CARILION MEDICAL CENTER: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: CARILION MEDICAL CENTER (EIN 54-0506332)
Tax period: 2021-10-01 to 2022-09-30
Filed: 2023-08-15
IRS object ID: 202342279349300934
Schema version: 2021v4.2
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	2023-08-15T13:30:48+00:00	ReturnTs
Tax Period End	2022-09-30	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 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	2021-10-01	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	2023-08-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	G ROBERT VAUGHAN	PersonFirstNm
Person Last	JR	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MIKE ENGLE	PreparerPersonNm
PTIN	P00482834	PTIN
Phone	8162216300	PhoneNum
Preparation	2020-08-14	PreparationDt

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2023-04-26 12:10:37Z	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	$2,441,655,060	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	12	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	10368	TotalEmployeeCnt
Total Volunteers	127	TotalVolunteersCnt
Total Gross UBI	$23,483	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$53,729,810	PYContributionsGrantsAmt
CY Contributions Grants	$42,789,011	CYContributionsGrantsAmt
PY Program Service Revenue	$1,553,690,747	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,589,719,229	CYProgramServiceRevenueAmt
PY Investment Income	$131,595,772	PYInvestmentIncomeAmt
CY Investment Income	$47,222,248	CYInvestmentIncomeAmt
PY Other Revenue	$24,640,419	PYOtherRevenueAmt
CY Other Revenue	$27,547,686	CYOtherRevenueAmt
PY Total Revenue	$1,763,656,748	PYTotalRevenueAmt
CY Total Revenue	$1,707,278,174	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,770,037	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$8,525,209	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$727,753,173	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$736,330,366	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$173,772	CYTotalFundraisingExpenseAmt
PY Other Expenses	$857,256,393	PYOtherExpensesAmt
CY Other Expenses	$966,339,261	CYOtherExpensesAmt
PY Total Expenses	$1,586,779,603	PYTotalExpensesAmt
CY Total Expenses	$1,711,194,836	CYTotalExpensesAmt
PY Revenues Less Expenses	$176,877,145	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$3,916,662	CYRevenuesLessExpensesAmt
Total Assets BOY	$2,196,887,752	TotalAssetsBOYAmt
Total Assets EOY	$1,949,690,459	TotalAssetsEOYAmt
Total Liabilities BOY	$1,184,883,483	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,000,916,370	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,012,004,269	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$948,774,089	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	$1,459,719,545	ExpenseAmt
Grant	$8,525,209	GrantAmt
Revenue	$1,609,488,352	RevenueAmt
Desc	SEE SCHEDULE O.	Desc
Total Program Service Expenses	$1,459,719,545	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	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	10368	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	12	GoverningBodyVotingMembersCnt
Independent Voting Member	7	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	THE CORPORATION ATTN H KIRK	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5402245102	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 (29 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	$6,836	$0
Steven Arner
Director/President/CEO	36.0	14.0	Yes (X)	Yes (X)	$0	$1,100,977	$280,265
Ann Hoff PhD
Director	2.0	0	Yes (X)		$0	$0	$0
Cathy Jo Swanson MD
Director	2.0	0	Yes (X)		$20,000	$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
Jason Bingham
Director	2.0	2.4	Yes (X)		$0	$9,950	$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)		$11,242	$0	$0
Michael Nussbaum MD
Director/SVP/Chair of Surgery	50.0	0	Yes (X)		$794,515	$0	$81,068
Paul Haskins MD
Director/Physician	50.0	0	Yes (X)		$377,926	$0	$134,302
David Hagadorn
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$154,286	$66,243
Donald Halliwill
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$1,027,399	$266,876
G Robert Vaughan Jr
Treasurer	0.5	49.5		Yes (X)	$0	$415,087	$180,417
Julie Smith-Hamilton
Asst. Secretary	0.5	49.5		Yes (X)	$0	$51,831	$18,964
Nicholas Conte
Secretary	3.0	47.0		Yes (X)	$0	$799,125	$197,025
Patrice Weiss MD
Chief Medical Officer/EVP	50.0	0.0		Yes (X)	$9,075	$1,048,229	$248,613
Jon Sweet MD
SVP/Chair, Dept. of Medicine	50.0	0			$326,914	$0	$108,764	Yes (X)
Joseph Moskal MD
SVP/Chair, Dept. of Orthopedics	50.0	0			$1,538,612	$0	$81,836	Yes (X)
Michael Abbott
Senior Vice President	50.0	0			$343,010	$0	$118,706	Yes (X)
Nancy Howell Agee
CEO, Carilion Clinic	2.0	48.0			$0	$2,498,861	$158,310	Yes (X)
Paul Skolnik MD
SVP/Chair, Dept. of Medicine	50.0	0			$804,028	$0	$57,006	Yes (X)
Adeolu Olasunkanmi MD
Physician	50.0	0			$1,333,561	$0	$45,732		Yes (X)
Eric Marvin MD
Physician	50.0	0			$1,519,598	$0	$76,820		Yes (X)
Gregory Howes MD
Physician	50.0	0			$1,776,201	$0	$63,448		Yes (X)
Jesse Stem MD
Physician	50.0	0			$1,365,902	$0	$65,676		Yes (X)
Jonathan Carmouche MD
Physician	50.0	0			$1,764,176	$0	$77,074		Yes (X)
Bruce Long MD
Physician/Former Key Employee	50.0	0			$341,807	$0	$20,781			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$12,326,567	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$7,114,827	TotReportableCompRltdOrgAmt
Total Other Compensation	$2,347,926	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	1128	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	Address Line2ContractorAddress/USAddress/AddressLine2Txt
ROBINS MORTON BRANCH BUILDS
400 SHADES CREEK PARKWAY	BIRMINGHAM	AL	35209	CONSTRUCTION SERVICES	$56,862,707
QUALIVIS LLC
1601 ASSEMBLY STREET	COLUMBIA	SC	29201	TEMPORARY STAFFING	$32,178,717	UNIT 1439
QUEST DIAGNOSTICS
500 PLAZA DRIVE	SECAUCUS	NJ	07094	LABORATORY SERVICES	$28,406,159
GE MEDICAL SYSTEMS
5517 COLLECTION CENTER DRIVE	CHICAGO	IL	60693	EQUIPMENT MAINTENANCE	$13,375,684
AVANT HEALTHCARE PROFESSIONALS
1211 SEMORAN BLVD	CASSELBERRY	FL	32707	TEMPORARY STAFFING	$5,164,429	SUITE 227

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	99	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$304	FederatedCampaignsAmt
Related Organizations	$600,209	RelatedOrganizationsAmt
Government Grants	$40,424,736	GovernmentGrantsAmt
All Other Contributions	$1,763,762	AllOtherContributionsAmt
Total Contributions	$42,789,011	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue	622110	$1,530,353,865	$1,530,353,865
Program Related Investments	621999	$5,862,682	$5,862,682
Clinical Research	541715	$1,647,081	$1,647,081
Other Patient Revenue	446110	$47,606,337	$47,606,337
Affiliate Rent Income	531120	$1,356,216	$1,356,216

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,893,048	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,893,048	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,589,719,229	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$18,845,918	TotalRevenueColumnAmt
Unrelated Business Revenue	$23,483	UnrelatedBusinessRevenueAmt
Exclusion	$18,822,435	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$484,066	TotalRevenueColumnAmt
Exclusion	$484,066	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$4,957,646	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$4,957,646	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,957,646	TotalRevenueColumnAmt
Exclusion	$4,957,646	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$762,245,848	SecuritiesAmt
Other	$23,302	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$734,246,775	SecuritiesAmt
Other	$130,111	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$27,999,073	SecuritiesAmt
Other	-$106,809	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$27,892,264	TotalRevenueColumnAmt
Exclusion	$27,892,264	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
Physician Other Affiliate Income	621111	$7,432,458	$7,432,458
Cafeteria	722514	$2,820,917		$2,820,917
Roanoke City Student Health	621400	$2,192,743	$2,192,743

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,143,922	TotalRevenueColumnAmt
Related Or Exempt Func Income	$10,143,922	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$22,590,040	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,707,278,174	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,609,488,352	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$23,483	UnrelatedBusinessRevenueAmt
Exclusion	$54,977,328	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	$8,525,209	TotalAmt
Program Services	$8,525,209	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$5,027,257	TotalAmt
Program Services	$4,568,848	ProgramServicesAmt
Management And General	$458,409	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$3,126,428	TotalAmt
Program Services	$3,126,428	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$587,160,305	TotalAmt
Program Services	$586,674,386	ProgramServicesAmt
Management And General	$451,427	ManagementAndGeneralAmt
Fundraising	$34,492	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$50,327,637	TotalAmt
Program Services	$50,286,023	ProgramServicesAmt
Management And General	$38,692	ManagementAndGeneralAmt
Fundraising	$2,922	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$51,343,426	TotalAmt
Program Services	$51,207,368	ProgramServicesAmt
Management And General	$126,400	ManagementAndGeneralAmt
Fundraising	$9,658	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$39,345,313	TotalAmt
Program Services	$39,285,492	ProgramServicesAmt
Management And General	$57,537	ManagementAndGeneralAmt
Fundraising	$2,284	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$220,115,930	TotalAmt
Management And General	$220,115,930	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$126,096	TotalAmt
Management And General	$126,096	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$108,879	TotalAmt
Program Services	$108,879	ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$2,928,731	TotalAmt
Management And General	$2,928,731	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$208,889,826	TotalAmt
Program Services	$186,371,262	ProgramServicesAmt
Management And General	$22,508,564	ManagementAndGeneralAmt
Fundraising	$10,000	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$62,173	TotalAmt
Program Services	$61,739	ProgramServicesAmt
Fundraising	$434	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$24,067,062	TotalAmt
Program Services	$24,008,474	ProgramServicesAmt
Management And General	$52,460	ManagementAndGeneralAmt
Fundraising	$6,128	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$6,043,039	TotalAmt
Program Services	$6,043,039	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$31,274,835	TotalAmt
Program Services	$31,254,994	ProgramServicesAmt
Management And General	$19,841	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$2,327,313	TotalAmt
Program Services	$2,321,926	ProgramServicesAmt
Management And General	$180	ManagementAndGeneralAmt
Fundraising	$5,207	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$18,104,993	TotalAmt
Program Services	$18,104,993	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$45,343,496	TotalAmt
Program Services	$45,343,496	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$17,099,470	TotalAmt
Program Services	$12,744,912	ProgramServicesAmt
Management And General	$4,354,558	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Medical Supplies	$244,782,380	$244,782,380
Bad Debt	$71,030,616	$71,030,616
Assessment Fees	$67,783,540	$67,783,540
Dues and Subscriptions	$2,112,588	$1,950,798	$59,143	$102,647

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,138,294	TotalAmt
Program Services	$4,134,743	ProgramServicesAmt
Management And General	$3,551	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,711,194,836	TotalAmt
Program Services	$1,459,719,545	ProgramServicesAmt
Management And General	$251,301,519	ManagementAndGeneralAmt
Fundraising	$173,772	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$16,661	BOYAmt
EOY	$16,249	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$8,436,375	BOYAmt
EOY	$9,646,128	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$607,573	BOYAmt
EOY	$2,106,278	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$310,756,552	BOYAmt
EOY	$294,640,960	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	$905,337	BOYAmt
EOY	$67,397	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$12,695,949	BOYAmt
EOY	$12,018,690	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$5,234,412	BOYAmt
EOY	$13,698,384	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,386,901,740	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$978,612,337	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$339,132,620	BOYAmt
EOY	$408,289,403	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$743,933,114	BOYAmt
EOY	$511,015,259	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$770,382,060	BOYAmt
EOY	$686,101,205	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$3,915,889	BOYAmt
EOY	$11,511,505	EOYAmt

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$820,994	BOYAmt
EOY	$528,785	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,196,887,752	BOYAmt
EOY	$1,949,690,459	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$252,433,479	BOYAmt
EOY	$246,271,723	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$645,000	BOYAmt
EOY	$720,000	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$134,997,227	BOYAmt
EOY	$39,348,352	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$457,853,734	BOYAmt
EOY	$607,166,441	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$338,954,043	BOYAmt
EOY	$107,409,854	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,184,883,483	BOYAmt
EOY	$1,000,916,370	EOYAmt

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$985,877,255	BOYAmt
EOY	$924,838,915	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$26,127,014	BOYAmt
EOY	$23,935,174	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,012,004,269	BOYAmt
EOY	$948,774,089	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,196,887,752	BOYAmt
EOY	$1,949,690,459	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$3,916,662	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$182,437,811	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$123,124,293	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	$108,879	OtherActivitiesAmt
Total Lobbying Expenditures	$108,879	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	$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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$16,731,963	BeginningYearBalanceAmt
Investment Earnings Or Losses	$1,278,959	InvestmentEarningsOrLossesAmt
Other Expenditures	$977,279	OtherExpendituresAmt
End Year Balance	$17,033,643	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.0	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.6422	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.3578	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	$6,076,044	OtherCostOrOtherBasisAmt
Book Value	$6,076,044	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$531,148,307	OtherCostOrOtherBasisAmt
Depreciation	$398,555,039	DepreciationAmt
Book Value	$132,593,268	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,171,138	OtherCostOrOtherBasisAmt
Depreciation	$897,085	DepreciationAmt
Book Value	$274,053	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$664,027,914	OtherCostOrOtherBasisAmt
Depreciation	$572,266,240	DepreciationAmt
Book Value	$91,761,674	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$184,478,337	OtherCostOrOtherBasisAmt
Depreciation	$6,893,973	DepreciationAmt
Book Value	$177,584,364	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$408,289,403	TotalBookValueLandBuildingsAmt

Financial Derivatives FinancialDerivativesGrp

Field	Value	IRS element (for citing)
Book Value	$5,420,067	BookValueAmt
Method Valuation	F	MethodValuationCd

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	Alternative Investments	Desc
Book Value	$680,681,138	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$686,101,205	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
Due to Affiliates	$8,773,393
Pension Liability	$39,625,508
Deferred Comp Liability	$34,138,400
Interest Rate Swap Liability	$12,195,063
Lease Liability Total	$12,677,490

Field	Value	IRS element (for citing)
Total Liability	$107,409,854	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	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,787,669	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$14,787,669	NetCommunityBenefitExpnsAmt
Total Expense	0.0090	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$318,674,308	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$373,787,172	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	$333,461,977	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$373,787,172	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$14,787,669	NetCommunityBenefitExpnsAmt
Total Expense	0.0090	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,913,859	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$494,777	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,419,082	NetCommunityBenefitExpnsAmt
Total Expense	0.0027	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$54,278,726	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,718,934	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$45,559,792	NetCommunityBenefitExpnsAmt
Total Expense	0.0277	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$18,976,489	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,209,819	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,766,670	NetCommunityBenefitExpnsAmt
Total Expense	0.0017	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,118,064	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,118,064	NetCommunityBenefitExpnsAmt
Total Expense	0.0013	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,360,120	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$114,074	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,246,046	NetCommunityBenefitExpnsAmt
Total Expense	0.0008	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$81,647,258	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$25,537,604	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$56,109,654	NetCommunityBenefitExpnsAmt
Total Expense	0.0341	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$415,109,235	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$399,324,776	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$70,897,323	NetCommunityBenefitExpnsAmt
Total Expense	0.0431	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$993	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$993	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$161,593	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$161,593	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$90,603	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$211	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$90,392	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$331	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$331	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,050	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$26,050	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$182,593	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$182,593	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$414,411	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$414,411	NetCommunityBenefitExpnsAmt
Total Expense	0.0003	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$453	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$453	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	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	$877,027	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$211	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$876,816	NetCommunityBenefitExpnsAmt
Total Expense	0.0005	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$71,146,123	BadDebtExpenseAmt
Reimbursed By Medicare	$225,963,571	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$262,679,146	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$36,715,575	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	0.5054	0.0337	0.386
SOUTHWEST VIRGINIA HEALTH PROPETIES LLC
REAL ESTATE	0.4993	0.0307	0.4069

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)
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	20	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	https://www.carilionclinic.org/sites/default/files/2022-02/2021%20CMC%20Implementation%20Strategy_FI	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
Other Criteria	Yes (X)	OtherCriteriaInd
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 (7 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 . Per Regulation Section 1.501(r)-3(c)(5) the implementation strategy must be adopted before 4.5 months after the end of the taxable year in which the CHNA is completed. The implementation strategy was adopted on January 18, 2022 and applies for the 2020 tax year (fiscal year 9/30/2021). 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 plan to address prioritized needs with the following strategies and a commitment of financial resources, staff time and leadership. Strategies to address mental health include 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 in efforts 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; assisting in the creation of Neighborhoods of Opportunity, a community leadership development program; and working with United Way and the Virginia Department of Health to assess engagement and interest from key community organizations in the utilization of Unite Us, a social resource referral platform that will be integrated with medical records for clinical utilization. Strategies to address access to care include enhancing virtual visit accessibility by launching Carilion Now; developing a plan to grow community health center presence; and opening the LIFT health 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 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 2022 in our additional strategies category was closely aligned with increasing infrastructure and strategic impact. Increased staffing infrastructure in the Planning and Community Development division has opened opportunities to evaluate and update current processes to better communicate initiative rationale, program outcomes, and expected community impact. Community Health and Outreach's community health worker (CHW) and peer support specialist programs have been integrated into the electronic medical record system-increasing provider capacity for referrals to community health services and streamlining CHW and peer case management, tracking, and reporting. Continuing our commitment to care, the Planning and Community Development division is working closely with the Quality team and the office of Diversity, Equity, and Inclusion to identify and leverage internal data to identify any disparities in the communities we serve.
Schedule H, Part V, Section B, Line 13 Facility A, 1	Facility A, 1 - Group A. Policy changed for February 1, 2021, Individuals with out of network insurance are eligible for financial assistance. Previously, these individuals were not eligible unless their plan did not meet the Patient Protection and Affordable Care Act (PPACA) minimum essential coverage.

Field	Value	IRS element (for citing)
Facility	30	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (30 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
Carilion Clinic Urogynecology
1107 B Brookdale Street	Martinsville	VA	24112	Physician Services
Carilion Clinic Community Care
1229 Third St SW	Roanoke	VA	24016	Physician Services
Carilion Clinic Reproductive Medicine and Fertility
1231 S Jefferson Street	Roanoke	VA	24016	Physican 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 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 Suite 103	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 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 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 February 1, 2021: Families with family income equal or below 300% of the FPG and assets equal or below $25,000 receive 100% adjustment under FAP. Families with family income greater than 300% of the FPG but less than or equal to 500% of the FPG or 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.
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	71146123
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 becoming increasingly more involved with housing-focused activities. Carilion has worked with various community partners to discuss collaborations around housing, including Community Housing Partners, 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 direct economic development expenses from support of the Go Virginia Foundation and the Virginia Economic Development Partnership. Carilion is 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 transportation, housing and education-and communities' overall health and well-being. Carilion supports nonprofit organizations addressing barriers to good health arising from these social determinants in various ways. Carilion also collaborates with local partners, such as the Boys and Girls Club of SWVA, the West End Center for Youth, and the Roanoke County Public Schools Education Foundation, to support better education and opportunities for children and families and improved housing, better nutrition and additional resources for our neighbors in need. These efforts help to remove a range of obstacles to good health for our region's residents. Carilion worked with the Rescue Mission homeless shelter to support the Back-to-School Blast, which equips around 1,000 area students with new backpacks containing school supplies at the start of the school year. Carilion physicians provided physicals and immunizations at the event. 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, Junior Achievement, Mill Mountain Theatre, the Roanoke Cultural Endowment, the Harrison Museum of African American Culture, and the Southwest Virginia Ballet. Line 4 - Environmental improvements: Carilion recognizes the impact of the physical environment on health both locally and globally. Studies on the heat island effect show Roanoke City, the heart of CMC's service area, to be at higher risk of heat-related illnesses that could be mitigated by environmental improvement strategies. As such, a team of Carilion staff are involved in a heat resiliency project in partnership with the City of Roanoke and Virginia Tech. 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. These coalition-building activities include participation with the Child Health Investment Partnership of the Roanoke Valley, the United Way and Healthy Roanoke Valley, 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 Medical Society of Virginia Foundation, the Virginia Health Care Foundation and the American Hospital Association. Carilion was also involved in building awareness and advocacy around domestic violence, sexual assault, sun safety and autism. All of 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 of 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 Foundation for Community College Education.
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	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 extraodinary 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 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. Needs are also identified through current collaborative relationships and community partnerships. Ongoing collaboration with stakeholders allows for regular communication of needs and gives our partners opportunities to respond cohesively. Carilion has adapted its community health improvement process from Associates in Process Improvement's Model for Improvement and the Plan-Do-Study-Act cycle developed by Walter Shewhart. It consists of five steps: (1) conducting the CHNA, (2) strategic planning, (3) creating the implementation strategy, (4) program implementation and (5) evaluation. This cycle is repeated every three years. Carilion fosters community development in its CHNA and community health improvement processes through the Strive Collective Impact Model for the Community Health Assessment Team. This evidence-based model focuses on "the commitment of a group of important players from different sectors to a common agenda for solving a specific social problem(s) and 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 CRMH, is commonly known as the Roanoke Valley. It is composed of the independent cities of Roanoke and Salem and the counties of 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 2017-2021 American Community Survey (ACS) found the Roanoke MSA's total population to be 313,501. The cities of Roanoke and Salem had 99,578 residents and 25,335 people, respectively. The counties of Botetourt, Craig, Franklin and Roanoke had 33,542, 4,914, 54,829 and 96,303 residents, respectively. The median household income ranges from a low of $48,476 in Roanoke City to a high of $72,941 in Botetourt County. Across the Roanoke Valley localities, 11.59% of the population has a household income below the federal poverty guideline. (US Census Bureau, ACS. 2017-2021.) Similarly, 16.0% of the population are receiving Medicaid, and 6.65% have no health insurance at all. (US Census Bureau, ACS. 2017-2021.) The highest rates of Medicaid patients are in Roanoke City (27.04%). Specific to CMC inpatients and outpatients in fiscal year 2022, 21.9% received Medicaid while 2.9% were self-pay. (Strata internal data) The median age in the MSA localities ranges from 38.0 in the city of Roanoke to 48.65 in Craig and Franklin counties, all above the state median of 38.5. The ACS finds that for 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 96.2% in Craig County. (US Census Bureau. ACS. 2017-2021.) 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 60.01% White, 29.3% Black and 3.2% Asian, with 6.0% 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, 6.65% are Hispanic or Latino. (US Census Bureau, ACS. 2017-2021.) 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 LewisGale 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 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 one of Virginia's top hospitals 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 patients regardless of their ability to pay. The hospital's governing board members are elected annually and reside in the region. The majority of members are neither hospital employees nor contractors. Medical staff privileges are extended to qualified providers. Surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. Reinvestments include providing free, discounted and subsidized care and critical medical services not otherwise offered in our region.
Schedule H, Part VI, Line 6 Affiliated health care system	Carilion 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, over 75 specialties and 282 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, and 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 (37 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)	$14,500	Event sponsorships
American Heart Association
4217 Park Place Court	Glen Allen	VA	23060	135613797	501(c)(3)	$17,500	Event sponsorships
CHIP of Roanoke Valley
1201 Third Street	Roanoke	VA	24016	541566451	501(c)(3)	$54,000	Program support
Feeding America Southwest Virginia
1025 Electric Road	Salem	VA	24153	541939556	501(c)(3)	$20,000	Food farmacy program
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
Harrison Museum of African American Culture
PO Box 12544	Roanoke	VA	24026	521417831	501(c)(3)	$20,000	Program support
Junior Achievement of Southwest Virginia
3433 Brambleton Ave SW Suite 202B	Roanoke	VA	24018	540628293	501(c)(3)	$6,250	Event sponsorships
National Multiple Sclerosis Society
900 S Broadway Suite 200	Denver	CO	80209	135661935	501(c)(3)	$11,200	General support
The Rescue Mission of Roanoke Inc
402 4th Street SE	Roanoke	VA	24013	540573900	501(c)(3)	$12,500	General Support	$67,272	Cost	Cleaning Supplies
NAACP - Roanoke Branch
PO Box 12362	Roanoke	VA	24025	546070115	501(c)(4)	$7,500	Program support
Roanoke Regional Partnership
111 Franklin Plaza Suite 333	Roanoke	VA	24011	521327998	501(c)(6)	$600,000	Promote economic development
Roanoke Symphony Orchestra
1125 1st Street SW	Roanoke	VA	24016	546019736	501(c)(3)	$57,926	Program support
Ronald McDonald House Charities of SW VA
2224 S Jefferson Street	Roanoke	VA	24014	541244769	501(c)(3)	$1,000	Donated rent	$270,926	FMV	Donated rent
Science Museum of Western Virginia
1 Market Square	Roanoke	VA	24011	541023953	501(c)(3)	$25,000	Program support
Taubman Museum of Art
110 Salem Avenue SE	Roanoke	VA	24011	546026841	501(c)(3)	$12,000	Event sponsorships
Valleys Innovation Council
2200 Kraft Drive	Blacksburg	VA	24060	462975294	501(c)(3)	$100,000	Program support
Virginia Health Care Foundation
707 E Main Street Suite 1350	Richmond	VA	23219	541639924	501(c)(3)	$150,000	Program support
Roanoke Valley Convention and Visitors Bureau
101 Shenandoah Avenue NE	Roanoke	VA	24016	541520963	501(c)(6)	$25,000	VBR Twenty24 Sponsorship
Blue Ridge Literacy
706 S Jefferson Street	Roanoke	VA	24016	541377063	501(c)(3)	$10,000	Program support
Blue Ridge Behavioral Healthcare
301 Elm Avenue SW	Roanoke	VA	24016	200869969	501(c)(3)	$20,000	Language line operations
Bradley Free Clinic
1240 3rd Street SW	Roanoke	VA	24016	237380491	501(c)(3)	$50,000	Behavioral health/language line
Children's Trust Roanoke Valley
541 Luck Avenue Suite 308	Roanoke	VA	24016	510235891	501(c)(3)	$65,000	General support
City of Roanoke
215 Church Avenue Room 364	Roanoke	VA	24011	546001569	City of Roanoke	$10,000	Financial Empowerment Center
Commonwealth Catholic Charities
1601 Rolling Hills Drive	Richmond	VA	23229	540505877	501(c)(3)	$15,000	Case management for refugees
Family Service of Roanoke Valley
360 Campbell Avenue SW	Roanoke	VA	24016	540505946	501(c)(3)	$22,000	Behavioral health
LEAP
PO Box 2349	Roanoke	VA	24015	271050909	501(c)(3)	$15,000	Access to healthy food
Planned Parenthood South Atlantic
100 S Boylan Avenue	Raliegh	NC	27603	561282557	501(c)(3)	$10,000	Sexual health education
Presbyterian Community Center
1228 Jamison Avenue SE	Roanoke	VA	24013	541610899	501(c)(3)	$45,000	Youth health education
National Academy of Sciences
500 5th Street NW	Washington	DC	20001	530196932	501(c)(3)	$25,000	Program support
Virginia Chamber of Commerce
919 E Main Street Suite 900	Richmond	VA	23219	540421190	501(c)(6)	$10,000	Event sponsorship
VA Growth and Opportunity Foundation
1108 E Main Street Suite 1100	Richmond	VA	23219	811586667	501(c)(3)	$50,000	Program support
VA Ready Initiative
107 S West Street 135	Alexandria	VA	22314	851103573	501(c)(3)	$62,500	Program support
Total Action for Progress
302 2nd Street SW	Roanoke	VA	24011	546057095	501(c)(3)	$15,000	Healthy homes/dental health
Cardinal Productions Inc
PO Box 4455	Roanoke	VA	24015	871532828	501(c)(3)	$100,000	General support
Virginia Harm Reduction Coalition
PO Box 2376	Roanoke	VA	24010	832479145	501(c)(3)	$14,846	Operations support
Virginia Tech Carilion School of Medicine
2 Riverside Circle	Roanoke	VA	24016	264556177	501(c)(3)	$6,344,695	Medical School Support

Field	Value	IRS element (for citing)
Total501c3 Org	33	Total501c3OrgCnt
Total Other Org	4	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (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	$710,945	$0	$320,483	$0	$69,549	$0	$261,164	$0	$19,101	$0	$1,381,242	$0	$64,231
Paul Haskins MD
Director/Physician	$328,627	$0	$42,907	$0	$6,392	$0	$113,718	$0	$20,584	$0	$512,228	$0	$0	$0
Michael Nussbaum MD
Director/SVP/Chair of Surgery	$596,725	$0	$182,003	$0	$15,787	$0	$67,952	$0	$13,116	$0	$875,583	$0	$0	$0
Nicholas Conte
Secretary	$0	$552,419	$0	$240,712	$0	$5,994	$0	$182,985	$0	$14,040	$0	$996,150	$0	$0
David Hagadorn
Asst. Treasurer	$0	$144,952	$0	$3,120	$0	$6,214	$0	$60,261	$0	$5,982	$0	$220,529	$0	$0
Donald Halliwill
Asst. Treasurer	$0	$628,026	$0	$276,629	$0	$122,744	$0	$249,075	$0	$17,801	$0	$1,294,275	$0	$118,313
G Robert Vaughan Jr
Treasurer	$0	$291,047	$0	$98,416	$0	$25,624	$0	$161,498	$0	$18,919	$0	$595,504	$0	$21,586
Patrice Weiss MD
Chief Medical Officer/EVP	$9,075	$637,518	$0	$278,012	$0	$132,699	$0	$228,029	$0	$20,584	$9,075	$1,296,842	$0	$125,067
Bruce Long MD
Physician/Former Key Employee	$266,308	$0	$71,643	$0	$3,856	$0	$10,961	$0	$9,820	$0	$362,588	$0	$0	$0
Michael Abbott
Senior Vice President	$252,041	$0	$86,260	$0	$4,709	$0	$110,847	$0	$7,859	$0	$461,716	$0	$0	$0
Nancy Howell Agee
CEO, Carilion Clinic	$0	$1,469,225	$0	$788,983	$0	$240,653	$0	$145,721	$0	$12,589	$0	$2,657,171	$0	$0
Joseph Moskal MD
SVP/Chair, Dept. of Orthopedics	$1,100,466	$0	$352,222	$0	$85,924	$0	$61,534	$0	$20,302	$0	$1,620,448	$0	$0	$0
Paul Skolnik MD
SVP/Chair, Dept. of Medicine	$462,287	$0	$147,392	$0	$194,349	$0	$49,833	$0	$7,173	$0	$861,034	$0	$130,030	$0
Jon Sweet MD
SVP/Chair, Dept. of Medicine	$245,082	$0	$79,069	$0	$2,763	$0	$99,420	$0	$9,344	$0	$435,678	$0	$0	$0
Jonathan Carmouche MD
Physician	$1,487,762	$0	$273,300	$0	$3,114	$0	$64,610	$0	$12,464	$0	$1,841,250	$0	$0	$0
Gregory Howes MD
Physician	$1,145,035	$0	$628,333	$0	$2,833	$0	$46,028	$0	$17,420	$0	$1,839,649	$0	$0	$0
Eric Marvin MD
Physician	$1,022,035	$0	$495,103	$0	$2,460	$0	$59,660	$0	$17,160	$0	$1,596,418	$0	$0	$0
Adeolu Olasunkanmi MD
Physician	$783,760	$0	$546,968	$0	$2,833	$0	$38,277	$0	$7,455	$0	$1,379,293	$0	$0	$0
Jesse Stem MD
Physician	$862,603	$0	$499,746	$0	$3,553	$0	$47,216	$0	$18,460	$0	$1,431,578	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments	EMPLOYEES ARE OCCASIONALLY PROVIDED SMALL GIFTS, PRIZES OR AWARDS WHICH MAY BE INCLUDED IN TAXABLE COMPENSATION AT AMOUNTS GROSSED UP FOR TAXES. DURING THE REPORTING PERIOD, DR. LEARMAN, Dr. Abbott, Dr. Marvin, Dr. Moskal, Dr. Nussbaum, Dr. Skolnik, Dr. Weiss, and DR. STEM 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.
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 and other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, the list of which was reviewed by the Compensation Committee. The Compensation Committee maintained minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	Mr. 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: $130,030 - Paul Skolnik $125,067 - Patrice Weiss $118,313 - Donald Halliwill $64,231 - Steven Arner $21,586 - G. Robert Vaughan, Jr. Vested and paid in current year: $75,000 - Joseph Moskal $53,241 - Paul Skolnik Ms. Agee participates in an Executive Flexible Benefit Plan, in which an allowance is provided to the participant for use in obtaining certain insurance benefits. In prior years, the amount of allowance in excess of elected benefits was credited to a capital accumulation account (CAA) with various deferred vesting dates of at least two years from the first day of the plan year, distributable upon vesting while employed by a Carilion Clinic affiliate, death, disability, or 24 months following certain qualifying separations from service. Deferrals no longer occur under this plan. $229,385 was distributed under this plan in the reporting year.
Schedule J, Part I, Line 7 Non-fixed payments	The organization pays annual "at-risk" compensation to certain members of management based on performance of an applicable scorecard. While the scorecard contains a formula as a basis for determining overall performance, in certain cases, senior managers have discretion to include additional elements in their assessment of managers reporting to them. In addition, for top management, the actual non-fixed payment awarded is in the discretion of the Carilion Clinic Board of Directors and its Compensation Committee.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Patricia Abbott
Family member of Michael Abbott, key employee	$191,567	Employee	false
Mary Sweet MD
Family member of Jon Sweet, key employee	$379,640	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 patients 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, and help in the hospice office. They also assist with fundraisers, assist with bereavement support activities, deliver birthday gifts, make holiday gifts and record patients' life stories. Total volunteer hours worked were 6,360.
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 30,442 patients and provided 188,539 days of care during Fiscal Year 2022. 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 (3,091 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 72,393 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 7 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 $70.9 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 Accounting 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 and 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	- Total Revenue: 2893048, Related or Exempt Function Revenue: 2893048, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	- Total Revenue: 10143922, Related or Exempt Function Revenue: 10143922, 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: 16796712, Program Service Expense: 16796712, Management and General Expenses: , Fundraising Expenses: ; Billing Collection Services - Total Expense: 19326775, Program Service Expense: , Management and General Expenses: 19326775, Fundraising Expenses: ; Laundry/Housekeeping Services - Total Expense: 10924269, Program Service Expense: 10914705, Management and General Expenses: 9564, Fundraising Expenses: ; Other Purchased Services - Total Expense: 5473866, Program Service Expense: 5458397, Management and General Expenses: 5469, Fundraising Expenses: 10000; Contract Fees/Consulting - Total Expense: 24944337, Program Service Expense: 21792993, Management and General Expenses: 3151344, Fundraising Expenses: ; Repairs and Maintenance - Total Expense: 15686625, Program Service Expense: 15671213, Management and General Expenses: 15412, Fundraising Expenses: ; Reference Labs - Total Expense: 28477962, Program Service Expense: 28477962, Management and General Expenses: , Fundraising Expenses: ; Temporary Staffing - Total Expense: 87259280, Program Service Expense: 87259280, 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 - -XXX-XX-XXXX; Pension-related changes other than net periodic pension costs - XXX-XX-XXXX; Returned Unused Grant Funds - -449798;

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 (9 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
FRANKLIN COUNTY VENTURES LLC
PO BOX 12385	ROANOKE	VA	24025	474365316	REAL ESTATE	VA	CARILION CLINIC	Related	-$4,087	$197,828	false	false	0.1
CARILION CLINIC MEDICARE SHARED SAVINGS COMPANY LLC
PO BOX 12385	ROANOKE	VA	24025	455235473	MEDICARE ACO	VA	CARILION CLINIC	Related	$5,306,774	$10,529,850	false	false	0.5
SOUTHWEST VIRGINIA HEALTH PROPERTIES LLC
1102 Jefferson Street SE	Roanoke	VA	24016	010691570	REAL ESTATE	VA	Carilion Medical Center	Related	$120,393	$1,242,701	false	false	0.4993
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
					SURGERY CENTER	VA	CARILION MEDICAL CENTER	Related	$716,591	$588,457	false	false	0.5054
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

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (10 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
BLACKMOOR OWNERSHIP HOLDINGS LIMITED
					INVESTMENTS		NA	C Corporation	Yes (true)	CJ
Doubleblue Argentina Consumer Finance Fund II LP
205 East 42nd St 20th FL	New York	NY	10017		INVESTMENTS		NA	C Corporation	Yes (true)	CJ
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 (25 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Carilion Clinic Foundation
A	$40,475	Cost
Carilion Services Inc
A	$1,122,605	Cost
CHS Inc
A	$60,644	Cost
Carilion Emergency Services Inc
A	$104,327	Cost
Carilion Healthcare Corporation
A	$28,165	Cost
Carilion New River Valley Medical Center
L	$3,256,853	Cost
Carilion Giles Community Hospital
L	$339,910	Cost
Carilion Franklin Memorial Hospital
L	$2,382,318	Cost
Carilion Rockbridge Community Hospital
L	$643,127	Cost
Carilion Tazewell Community Hospital
L	$2,340,284	Cost
Carilion Services Inc
L	$33,239	Cost
Carilion Emergency Services Inc
L	$389,960	Cost
Carilion Healthcare Corporation
L	$227,571	Cost
Carilion New River Valley Medical Center
K	$258,923	Cost
Carilion Services Inc
M	$244,096,227	Cost
Carilion Behavioral Health Inc
M	$134,211	Cost
CHS Inc
K	$1,967,708	Market Rate
CHS Inc
M	$4,986,745	Cost
SCA Credit Services Inc
M	$1,220,094	Cost
Medkey Inc
M	$328,678	Cost
Carilion Services Inc
R	$101,947,021	Cash
CHS Inc
R	$30,000,000	Cash
Carilion Clinic
S	$30,000,000	Cash
Carilion Healthcare Corporation
R	$1,563,255	Book Value
Carilion Clinic Foundation
C	$600,209	Cash