CARILION MEDICAL CENTER: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: CARILION MEDICAL CENTER (EIN 54-0506332)
Tax period: 2022-10-01 to 2023-09-30
Filed: 2024-08-15
IRS object ID: 202412289349303876
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	2024-08-15T21:36:45+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	540506332	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Carilion 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	240252385	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
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

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	STEVE ARNER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 12385	AddressLine1Txt
City	Roanoke	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	240252385	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$2,462,826,852	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	1899	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	11	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	10196	TotalEmployeeCnt
Total Volunteers	199	TotalVolunteersCnt
Total Gross UBI	$26,537	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$42,789,011	PYContributionsGrantsAmt
CY Contributions Grants	$18,680,033	CYContributionsGrantsAmt
PY Program Service Revenue	$1,589,719,229	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,677,450,373	CYProgramServiceRevenueAmt
PY Investment Income	$47,222,248	PYInvestmentIncomeAmt
CY Investment Income	$20,993,797	CYInvestmentIncomeAmt
PY Other Revenue	$27,547,686	PYOtherRevenueAmt
CY Other Revenue	$25,698,737	CYOtherRevenueAmt
PY Total Revenue	$1,707,278,174	PYTotalRevenueAmt
CY Total Revenue	$1,742,822,940	CYTotalRevenueAmt
PY Grants And Similar Paid	$8,525,209	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$6,051,197	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$736,330,366	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$759,154,812	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$222,509	CYTotalFundraisingExpenseAmt
PY Other Expenses	$966,339,261	PYOtherExpensesAmt
CY Other Expenses	$1,004,361,607	CYOtherExpensesAmt
PY Total Expenses	$1,711,194,836	PYTotalExpensesAmt
CY Total Expenses	$1,769,567,616	CYTotalExpensesAmt
PY Revenues Less Expenses	-$3,916,662	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$26,744,676	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,949,690,459	TotalAssetsBOYAmt
Total Assets EOY	$1,989,095,314	TotalAssetsEOYAmt
Total Liabilities BOY	$1,000,916,370	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,033,618,621	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$948,774,089	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$955,476,693	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	$1,521,690,046	ExpenseAmt
Grant	$6,051,197	GrantAmt
Revenue	$1,694,160,187	RevenueAmt
Desc	SEE SCHEDULE O.	Desc
Total Program Service Expenses	$1,521,690,046	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	Yes (true)	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	Yes (true)	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	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	10196	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
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	11	GoverningBodyVotingMembersCnt
Independent Voting Member	6	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	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
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	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Damon Williams
Director/Chair	2.0	4.5	Yes (X)	Yes (X)	$0	$7,948	$0
Steven Arner
Director/President/CEO	36.0	14.0	Yes (X)	Yes (X)	$0	$1,120,207	-$113,754
Ann Hoff PhD
Director	2.0	0.0	Yes (X)		$0	$468	$0
Cathy Jo Swanson MD
Director / Chief of Medical Staff	2.0	0	Yes (X)		$72,500	$0	$0
Isabel Thornton
Director	2.0	0	Yes (X)		$0	$0	$0
Janet Frantz
Director	2.0	0.0	Yes (X)		$0	$1,123	$0
Katherin Elam
Director	2.0	0	Yes (X)		$0	$0	$0
Kianna Price Marshall
Director	2.0	0.0	Yes (X)		$0	$1,123	$0
Lee Learman MD PhD
Director	2.0	0	Yes (X)		$8,000	$0	$0
Michael Nussbaum MD
Director/SVP/Surgical Services Chair	50.0	0	Yes (X)		$1,074,080	$0	-$2,649
Paul Haskins MD
Director/Physician	50.0	0	Yes (X)		$364,453	$0	-$228,096
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
Treasurer	0.5	49.5		Yes (X)	$0	$409,821	-$254,014
Julie Smith-Hamilton
Asst. Secretary	0.5	49.5		Yes (X)	$0	$61,128	$12,403
Nicholas Conte
Secretary	3.0	47.0		Yes (X)	$0	$817,822	$83,882
Daniel Harrington MD
Interim Chief Medical Officer/EVP	50.0	0.0			$121,832	$32,000	$0	Yes (X)
Jon Sweet MD
SVP/Chair, Dept. of Medicine	50.0	0			$594,988	$0	-$157,606	Yes (X)
Joseph Moskal MD
SVP/Chair, Dept. of Orthopedics	50.0	0			$1,375,243	$0	-$30,761	Yes (X)
Michael Abbott
Senior Vice President	50.0	0			$326,605	$0	$35,352	Yes (X)
Nancy Howell Agee
CEO, Carilion Clinic	2.0	48.0			$0	$2,186,283	$1,001,688	Yes (X)
Patrice Weiss MD
Chief Medical Officer/EVP	50.0	0.0			$1,223	$2,390,863	-$147,548	Yes (X)
Adeolu Olasunkanmi MD
Physician	50.0	0			$1,291,485	$0	-$16,819		Yes (X)
Eric Marvin MD
Physician	50.0	0			$1,483,034	$0	-$133,698		Yes (X)
Gregory Howes MD
Physician	50.0	0			$1,448,770	$0	-$55,451		Yes (X)
Jesse Stem MD
Physician	50.0	0			$1,246,441	$0	-$10,696		Yes (X)
Jonathan Carmouche MD
Physician	50.0	0			$1,637,010	$0	-$133,157		Yes (X)
Paul Skolnik MD
Former SVP/Chair, Dept. of Medicine	50.0	0			$440,154	$0	-$4,535			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$11,485,818	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$8,177,863	TotReportableCompRltdOrgAmt
Total Other Compensation	-$415,081	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	1232	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	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
QUALIVIS LLC
1601 ASSEMBLY STREET	COLUMBIA	SC	29201	TEMPORARY STAFFING	$85,234,902
ROBINS & MORTON BRANCH BUILDS
400 SHADES CREEK PARKWAY	BIRMINGHAM	AL	35209	CONSTRUCTION SERVICES	$80,043,269
QUEST DIAGNOSTICS
500 PLAZA DRIVE	SECAUCUS	NJ	07094	LABORATORY SERVICES	$27,588,647
GE MEDICAL SYSTEMS
5517 COLLECTION CENTER DRIVE	CHICAGO	IL	60693	EQUIPMENT MAINTENANCE	$12,612,283
CROTHALL HEALTHCARE PROFESSIONALS
13028 COLLECTIONS CENTER DRIVE	CHICAGO	IL	60693	HOUSEKEEPING SERVICES	$5,873,290

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	127	CntrctRcvdGreaterThan100KCnt
Related Organizations	$400,053	RelatedOrganizationsAmt
Government Grants	$16,564,595	GovernmentGrantsAmt
All Other Contributions	$1,715,385	AllOtherContributionsAmt
Total Contributions	$18,680,033	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue	622110	$1,598,286,738	$1,598,286,738
Program Related Investments	621999	-$379,583	-$379,583
Clinical Research	541715	$1,992,745	$1,992,745
Other Patient Revenue	446110	$73,729,288	$73,729,288
Affiliate Rent Income	531120	$1,332,428	$1,332,428

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,488,757	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,488,757	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,677,450,373	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$22,003,086	TotalRevenueColumnAmt
Unrelated Business Revenue	$26,537	UnrelatedBusinessRevenueAmt
Exclusion	$21,976,549	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$589,213	TotalRevenueColumnAmt
Exclusion	$589,213	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$5,509,903	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$5,509,903	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,509,903	TotalRevenueColumnAmt
Exclusion	$5,509,903	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$718,302,751	SecuritiesAmt
Other	$102,659	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$719,889,868	SecuritiesAmt
Other	$114,044	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$1,587,117	SecuritiesAmt
Other	-$11,385	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$1,598,502	TotalRevenueColumnAmt
Exclusion	-$1,598,502	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
Income from Affiliates	621111	$5,658,139	$5,658,139
Cafeteria	722514	$3,479,020		$3,479,020
Roanoke City Student Health	621400	$2,295,379	$2,295,379

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,756,296	TotalRevenueColumnAmt
Related Or Exempt Func Income	$8,756,296	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$20,188,834	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,742,822,940	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,694,160,187	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$26,537	UnrelatedBusinessRevenueAmt
Exclusion	$29,956,183	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	$5,925,485	TotalAmt
Program Services	$5,925,485	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$125,712	TotalAmt
Program Services	$125,712	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$4,120,107	TotalAmt
Program Services	$3,710,167	ProgramServicesAmt
Management And General	$409,940	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$3,559,530	TotalAmt
Program Services	$3,559,530	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$637,937,050	TotalAmt
Program Services	$637,400,056	ProgramServicesAmt
Management And General	$464,713	ManagementAndGeneralAmt
Fundraising	$72,281	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$15,045,456	TotalAmt
Program Services	$15,034,495	ProgramServicesAmt
Management And General	$10,961	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$55,714,998	TotalAmt
Program Services	$55,592,866	ProgramServicesAmt
Management And General	$117,337	ManagementAndGeneralAmt
Fundraising	$4,795	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$42,777,671	TotalAmt
Program Services	$42,721,471	ProgramServicesAmt
Management And General	$54,513	ManagementAndGeneralAmt
Fundraising	$1,687	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$216,742,408	TotalAmt
Management And General	$216,742,408	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$32,952	TotalAmt
Management And General	$32,952	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$117,887	TotalAmt
Program Services	$117,887	ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$4,157,834	TotalAmt
Management And General	$4,157,834	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$203,814,423	TotalAmt
Program Services	$183,383,373	ProgramServicesAmt
Management And General	$20,421,050	ManagementAndGeneralAmt
Fundraising	$10,000	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$52,607	TotalAmt
Program Services	$52,607	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$26,015,011	TotalAmt
Program Services	$25,729,951	ProgramServicesAmt
Management And General	$255,745	ManagementAndGeneralAmt
Fundraising	$29,315	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$3,750,496	TotalAmt
Program Services	$3,749,902	ProgramServicesAmt
Management And General	$594	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$35,039,329	TotalAmt
Program Services	$35,019,091	ProgramServicesAmt
Management And General	$20,238	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$3,172,492	TotalAmt
Program Services	$3,165,252	ProgramServicesAmt
Management And General	$1,870	ManagementAndGeneralAmt
Fundraising	$5,370	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$14,091,432	TotalAmt
Program Services	$14,091,432	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$44,325,516	TotalAmt
Program Services	$44,325,516	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$18,477,609	TotalAmt
Program Services	$13,543,480	ProgramServicesAmt
Management And General	$4,934,129	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Medical Supplies	$272,597,542	$272,597,542
Assessment Fees	$81,811,434	$81,811,434
Bad Debt	$73,111,388	$73,111,388
Dues and Subscriptions	$2,186,852	$2,057,156	$30,777	$98,919

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,864,395	TotalAmt
Program Services	$4,864,253	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$142	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,769,567,616	TotalAmt
Program Services	$1,521,690,046	ProgramServicesAmt
Management And General	$247,655,061	ManagementAndGeneralAmt
Fundraising	$222,509	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$16,249	BOYAmt
EOY	$14,997	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$9,646,128	BOYAmt
EOY	$5,570,330	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$2,106,278	BOYAmt
EOY	$939,228	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$294,640,960	BOYAmt
EOY	$303,785,103	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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$67,397	BOYAmt
EOY	$3,175	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$12,018,690	BOYAmt
EOY	$11,148,391	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$13,698,384	BOYAmt
EOY	$15,661,346	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,564,188,759	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$990,743,430	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$408,289,403	BOYAmt
EOY	$573,445,329	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$511,015,259	BOYAmt
EOY	$359,987,021	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$686,101,205	BOYAmt
EOY	$703,053,540	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$11,511,505	BOYAmt
EOY	$11,002,032	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$50,216	BOYAmt
EOY	$383,150	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$528,785	BOYAmt
EOY	$4,101,672	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,949,690,459	BOYAmt
EOY	$1,989,095,314	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$246,271,723	BOYAmt
EOY	$292,809,367	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$720,000	BOYAmt
EOY	$472,500	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$39,348,352	BOYAmt
EOY	$3,206,100	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$607,166,441	BOYAmt
EOY	$604,039,951	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)
EOY	$273,000	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$107,409,854	BOYAmt
EOY	$132,817,703	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,000,916,370	BOYAmt
EOY	$1,033,618,621	EOYAmt

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$924,838,915	BOYAmt
EOY	$929,713,842	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$23,935,174	BOYAmt
EOY	$25,762,851	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$948,774,089	BOYAmt
EOY	$955,476,693	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,949,690,459	BOYAmt
EOY	$1,989,095,314	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$26,744,676	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$128,524,398	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$95,077,118	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	$117,887	OtherActivitiesAmt
Total Lobbying Expenditures	$117,887	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

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$18,491,904	BeginningYearBalanceAmt
Contributions	$238,935	ContributionsAmt
Investment Earnings Or Losses	$2,021,518	InvestmentEarningsOrLossesAmt
Other Expenditures	$705,849	OtherExpendituresAmt
End Year Balance	$20,046,508	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$20,613,255	BeginningYearBalanceAmt
Contributions	$190,000	ContributionsAmt
Investment Earnings Or Losses	-$1,682,218	InvestmentEarningsOrLossesAmt
Other Expenditures	$629,133	OtherExpendituresAmt
End Year Balance	$18,491,904	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$16,794,123	BeginningYearBalanceAmt
Contributions	$348,535	ContributionsAmt
Investment Earnings Or Losses	$4,146,435	InvestmentEarningsOrLossesAmt
Other Expenditures	$675,838	OtherExpendituresAmt
End Year Balance	$20,613,255	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$16,881,056	BeginningYearBalanceAmt
Investment Earnings Or Losses	$609,120	InvestmentEarningsOrLossesAmt
Other Expenditures	$696,053	OtherExpendituresAmt
End Year Balance	$16,794,123	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$17,033,643	BeginningYearBalanceAmt
Investment Earnings Or Losses	$803,774	InvestmentEarningsOrLossesAmt
Other Expenditures	$956,361	OtherExpendituresAmt
End Year Balance	$16,881,056	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.0	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.5924	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.4076	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,067,755	OtherCostOrOtherBasisAmt
Book Value	$6,067,755	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$545,673,876	OtherCostOrOtherBasisAmt
Depreciation	$413,522,611	DepreciationAmt
Book Value	$132,151,265	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,207,815	OtherCostOrOtherBasisAmt
Depreciation	$968,637	DepreciationAmt
Book Value	$239,178	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$670,643,487	OtherCostOrOtherBasisAmt
Depreciation	$569,231,787	DepreciationAmt
Book Value	$101,411,700	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$340,595,826	OtherCostOrOtherBasisAmt
Depreciation	$7,020,395	DepreciationAmt
Book Value	$333,575,431	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$573,445,329	TotalBookValueLandBuildingsAmt

Financial Derivatives FinancialDerivativesGrp

Field	Value	IRS element (for citing)
Book Value	$7,969,191	BookValueAmt
Method Valuation	F	MethodValuationCd

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	Alternative Investments	Desc
Book Value	$695,084,349	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$703,053,540	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
Due to Affiliates	$11,062,993
Pension Liability	$58,667,892
Deferred Comp Liability	$39,962,499
Interest Rate Swap Liability	$8,398,126
Lease Liability Total	$14,726,193

Field	Value	IRS element (for citing)
Total Liability	$132,817,703	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule D, Part V, Line 4 Intended uses of endowment funds	FormAndLineReferenceDesc
Explanation	Income from endowment funds are used for the following. (1) Pediatric programs- both internal and external- and/or pediatric equipment. (2) Patient care assistance.	ExplanationTxt

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	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
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	$15,701,863	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$15,701,863	NetCommunityBenefitExpnsAmt
Total Expense	0.0092	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$330,107,792	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$408,633,453	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	$345,809,655	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$408,633,453	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$15,701,863	NetCommunityBenefitExpnsAmt
Total Expense	0.0092	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,656,815	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$541,216	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,115,599	NetCommunityBenefitExpnsAmt
Total Expense	0.0024	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$53,126,078	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,807,007	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$43,319,071	NetCommunityBenefitExpnsAmt
Total Expense	0.0255	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,221,120	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$17,569,306	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,651,814	NetCommunityBenefitExpnsAmt
Total Expense	0.0016	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,356,643	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,356,643	NetCommunityBenefitExpnsAmt
Total Expense	0.0014	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,112,002	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$111,354	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,000,648	NetCommunityBenefitExpnsAmt
Total Expense	0.0006	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$81,472,658	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$28,028,883	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$53,443,775	NetCommunityBenefitExpnsAmt
Total Expense	0.0314	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$427,282,313	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$436,662,336	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$69,145,638	NetCommunityBenefitExpnsAmt
Total Expense	0.0407	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,714	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,714	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$59,394	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$59,394	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$77,036	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$77,036	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	$17,759	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$17,759	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$85,361	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$93	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$85,268	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$488,855	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$488,855	NetCommunityBenefitExpnsAmt
Total Expense	0.0003	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	$730,119	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$93	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$730,026	NetCommunityBenefitExpnsAmt
Total Expense	0.0004	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$73,299,036	BadDebtExpenseAmt
Reimbursed By Medicare	$222,918,040	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$252,808,545	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$29,890,505	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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
ROANOKE AMBULATORY SURGERY CENTER LLC
AMBULATORY SURGERY	0.5	0.0465	0.3536
SOUTHWEST VIRGINIA HEALTH PROPETIES LLC
REAL ESTATE	0.4931	0.0336	0.4038

Field	Value	IRS element (for citing)
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Childrens HospitalChildrensHospitalInd	Teaching HospitalTeachingHospitalInd	Research FacilityResearchFacilityInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Facility Reporting GroupFacilityReportingGroupCd	OtherOtherDesc
CARILION MEDICAL CENTER -DBA CRMH
1	1906 BELLEVIEW AVE	ROANOKE	VA	24014	HTTPS://CARILIONCLINIC.ORG/LOCATIONS/CARILION-ROANOKE-MEMORIAL-HOSPITAL	H 1840	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
CARILION MEDICAL CENTER -DBA CRCH
2	101 ELM AVE	ROANOKE	VA	24013	HTTPS://CARILIONCLINIC.ORG/LOCATIONS/CARILION-ROANOKE-COMMUNITY-HOSPITAL	H 1839	Yes (X)						A	REHABILITATION UNIT

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Facility	2	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	Yes (true)	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_cmc_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 (6 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 A, 1	Facility A, 1 - GROUP A. 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 Roanoke Valley Community Health Needs Assessment (RVCHNA): Carilion Clinic, Carilion Medical Center, American National Bank, Blue Blaze Consulting, Blue Ridge Behavioral Healthcare, Botetourt County Libraries, Children's Trust, CHIP of Roanoke Valley, City of Roanoke - Department of Social Services, City of Roanoke's Financial Empowerment Center, Council of Community Services, Craig County Health Center, Family Service of Roanoke Valley, Feeding Southwest Virginia, Freedom First Credit Union, Goodwill Industries of the Valleys, Leffel Consulting Group, LLC, New Horizons Healthcare, Radford University Carilion, Rescue Mission Ministries, Inc., Restoration Housing, Roanoke City & Alleghany Health Districts, Roanoke City Public Schools, Roanoke County Department of Social Services, Roanoke Valley Alleghany Regional Commission, Sisters of Change, United Way of Roanoke Valley, Virginia Blue Ridge Works (Western VA Workforce Development Board), and Virginia Western Community College. To obtain input from the community, the RVCHNA conducted a focus group among CHAT stakeholders and administered a 40-question community health survey 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. 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 Roanoke Valley residents 18 years of age and older in the following service area: Bedford, Botetourt, Craig and Roanoke counties, Roanoke City, and Salem City. 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 Roanoke Valley. Due to the COVID-19 pandemic, most responses were collected electronically, though the survey was also available by phone and on paper.
Schedule H, Part V, Section B, Line 6a Facility A, 1	Facility A, 1 - Group A. Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital, both owned by Carilion Medical Center and serving the same area, jointly conducted their Community Health Needs Assessment. The Salem Veteran Affairs Medical Center also participated on the Community Health Assessment Team.
Schedule H, Part V, Section B, Line 6b Facility A, 1	Facility A, 1 - GROUP A. The 2021 Roanoke Valley CHNA was conducted with: American National Bank, Blue Blaze Consulting, Blue Ridge Behavioral Healthcare, Botetourt County Libraries, Children's Trust, CHIP of Roanoke Valley, City of Roanoke - Department of Social Services, City of Roanoke's Financial Empowerment Center, Council of Community Services, Craig County Health Center, Family Service of Roanoke Valley, Feeding Southwest Virginia, Freedom First Credit Union, Goodwill Industries of the Valleys, Leffel Consulting Group, LLC, New Horizons Healthcare, Radford University Carilion, Rescue Mission Ministries, Inc., Restoration Housing, Roanoke City & Alleghany Health Districts, Roanoke City Public Schools, Roanoke County Department of Social Services, Roanoke Valley Alleghany Regional Commission, Sisters of Change, United Way of Roanoke Valley, Virginia Blue Ridge Works (Western VA Workforce Development Board), and Virginia Western Community College.
Schedule H, Part V, Section B, Line 7 Facility A, 1	Facility A, 1 - Group A. The Community Health Assessment Team shared the 2021 Roanoke Valley Community Health Needs Assessment (RVCHNA) on partner websites and social media. The RVCHNA was also shared through community presentations to groups including Radford University Carilion students and staff, the local chapter of the American College of Health Executives, Virginia Tech Carilion School of Medicine students, and other internal and external audiences.
Schedule H, Part V, Section B, Line 11 Facility A, 1	Facility A, 1 - Group A. The following information describes the implementation strategy used by Carilion Medical Center (CMC)-comprised of Carilion Roanoke Memorial Hospital (CRMH) and Carilion Roanoke Community Hospital (CRCH)-to address the community health needs identified in the 2021 Roanoke Valley Community Health Needs Assessment (RVCHNA). The complete implementation strategy is available online at https://www.carilionclinic.org/sites/default/files/2022-02/2021%20CMC%20Implementation%20Strategy_FINAL%20APPROVED.pdf. The top prioritized needs for the 2021 RVCHNA were grouped into four overarching categories: mental health, socioeconomic factors, access to care, and COVID-19. We have been addressing prioritized needs with the following strategies and a commitment of financial resources, staff time and leadership. Strategies to address mental health include developing a community-wide Mental Health Collaborative; supporting ongoing work of Roanoke Valley Collective Response in addressing recovery and transitional housing needs; providing community grants to mental health safety net providers such as Bradley Free Clinic, Children's Advocacy Programs of the Blue Ridge, and Family Service of Roanoke Valley; increasing CMC's internal capacity to address substance use by hiring a community-based workforce manager to oversee and expand the peer support program; continuing an addiction task force; developing capacity to provide mental health services at Fallon Park Elementary School; and providing grant funding to the Virginia Harm Reduction Coalition to expand comprehensive harm reduction services in Roanoke. Strategies to address socioeconomic factors include working with the Blue Ridge Partnership for Health Science Careers to increase enrollment in health sciences education; continuing to support the Healthy Homes initiative to provide health-related home repair for low-income residents; investing in local housing-focused organizations; working with United Way and the Virginia Department of Health to launch Unite Us, a social resource referral platform that will be integrated with medical records for clinical utilization; and building infrastructure within Carilion to screen patients for Social Determinants of Health and make referrals to the Community Health and Outreach Department and community-based organizations through EPIC (an electronic health records system). Strategies to address access to care include enhancing virtual visit accessibility by launching Carilion Now; growing PCP and community health center presence; and opening the LIFT Center at Fallon Park Elementary School to provide pediatric medical, dental and mental health services to students. Strategies to address COVID-19 include providing quality care and treatment for COVID-19 patients, disease prevention, and aiding in the community's economic recovery. Although we will not be addressing the priority need of transportation/transit system during this implementation strategy period, we are working to bring prevention services to neighborhoods and other easily accessible locations to overcome some transportation barriers and improve access to care. CMC has limited ability and expertise to impact the large-scale transit system infrastructure. Instead, we will allow other organizations such as the Roanoke Valley Regional Commission to continue addressing these needs. Additional strategies to more 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; leveraging internal data to assess health disparities; and continuing to provide health education and community outreach events such as health fairs, immunizations and health screenings. 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	33	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (33 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
Carilion Clinic Riverside 1 Medical Office Building
1 Riverside Circle	Roanoke	VA	24016	Physician and Ancillary Services
Carilion Roanoke Community Hospital Medical Office Building
102 Highland Ave	Roanoke	VA	24013	Physician and Ancillary Services
Carilion Clinic Sleep Center
1030 S Jefferson St Ste G100	Roanoke	VA	24016	Physician and Ancillary Services
Carilion Clinic Anticoagulation and Diabetes Clinic
1030 S Jefferson St Ste G101	Roanoke	VA	24016	Physician and Ancillary Services
Carilion Clinic Outpatient Therapy
105 Summerfield Court	Roanoke	VA	24019	Ancillary Services
Roanoke Ambulatory Surgery Center LLC
1102 Jefferson St SE	Roanoke	VA	24016	Outpatient Surgery Center
Carilion Clinic Diabetes Management & Prevention
1231 S Jefferson Street	Roanoke	VA	24016	Ancillary Services
Carilion Clinic Vascular Surgery Urology Otolarynology
1234 Franklin Road	Roanoke	VA	24016	Physician Services
Carilion Clinic Cardiology
127 McClanahan Street	Roanoke	VA	24014	Physician and Ancillary Services
Carilion Clinic Family Medicine
1314 Peters Creek Road	Roanoke	VA	24017	Physician Services
Carilion Clinic Medical Office Building
150 Market Ridge Lane	Daleville	VA	24083	Physician and Ancillary Services
Carilion Clinic Pediatric Subspecialty Clinic
1620 Graves Mill Road	Lynchburg	VA	24502	Physician Services
Carilion Clinic Outpatient Therapy
1935 West Main Street	Salem	VA	24153	Ancillary Services
Carilion Clinic OBGYN
1957 W Main Street	Salem	VA	24153	Physician Services
Carilion Clinic Crystal Springs Medical Office Building
2001 Crystal Spring Ave SW	Roanoke	VA	24014	Physician and Ancillary Services
Carilion Clinic Psychiatry and Behavioral Medicine
2017 S Jefferson Street	Roanoke	VA	24014	Physician and Ancillary Services
Carilion Clinic Family Medicine
2145 Mount Pleasant Boulevard	Roanoke	VA	24014	Physician Services
Carilion Clinic Institute for Orthopedics and Neurosciences
2331 Franklin Road	Roanoke	VA	24014	Physician and Ancillary Services
Carilion Clinic Riverside 3 Medical Office Building
3 Riverside Circle	Roanoke	VA	24016	Physician and Ancillary Services
Carilion Clinic Family Medicine
3 Westwood Medical Park	Bluefield	VA	24605	Physician Services
Carilion Clinic Westlake Medical Office Building
35 Medical Court	Hardy	VA	24101	Physician and Ancillary Services
Carilion Clinic Imaging
3707 Brambleton Avenue	Roanoke	VA	24018	Ancillary Services
Carilion Clinic Veterans Administration Clinic
388 Ben Bolt Avenue	Tazewell	VA	24651	Physician Services
Carilion Franklin Memorial Hospital Medical Office Building
390 S Main Street	Rocky Mount	VA	24151	Physician Services
Carilion Children's -Tanglewood Center
4348 Electric Road	Roanoke	VA	24018	Physician and Ancillary Services
Carilion Dental Care
4348 Electric Road Entrance 3 2nd	Roanoke	VA	24018	Dental Services
Carilion Clinic Vascular Surgery
4437 Starkey Road SW Suite A	Roanoke	VA	24018	Physician Services
Carilion Clinic Outpatient Therapy
4508 Starkey Road	Roanoke	VA	24018	Ancillary Services
Carilion Clinic Allergy and Immunology
46 Wesley Road	Daleville	VA	24083	Physician Services
Carilion Clinic Pediatric Medicine
490 S Main St	Rocky Mount	VA	24151	Physician Services
Carilion Clinic Urology
5372 Fallowater Lane	Roanoke	VA	24018	Physician Services
Carilion Clinic Breast Care Center
6415 Peters Creek Road	Roanoke	VA	24019	Ancillary Services
Carilion Clinic Obstetrics and Gynecology
902 South Jefferson Street Upper L	Roanoke	VA	24016	Physician Services

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c 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 Community Benefit Report	Information on 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	73299036
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 and 7f are reported at actual cost. Line 7g: A combination of Cost Accounting and Actual Costs per service line financial statement was used. Lines 7h and 7i are reported at actual cost.
Schedule H, Part II Community Building Activities	Line 1 - Physical improvements and housing: Carilion acknowledges the impact of housing on health and is involved with housing-focused activities. Carilion has worked with various community partners to discuss collaborations around housing, including Community Housing Partners, serves on the review team for HUD funding through the City of Roanoke, and serves a key role in supporting Healthy Homes Roanoke, a collaboration that will help identify and remediate health hazards within Roanoke City homes. 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 economic development expenses from support of the Go Virginia Foundation, the local business council, the Roanoke Regional Partnership, and Visit Virginia's Blue Ridge. Carilion is also active in many local economic development endeavors, including supporting the Valleys Innovation Council, investing in research and technology, communicating with local businesses about the region's current business climate and prospective companies, and the Roanoke Region Chamber of Commerce. All of 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 income, transportation, 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 and better nutrition for our neighbors in need. These efforts help to remove a range of obstacles to good health for our region's residents. Examples include the Boys and Girls Club of SWVA, the West End Center for Youth, Make-A-Wish Virginia, the American Red Cross, and the Roanoke County Public Schools Education Foundation. Through monetary donations and organizational support, Carilion promotes mental health through local arts and culture, reduces inequity, promotes youth development, and supports events for organizations like the Humble Hustle Company, the Harrison Museum of African American Culture, the Ronald McDonald House Charities, the Virginia Museum of Historical Culture, First Tee of Roanoke Valley, and the local NAACP. 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 Roanoke Valley. We also partner with multiple community and business organizations on initiatives to improve health and wellness for everyone living in the Roanoke Valley. These coalition-building activities include participation with local substance use prevention coalitions, the Belmont Fallon Target Area community meetings, the Child Health Investment Partnership of the Roanoke Valley, the Rural Trauma Team Coalition, Children's Trust of Roanoke Valley, DePaul Community Resources, and the Virginia Rural Health Association. Line 7 - Community health improvement advocacy: Carilion's mission of community health improvement focuses not only on what the organization does directly but also on supporting the advocacy efforts of other organizations. Carilion supported the Brain Injury Association of America, the Virginia Health Care Foundation and participated in the American Hospital Association's Accelerating Health Equity conference. Carilion was also involved in building awareness and advocacy around neighborhood walkability and trauma-informed care. All these efforts promote better health by advocating for specific causes under the larger umbrella of health, safety, and the social determinants of health. 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 for future health care workers. Carilion again partnered to offer Project SEARCH, a one-year high school transition program providing employment and educational opportunities for individuals with significant disabilities. This collaborative program includes Goodwill Industries of the Valleys, the Virginia Department of Aging and Rehabilitative Services, and local school systems. Carilion continues to convene the Blue Ridge Partnership for Health Science Careers, a program that will increase awareness of health science careers in elementary, middle and high school children and create pipelines for students to enter specific health science higher education programs. Carilion is involved in the Virginia Business Higher Education Council, promoting reform and reinvestment in the higher education system, and supports the Virginia Western Community College and the Virginia Western Community College Education Foundation. Carilion also supported the Virginia Ready Initiative, which works to retrain unemployed community members for in-demand jobs.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Carilion 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 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	A - CARILION MEDICAL CENTER -DBA CRMH: Line 16a URL: https://www.carilionclinic.org/billing/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	A - CARILION MEDICAL CENTER -DBA CRMH: Line 16b URL: https://www.carilionclinic.org/billing/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	A - CARILION MEDICAL CENTER -DBA CRMH: 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 health data from various secondary sources and 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 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 Roanoke metropolitan statistical area (MSA), home to Carilion Clinic's flagship hospital Carilion Roanoke Memorial Hospital, is commonly known as the Roanoke Valley. It is composed of the independent cities of Roanoke and Salem and the counties of Bedford, Botetourt, Craig, Franklin and Roanoke. The Valley is mostly rural, nestled among the Blue Ridge Mountains with the urban city of Roanoke at its heart. Roanoke is a destination place, rich in cultural diversity, the arts, shopping, recreational opportunities, natural beauty and services not available in more rural areas of the region. The Roanoke Valley is comprised of distinct communities with significant disparities in size, population and social determinants of health. The 2018-2022 American Community Survey (ACS) found the Roanoke MSA's total population to be 394,469. The cities of Roanoke and Salem had 99,213 and 25,372 residents, respectively. The counties of Bedford, Botetourt, Craig, Franklin and Roanoke had 79,761, 33,734, 4,898, 54,838 and 96,653 residents, respectively. The median household income ranges from a low of $51,253 in Roanoke City to a high of $80,872 in Roanoke County. Across the Roanoke Valley localities, 5.34% of the population has a household income below the federal poverty guideline. Similarly, 17.97% of the population are receiving Medicaid, and 6.66% have no health insurance at all. The highest rates of Medicaid patients are in Roanoke City at 29.76% ((US Census Bureau, ACS, 2018-2022). Specific to Carilion Medical Center inpatients and outpatients in fiscal year 2023, 23.43% received Medicaid while 4.39% were self-pay (Strata internal data). The median age in the MSA localities ranges from 38.1 in the city of Roanoke to 48.4 in Franklin County, and all other counties are above the state median of 38.5. Across most of the Roanoke MSA, a more significant percentage of the population is White than in the Commonwealth of Virginia as a whole, with rates ranging up to 94.7% in Craig County (US Census Bureau, ACS, 2018-2022). The Weldon Cooper Center for Public Service predicts positive population change by 2040 for all communities except Craig County, which may have very slight population loss. The city of Roanoke, Roanoke Valley's urban hub, is more racially and ethnically diverse than the rest of the MSA. Roanoke's population is 57.01% White, 29.37% Black and 5.46% Asian, with 10.89% representing more than one race. The remainder represents small minorities of American Indian/Alaskan Native, Native Hawaiian/Pacific Islander or some other race. Of the population, 6.89% are Hispanic or Latino. (US Census Bureau, ACS, 2018-2022.) Roanoke City is divided into quadrants (Northwest, Northeast, Southwest and Southeast) separated geographically by railroad tracks, the Roanoke River and Interstate 581. These quadrants vary significantly in the demographic and economic make-up of their residents. Specifically, two of the quadrants-Northwest and Southeast-have federal designations as Medically Underserved Areas (MUAs). These areas are home to a large proportion of the low-income individuals and families in the city who may be uninsured, underinsured or are Medicaid recipients facing additional barriers due to cultural differences. MUAs are also present in Bedford County, Botetourt County, Craig County and Franklin County. (https://data.hrsa.gov/tools/shortage-area) In addition to Carilion, two other hospitals serve the MSA: the Salem Veterans Administration Medical Center and Lewis Gale Medical Center. Key safety net providers in the region include the Veteran Affairs Medical Center, a federally qualified health center, free clinics, local offices of the Virginia Department of Health and other service organizations.
Schedule H, Part VI, Line 5 Promotion of community health	Carilion 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. Carilion Medical Center (CMC) includes Carilion's flagship facility, Carilion Roanoke Memorial Hospital (CRMH). CRMH includes a Level 1 Trauma Center, a Neonatal Intensive Care Unit, Carilion Children's Hospital and 718 patient beds. Offering a wide range of inpatient and outpatient care, specialty care, medical education, and fellowships, CRMH has gained recognition as Virginia's top four hospital by U.S. News and World Report. CRMH provides access to the region's most experienced providers and specialty services while teaching and developing tomorrow's medical leaders through residencies and fellowships sponsored by the Virginia Tech Carilion School of Medicine. Additionally, Carilion Roanoke Community Hospital houses a highly skilled inpatient rehabilitation unit. CMC 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, staff development, 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 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 (34 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
American Cancer Society
PO Box 4110	Glen Allen	VA	23058	131788491	501(c)(3)	$10,000	Program support
American Heart Association
4217 Park Place Court	Glen Allen	VA	23060	135613797	501(c)(3)	$10,000	Event sponsorships
Blue Ridge Literacy
706 S Jefferson St	Roanoke	VA	24016	541377063	501(c)(3)	$10,500	Program support
Boys & Girls Clubs of SW Virginia Inc
1714 9th Street SE	Roanoke	VA	24013	541867366	501(c)(3)	$6,850	Program support
Compress and Shock Foundation
2128 Chestnut Oak Ct SW	Roanoke	VA	24018	814994130	501(c)(3)	$11,000	Program support
The First Tee of Roanoke Valley
3707 Densmore Road NW	Roanoke	VA	24017	201237999	501(c)(3)	$10,000	Event sponsorship
Grandin Theatre Foundation Inc
1310 Grandin Road	Roanoke	VA	24015	010557881	501(c)(3)	$25,000	Program support
Junior Achievement of SWVA
3433 Brambleton Ave	Roanoke	VA	24018	540628293	501(c)(3)	$6,250	Event sponsorship
LEAP
PO Box 3249	Roanoke	VA	24015	271050909	501(c)(3)	$25,000	Access to healthy food
Local Office on Aging Inc
4932 Frontage Road NW	Roanoke	VA	24019	540916248	501(c)(3)	$6,000	Companionship Program
National Multiple Sclerosis Society
733 Third Ave 3rd Floor	New York	NY	10017	135661935	501(c)(3)	$11,500	Event sponsorship
Radford University
PO Box 6923	Radford	VA	24142	546001789	Virginia	$144,987	Assoc Provost Health Sciences
ResearchAmerica
241 18th Street South Suite 501	Arlington	VA	22202	521609875	501(c)(3)	$10,000	Event sponsorship
The Rescue Mission of Roanoke Inc
402 4th St SE	Roanoke	VA	24013	540573900	501(c)(3)	$12,500	Medical street outreach
NAACP-Roanoke Branch
PO Box 12362	Roanoke	VA	24025	546070115	501(c)(4)	$7,500	Program support
Roanoke Symphony Orchestra
1125 1st Street SW	Roanoke	VA	24016	546019736	501(c)(3)	$21,000	Program support
Ronald McDonald House Charities of SW VA
2224 S Jefferson St	Roanoke	VA	24014	541244769	501(c)(3)	$2,000	Donated Rent	$277,017	FMV	Donated rent
Taubman Museum of Art
110 Salem Ave SE	Roanoke	VA	24011	546026841	501(c)(3)	$12,000	Event sponsorships
Valleys Innovation Council Verge
2200 Kraft Drive	Blacksburg	VA	24060	462975294	501(c)(3)	$325,000	Program support
Virginia Health Care Foundation
707 East Main Street Suite 1350	Richmond	VA	23219	541639924	501(c)(3)	$75,000	Program support
Virginia Business Higher Education Council
1108 East Main Street Ste 1100	Richmond	VA	23219	541827038	501(c)(3)	$25,000	Growth4VA
Virginia Historical Society
428 N Arthur Ashe Blvd	Richmond	VA	23220	540419452	501(c)(3)	$10,000	Exhibition Support
Virginia Ready Initiative
107 S West Street 135	Alexandria	VA	22314	851103573	501(c)(3)	$187,500	Program support
City of Roanoke
215 Church Avenue Room 364	Roanoke	VA	24011	546001569	City of Roanoke	$10,000	Financial Empowerment Center
Family Service of Roanoke Valley
360 Campbell Ave SW	Roanoke	VA	24011	540505946	501(c)(3)	$18,500	Behavioral health services
Lick Run Community Development Corp
1626 10th St NW	Roanoke	VA	24012	455343447	501(c)(3)	$10,000	Youth urban agriculture program
Planned Parenthood South Atlantic
100 S Boylan Ave	Raleigh	NC	27603	561282557	501(c)(3)	$10,000	Sexual health education
Virginia Harm Reduction Coalition
PO Box 2376	Roanoke	VA	24010	832479145	501(c)(3)	$24,789	Operation support for harm reduction programming
Bradley Free Clinic
1240 3rd Street SW	Roanoke	VA	24016	237380491	501(c)(3)	$20,000	Behavioral health services
New Horizons Healthcare
3716 Melrose Ave NW	Roanoke	VA	24017	541937835	501(c)(3)	$10,000	Dental program support
Cardinal Productions Inc
PO Box 4455	Roanoke	VA	24015	871532828	501(c)(3)	$75,000	General support
CHIP of Roanoke Valley
1201 Third Street	Roanoke	VA	24016	541566451	501(c)(3)	$51,000	Program support
Children's Trust Roanoke Valley
541 Luck Avenue Suite 308	Roanoke	VA	24016	510235891	501(c)(3)	$60,000	General support
Virginia Tech Carilion School of Medicine
2 Riverside Circle	Roanoke	VA	24016	264556177	501(c)(3)	$4,293,581	Medical School Support

Field	Value	IRS element (for citing)
Total501c3 Org	33	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	Endowment Funded Patient Care	GrantTypeTxt
Recipient	2	RecipientCnt
Cash Grant	$125,712	CashGrantAmt

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	Yes (true)	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 (19 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
Steven Arner
Director/President/CEO	$0	$892,203	$0	$149,632	$0	$78,372	$0	-$135,050	$0	$21,296	$0	$1,006,453	$0	$73,054
Paul Haskins MD
Director/Physician	$337,551	$0	$20,520	$0	$6,382	$0	-$250,846	$0	$22,750	$0	$136,357	$0	$0	$0
Michael Nussbaum MD
Director/SVP/Surgical Services Chair	$620,917	$0	$90,786	$0	$362,377	$0	-$19,398	$0	$16,749	$0	$1,071,431	$0	$271,484	$0
Nicholas Conte
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
Treasurer	$0	$341,967	$0	$44,219	$0	$23,635	$0	-$275,310	$0	$21,296	$0	$155,807	$0	$19,258
Paul Skolnik MD
Former SVP/Chair, Dept. of Medicine	$370,926	$0	$0	$0	$69,228	$0	-$14,517	$0	$9,982	$0	$435,619	$0	$0	$0
Michael Abbott
Senior Vice President	$285,535	$0	$35,761	$0	$5,309	$0	$26,751	$0	$8,601	$0	$361,957	$0	$0	$0
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
Daniel Harrington MD
Interim Chief Medical Officer/EVP	$117,801	$32,000	$0	$0	$4,031	$0	$0	$0	$0	$0	$121,832	$32,000	$0	$0
Joseph Moskal MD
SVP/Chair, Dept. of Orthopedics	$1,145,831	$0	$143,643	$0	$85,769	$0	-$53,257	$0	$22,496	$0	$1,344,482	$0	$0	$0
Jon Sweet MD
SVP/Chair, Dept. of Medicine	$487,529	$0	$104,059	$0	$3,400	$0	-$170,510	$0	$12,904	$0	$437,382	$0	$0	$0
Patrice Weiss MD
Chief Medical Officer/EVP	$1,223	$546,237	$0	$114,831	$0	$1,729,795	$0	-$166,884	$0	$19,336	$1,223	$2,243,315	$0	$165,519
Jonathan Carmouche MD
Physician	$1,470,786	$0	$163,110	$0	$3,114	$0	-$149,752	$0	$16,595	$0	$1,503,853	$0	$0	$0
Gregory Howes MD
Physician	$1,215,362	$0	$230,575	$0	$2,833	$0	-$74,805	$0	$19,354	$0	$1,393,319	$0	$0	$0
Eric Marvin MD
Physician	$1,088,862	$0	$391,279	$0	$2,893	$0	-$153,052	$0	$19,354	$0	$1,349,336	$0	$0	$0
Adeolu Olasunkanmi MD
Physician	$845,914	$0	$442,738	$0	$2,833	$0	-$24,960	$0	$8,141	$0	$1,274,666	$0	$0	$0
Jesse Stem MD
Physician	$860,427	$0	$382,461	$0	$3,553	$0	-$31,350	$0	$20,654	$0	$1,235,745	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (7 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, DR. SWEET 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. Two reported individuals received this benefit, the value of which is included in reported compensation.
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 Chief Executive Officer, 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 4a Severance or change-of-control payment	Patrice Weiss - $1,558,223
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	Mr. Abbott, Mr. Arner, Mr. Conte, Mr. Halliwill, Dr. Moskal, Dr. Nussbaum, Dr. Skolnik, Mr. Vaughan, and Dr. Weiss 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: $271,484 - Michael Nussbaum $165,519 - Patrice Weiss $113,415 - Donald Halliwill $73,054 - Steven Arner $19,258 - G. Robert Vaughan, Jr. $60,115 - Nicholas Conte Vested and paid in current year: $75,000 - Joseph Moskal $75,000 - Michael Nussbaum $61,517 - Paul Skolnik 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 (3 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Patricia Abbott
Family member of Michael Abbott, key employee	$182,150	Employee	false
Mary Sweet MD
Family member of Jon Sweet, key employee	$346,070	Employee	false
Andrew Maslich
Family member of Steven Arner, Director	$50,697	Employee	false

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (19 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part I, Line 6 Volunteers	The hospital operates a Customer Service-based program for volunteers and we work hard to make our patients and patient families comfortable in very uncomfortable circumstances. Tasks include delivering mail, delivering flowers, and greeting and escorting patients. Through Hospice, volunteers provide respite support for caregivers, visits for socialization and comforting presence, check in calls, care for patients' pets, help in the hospice office, plant/harvest/deliver fresh veggies, offer Virtual Reality experiences, sing in the hospice choir to patients, provide ceremonies to honor military veteran patients, offer pet therapy and Reiki therapy, provide visits from a Santa Claus with a real beard, offer end of life Doula support including Vigil planning, assist with fundraisers, assist with bereavement support activities, make fidget quilts for dementia patients and sew dignity patient gowns, deliver birthday gifts, craft holiday gifts and record patient's life stories.
Form 990, Part III, Line 4a Program Service Description	Carilion Medical Center (CMC) exists to serve the healthcare needs of its communities and region, regardless of the patient's ability to pay. CMC is comprised of Carilion Roanoke Memorial Hospital, Carilion Roanoke Community Hospital, and a collaborative network of physician specialists providing outpatient care. CMC admitted 31,632 patients and provided 198,953 days of care during Fiscal Year 2023. Carilion Roanoke Memorial Hospital has consistently ranked among the nation's top 100 hospitals by Becker's Hospital Review and among the top five hospitals in Virginia by U.S. News and World Report. National Research Corporation surveys show it is the region's hospital of choice. CMC has earned four consecutive Nursing Magnet designations, placing it in the top tier of nursing care in the country. CMC is the region's only Level 1 trauma center and a tertiary care center for adults and pediatric patients. It provides acute care services for primary and comprehensive stroke care, neurosurgery for adults and children, women's services including obstetrics (3,100 babies delivered), high-risk pregnancy, urogynecology, gynecologic oncology and fertility and reproductive care. Our orthopaedic team provides surgical excellence for joint replacements, spine surgery, sports medicine interventions, trauma surgery, foot and ankle procedures, hand and upper extremity procedures and pediatric interventions. Other medical programs include specialized intensive care units for neurotrauma, cardiac care and cardiac surgery, vascular, and medical intensive care and dedicated units for oncology and thoracic surgery patients. Additional programs include advanced diagnostics and expertise for gastroenterology conditions, inpatient and outpatient psychiatric services, a comprehensive inpatient rehabilitation unit, and inpatient and outpatient surgical care utilizing advanced techniques in robotic and endovascular procedures. Diagnostic testing capabilities in radiology support all CMC programs, including advanced imaging in CT, MRI and PET/CT. We've expanded our field of experts in molecular imaging, nuclear medicine procedures, and ultrasound and provide screening mammography and diagnostic breast imaging. Carilion Children's Hospital is a "hospital within a hospital" at CMC. It is our region's only pediatric center of excellence, and operates a pediatric intensive care unit, a NICU, and trauma care. Pediatric sub-specialists support the facility in surgery, pulmonology, oncology, cardiology, gastroenterology, psychiatry, orthopaedics, neurosurgery, dentistry, neurology, and endocrinology. CMC provides several services and programs to target the specific health needs of the area, including diabetes management, medically supervised weight loss, urgent care, physical, speech and occupational therapy programs, cardiac and pulmonary rehab, and home health and hospice care. With 76.687 visits, CMC's emergency services are a critical component of the health safety net in its service area, acting as a key health provider for a significant number of uninsured patients, who comprise about 6 percent of ED visits. CMC also supports community screenings and education on chronic disease prevention and management. CMC supports a cancer registry program, and participates in a number of research projects. In furtherance of its mission, CMC provides extensive uncompensated care and community support. Stated at cost, financial assistance and other community benefits of nearly $70 million were provided for the year.
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 FORMS 1099	1099s are issued on Carilion Medical Center's behalf by Carilion Services, Inc., a related supporting organization providing management and administrative services, including payment processing.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	Nancy Howell Agee, Steven Arner, Nicholas Conte, David Hagadorn, Donald Halliwill, G. Robert Vaughan Jr., Patrice Weiss, and Julie Smith-Hamilton - 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, Steven Arner, Nicholas Conte, David Hagadorn, Donald Halliwill, Julie Smith-Hamilton, G. Robert Vaughan, Jr., and Patrice Weiss.
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. Management reviewed a draft of the Form 990 at the August meeting of the Carilion Clinic Board of Directors Audit Committee and answered questions at that meeting. Several days 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 2f Other Program Service Revenue	Other - Total Revenue: 2488757, Related or Exempt Function Revenue: 2488757, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	- Total Revenue: 8756296, Related or Exempt Function Revenue: 8756296, 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: 20717011, Program Service Expense: 20717011, Management and General Expenses: , Fundraising Expenses: ; Billing & Collection Services - Total Expense: 18819989, Program Service Expense: , Management and General Expenses: 18819989, Fundraising Expenses: ; Laundry/Housekeeping Services - Total Expense: 10510037, Program Service Expense: 10501699, Management and General Expenses: 8338, Fundraising Expenses: ; Other Purchased Services - Total Expense: 5330925, Program Service Expense: 5173522, Management and General Expenses: 147403, Fundraising Expenses: 10000; Contract Fees/Consulting - Total Expense: 28197037, Program Service Expense: 26760232, Management and General Expenses: 1436805, Fundraising Expenses: ; Repairs and Maintenance - Total Expense: 15667331, Program Service Expense: 15658816, Management and General Expenses: 8515, Fundraising Expenses: ; Reference Labs - Total Expense: 29860415, Program Service Expense: 29860415, Management and General Expenses: , Fundraising Expenses: ; Temporary Staffing - Total Expense: 74711678, Program Service Expense: 74711678, 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 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	Transfers from/(to) Affiliates - -76524394; Pension-related changes other than net periodic pension costs - -18552724;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	RMH EMERGENCY SERVICES LLC	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)
EIN	541686589	EIN
Primary Activities	PHYSICIAN BILLING	PrimaryActivitiesTxt
Legal Domicile State	VA	LegalDomicileStateCd
Total Income	$0	TotalIncomeAmt
End Of Year Assets	$0	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CARILION 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 NEW RIVER VALLEY MEDICAL CENTER
PO BOX 12385	ROANOKE	VA	24025	540553805	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)
CARILION BIOMEDICAL INSTITUTE
PO BOX 12385	ROANOKE	VA	24025	541965057	SUPPORTING ORGANIZATION	VA	501(c)(3)	Type I	CARILION CLINIC	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	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
FRANKLIN COUNTY VENTURES LLC
PO BOX 12385	ROANOKE	VA	24025	474365316	REAL ESTATE	VA	CARILION CLINIC	Related	-$139,569	$53,831	false	false	0.1
CARILION CLINIC MEDICARE SHARED SAVINGS COMPANY LLC
PO BOX 12385	ROANOKE	VA	24025	455235473	MEDICARE ACO	VA	CARILION CLINIC	Related	$17,727	$9,207,564	false	false	0.5
SOUTHWEST VIRGINIA HEALTH PROPERTIES LLC
1102 Jefferson Street SE	Roanoke	VA	24016	010691570	REAL ESTATE	VA	Carilion Medical Center	Related	$126,747	$1,211,649	false	false	0.4931
RAVEN ASSET BASED OPPORTUNITY FUND IV LP
75 Spring St 6th FL	New York	NY	10012	824119491	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
STARWOOD VEP II CO-INVEST LLC
591 W Putman Avenue	Greenwich	CT	06830	833262407	Investments	DE	NA	N/A
Roanoke Ambulatory Surgery Center LLC
1102 Jefferson Street SE	Roanoke	VA	24016	010691564	SURGERY CENTER	VA	CARILION MEDICAL CENTER	Related	$281,214	$1,237,185	false	false	0.50
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	Yes (true)	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 (24 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Carilion Clinic Foundation
A	$41,280	Cost
Carilion Services Inc
A	$278,060	Cost
CHS Inc
A	$68,352	Cost
Carilion Emergency Services Inc
A	$106,416	Cost
Carilion Healthcare Corporation
A	$28,725	Cost
Carilion New River Valley Medical Center
L	$2,436,651	Cost
Carilion Giles Community Hospital
L	$511,025	Cost
Carilion Franklin Memorial Hospital
L	$1,695,491	Cost
Carilion Rockbridge Community Hospital
L	$780,750	Cost
Carilion Tazewell Community Hospital
L	$2,166,694	Cost
Carilion Services Inc
L	$843,981	Cost
Carilion Emergency Services Inc
L	$480,680	Cost
Carilion Healthcare Corporation
L	$224,883	Cost
Carilion New River Valley Medical Center
K	$276,071	Market Rate
Carilion Tazewell Community Hospital
M	$129,598	Cost
Carilion Services Inc
M	$242,077,553	Cost
Carilion Behavioral Health Inc
M	$207,979	Cost
CHS Inc
K	$2,090,305	Cost
CHS Inc
M	$6,636,917	Cost
SCA Credit Services Inc
M	$442,817	Cost
Medkey Inc
M	$111,428	Cost
Carilion Services Inc
R	$76,524,394	Cash
Carilion Clinic Foundation
C	$400,053	Cash
Carilion Clinic Foundation
R	$108,614	Cash