CARILION NEW RIVER VALLEY MEDICAL CENTER: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: CARILION NEW RIVER VALLEY MEDICAL CENTER (EIN 54-0553805)
Tax period: 2022-10-01 to 2023-09-30
Filed: 2024-08-15
IRS object ID: 202412289349304071
Schema version: 2022v5.0
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 B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2024-08-15T20:21:28+00:00	ReturnTs
Tax Period End	2023-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	440160260	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	FORVIS MAZARS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1201 WALNUT ST SUITE 1700	AddressLine1Txt
City	KANSAS CITY	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	641062246	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	540553805	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Carilion New River Valley Medical Center	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	CARI	BusinessNameControlTxt
Phone	5402245102	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 12385	AddressLine1Txt
City	Roanoke	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24025	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	G ROBERT VAUGHAN JR	PersonNm
Person Title	TREASURER	PersonTitleTxt
Phone	5402245102	PhoneNum
Signature	2024-08-16	SignatureDt

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	Yes (true)	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MIKE ENGLE	PreparerPersonNm
PTIN	P00482834	PTIN
Phone	8162216300	PhoneNum

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2024-08-08 14:25:15Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	WILLIAM J FLATTERY	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 12385	AddressLine1Txt
City	Roanoke	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24025	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$457,897,253	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CARILIONCLINIC.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1941	FormationYr
Legal Domicile State	VA	LegalDomicileStateCd
Activity Or Mission	Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	1880	TotalEmployeeCnt
Total Volunteers	58	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$6,298,098	PYContributionsGrantsAmt
CY Contributions Grants	$1,739,142	CYContributionsGrantsAmt
PY Program Service Revenue	$281,747,116	PYProgramServiceRevenueAmt
CY Program Service Revenue	$290,413,455	CYProgramServiceRevenueAmt
PY Investment Income	$10,640,972	PYInvestmentIncomeAmt
CY Investment Income	$4,762,905	CYInvestmentIncomeAmt
PY Other Revenue	$1,571,101	PYOtherRevenueAmt
CY Other Revenue	$1,464,363	CYOtherRevenueAmt
PY Total Revenue	$300,257,287	PYTotalRevenueAmt
CY Total Revenue	$298,379,865	CYTotalRevenueAmt
PY Grants And Similar Paid	$221,322	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$255,953	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$92,402,011	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$92,246,603	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$191,219,250	PYOtherExpensesAmt
CY Other Expenses	$185,799,442	CYOtherExpensesAmt
PY Total Expenses	$283,842,583	PYTotalExpensesAmt
CY Total Expenses	$278,301,998	CYTotalExpensesAmt
PY Revenues Less Expenses	$16,414,704	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$20,077,867	CYRevenuesLessExpensesAmt
Total Assets BOY	$425,753,311	TotalAssetsBOYAmt
Total Assets EOY	$440,585,289	TotalAssetsEOYAmt
Total Liabilities BOY	$93,866,158	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$86,158,095	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$331,887,153	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$354,427,194	NetAssetsOrFundBalancesEOYAmt
Mission	Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$231,618,564	ExpenseAmt
Grant	$255,953	GrantAmt
Revenue	$290,526,051	RevenueAmt
Desc	See schedule O.	Desc
Total Program Service Expenses	$231,618,564	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	4	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1880	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (true)	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MATTHEW BARR	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5402245021	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	213 S JEFFERSON ST	AddressLine1Txt
City	ROANOKE	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24011	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Diane Akers
Director/Chair	2.5	0.0	Yes (X)	Yes (X)	$0	$480	$0
Sandra Davis
Director/Vice Chair	1.2	0	Yes (X)	Yes (X)	$0	$0	$0
William Flattery
Director/Sec/Treas./Hosp. VP	46.3	3.7	Yes (X)	Yes (X)	$310,917	$0	-$111,629
Anthony Wilson
Director	1.2	0	Yes (X)		$0	$0	$0
Bret Danilowicz PhD
Director	1.2	0	Yes (X)		$0	$0	$0
Charles Bissell MD
Director	1.2	48.8	Yes (X)		$0	$624,495	-$187,130
Eric Stanley MD
Director	1.2	48.8	Yes (X)		$0	$313,332	-$104,120
J Thomas Ryan MD
Director	1.2	0	Yes (X)		$0	$0	$0
James McAlister
Director	1.2	0	Yes (X)		$0	$0	$0
Karla Yates
Director	1.2	0	Yes (X)		$0	$0	$0
Kevin Byrd
Director	1.2	0	Yes (X)		$0	$0	$0
Mark Rogers DO
Director	1.2	0	Yes (X)		$0	$0	$0
Michael Hickman Ed D
Director	1.2	0	Yes (X)		$0	$0	$0
Nathaniel Bishop DMin
Director	1.2	48.8	Yes (X)		$0	$404,202	-$235,927
William Aden
Director	1.2	0	Yes (X)		$0	$480	$0
David Hagadorn
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$160,104	-$121,301
Donald Halliwill
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$988,973	-$138,321
G Robert Vaughan Jr
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$409,821	-$254,014
J Harrison Lapuasa
Asst. Treasurer	0.5	3.0		Yes (X)	$0	$0	$0
Julie Smith-Hamilton
Asst. Secretary	0.5	49.5		Yes (X)	$0	$61,128	$12,403
Nicholas Conte
Asst. Secretary	1.0	49.0		Yes (X)	$0	$817,822	$83,882
Nancy Howell Agee
CEO, Carilion Clinic	2.0	48.0			$0	$2,186,283	$1,001,688	Yes (X)
Steven Arner
COO, Carilion Clinic	2.0	48.0			$0	$1,120,207	-$113,754	Yes (X)
Donna Shelor
Pharmacist	50.0	0			$172,668	$0	-$163,426		Yes (X)
Kathleen Tickle
Pharmacist	50.0	0			$171,278	$0	-$97,344		Yes (X)
Michael Czar
Pharmacy Director	50.0	0			$164,813	$0	-$37,789		Yes (X)
Ralph Brown MD
Physician	50.0	0			$262,747	$0	-$197,300		Yes (X)
Raymart Gerena
RN	50.0	0			$179,471	$0	$6,703		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,261,894	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$7,087,327	TotReportableCompRltdOrgAmt
Total Other Compensation	-$657,379	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	65	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt	Address Line2ContractorAddress/USAddress/AddressLine2Txt
QUALIVIS LLC
1601 ASSEMBLY STREET	COLUMBIA	SC	29201	TEMPORARY STAFFING	$13,087,706
QUEST DIAGNOSTICS
500 PLAZA DRIVE	SECAUCUS	NJ	07094	LABORATORY SERVICES	$5,820,757
ANESTHESIOLOGY ASSOC OF RADFORD
2900 LAMB CIRCLE	CHRISTIANSBURG	VA	24073	ANESTHESIOLOGY SERVICES	$4,585,910	SUITE 340
AVANT HEALTHCARE PROFESSIONALS LLC
1211 SEMORAN BLVD	CASSELBERRY	FL	32707	TEMPORARY EMPLOYMENT	$1,459,598	SUITE 227
SYSTEMS ELECTRONICS INC
4432 K-HELD ROAD	KNIGHTSDALE	NC	27545	CONTRACTOR SERVICES	$738,227

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	27	CntrctRcvdGreaterThan100KCnt
Related Organizations	$12,386	RelatedOrganizationsAmt
Government Grants	$1,685,180	GovernmentGrantsAmt
All Other Contributions	$41,576	AllOtherContributionsAmt
Total Contributions	$1,739,142	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue	622110	$289,283,100	$289,283,100
Rent from Affiliates	531120	$1,130,355	$1,130,355

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$290,413,455	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,211,509	TotalRevenueColumnAmt
Exclusion	$5,211,509	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$205,917	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$205,917	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$205,917	TotalRevenueColumnAmt
Exclusion	$205,917	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$159,067,576	SecuritiesAmt
Other	$1,208	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$159,418,772	SecuritiesAmt
Other	$98,616	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$351,196	SecuritiesAmt
Other	-$97,408	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$448,604	TotalRevenueColumnAmt
Exclusion	-$448,604	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Cafeteria	722514	$804,800	$804,800
Gift Shop	459420	$341,050	$341,050
Other Revenue	900099	$56,066		$56,066

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$56,530	TotalRevenueColumnAmt
Related Or Exempt Func Income	$56,530	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,258,446	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$298,379,865	TotalRevenueColumnAmt
Related Or Exempt Func Income	$290,526,051	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$6,114,672	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$255,953	TotalAmt
Program Services	$255,953	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$352,465	TotalAmt
Management And General	$352,465	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$121,755	TotalAmt
Program Services	$121,755	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$74,043,922	TotalAmt
Program Services	$73,804,491	ProgramServicesAmt
Management And General	$239,431	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,864,083	TotalAmt
Program Services	$1,858,054	ProgramServicesAmt
Management And General	$6,029	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$10,636,643	TotalAmt
Program Services	$10,508,781	ProgramServicesAmt
Management And General	$127,862	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$5,227,735	TotalAmt
Program Services	$5,187,943	ProgramServicesAmt
Management And General	$39,792	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$41,764,904	TotalAmt
Management And General	$41,764,904	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$40,445	TotalAmt
Management And General	$40,445	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$21,792	TotalAmt
Program Services	$21,792	ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$1,084,411	TotalAmt
Management And General	$1,084,411	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$35,144,108	TotalAmt
Program Services	$33,240,589	ProgramServicesAmt
Management And General	$1,903,519	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$18,859	TotalAmt
Program Services	$16,409	ProgramServicesAmt
Management And General	$2,450	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,736,549	TotalAmt
Program Services	$4,464,448	ProgramServicesAmt
Management And General	$272,101	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$635,306	TotalAmt
Program Services	$635,018	ProgramServicesAmt
Management And General	$288	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$4,676,317	TotalAmt
Program Services	$4,676,317	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$800,709	TotalAmt
Program Services	$780,679	ProgramServicesAmt
Management And General	$20,030	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,460,021	TotalAmt
Program Services	$1,460,021	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$8,467,835	TotalAmt
Program Services	$8,467,835	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,650,833	TotalAmt
Program Services	$856,577	ProgramServicesAmt
Management And General	$794,256	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$37,052,256	$37,051,968	$288
Intercompany Practice Subsidy	$17,036,630	$17,036,630
Bad Debt	$15,776,900	$15,776,900
Assessment Fees	$15,021,775	$15,021,775

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$409,792	TotalAmt
Program Services	$374,629	ProgramServicesAmt
Management And General	$35,163	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$278,301,998	TotalAmt
Program Services	$231,618,564	ProgramServicesAmt
Management And General	$46,683,434	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$3,458	BOYAmt
EOY	$3,308	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$23,229	BOYAmt
EOY	$25,975	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$30,000	BOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$50,241,788	BOYAmt
EOY	$49,076,535	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,501,884	BOYAmt
EOY	$1,731,891	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$2,598,773	BOYAmt
EOY	$2,574,551	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$220,940,564	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$161,136,082	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$63,479,559	BOYAmt
EOY	$59,804,482	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$117,057,145	BOYAmt
EOY	$102,287,192	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$190,723,270	BOYAmt
EOY	$224,846,825	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$94,205	BOYAmt
EOY	$234,530	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$425,753,311	BOYAmt
EOY	$440,585,289	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$25,914,109	BOYAmt
EOY	$32,360,435	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$3,152,291	BOYAmt
EOY	$124,836	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$46,175,074	BOYAmt
EOY	$45,792,464	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$15,933	BOYAmt
EOY	$1,795	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$18,608,751	BOYAmt
EOY	$7,878,565	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$93,866,158	BOYAmt
EOY	$86,158,095	EOYAmt

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$331,870,308	BOYAmt
EOY	$354,410,349	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$16,845	BOYAmt
EOY	$16,845	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$331,887,153	BOYAmt
EOY	$354,427,194	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$425,753,311	BOYAmt
EOY	$440,585,289	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$20,077,867	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$30,666,390	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$28,204,216	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$21,792	OtherActivitiesAmt
Total Lobbying Expenditures	$21,792	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	FormAndLineReferenceDesc
Explanation	A portion of dues paid to various healthcare industry associations is attributable to lobbying activities.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,887,465	OtherCostOrOtherBasisAmt
Book Value	$1,887,465	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$115,957,441	OtherCostOrOtherBasisAmt
Depreciation	$74,703,298	DepreciationAmt
Book Value	$41,254,143	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$257,609	OtherCostOrOtherBasisAmt
Depreciation	$257,609	DepreciationAmt
Book Value	$0	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$97,419,584	OtherCostOrOtherBasisAmt
Depreciation	$82,949,720	DepreciationAmt
Book Value	$14,469,864	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,418,465	OtherCostOrOtherBasisAmt
Depreciation	$3,225,455	DepreciationAmt
Book Value	$2,193,010	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$59,804,482	TotalBookValueLandBuildingsAmt

Financial Derivatives FinancialDerivativesGrp

Field	Value	IRS element (for citing)
Book Value	$870,145	BookValueAmt
Method Valuation	F	MethodValuationCd

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	Alternative Investments	Desc
Book Value	$223,976,680	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$224,846,825	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Pension Liability	$4,579,850
Interest Rate Swap Liability	$1,513,488
Lease Liability	$1,784,731
Intercompany Due To/From	$496

Field	Value	IRS element (for citing)
Total Liability	$7,878,565	TotalLiabilityAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	300	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	500	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	false	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,513,054	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,513,054	NetCommunityBenefitExpnsAmt
Total Expense	0.0058	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$48,975,468	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$60,386,441	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$50,488,522	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$60,386,441	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,513,054	NetCommunityBenefitExpnsAmt
Total Expense	0.0058	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$528,013	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$41,576	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$486,437	NetCommunityBenefitExpnsAmt
Total Expense	0.0019	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$698,604	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$169,130	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$529,474	NetCommunityBenefitExpnsAmt
Total Expense	0.0020	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$32,164	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$32,164	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$138,194	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$138,194	NetCommunityBenefitExpnsAmt
Total Expense	0.0005	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$1,396,975	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$210,706	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,186,269	NetCommunityBenefitExpnsAmt
Total Expense	0.0045	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$51,885,497	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$60,597,147	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,699,323	NetCommunityBenefitExpnsAmt
Total Expense	0.0103	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,094	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$24,094	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,012	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$11,012	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,049	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,049	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,291	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,291	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$46,446	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$46,446	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$15,776,900	BadDebtExpenseAmt
Reimbursed By Medicare	$52,134,441	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$64,556,783	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$12,422,342	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CARILION NEW RIVER VALLEY MEDICAL CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2900 LAMB CIRCLE	AddressLine1Txt
City	CHRISTIANSBURG	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24073	ZIPCd

Field	Value	IRS element (for citing)
Website Address	https://carilionclinic.org/locations/carilion-new-river-valley-medical-center	WebsiteAddressTxt
State License	H 1838	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	CARILION NEW RIVER VALLEY MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	20	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	https://www.carilionclinic.org/cho-community-health-assessments#reports	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	https://issuu.com/carilionclinic/docs/2021_cnrv_cha_report_final	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	21	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	https://www.carilionclinic.org/cho-community-health-assessments#reports	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	300.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	500.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	https://www.carilionclinic.org/billing/financial-assistance	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	https://www.carilionclinic.org/billing/financial-assistance	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	https://www.carilionclinic.org/billing/financial-assistance	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	The publicly available community health needs assessment report details the prioritization process for the community's significant health needs as identified through the CHNA. The Community Health Assessment Team (CHAT), made up of community stakeholders, reviews all data and completes a prioritization survey. Through the survey, each CHAT member selects and ranks the most pertinent community needs. The data are combined and priorities are selected based on the highest weighted score of each need. Through this process, CHAT members prioritize needs according to the need's perceived burden, scope, severity or urgency; the importance the community places on addressing the need through survey responses and other interactions; and each member's unique perspective on community health.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Carilion New RIver Valley Medical Center. Carilion Clinic's Community Health Needs Assessments (CHNAs) are community-driven projects. Their success is highly dependent on engaging citizens, health and human service agencies, businesses and community leaders. Stakeholder collaborations known as Community Health Assessment Teams (CHATs) lead the CHNAs. The CHATs are a dynamic group that includes health and human service agency leaders, people with exceptional knowledge of, or expertise in, public health, and local health department officials. The CHATs obtain input from leaders, representatives or members of medically underserved populations who report low-income, are minorities and suffer from chronic diseases. The following organizations served on the CHAT for the 2021 New River Valley Community Health Needs Assessment (NRVCHNA): Carilion Clinic, Carilion New River Valley Medical Center, Children's Health Improvement Program (CHIP) of NRV, Community Foundation of the New River Valley, Community Health Center of the NRV, Edward Via College of Osteopathic Medicine (VCOM) - Virginia, Giles County Christian Service Mission, Montgomery County Health and Human Services (HHS), Montgomery County-Radford City-Floyd County Chapter of the National Association for the Advancement of Colored People (NAACP), Montgomery-Floyd Regional Library System, National Alliance on Mental Illness (NAMI), New River Valley Agency on Aging, New River Valley Community Services (NRVCS), Newport-Mt. Olivet United Methodist Church, NRV Cares, Planned Parenthood South Atlantic, Radford University School of Nursing, To Our House Thermal Shelter for Homeless Men & Women in the NRV, Town of Christiansburg Parks and Recreation Department, University of Virginia (UVA), UVA Cancer Center, Virginia Department of Health (VDH) New River Health District, Virginia Organizing, Virginia Polytechnic Institute and State University (Virginia Tech), Virginia Tech Center for Public Health Practice and Research, Virginia Tech Cooperative Extension, and Virginia Tech Institute for Policy and Governance. To obtain input from the community, the NRVCHNA included five target population focus groups, one stakeholder focus group and a 40-question community health survey that was administered broadly across the service area. This occurred from October 1, 2020, through January 31, 2021. The survey was developed (in English and Spanish) with questions about socioeconomic factors; access to medical, dental and mental health care; health behaviors; physical environment; health outcomes; and demographics. The survey included commonly used questions and metrics from previously validated community surveys conducted by organizations such as the National Association of County and City Health Officials and Centers for Disease Control and Prevention. A team of Virginia Tech Public Health/Policy and Governance stakeholders participating on the CHAT took the lead in planning, conducting and analyzing four virtual and one in-person target population focus groups to gain further input from community members. During the CHNA process, community stakeholders, leaders and providers were encouraged to complete a stakeholder survey electronically to provide additional perspectives about our community's health needs and barriers. A focus group was held with the CHAT stakeholders to further discuss the data collected through the stakeholder survey. The CHAT assisted with survey distribution in an effort to reach particular target populations. The survey focused on New River Valley residents 18 years of age and older in the following service area: Montgomery County, Floyd County, Pulaski County, Radford City and Wythe County. Special efforts were made to include underserved/vulnerable populations disproportionately impacted by social determinants of health such as income, race/ethnicity, education and insurance status. Specific populations served by CHAT representatives include the un- or underinsured, the homeless, the food insecure, small business owners, and low-income individuals and families with young children. The survey was also made available to all residents living in the New River Valley. Due to the COVID-19 pandemic, most survey responses were collected electronically, though the survey was also available by phone and on paper.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - Carilion New River Valley Medical Center. The 2021 New River Valley CHNA was conducted with: Children's Health Improvement Program (CHIP) of NRV, Community Foundation of the New River Valley, Community Health Center of the NRV, Edward Via College of Osteopathic Medicine (VCOM) - Virginia, Giles County Christian Service Mission, Montgomery County Health and Human Services (HHS), Montgomery County-Radford City-Floyd County Chapter of the National Association for the Advancement of Colored People (NAACP), Montgomery-Floyd Regional Library System, National Alliance on Mental Illness (NAMI), New River Valley Agency on Aging, New River Valley Community Services (NRVCS), Newport-Mt. Olivet United Methodist Church, NRV Cares, Planned Parenthood South Atlantic, Radford University School of Nursing, To Our House Thermal Shelter for Homeless Men & Women in the NRV, Town of Christiansburg Parks and Recreation Department, University of Virginia (UVA), UVA Cancer Center, Virginia Department of Health (VDH) New River Health District, Virginia Organizing, Virginia Polytechnic Institute and State University (Virginia Tech), Virginia Tech Center for Public Health Practice and Research, Virginia Tech Cooperative Extension, and Virginia Tech Institute for Policy and Governance.
Schedule H, Part V, Section B, Line 7 Facility , 1	Facility , 1 - Carilion New River Valley Medical Center. The Community Health Assessment Team shared the 2021 New River Valley Community Health Needs Assessment (NRVCHNA) on partner websites and social media. The NRVCHNA was also shared through community presentations to groups including Radford University nursing students, the New River Valley Livability Initiative Health Forum and the New River Valley Long-Term Care Council.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Carilion New River Valley Medical Center. The following information describes the implementation strategy used by Carilion New River Valley Medical Center (CNRV) to address the community health needs identified in the 2021 New River Valley Community Health Needs Assessment (NRVCHNA). The complete implementation strategy is available online at https://www.carilionclinic.org/sites/default/files/2022-02/2021%20CNRV%20Implementation%20Strategy_FINAL%20APPROVED.pdf. The top prioritized needs for the 2021 NRVCHNA were grouped into three overarching categories: mental health, socioeconomic factors and health behaviors. We plan to address prioritized needs with the following strategies and a commitment of financial resources, staff time and leadership. Strategies to address mental health include the continuation of the emergency department bridge program to ensure continuity of care despite provider shortages; the exploration of expanding peer recovery support services to Saint Albans Hospital on CNRV's campus; the continued support of local networks and coalitions that advance mental health awareness and treatment; the exploration of expanding community programming for abuse/overdose prevention and first aid (REVIVE) training; and the continuation of programming and activities that increase community knowledge of medication disposal sites and methods. Strategies to address socioeconomic factors include continuing to provide coalition development support to the Community Foundation of the New River Valley; participation in Healthy Roots NRV; and participation in the Aging in Community leadership team. Strategies to address health behaviors include providing or partnering to provide evidence-based and needs-focused health education and community outreach events such as health fairs, immunizations and health screenings; supporting local food access coalitions and organizations; implementing the Unite Us platform for social services referrals and integrating with electronic medical records internally and externally; continued participation on PATH (Partnership for Access to Healthcare) and other healthy behavior community coalitions; and the exploration of a pathway for employees outside of Carilion Community Health and Outreach to participate in health education, screenings and immunizations in the community setting. Additional strategies to broadly address a culture of community health and its ties to each of the priority needs include developing a system-wide community health investment plan; further developing community health infrastructure; engaging employees in supporting community partnerships; and leveraging internal data to assess health disparities. Progress made in 2023 to further develop a culture of community health continued to build upon increasing infrastructure and strategic impact. Community Health and Outreach services have been integrated into the electronic medical record system-increasing provider knowledge of and capacity for referrals to health education, community health nursing, and community health worker services. The Community Health and Development division continues working closely with the Clinical Advancement and Patient Safety department, the office of Diversity, Equity, and Inclusion, Healthy Analytics, and others on a health equity steering committee to identify and address health disparities in the communities we serve.

Field	Value	IRS element (for citing)
Facility	8	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
CARILION NEW RIVER VALLEY REHABILITATION
118 BROAD STREET	DUBLIN	VA	24084	OUTPATIENT THERAPY
CARILION NEW RIVER HOSPICEHOME HEALTH
707 RANDOLPH STREET SUITE 251	RADFORD	VA	24141	HOSPICE AND HOME HEALTH
NEW RIVER VALLEY AMBULATORY SURGERY CENTER
2901 LAMB CIRCLE	CHRISTIANSBURG	VA	24073	AMBULATORY SURGERY CENTER
BLACKSBURG SPORTS MEDICINE AND REHABILITATION
213 GILBERT STREET	BLACKSBURG	VA	24060	PHYSICAL THERAPY
PHYSICAL THERAPY CHRISTIANSBURG
120 PONDEROSA DRIVE	CHRISTIANSBURG	VA	24084	PHYSICAL THERAPY
PHYSICAL THERAPY WYTHEVILLE
178 WEST MAIN STREET	WYTHEVILLE	VA	24382	PHYSICAL THERAPY
HILLSVILLE PHYSICAL THERAPY
416 SOUTH MAIN STREET	HILLSVILLE	VA	24343	PHYSICAL THERAPY

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c Other Financial Assistance Eligibility Criteria	Financial assistance policy in effect for fiscal year 2023: families with family income equal or below 300% of the Federal Poverty Guidelines and countable assets equal or below $25,000 receive 100% adjustment under FAP. Families with family income greater than 300% of the Federal Poverty Guidelines but less than or equal to 500% of the Federal Poverty Guidelines or countable assets above $25,000 and less than or equal to $100,000 receive a partial adjustment under FAP. The partial adjustment matches the highest AGB percentage determined for all facilities.
Schedule H, Part I, Line 6a Public Avaliability of Community Benefit Report	Information about community benefit is reported annually through a consolidated report prepared by Carilion Clinic (EIN 54-1190771). 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 Clinic's website: https://www.carilionclinic.org/cho-community-health-assessments#community-benefit-reports
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	15776900
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	Line 7a and 7b: For activities reported on the Medicaid Cost Report, a cost-to-charge ratio as determined from the Medicaid Cost Report was used. For all other activities, a cost to charge ratio derived from Worksheet 2 of the 990 instructions was used. Lines 7e through 7i are reported at actual cost.
Schedule H, Part II Community Building Activities	Line 2 - Economic development: As the largest employer in Southwest Virginia, Carilion impacts economic development by investing in jobs, increased wages for employees and various capital building projects. In addition, Carilion had direct economic development expenses from programming and support of local chambers of commerce and pro-business advocacy. Carilion is active in local economic development endeavors, including participating in OnWARD NRV-a regional economic development organization working to attract jobs and talent to the New River Valley-and investing in research and technology. We also converse with local businesses about the region's current business climate and prospective companies. CNRV actively participates in the Blacksburg Partnership-a nonprofit, independent economic development organization focused on projects that attract visitors, developers and retail prospects to Blacksburg-and is a contributing member in the Montgomery Chamber of Commerce. These initiatives promote the community's health by improving economic vitality and making the region a vibrant place to live, work and play. Line 3 - Community Support: Research demonstrates the strong connection between social determinants of health-such as transportation, housing and education-and communities' overall health and well-being. Carilion supports nonprofit organizations addressing barriers to good health arising from these social determinants in various ways. Carilion also collaborates with local partners to support better education and opportunities for children and families and improved housing, better nutrition and additional resources for our neighbors in need. These efforts help remove a range of obstacles to good health for our region's residents. For example, Carilion participated in conversations around opening a community mission in the NRV and participated on the leadership team for Aging in Community, a coalition focused on building a community that meets the needs for each life stage. Carilion also provides financial and in-kind support for organizations such as the Montgomery-Radford-Floyd branch of the NAACP, Christiansburg Institute, and the New River Valley Re-Entry Council. Line 6 - Coalition Building: Carilion believes in the power of collaboration and understands that we must address our most significant health issues in concert with the community. To ensure lasting impact from the health assessment and community health improvement process, Carilion participates in coalitions that address health, safety and social determinant needs in the New River Valley. We also partner with multiple community and business organizations around initiatives to improve health and wellness for everyone living in the New River Valley. Examples include Carilion's representation on locality-specific substance use prevention coalitions. Line 7 - Community health improvement advocacy: Carilion believes in leveraging our efforts to support community health improvement across our footprint, as well as across Virginia. As such, our President and CEO participates on the Governor's Medical Advisory Team focused on community health and resiliency in the wake of the COVID-19 pandemic. Line 8 - Workforce development: With the understanding that employment is directly linked to health and wellness, Carilion partners to provide workforce development and training for community members. These efforts also develop a pipeline of future health care workers. Carilion New River Valley Medical Center supports workforce development through service to the New River Community College Educational Foundation board, a nonprofit corporation that secures voluntary support and manages funds solely for the benefit of New River Community College. The foundation assists New River Community College in various ways, including endowing and distributing of scholarship funds, purchasing equipment and furnishings, and financially supporting academic and community enrichment programs. Support is also provided to the Southwest Virginia Governor's School-an institution which helps high school students excel in STEM learning-for student scholarships. Carilion New River Valley Medical Center provides leadership to the New River Chapter of the Virginia Nurse's Association, the serves on the Virginia College of Osteopathic Medicine (VCOM) Advisory Board.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Carilion New River Valley Medical Center estimates bad debt expense by reserving a percentage of all self-pay patient accounts receivable by aging category, based on collection history, adjusted for expected recoveries and, if present, anticipated changes in trends.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Patient accounts receivable are stated at net realizable amounts due from patients, third-party payors, and other insurers for which Carilion New River Valley Medical Center expects to be entitled in exchange for providing patient care. In accordance with Accounting Standards Update (ASU) No. 2014-09, Revenue from Contracts with Customers (Topic 606) (ASU 2014-09), the estimated uncollectible amounts are generally considered implicit price concessions that are a direct reduction to patient accounts receivable.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Medicare allowable costs are determined from the Medicare cost report using the cost-to-charge ratio. The hospital believes our Medicare shortfall is a cost we incur as a benefit to the community. IRS REV. RUL. 69-545 provides that one of the factors demonstrating community benefit is caring for patients who pay their bills through public programs such as Medicare. In order to operate for the benefit of the broad community that we serve we must include our significant Medicare population, even if we are required to subsidize care to our Medicare patients due to being reimbursed at less than cost by Medicare's nonnegotiable rates.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	When accounts receivable efforts are exhausted, the account may be placed with a collection agency and extraordinary collection actions (ECAs) may be considered. Accounts will not be placed with a collection agency prior to 120 days from the date the first post-discharge billing statement is provided except when mailings are returned with no forwarding address and combining multiple accounts of varying age with those already transferred or for legal verification regarding other liabilities. Reasonable efforts will be made to identify appropriate forwarding addresses. When a financial assistance application (FAA) is received during the application period (within 240 days after the date the first post-discharge billing statement is provided), but after initiation of ECAs, all ECAs will be suspended. Best efforts will be made to process completed applications within 30 days of receipt of the application; financial assistance eligibility will be determined and communicated to the individual. Incomplete applications must be completed within 30 days of the initial notification of additional items required; otherwise, the application will be deemed incomplete and closed. If an individual is eligible for financial assistance, ECAs, other than the sale of debt, will be reversed and any payments related to eligible care refunded to the extent no longer owed. ECAs will be reinstated if the individual is not eligible for financial assistance or does not complete the FAA by the deadline. At least 30 days before initiating an ECA, Carilion will send the patient written notice of intended ECA(s), a plain language summary explaining financial assistance available and the process for determining eligibility, and the deadline for applying for assistance. Carilion will also attempt to call individuals at least 30 days before initiating an ECA to make them aware of the financial assistance available and how to obtain assistance with the application process. Carilion shall enter into a written contract with any collection agency to which it refers bad debt. The contract will obligate the collection agency to observe and comply with Carilion's obligations under this policy and the Financial Assistance Policy. A collection agency to which bad debt is referred for collection may not engage in any ECAs without the prior written consent of Carilion. After making reasonable efforts to determine if a patient qualifies for financial assistance and the patient either does not qualify for financial assistance or fails to submit an application as requested, within 240 days from the date the first post-discharge billing statement is provided, Carilion may engage in one or more of the following ECAs: 1. Place a lien on an individual's property; 2. Attach or seize an individual's bank account or any other personal property; 3. Commence a civil action against an individual; 4. Garnish an individual's wages; 5. Sell an individual's debt to another party; or 6. Report the account to credit agencies. Individual account balances greater than $5,000 are not sent to a collection agency. These are handled through the Debt Recovery Department (DRD) for verification of financial assistance status before further collection activity occurs. DRD will also investigate any accounts that require special handling. For example, in cases of a deceased patient, auto accident, or any other unique circumstances requiring special handling, the accounts are placed with the DRD. When all collection efforts have been exhausted, all hospital accounts will be returned and closed as uncollectible. No further collection activity is taken at that time. Accounts with satisfactory payment arrangements, legal activity or accounts with pending payment will be considered active and are not returned.
Schedule H, Part V, Section B, Line 16a FAP website	- CARILION NEW RIVER VALLEY MEDICAL CENTER: Line 16a URL: https://www.carilionclinic.org/billing/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	- CARILION NEW RIVER VALLEY MEDICAL CENTER: Line 16b URL: https://www.carilionclinic.org/billing/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- CARILION NEW RIVER VALLEY MEDICAL CENTER: Line 16c URL: https://www.carilionclinic.org/billing/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessment	In addition to conducting regular Community Health Needs Assessments (CHNAs), Carilion Clinic closely monitors community health indicators and responds to needs as they arise. Each year, Carilion updates scorecards with refreshed County Health Rankings indicators provided by the Robert Wood Johnson Foundation. Carilion is also responsive to needs identified through clinical data and internal departments. Carilion's call center, Carilion Direct, is available for community members to ask questions and connect with community resources. Community health workers (CHWs) are also utilized to help address needs, and data is reviewed periodically to identify trends in health care needs of patients served by CHWs. Unite Virginia data on referrals to community-based resources is also monitored regularly in order to understand the social determinant of health needs across our region. Needs are also identified through current collaborative relationships and community partnerships. Ongoing collaboration with stakeholders allows for regular communication of needs and gives our partners opportunities to respond cohesively. Carilion has adapted its community health improvement process from Associates in Process Improvement's Model for Improvement and the Plan-Do-Study-Act cycle developed by Walter Shewhart. It consists of five steps: (1) conducting the CHNA, (2) strategic planning, (3) creating the implementation strategy, (4) program implementation, and (5) evaluation. This cycle is repeated every three years. Carilion fosters community development in its CHNA and community health improvement processes through the Strive Collective Impact Model for the Community Health Assessment Team. This evidence-based model focuses on "the commitment of a group of important players from different sectors to a common agenda for solving a specific social problem(s) has been proven to lead to large-scale changes. It focuses on relationship-building between organizations and the progress toward shared strategies.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Information on Financial Assistance is provided to the patient at hospital admission and ambulatory areas in the form of signage, a plain language summary which includes contact information, financial assistance application and documentation in the inpatient handbook. Patient Access staff, Hospital social workers and customer service representatives verbally inform patients on availability of assistance. Each patient statement and patient financial responsibility letter includes information on the Financial Assistance policy including who to contact for additional information and location of in-person assisters. The Application, the Policy, and the plain language summary are available free of charge to the patient. They are available by mail and on the web site if the patient did not receive written information at the time of service. Financial Assistance policy and application are also distributed to community partners through electronic mailing groups. Carilion Clinic employs an Eligibility staff that counsel patients on federal and state programs. The staff completes applications for Medicaid and provides information on Social Security, Social Security Disability and Medicare. The staff provides support services ensuring the applications are processed correctly based on federal and state policy. In addition, Eligibility staff are trained as Certified Application Counselors and will assist patients in enrollment in the Marketplace. Eligibility staff will also complete Carilion's financial assistance application and counsel patients on the requirements for financial assistance.
Schedule H, Part VI, Line 4 Community information	The New River Valley (NRV), home to Carilion New River Valley Medical Center (CNRV), is composed of the independent city of Radford and the counties of Floyd, Giles, Montgomery and Pulaski. It is nestled among the Blue Ridge and Appalachian Mountains in Southwest Virginia. The NRV is home to two universities, Virginia Tech and Radford University, and the New River Community College. Their presence enriches the local culture and workforce. A vibrant mix of urban and rural communities, the NRV boasts scenic views and thriving communities complete with restaurants, arts and culture offerings, and an abundance of outdoor recreation and relaxation opportunities. (https://www.newrivervalleyva.org/) In addition to Carilion Clinic's two hospitals located in the New River Valley, CNRV and Carilion Giles Community Hospital (CGCH), the region is also served by Lewis Gale Hospital-Montgomery, located in the town of Blacksburg. Key safety-net providers in the region include two federally qualified health centers with multiple locations, the Community Health Center of the New River Valley and Tri-Area Community Health Center; the Virginia Department of Health New River Health District clinics; the Pulaski Free Clinic; New River Valley Community Services; and other service organizations. The service area for the 2021 New River Valley Community Health Needs Assessment (NRVCHNA) includes the city of Radford and the counties of Floyd, Montgomery, Pulaski and Wythe, with secondary data included for Giles County. It is important to note that Giles County is also served by CGCH located in Pearisburg, Virginia. Giles County is not included as part of the service area for the 2021 NRVCHNA because CGCH also conducted its own CHNA of Giles County and Monroe County, West Virginia, concurrently. Giles County data are included in secondary data so complete data for the NRV will be available in this report. Please note that while Wythe County is included in the service area, it is not traditionally considered part of the NRV. The 2018-2022 American Community Survey (ACS) found the total population of the complete service area to be 210,111-with 15,532 residents in Floyd, 16,711 in Giles, 99,373 in Montgomery, 33,841 in Pulaski, 28,275 in Wythe and 16,379 in Radford. Population density varied widely, from 41 persons per square mile in Floyd to 1,693 per square mile in Radford. Average household income varies by locality-starting at $69,105 in Radford, leveling around the mid-sixties for most of the localities, then jumping up to $85,495 in Montgomery. However, Montgomery is still well below the national ($105,833) and state ($120,553) averages. When considering the entire service area, the ACS shows that 13.30% of households in the service area are living below 50% of the federal poverty line, which equates to 25,878 individuals. The highest percentage of a locality's population living below the federal poverty line is in Montgomery County (21.07%). (US Census Bureau, ACS. 2018-2022.) Of the 196,035 population in the service area that is covered by any type of medical insurance, 13.56% of those individuals are receiving Medicaid. This is close to the state average of 15.51%. (US Census Bureau, American Community Survey. 2018-2022.) The rate of uninsured population aged 18-64 is also similar to that of the states, at 8.57%. However, Wythe County's percentage is currently 18.34%, exceeding both state and national averages. Wythe's rate of uninsured children is also higher than state and national averages, at 7.56%, compared to 4.67% for Virginia, 5.34% nationally, and 3.13% for the NRV service area. (US Census Bureau, ACS. 2018-2022.) Of the patients receiving care at CNRV during fiscal year 2023, 19.48% are receiving Medicaid while 2.99% are self-pay. (Strata internal data) In the NRV service area, Health Professional Shortage Areas (HPSAs) exist for primary care, dental and mental health services. Primary care HPSAs exist in the counties of Floyd and Giles. Dental health HPSAs exist in Wythe County and for low-income populations in all remaining localities in the service area. Mental health HPSAs exist for the high-needs population in the Mount Rogers service area, which includes Wythe County and the NRV's low-income population, encompassing the remainder of the service area. (HPSA Find. Accessed: https://data.hrsa.gov/tools/shortage-area/hpsa-find)
Schedule H, Part VI, Line 5 Promotion of community health	Carilion New River Valley Medical Center is part of the non-profit Carilion Clinic integrated health care system located among the Blue Ridge Mountains. Carilion provides quality care for nearly one million individuals through a comprehensive network of hospitals, primary and specialty physician practices, wellness centers, and other complementary services. Carilion's roots go back more than a century when a group of dedicated citizens came together and built a hospital to meet the community's health care needs. Today, Carilion is a vital anchor institution focused on health care and dedicated to our mission of improving the health of the communities we serve. With an enduring commitment to our region's health, care is advanced through clinical services, medical education, research and community health investments. Carilion believes in service, collaboration and caring for all. Carilion invests in discovering and responding to local and regional health needs, understanding that we must involve additional stakeholders to address community health issues and create change effectively. Carilion recognizes the impact the environment has on the health of our communities. Efforts continue to make our hospitals and other facilities more energy-efficient, increase recycling and use of recyclable or bio-degradable materials, reduce waste materials and serve local, sustainable foods to patients and in our cafeterias. Carilion has an office of sustainability which leads these efforts and empowers employees to be involved in environmental health related projects. As the leading health care provider in the New River Valley, Carilion New River Valley Medical Center (CNRV) serves the Southwest Virginia counties of Montgomery, Pulaski, Floyd, Wythe, and Giles, in addition to the city of Radford (https://www.carilionclinic.org/locations/carilion-new-river-valley-medical-center). CNRV's history dates back to 1941, when Radford Community Hospital (RCH) was first established to serve the industrial developments in the area at the time. RCH continued to modernize and grow and became affiliated with the Roanoke Hospital Association in November of 1987, during the transition of the Roanoke Hospital Association into Carilion Health System (now Carilion Clinic). On March 20, 1999, RCH capitalized on its standing as a regional hospital and opened CNRV at its current location in Christiansburg, Virginia. The 146-bed acute care facility offers modern medical operating rooms and state of the art technology (including advanced imaging and robotic surgery). The Level III Trauma Center treats more than 30,000 cases per year. The current medical complex includes multiple surgical and medical care practices, Carilion Children's and Carilion Clinic Saint Albans Hospital for psychiatry and behavioral medicine. CNRV serves all patients regardless of their ability to pay. The hospital's governing board members are elected annually and reside in the region. The majority of members are neither hospital employees nor contractors. Medical staff privileges are extended to qualified providers. Surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. Reinvestments include providing free, discounted and subsidized care and critical medical services not otherwise offered in our region.
Schedule H, Part VI, Line 6 Affiliated health care system	Carilion New River Valley Medical Center is wholly owned by Carilion Clinic, a not-for-profit health care organization based in Roanoke, Virginia. Carilion Clinic includes a comprehensive network of hospitals, primary and specialty physician practices, and complementary services consisting of six hospital entities, 81 specialties and 248 practice sites across Southwest Virginia. All of these are centered on a common mission and shared values. In the mid-2000s, Carilion made the strategic decision to transform from a collection of hospitals to a physician-led, integrated health care system. Advances include developing a multi-specialty physician group, transforming our primary care practices into patient-centered medical homes, implementing electronic health records system-wide, creating a robust partnership with Virginia Tech, including developing the Virginia Tech Carilion (VTC) School of Medicine and the Fralin Biomedical Research Institute at VTC. Each decision and adaptation have fundamentally changed the way Carilion collaborates and provides care (https://www.carilionclinic.org/about-carilion-clinic). Carilion's community and population health infrastructure is the health system's engine for providing collaborative opportunities to improve and promote the community's health. Carilion's Community Health Assessment process helps identify the strengths and barriers impacting health. Our community-based programs reflect the Robert Wood Johnson Foundation's framework of four main influences of health: health behaviors, social and economic factors, clinical care access and quality, and physical environment. Our many partnerships with cross-sector organizations create a collaborative culture of health and wellness. Carilion has a long history of working with Radford University and Jefferson College to advance health professionals' education. Founded in 1914 as the Jefferson Hospital School of Nursing, what became known as the Jefferson College of Health Sciences merged with Radford University in early 2018 to form Radford University Carilion (RUC). Located on the campus of Carilion Roanoke Community Hospital, this higher education institution "prepares, within a scholarly environment, ethical, knowledgeable, competent and caring healthcare professionals." Today, RUC provides more than 1,100 students with opportunities to become part of the health care profession, serving communities ranging from Southwest Virginia to the Shenandoah Valley and beyond. The school's graduates are building healthier tomorrows in our region and across the country every day.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (12 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
Floyd County High School
722 Baker Street	Floyd	VA	24092	546001281	Floyd County	$5,654	Event athletic trainers
Edward Via VA College Osteopathic Med
2265 Kraft Drive	Blacksburg	VA	24060	542052107	501(c)(3)	$7,500	Event sponsorship
Onward New River Valley
2020 Kraft Drive	Blacksburg	VA	24060	541545804	501(c)(6)	$25,000	Economic development
NRV Cares
201 W Main St B-1	Christiansburg	VA	24073	541773419	501(c)(3)	$6,100	Parenting Courses
Habitat for Humanity NRV
1675 N Franklin St	Christiansburg	VA	24073	541367548	501(c)(3)	$10,000	Critical home repair
Plenty Inc
192 Elephant Curve Road	Floyd	VA	24090	464356623	501(c)(3)	$8,972	Healthy food access
United Way of Southwest Virginia
1096 Ole Berry Drive	Abingdon	VA	24210	540718860	501(c)(3)	$10,000	Program support
Radford Child Development Inc
518 Meadow Ridge	Radford	VA	24141	461775838	501(c)(3)	$8,000	Child Care Scholarships
American Heart Association
4217 Park Place Court	Glen Allen	VA	23060	135613797	501(c)(3)	$7,500	Event sponsorship
Blacksburg Country Club Chtble Fdn
1064 Clubhouse Rd	Blacksburg	VA	24060	474776644	501(c)(3)	$15,000	Event sponsorship
Radford University Foundation
905 Tyler Ave	Radford	VA	24141	237219782	501(c)(3)	$105,000	Program support
Virginia Tech Fdn Inc
902 Prices Fork Rd	Blacksburg	VA	24061	540721690	501(c)(3)	$28,000	Scholarships

Field	Value	IRS element (for citing)
Total501c3 Org	11	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	FormAndLineReferenceDesc
Explanation	The hospital donates funds to other charitable organizations in support of health and community improvement. Such organizations also have community boards which oversee the expenditure of such funds. Carilion Clinic is committed to improving the health of the communities that we serve by addressing key health priorities identified through our triennial Community Health Assessments. Carilion fulfills this commitment in many ways, one of which is through targeted grants for community health improvement programs, and those that impact the social determinants of health. For Carilion Clinic's Community Grant Program, each grantee must sign a letter of agreement with Carilion Clinic that delineates the terms and specific objectives of the project. By accepting a Carilion award, grantees are asked to acknowledge the support of Carilion Clinic in all materials and/or related special events or fundraisers throughout the award cycle where other donors are publicly recognized. One mid-cycle progress report and a final program evaluation are required for each funded project. Site visits may be made to grantees. Program evaluation includes alignment with Community Health Assessment priorities, program impact, organizational effectiveness and community benefit through collection of data including clients served, cost effectiveness of the program (cost per client or service), tangible community or client outcomes, collaboration with other organizations, and specific efforts to cultivate diverse funding sources for program sustainability. Each grantee must agree to submit requested data and reports on a timely basis and to complete the evaluation process as requested.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	false	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
William Flattery
Director/Sec/Treas./Hosp. VP	$268,473	$0	$28,537	$0	$13,907	$0	-$126,080	$0	$14,451	$0	$199,288	$0	$0	$0
Nathaniel Bishop DMin
Director	$0	$316,054	$0	$38,918	$0	$49,230	$0	-$238,575	$0	$2,648	$0	$168,275	$0	$0
Charles Bissell MD
Director	$0	$517,508	$0	$100,954	$0	$6,033	$0	-$189,419	$0	$2,289	$0	$437,365	$0	$0
Eric Stanley MD
Director	$0	$295,458	$0	$15,635	$0	$2,239	$0	-$124,554	$0	$20,434	$0	$209,212	$0	$0
Nicholas Conte
Asst. Secretary	$0	$642,289	$0	$107,354	$0	$68,179	$0	$68,334	$0	$15,548	$0	$901,704	$0	$60,115
David Hagadorn
Asst. Treasurer	$0	$150,264	$0	$2,700	$0	$7,140	$0	-$127,993	$0	$6,692	$0	$38,803	$0	$0
Donald Halliwill
Asst. Treasurer	$0	$745,723	$0	$125,641	$0	$117,609	$0	-$159,617	$0	$21,296	$0	$850,652	$0	$113,415
G Robert Vaughan Jr
Asst. Treasurer	$0	$341,967	$0	$44,219	$0	$23,635	$0	-$275,310	$0	$21,296	$0	$155,807	$0	$19,258
Nancy Howell Agee
CEO, Carilion Clinic	$0	$1,567,773	$0	$358,583	$0	$259,927	$0	$987,742	$0	$13,946	$0	$3,187,971	$0	$0
Steven Arner
COO, Carilion Clinic	$0	$892,203	$0	$149,632	$0	$78,372	$0	-$135,050	$0	$21,296	$0	$1,006,453	$0	$73,054
Ralph Brown MD
Physician	$241,546	$0	$17,367	$0	$3,834	$0	-$217,475	$0	$20,175	$0	$65,447	$0	$0	$0
Michael Czar
Pharmacy Director	$156,882	$0	$2,700	$0	$5,231	$0	-$56,779	$0	$18,990	$0	$127,024	$0	$0	$0
Raymart Gerena
RN	$178,432	$0	$1,000	$0	$39	$0	$0	$0	$6,703	$0	$186,174	$0	$0	$0
Donna Shelor
Pharmacist	$152,679	$0	$13,720	$0	$6,269	$0	-$163,600	$0	$174	$0	$9,242	$0	$0	$0
Kathleen Tickle
Pharmacist	$166,913	$0	$1,000	$0	$3,365	$0	-$98,249	$0	$905	$0	$73,934	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments	EMPLOYEES ARE OCCASIONALLY PROVIDED SMALL GIFTS, PRIZES OR AWARDS WHICH MAY BE INCLUDED IN TAXABLE COMPENSATION AT AMOUNTS GROSSED UP FOR TAXES. DURING THE REPORTING PERIOD, MR. FLATTERY, MS. TICKLE, AND MS. SHELOR RECEIVED SUCH BENEFIT.
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	All Directors are offered a free family or individual membership to a health club owned by a related organization if they choose to accept it. Mr. Flattery received this benefit and the value was included in taxable compensation from the organization.
Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses	Provision of the health club benefit is documented in Board meeting minutes and Carilion internally tracks the memberships and pays the health club directly. MANAGEMENT MAKES TAX GROSS-UP DECISIONS AT ITS DISCRETION FOR NON-ROUTINE SMALL GIFTS, PRIZES OR AWARDS CONSIDERING IRS REQUIREMENTS, AMOUNT, AND NON-CASH STATUS.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation, including that of the organization's Hospital Vice President, is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of independent Board members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, the list of which was reviewed by the Compensation Committee. The Compensation Committee maintained minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	Mr. Arner, Dr. Bishop, Mr. Conte, Mr. Halliwill, and Mr. Vaughan participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP). Contributions to the plan are at the discretion of Carilion Clinic's Compensation Committee. Amounts vest and become non-forfeitable and payable upon the first of the following (1) attainment of scheduled vesting date (2) attainment of age and years of service requirements (3) disability or death while an eligible employee or (4) entitlement to severance benefits from an involuntary termination without reasonable cause or resignation with good reason. Unvested contributions made to the DC SERP in the reporting period are included in Part II, Column C of this schedule with "retirement and other deferred compensation," while vested contributions paid out during the year are included in Part II, Column B(iii). The following distributions were made to these individuals under this plan in the reporting year. Deferred in prior year and paid out in current year: $113,415 - Donald Halliwill $73,054 - Steven Arner $19,258 - G. Robert Vaughan, Jr. $60,115 - Nicholas Conte Vested and paid in current year: $40,484 - Nathaniel Bishop Ms. Agee participates in an Executive Flexible Benefit Plan, under which she receives an allowance which can be used to obtain certain benefits, with the excess deferred until the applicable vesting date. Amounts now received under this plan vest immediately and thus are no longer deferred. $245,365 was distributed under this plan in the reporting year.
Schedule J, Part I, Line 7 Non-fixed payments	The organization pays annual 'at-risk' compensation to certain members of management based on performance of an applicable scorecard. While the scorecard contains a formula as a basis for determining overall performance, in certain cases, senior managers have discretion to include additional elements in their assessment of managers reporting to them. In addition, for top management, the actual non-fixed payment awarded is in the discretion of the Carilion Clinic Board of Directors and its Compensation Committee.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
KATHERINE ROGERS
FAMILY MEMBER OF MARK ROGERS, D.O., DIRECTOR	$72,237	EMPLOYEE	false
ANIA AUSTIN
Family member of Michael Hickman, ED. D., Director	$12,916	EMPLOYEE	false

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part I, Line 6 Volunteers	With COVID-19 restrictions lifted, CNRV actively recruited adult volunteers to work at the front desk. We continued to grow our musical program with additional performances during the Holidays and Spring concerts. Pet Pals was able to add additional visits to staff on the units and we have several volunteers visiting Saint Albans for needed programs. Plans are in the works to restart the Summer Youth Volunteer Program for Summer 2023. Volunteers provide office activities as in helping to prepare grief mailings each month, tuck in calls, helping with Admission binders and other office tasks as needed. Patient care volunteers provide socialization for our patients and families. They also provided a respite for our families. Veteran to Veteran volunteers provided socialization and honoring of veteran patients. We also offered pet therapy volunteer this year. Started a new program of Virtual Reality for patients. We offered End of Life Doula volunteer.
Form 990, Part III, Line 4a Program Accomplishments	Carilion New River Valley Medical Center, part of Carilion Clinic, is a not-for-profit healthcare organization committed to improving health outcomes for every patient while advancing the quality of care in the community it serves. The medical center is a modern hospital facility with diagnostic and medical and surgical care, a Level III Trauma emergency department, and Carilion Clinic Saint Albans Hospital for psychiatry and behavioral medicine. Carilion New River Valley Medical Center (CNRV) exists to serve the health care needs of its community, regardless of a patient's ability to pay. CNRV admitted 6,819 patients, provided 34,788 days of care during the year, and delivered 765 babies. Hospital programs include the provision of nursing care, extensive outpatient and inpatient medical , surgical and endoscopic services, comprehensive heart treatment with interventional cardiac catheterization, diagnostic, therapeutic and rehab solutions, and diagnostic imaging services including CT, MRI,PET/CT, mammography, x-ray and ultrasound. Additional specialty surgical care includes advanced surgery with robotics, vascular, orthopedics, urology, gynecologic, and ENT care. Medical care in pulmonary, neurology, physical medicine and pediatrics support patient care. With 16% of its inpatient admissions representing psychiatric admissions and a significant outpatient presence in behavioral medicine, CNRV plays a critical role in providing mental health services to the region. CNRV is a Level III trauma center and provides a home base for Lifeguard, the emergency medical air transport that serves the surrounding area. CNRV provides several inpatient and outpatient services targeting the specific health needs of its population, including diabetes management, home health and hospice, physical, speech, occupational and pediatric therapy programs, and cardiac and respir8atory rehab. CNRV also provides an emergency department with 24-hour care and emergency transportation. With 29,618 visits, CNRV's emergency services are a critical component of the health safety net in its service area, acting as the primary health provider for a significant number of uninsured patients, who comprise nearly 5 percent of ED visits. In furtherance of its mission, CNRV provides extensive uncompensated care and community support. Activities include numerous community screening events and education on chronic disease prevention and management. CNRV also champions and supports a Medication Assistance Program in partnership with community-based social services. Stated at cost, total financial assistance and other community benefits for the year exceeded $2.7 million.
Form 990, Part IV, Line 11f Disclosure of Uncertain Tax Positions	Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.
Form 990, Part V, Line 1a 1099's	1099s are issued on Carilion New River Valley Medical Center's behalf by Carilion Services, Inc., a related supporting organization providing management and administrative services, including payment processing. Carilion New River Valley Medical Center's disregarded entity, Carilion New River Valley Surgery Center, LLC, issued 4 1099s for the year.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	Nancy Howell Agee, Steven Arner, Nicholas Conte, William Flattery, David Hagadorn, Donald Halliwill, J. Harrison Lapuasa, G. Robert Vaughan, Jr, Julie Smith-Hamilton, Charles Bissell, Eric Stanley and Nathaniel Bishop - Business relationship
Form 990, Part VI, Line 3 Delegation of management duties	Certain management and related services for the organization are provided by the management and employees of Carilion Services, Inc., a related and supporting organization of the filing organization. Some or all of the compensation of the following individuals listed in Part VII, Section A was provided by Carilion Services, Inc.: Nancy Howell Agee, Steve Arner, Nathaniel Bishop, Nicholas Conte, David Hagadorn, Donald Halliwill, Julie Smith-Hamilton and G. Robert Vaughan, Jr. Certain management and related services for Carilion New River Valley Surgery Center, LLC, a disregarded entity of the filing organization, are provided by the employees of ASD Management. None of the individuals listed in Part VII, Section A received compensation from ASD Management.
Form 990, Part VI, Line 6 Classes of members or stockholders	The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the Board that may occur for any reason.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO; approval of borrowings, budgets, and strategic plans; and amendments of Articles of Incorporation and Bylaws, among others. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia, certain extraordinary actions require member approval, such as mergers, consolidations, liquidations, and the sale of substantially all of the assets of the organization. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a
Form 990, Part VI, Line 11b Review of form 990 by governing body	The Form 990 was prepared by Carilion's internal tax department with input from various Carilion departments, as applicable, and reviewed by internal management and an independent CPA firm. Prior to filing, all Board Members were notified via email that the final Form 990 was posted on the organization's Board portal, which is the mechanism used to disseminate meeting materials to the directors, and were encouraged to call with any questions they might have.
Form 990, Part VI, Line 12c Conflict of interest policy	Our organization monitors and reviews proposed and current transactions for conflicts of interest in a variety of ways. At the governing board level, we have board members complete an initial (upon appointment) and annual conflict of interest questionnaire to disclose actual or potential conflicts. Board members are required to update their disclosure as needed in between questionnaires. All disclosures are reviewed by the Compliance Office and as needed escalated to the appropriate leaders/board members for further discussion/review. If a disclosure is viewed as an actual or potential conflict, an action is recommended to the Compliance Committee of the Carilion Clinic Board and implemented as approved. Actions can include recusal in discussion/voting at board meetings, limitation/termination of the transaction, removal from board appointment or other appropriate controls. In addition, at any time, board members are encouraged to disclose any potential conflicts as they arise at a board meeting and to recuse themselves as deemed appropriate. The same process takes place as described above for key employees (upon hire and annually thereafter), including all officers, members of the management team, physicians/mid-level practitioners, pharmacists and key supply chain buyers. After review and further discussion as needed, action may be required to manage an actual conflict or to reduce the appearance of such as approved by the Compliance Office and other key management team members. As needed, the governing board leaders are notified of any conflicts which may impact board proceedings.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of independent 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 Board of Governors annually, which includes the President and Chief Executive Officer, the Executive Vice Presidents (Chief Financial Officer, Chief Medical Officer, Chief Operating Officer, Chief Administrative Officer and Chief Legal Officer), and select Senior Vice Presidents who are the physician Chairs of the Clinical Departments. 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. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders, which includes Vice Presidents, Senior Vice Presidents, Executive Vice Presidents, and the CEO, as well as the compensation philosophy for employed physicians. Some officers of the organization who are not compensated in their capacity as an officer but rather in their role as employee in a position not mentioned above are not subject to Committee review. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for certain select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, the list of which was reviewed by the Compensation Committee. The Compensation Committee maintained minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	See response to line 15A.
Form 990, Part VI, Line 19 Required documents available to the public	The organization's governing documents, conflict of interest statement, and financial statements are released from time to time during the tax year upon request. The conflict of interest policy is included in our Code of Excellence which is available to the public on our website. The Articles of Incorporation are available from the Virginia State Corporation Commission. Limited financial information is available on our website.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Affiliate Revenue - Total Revenue: 44795, Related or Exempt Function Revenue: 44795, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Court Cost Recovery - Total Revenue: 11018, Related or Exempt Function Revenue: 11018, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Miscellaneous Revenue - Total Revenue: 697, Related or Exempt Function Revenue: 697, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Returned Check Fees - Total Revenue: 20, Related or Exempt Function Revenue: 20, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	Physician/Professional Services - Total Expense: 10855968, Program Service Expense: 10855456, Management and General Expenses: 512, Fundraising Expenses: ; Billing & Collection Services - Total Expense: 669079, Program Service Expense: , Management and General Expenses: 669079, Fundraising Expenses: ; Laundry/Housekeeping Services - Total Expense: 1169436, Program Service Expense: 1169436, Management and General Expenses: , Fundraising Expenses: ; Other Purchased Services - Total Expense: 1511572, Program Service Expense: 1494652, Management and General Expenses: 16920, Fundraising Expenses: ; Contract Fees/Consulting - Total Expense: 3191819, Program Service Expense: 1979976, Management and General Expenses: 1211843, Fundraising Expenses: ; Repairs and Maintenance - Total Expense: 2525749, Program Service Expense: 2520584, Management and General Expenses: 5165, Fundraising Expenses: ; Reference Labs - Total Expense: 6289164, Program Service Expense: 6289164, Management and General Expenses: , Fundraising Expenses: ; Temporary Employment - Total Expense: 8931321, Program Service Expense: 8931321, Management and General Expenses: , Fundraising Expenses: ;
Form 990, Part X, Line 20 Tax-Exempt Bond Liabilities	The amount reported as Tax-Exempt Bonds is the portion of Carilion Clinic Bonds allocated to Carilion New River Valley Medical Center. Required information for the Bonds, including Schedule K, is reported in the Carilion Clinic (EIN: 54-1190771) IRS Form 990.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Pension-related changes other than net periodic pension costs - -1451767; Transfers from/(to) Affiliates - -26752449;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CARILION NEW RIVER VALLEY SURGERY CENTER LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2901 LAMB CIRCLE	AddressLine1Txt
City	CHRISTIANSBURG	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24073	ZIPCd

Field	Value	IRS element (for citing)
EIN	800091329	EIN
Primary Activities	SURGERY	PrimaryActivitiesTxt
Legal Domicile State	VA	LegalDomicileStateCd
Total Income	$4,061,179	TotalIncomeAmt
End Of Year Assets	$5,007,007	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CARILION NEW RIVER VALLEY MEDICAL CENTER	BusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
CARILION CLINIC
PO BOX 12385	ROANOKE	VA	24025	541190771	SUPPORTING ORGANIZATION	VA	501(c)(3)	Type II	NA	false
CARILION CLINIC FOUNDATION
PO BOX 12385	ROANOKE	VA	24025	541190773	FUNDRAISING	VA	501(c)(3)	7	CARILION CLINIC	Yes (true)
CARILION FRANKLIN MEMORIAL HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	540480606	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION GILES COMMUNITY HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	540549603	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION MEDICAL CENTER
PO BOX 12385	ROANOKE	VA	24025	540506332	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION SERVICES INC
PO BOX 12385	ROANOKE	VA	24025	541190879	SUPPORTING ORGANIZATION	VA	501(c)(3)	Type II	CARILION CLINIC	Yes (true)
CARILION ROCKBRIDGE COMMUNITY HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	540568001	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION TAZEWELL COMMUNITY HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	546074580	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
NEW RIVER VALLEY HEALTH FOUNDATION
PO Box 40032	Roanoke	VA	24022	521349560	Supporting Organization	VA	501(c)(3)	Type I	NA	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (13 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
FRANKLIN COUNTY VENTURES LLC
PO BOX 12385	ROANOKE	VA	24025	474365316	REAL ESTATE	VA	NA	N/A
CARILION CLINIC MEDICARE SHARED SAVINGS COMPANY LLC
PO BOX 12385	ROANOKE	VA	24025	455235473	MEDICARE ACO	VA	NA	N/A
ROANOKE AMBULATORY SURGERY CENTER LLC
1102 JEFFERSON ST SE	ROANOKE	VA	24016	010691564	SURGERY CENTER	VA	NA	N/A
SOUTHWEST VIRGINIA HEALTH PROPERTIES LLC
1102 Jefferson Street SE	Roanoke	VA	24016	010691570	REAL ESTATE	VA	NA	N/A
RAVEN ASSET-BASED OPPORTUNITY FUND IV LP
75 Spring St 6th FL	New York	NY	10012	824119491	Investments	DE	NA	N/A
STARWOOD VEP II CO-INVEST LLC
591 W Putnam Avenue	Greenwich	CT	06830	833262407	INVESTMENTS	DE	NA	N/A
TI PLATFORM CC SMA LP
255 Kansas Street Suite 300	San Francisco	CA	94103	842852539	INVESTMENTS	DE	NA	N/A
TI FBV GR LP
255 Kansas Street Suite 300	San Francisco	CA	94103	862597246	INVESTMENTS	DE	NA	N/A
TI Platform DCI SPV LP
800 Town and Country Suite 500	Houston	TX	77024	871897835	INVESTMENTS	DE	NA	N/A
Transpose Platform Zippedi SPV LP
4304 18th Street 14427	San Francisco	CA	941149991	873425361	Investments	DE	NA	N/A
Transpose Platform Gorgias SPV LP
800 Town and Country Suite 500	Houston	TX	77024	874563291	Investments	DE	NA	N/A
Transpose Platform Fintech Fund II LP
4304 18th Street 14427	San Francisco	CA	941149991	873126138	Investments	DE	NA	N/A
Opera Investment Two SCSP
					Investments		NA	N/A	LU

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
CHS INC
PO BOX 12385	ROANOKE	VA	24025	541725732	SERVICES	VA	NA	C Corporation	Yes (true)
CARILION BEHAVIORAL HEALTH INC
PO BOX 12385	ROANOKE	VA	24025	203136891	HEALTHCARE	VA	NA	C Corporation	Yes (true)
CARILION EMERGENCY SERVICES INC
PO BOX 12385	ROANOKE	VA	24025	542033006	HEALTHCARE	VA	NA	C Corporation	Yes (true)
SCA CREDIT SERVICES INC
PO BOX 12385	ROANOKE	VA	24025	541180398	COLLECTION AGENCY	VA	NA	C Corporation	Yes (true)
CARILION HEALTHCARE CORPORATION
PO BOX 12385	ROANOKE	VA	24025	541586601	HEALTHCARE	VA	NA	C Corporation	Yes (true)
MEDKEY INC
PO BOX 12385	ROANOKE	VA	24025	541645357	FINANCING SERVICES	VA	NA	C Corporation	Yes (true)
SPROTT PRIVATE RESOURCE LENDING (C-CO-INVEST) LP
				981378742	INVESTMENTS		NA	C Corporation	Yes (true)	CA
CARILION DTC SERVICES INC
PO BOX 12385	ROANOKE	VA	24025	872635239	HEALTHCARE	VA	NA	C Corporation	Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (11 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Carilion Medical Center
A	$276,071	Cost
Carilion Behavioral Health Inc
A	$16,860	Cost
CHS Inc
A	$59,148	Cost
Carilion Healthcare Corporation
A	$776,176	Cost
Carilion Medical Center
M	$2,436,651	Cost
Carilion Services Inc
M	$46,653,500	Cost
CHS Inc
K	$395,112	Market Rate
CHS Inc
M	$903,405	Cost
SCA Credit Services Inc
M	$88,473	Cost
Carilion Healthcare Corporation
M	$14,702,666	Cost
Carilion Services Inc
R	$26,752,449	Cash