2011-08-15T14:43:09-00:00 2010-09-30 Deloitte Tax LLP 424 Church Street Nashville TN 37027 990 2009-10-01 546074580 Carilion Tazewell Community Hospital CARI 5402245112 PO Box 12385 Roanoke VA 24025 Don Lorton 2011-08-15 true Francis Bedard 6152591811 2011-08-15 2009 2016-02-24 21:20:13Z Melina Perdue PO Box 12385 Roanoke VA 24025 11993991 false X www.carilionclinic.org X 1968 VA See Schedule O 10 7 233 26 0 32892 91957 14912814 11802230 8818 5703 114224 94101 15068748 11993991 0 0 8347595 7081191 0 0 11689038 10436822 20036633 17518013 -4967885 -5524022 6297509 4779687 6648741 10654942 -351232 -5875255 Se Schedule O false false 15318415 11821644 See Schedule O 15318415 true true false true false false false false false true false 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 false true false false false true 0 0 true 233 true false false false false false false false false false 10 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 PO Box 12385 Roanoke VA 24025 Nancye Howell 002.00 X 0 0 0 John Biggs III 002.00 X 0 0 0 Melina Perdue 040.00 X 0 265630 154608 Charles Green 002.00 X 0 0 0 Stephen Rinehart MD 002.00 X 0 0 0 Peggy Riley 002.00 X 0 0 0 Stephen Barrett 002.00 X 0 0 0 Randal Swatzyna 040.00 X 0 89536 45710 James Thompson 002.00 X X 0 0 0 Donald Lorton 040.00 X 0 545546 565924 Rachel Mabe 040.00 X 0 68552 28346 Christopher Wearmouth 040.00 X X 192331 0 53038 William Flattery 040.00 X X 0 216400 41606 Kerry Moore MD 040.00 X 119259 0 15405 Assaad Mounzer MD 040.00 X 399487 0 54552 David Harris MD 040.00 X 279669 0 63668 Charles Lambert 040.00 X 139888 0 33815 Duane Blevins 040.00 X 115972 0 34956 1246606 1185664 1091628 4 false true false Acute Care Inc 1609 N Ankeny Blvd Ste 200 Ankeny IA 50021 Physician services 487782 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 476204 Oscar Chan MD 43356 Vestals Place Leesburg VA 20176 Physician services 242299 Weatherby Locums Inc PO Box 972633 Dallas TX 753972633 Physician services 140933 9 8718 83239 91957 Net Patient Revenues 900099 11802230 11802230 11802230 5703 5703 30908 30908 30908 30908 Cafeteria 900099 36081 36081 Miscellaneous 900099 18864 18864 Other Sales 900099 550 550 7698 7698 63193 11993991 11821644 80390 0 0 0 0 281374 281374 0 5531096 5295375 235721 173880 173880 684559 634733 49826 410282 410282 1672094 1672094 0 0 3091 3091 0 3773090 3736505 36585 23675 23391 284 1428726 1409972 18754 55247 55247 0 358246 351046 7200 78448 68468 9980 0 0 332319 332319 0 761996 761996 227419 224825 2594 Bad Debt 1526558 1526558 Contributions 2695 2695 Dues Subscriptions 26707 14510 12197 Special Events Items 12079 12079 I/C Practice Subsidy 126625 126625 27807 14843 12964 17518013 15318415 2199598 0 1307 1069 110102 36633 2522301 1806382 211370 93079 79963 60280 11995705 9224866 3360250 2770839 497 311 11408 11405 6297509 4779687 1858535 2294234 30782 8197 4759424 8352511 6648741 10654942 X -351232 -5875255 -351232 -5875255 6297509 4779687 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 3091 3091 false II-B 1i Portion of dues paid to American Hospital Assn., Virginia Hospital and Healthcare Assn. and other healthcare related organizations spent on lobbying. false 48753 48753 4484564 3242524 1242040 7198071 5917380 1280691 264317 64962 199355 2770839 Due to Affiliate 8311324 Qualified Pension Liability 41187 8352511 true true X true X true X true true true false true true 1196596 1196596 0.07480 894366 783816 110550 0.00690 2090962 783816 1307146 0.08170 5 710 20510 20510 0.00130 2 1046 1046 0.00010 7 710 21556 21556 0.00140 7 710 2112518 783816 1328702 0.08310 2 750 750 1 350 350 3 1100 1100 false 817458 387542 4241007 4404375 -163368 X true true Carilion Tazewell Community Hospital

141 Ben Bolt Avenue Tazewell VA 24651

X X X Dr Assaad Mounzer

17 Westwood Medical Park Unit 12 Bluefield VA 24605

Urology Dr David M Harris

3 Westwood Medical Park Bluefield VA 24605

ENT Carilion Clinic Family Medicine

982 Ben Bolt Avenue Tazewell VA 24651

Family Practice Carilion Pediatrics

992 1/2 Ben Bolt Avenue Tazewell VA 24651

Pediatrics Carilion Speciality Clinic

3150 Clinch Street Suite 100 Richlands VA 24641

Surgical office N/A Carilion Clinic, the sole 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 1,526,558. 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. 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 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 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 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 almost 44,000. Approximately 27 of adults under age 64 and 13 of children who live in the Tazewell County are uninsured. Additionally, 17 of residents live below the poverty level. Carilion Tazewell Community Hospital provided support of economic and workforce development in Tazewell County through financial and in-kind support of the Tazewell Area Chamber of Commerce. Additional financial support was provided to Young Life for childhood development 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. Carilion Tazewell Community Hospital provides community health education and screenings at several events annually. During 2010, these events included a day focused on children and another focused on senior citizens. In total, more than 700 people received health information during five community events. 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. In 2009, the Four Seasons YMCA opened on a parcel of land adjacent to the hospital and is providing a long awaited facility that incorporates fitness and social activities. Financial support was also provided to the American Cancer Society for education and research. Carilion Tazewell Community Hospital is wholly owned by 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 Melina Perdue 240000 27360 -1730 143483 11125 420238 Donald Lorton 436800 49620 59126 548892 17032 1111470 55087 Christopher Wearmouth 161457 25647 5227 37739 15299 245369 William Flattery 191100 21709 3591 30693 10913 258006 Assaad Mounzer MD 400005 -518 39525 15027 454039 David Harris MD 280010 -341 48899 14769 343337 Charles Lambert 143076 -3188 19356 14459 173703 Duane Blevins 113593 2379 20715 14241 150928 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 Form 990 I 1 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. Form 990 III 1 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. Form 990 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 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 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. Form 990 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 787 patients and provided 2,219 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. Tazewell also provides an emergency department with 24-hour care and emergency transportation. Form 990 III 4a contd With 9,441 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 18 of ED visits. Tazewell supports community screenings and education on chronic disease management, sponsoring events touching 710 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 exceeded 1.6 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. 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 Stonewall Jackson Hospital PO Box 12385 Roanoke VA 24025 540568001 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 false false false false false false false false false true true false false false false false false