2016-02-24 21:20:13Z Thomas McNamara DO PO Box 12385 Roanoke VA 24025 38210864 false X www.carilion.com X 1955 VA See Schedule O 11 7 331 100 0 274861 28663 34691452 30156957 -1442880 1203578 373482 627997 33896915 32017195 0 0 13270077 13335030 0 0 21676062 19729338 34946139 33064368 -1049224 -1047173 49080444 46491260 36743537 35066815 12336907 11424445 See Schedule O. false false 28512732 30431716 See Schedule O. 28512732 true true false true false false false false false true true true false false false false false false false false true false false true false false false false false false false false false false false false true true false false false true 0 0 true 331 true false true CA CJ EI UK false false false false false false false 11 7 false true false false true true true true true false false true true true true true true true true false VA X X The Organization 5402245112 213 S Jefferson Street Roanoke VA 240111331 Charles Carr 002.00 X 0 0 0 Donald Halliwill 040.00 X 0 238576 63838 Laurent Boetsch 002.00 X 0 0 0 Melina Perdue 040.00 X 0 265630 154608 Joseph Troise MD 002.00 X 0 0 0 Rebecca Gates 002.00 X 0 0 0 John Sheridan DO 002.00 X 0 0 0 Thomas McNamara DO 040.00 X X 307643 0 98677 Kermit Rockett 002.00 X X 0 0 0 Richard Teaff 002.00 X X 0 0 0 H E Derrick Jr 002.00 X X 0 0 0 Donald Lorton 040.00 X X 0 545546 565924 Farris Hotchkiss 002.00 X X 0 0 0 Briggs Andrews 040.00 X X 0 336244 250796 John Sedovy MD 040.00 X 0 0 0 Jay Sailer MD 040.00 X 0 0 0 Sheila Hatmaker 040.00 X 131666 0 33923 Regina Donald 040.00 X 130436 0 44129 Tonia McFaddin 040.00 X 108734 0 4218 678479 1385996 1216113 3 false true false Lexington VA Emergency Physicians PO Box 793 Traverse City MI 496850793 Physician services 403541 Anesthesia Healthcare Partners 3079 Peachtree Industrial Blvd Duluth GA 30097 Anesthesia services 189021 Trane 3600 Pammel Creek Rd La Crosse WI 54601 Equipment maintenance 129625 GE Medical Systems 5517 Collections Center Dr Chicago IL 60693 Equipment maintenance 129504 Computer Programs and Systems 6600 Wall St Mobile AL 36695 Software maintenance 117548 5 8718 19945 28663 Net Patient Service Revenues 900099 30156957 30156957 30156957 -43052 -43052 302962 302962 261596 261596 261596 261596 6989036 148301 6178882 14787 810154 133514 943668 943668 Contract Revenue 900099 190113 190113 Cafeteria 900099 91642 91642 Other Revenue 900099 75488 75488 9158 9158 366401 32017195 30431716 1556816 0 0 0 0 305358 305358 0 10408963 10131264 277699 462697 462697 1376778 1317266 59512 781234 781234 3649126 3649126 153004 153004 32000 32000 5220 5220 39285 39285 2982979 2837771 145208 2575 2575 3130183 3119320 10863 201543 201543 0 480629 480629 135776 130475 5301 0 0 2060361 2060361 0 2196843 2196843 295775 164226 131549 Bad Debt 3513793 3513793 I/C Pracrice subsidy 720001 720001 Dues Subscriptions 58740 58740 Donations Sponsorships 28003 5500 22503 Miscellaneous 43502 17916 25586 0 33064368 28512732 4551636 0 1135 1135 1736191 24076 4620742 3502179 220939 230266 197301 187696 43297608 25019703 20183571 18277905 11476511 12660926 6579351 7555384 4064703 4051693 49080444 46491260 4679496 4144361 34821 42735 28092492 27453343 3057900 2891450 878828 534926 36743537 35066815 X 12336907 11424445 12336907 11424445 49080444 46491260 X false true true X X 0.00000 0.00000 0.00000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 5220 5220 false II-B 1i Portion of dues paid to American Hospital Assn., Vrginia Hospital and Healthcare Assn. and other healthcare related organizations spent on lobbying. false 707453 707453 25143251 10739994 14403257 16384292 13301638 3082654 1062612 978071 84541 18277905 7555384 F 7555384 2002 Bond Principal Fund 3275643 Bond Issue Costs 776050 Other Long Term Assets 4051693 Deferred Physicians Payable 426649 Due to Restricted Fund Due to Caril Enterprises 29000 Qualified Pension Liability 79277 534926 32017195 33064368 -1047173 139422 -4711 134711 -912462 32156617 139422 139422 32017195 32017195 33064368 33064368 33064368 XI 8 Adjustment for Pension of 4,712 XI 8 Rounding 1 XII 8 Total 4.711 true true X true X true X true true true false true true 1595826 1595826 0.05410 1891664 1186835 704829 0.02390 3487490 1186835 2300655 0.07800 163 9194 60662 2310 58352 0.00200 5 866 26118 26118 0.00090 168 10060 86780 2310 84470 0.00290 168 10060 3574270 1189145 2385125 0.08090 3 2795 2795 0.00010 3 2795 2795 0.00010 false 1494131 717525 11551362 11793857 -242495 X true true Carilion Stonewall Jackson Hospital

1 Health Circle Lexington VA 24450

X X X X Lexington Medical Building West

108 Houston Street Lexington VA 24450

Physician offices N/A Carilion Clinic, an 80 member of the Hospital, includes the community benefit report for the Hospital in a system-wide annual report. Ratio of cost-to-charges was used to calculate the expense. N/A Bad debt expense subtracted from total expenses for the calculation is 3,513,793. The audited financial statements footnote on bad debt states an allowance of uncollectible accounts is recorded 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. 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. 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. Patient account balances are reduced by discounts allowed and payments. Medicare allowable costs are determined from the Medicare cost report using the cost-to-charges ratio. The Hospital does not consider a Medicare shortfall as a community benefit. 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. 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. 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. 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. N/A Carilion Stonewall Jackson 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 Stonewall Jackson Hospital. A community health needs assessment is scheduled for completion in compliance with recent guidelines related to quantifying community benefit. 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. Carilion Stonewall Jackson Hospital is a 25-bed critical access facility serving the more than 35,000 residents of the Rockbridge County community. Rockbridge County is centrally located in the historic and scenic Shenandoah Valley in west-central Virginia. The County is bordered on the west by the lower elevations of the Allegheny Mountains and on the east by the crest of the Blue Ridge Mountains. With 610 square miles of diverse, rolling terrain, Rockbridge County includes the cities of Lexington and Buena Vista and incorporated towns of Glasgow and Goshen. Approximately 22 of adults under age 64 and 12 of children who live in the Rockbridge County are uninsured. Additionally, 12 of residents live below the poverty level. Carilion Stonewall Jackson Hospital provided support of economic and workforce development in Rockbridge County through financial and in-kind support of the Shenandoah Valley Partnership and Lexington-Rockbridge County Chamber of Commerce. Carilion Stonewall Jackson 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. The dangers of obesity and diabetes are a concern in Rockbridge County, particularly for our youngsters so Carilion Stonewall Jackson Hospitals community health educator provided sessions on nutrition, diet, and exercise. Five programs were offered to 125 children attending summer camp and after school programs at the YMCA. As a member of the Rockbridge County School Health Advisory Board, nutrition education was developed and provided to all students from elementary, middle, and high school in the form of materials and assemblies. Additionally, food slide guides were distributed to more than 700 elementary students. A diabetes task force identified support of diabetics as an opportunity for improving health status. As a result, a diabetes support group was created with monthly meetings featuring important health topics such as eye care, foot care, and sleep apnea. With a focus on teen wellness and suicide prevention, presentations and activities were developed and provided to more than 400 teens during nine events. Overall, during 2010 almost 9,000 residents received health education by attending one of more than 160 community health outreach events including screenings, health fairs and presentations. Carilion Stonewall Jackson Hospital provided financial support to Rockbridge Area Hospice and the Free Clinic of Rockbridge County to assist with operational expenses related to the increased demand for health services of the uninsured. Carilion Stonewall Jackson Hospital is an affiliate 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. 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. Additional improvements in medical programs and services include a new nationally certified Stroke Alert protocol that speeds lifesaving care to stroke patients the introduction of hypothermia therapy to southwest Virginia for the treatment of cardiac arrest patients 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 the introduction of MyChart, an online tool that gives patients secure access to their health information. 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, Virginia Tech and Carilion Clinic recently opened the Virginia Tech Carilion School of Medicine and Research Institute in Roanoke. The School welcomed an inaugural class of 42 students in August 2010. The Research Institute opened in September 2010 with a mission to advance the health of the nation and the world by making major scientific advances in understanding human health and developing new diagnostics, treatments and cures for disorders that limit the quality of life and the realization of full human potential. This is done through biomedical and behavioral research. 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 625 million in 2010. X X true true X X X X X false true false false false false false true false Donald Halliwill 220387 25036 -6847 48938 14900 302414 Melina Perdue 240000 27360 -1730 143483 11125 420238 Thomas McNamara DO 273050 35604 -1011 80053 18624 406320 Donald Lorton 436800 49620 59126 548892 17032 1111470 55087 Briggs Andrews 301600 34262 382 239565 11231 587040 Sheila Hatmaker 112592 18238 836 28663 5260 165589 Regina Donald 124533 5903 30138 13991 174565 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 - 308,492, Briggs Andrews - 82,342 Form 990 I 1 Carilion Stonewall Jackson 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. Form 990 III 1 Carilion Stonewall Jackson 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. Form 990 VI 6 The organization has two classes of members. Carilion Clinic, a charitable tax-exempt healthcare organization, has an 80 membership interest and is entitled to elect directors having 80 of the vote on any issue. The Stonewall Jackson Community Foundation, a tax-exempt community foundation which supports healthcare within the local community, has a 20 membership interest and is entitled to elect directors having 20 of the vote on any issue. Form 990 VI 7a The organization has two classes of members. Carilion Clinic, a charitable tax-exempt healthcare organization, has an 80 membership interest and is entitled to elect one class of directors having 80 of the vote on any issue. The Stonewall Jackson Community Foundation, a tax-exempt community foundation which supports healthcare within the local community, has a 20 membership interest but is not entitled to elect directors. The remaining class of directors, which has 20 of the vote on any issue, came from the local community and those directors elect their own successors. Form 990 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 VI 11 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 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 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 VI 15a and b This organizations CEO is an employee of Carilion Services, Inc. The CEOs compensation is determined by the Human Resources Department of Carilion Clinic based on the job description, experience of the individual and the results of comparisons to 6 to 8 nationwide third party surveys of compensation. The Board of Directors of the organization and the Board of Directors of Carilion Clinic have to approve the appointment of the CEO. Form 990 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 XI 2 The organizations financial statements were audited on a consolidated basis as part of Carilion Clinic as well as on a separate basis. Form 990 III 4a Carilion Stonewall Jackson Hospital, a critical access hospital, exists to serve the health care needs of its community, regardless of patient ability to pay. Stonewalls acute hospital admitted 1,506 patients and provided 5,365 days of care during the year. Hospital programs include provision of nursing care extensive outpatient and inpatient surgical and endoscopic services and diagnostic imaging services including CT, MRI, and mammography. Stonewall provides a number of services targeting the specific health needs of its population, including diabetes management home health physical, speech, and occupational therapy programs and cardiac and respiratory rehab. Stonewall also provides an emergency department with 24-hour care, emergency transportation, and a chest pain and stroke program. Form 990 III 4a contd With 16,131 visits, Stonewalls 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 22 percent of ED visits. Stonewall supports community screenings and education on chronic disease prevention and management, sponsoring 163 events touching 9,200 people. In furtherance of its mission, Stonewall provides extensive uncompensated care. Stated at cost, charity, charity-eligible bad debt, and unreimbursed Medicaid costs for the year exceeded 3 million. Form 990 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. Stonewall Jackson Ambulatory Health LLC PO Box 12385 Roanoke VA 24025 203842434 Inactive VA N/A Carilion Clinic PO Box 12385 Roanoke VA 24025 541190771 Supporting organization VA 501c3 11 Type I N/A Carilion Clinic Foundation PO Box 12385 Roanoke VA 24025 541190773 Supporting organization VA 501c3 11 Type I N/A Carilion Franklin Memorial Hospital PO Box 12385 Roanoke VA 24025 540480606 Healthcare VA 501c3 3 N/A Carilion Giles Community Hospital PO Box 12385 Roanoke VA 24025 540549603 Healthcare VA 501c3 3 N/A Carilion Medical Center PO Box 12385 Roanoke VA 24025 540506332 Healthcare VA 501c3 3 N/A Carilion New River Valley Medical Center PO Box 12385 Roanoke VA 24025 540553805 Healthcare VA 501c3 3 N/A Carilion Services Inc PO Box 12385 Roanoke VA 24025 541190879 Supporting organization VA 501c3 11 Type I N/A Carilion Tazewell Community Hospital PO Box 12385 Roanoke VA 24025 546074580 Healthcare VA 501c3 3 N/A Hugh Trout Memorial Foundation PO Box 12385 Roanoke VA 24025 510236357 Supporting organization VA 501c3 11 Type I N/A false true false false false false false false false false false true false false false false false false