2022-08-14T15:30:35-05:00 2021-09-30 440160260 FORVIS LLP 1201 WALNUT ST SUITE 1700 KANSAS CITY MO 641062246 990 2020-10-01 540506332 Carilion Medical Center CARI 5402245102 PO BOX 12385 Roanoke VA 240252385 G ROBERT VAUGHAN JR TREASURER 2022-08-14 true G ROBERT VAUGHAN JR 999009999 MIKE ENGLE P00482834 8162216300 2020-08-14 2020 2022-09-23 18:48:47Z STEVE ARNER PO BOX 12385 Roanoke VA 240252385 2032312077 false X WWW.CARILIONCLINIC.ORG X 1899 VA 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. 12 8 9777 73 26824 0 38181365 53729810 1378831131 1553690747 67040275 131595772 24159089 24640419 1508211860 1763656748 4561677 1770037 0 649613528 727753173 0 284436 749272389 857256393 1403447594 1586779603 104764266 176877145 1930321569 2196887752 1347521886 1184883483 582799683 1012004269 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. false false 1356823089 1770037 1570901675 SEE SCHEDULE O. 1356823089 true true false true false false false false true true true false false true false false true false false false false false false false false true true true true true false false false false false false true false false false false false true true true true false false true X 0 0 9777 true true true false false false false false false false false false false false X 12 8 true true true false true true true true true false false true true true true true true true true true true VA X THE CORPORATION ATTN H KIRK 5402245102 213 S JEFFERSON ST ROANOKE VA 24011 Damon Williams Director/Chair 2.0 4.5 X X 0 8375 0 Steven Arner Director/President/CEO 36.0 14.0 X X 0 843427 229064 George Cartledge III Director 2.0 0.0 X 0 842 0 Isabel Thornton Director 2.0 0 X 0 0 0 Janet Frantz Director 2.0 0.0 X 0 842 0 Jason Bingham Director 2.0 2.4 X 0 11825 0 Katherin Elam Director 2.0 0 X 0 0 0 Kianna Price Marshall Director 2.0 0.0 X 0 842 0 Lee Learman MD PhD Director 2.0 0 X 6113 0 0 Michael Nussbaum MD Director 50.0 0 X 607316 0 143319 Neil Macdonald MD Director 50.0 0 X 311189 0 72180 Paul Haskins MD Director 50.0 0 X 348503 0 91067 David Hagadorn Asst. Treasurer 0.5 49.5 X 0 156550 43171 Donald Halliwill Asst. Treasurer 0.5 49.5 X 0 810340 217049 G Robert Vaughan Jr Treasurer 0.5 49.5 X 0 328415 129501 Nicholas Conte Secretary 3.0 47.0 X 0 578993 169751 Patrice Weiss MD Chief Medical Officer/EVP 46.0 4.0 X 11749 747665 208667 Susan Lucas Asst. Secretary 0.5 49.5 X 0 56807 6179 Joseph Moskal MD SVP/Chair, Dept. of Orthopedics 50.0 0 X 1158941 0 89101 Michael Abbott Senior Vice President 50.0 0 X 288051 0 82161 Nancy Howell Agee CEO, Carilion Clinic 2.0 48.0 X 0 1947087 175699 Paul Skolnik MD SVP/Chair, Dept. of Medicine 50.0 0 X 497475 0 57302 ADEOLU OLASUNKANMI MD Physician 50.0 0 X 1125491 0 38519 Eric Marvin MD Physician 50.0 0 X 1287516 0 74955 Gregory Howes MD Physician 50.0 0 X 1401998 0 49123 Jesse Stem MD Physician 50.0 0 X 1069944 0 54067 Jonathan Carmouche MD Physician 50.0 0 X 1553351 0 60054 Bruce Long MD Physician/Former Key Employee 50.0 0 X 396678 0 92119 Jon Sweet MD Physician/Former Key Employee 50.0 0 X 283899 0 72335 Tracey Criss MD Physician/Former Officer 50.0 0 X 317610 0 108442 10665824 5492010 2263828 1005 true true false QUEST DIAGNOSTICS 500 PLAZA DRIVE SECAUCUS NJ 07094 LABORATORY SERVICES 26156435 EARL SWENSSON ASSOCIATES INC 1033 DEMONBREUEN ST SUITE 800 NASHVILLE TN 37203 ARCHITECTURAL DESIGN SERVICES 9844320 GE MEDICAL SYSTEMS 5517 COLLECTION DRIVE CHICAGO IL 60693 EQUIPMENT MAINTENANCE 8541975 F & S BUILDING INNOVATIONS INC 2944 ORANGE AVENUE NE ROANOKE VA 24012 CONSTRUCTION SERVICES 7685034 QUALIVIS LLC 1601 ASSEMBLY ST PO BOX 1180 COLUMBIA SC 29201 TEMPORARY STAFFING 6907771 102 76258 648319 51677152 1328081 53729810 Net Patient Revenue 622110 1495285318 1495285318 Program Related Investments 621999 6555988 6555988 Clinical Research 541715 985930 985930 Other Patient Revenue 446110 46748753 46748753 Affiliate Rent Income 531120 1139476 1139476 2975282 2975282 0 0 1553690747 22158025 26824 22131201 -21318 -21318 5103218 5103218 0 5103218 5103218 378043869 70525 268599606 55723 109444263 14802 109459065 109459065 Physician & Other Affiliate Income 621111 6107359 6107359 Cafeteria 722514 2326273 2326273 Roanoke City Student Health 621400 2108607 2108607 8994962 8994962 0 0 19537201 1763656748 1570901675 26824 138998439 1720030 1720030 50007 50007 4124620 3686580 438040 4255265 4255265 577112384 576619690 375029 117665 57204217 57167371 36846 47227366 47089412 105008 32946 37829321 37778440 43256 7625 197133174 197133174 115471 115471 66835 66835 7306907 7306907 153880114 133906010 19959892 14212 402283 400139 2144 19271750 19177442 89356 4952 4866892 4866368 524 26536365 26521365 15000 1500092 1495597 4495 14062124 14062124 46366206 46366206 15982772 12027002 3955770 Medical Supplies 234983332 234983332 Bad Debt 77186675 77186675 Assessment Fees 51766151 51766151 Dues and Subscriptions 2206399 2106002 100397 3622851 3525046 97805 0 1586779603 1356823089 229672078 284436 17411 16661 18923445 8436375 1423906 607573 265679526 310756552 0 0 1349460 905337 12775422 12695949 4300243 5234412 1273076413 933943793 309949612 339132620 591629581 743933114 725926201 770382060 -1880475 3915889 65123 50216 162114 820994 1930321569 2196887752 211803738 252433479 7877994 645000 160540791 134997227 467470376 457853734 0 499828987 338954043 1347521886 1184883483 X 561406380 985877255 21393303 26127014 582799683 1012004269 1930321569 2196887752 X 176877145 157114632 95212809 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 66835 66835 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY A portion of dues paid to various healthcare industry associations is attributable to lobbying activities. 16794123 348535 4146435 675838 20613255 16881056 609120 696053 16794123 17033643 803774 956361 16881056 16731963 1278959 977279 17033643 15801516 1914128 983681 16731963 0.0 0.5761 0.4239 false false 6116287 6116287 525798908 380971345 144827563 960828 860229 100599 647712636 545372851 102339785 92487754 6739368 85748386 339132620 8734534 F 1992277 C Alternative Investments 759655249 F 770382060 Due to Affiliates 4642901 Pension Liability 267665965 Deferred Comp Liability 36320812 Interest Rate Swap Liability 29576707 Lease Liability Total 747658 338954043 Schedule D, Part V, Line 4 Intended uses of endowment funds Income from endowment funds are used for the following. (1) Pediatric programs- both internal and external- and/or pediatric equipment. (2) Patient care assistance. true true X true X 300 true X 500 false true false true true 16489645 16489645 0.0109 267950534 293287973 0 0.0 0 0.0 0 0 284440179 293287973 16489645 0.0109 9882 28818 4929674 367506 4562168 0.0030 7 58 47788792 8486073 39302719 0.0260 0 0.0 2 1543 1767942 1767942 0.0012 205 10161 886020 112726 773294 0.0005 10096 40580 55372428 8966305 46406123 0.0307 10096 40580 339812607 302254278 62895768 0.0416 1 243 243 0.0000 9 3658 178843 178843 0.0001 37 120 259343 178 259165 0.0002 0 0.0 0 0.0 69 221 36812 1245 35567 0.0000 9 8638 8638 0.0000 12 381192 381192 0.0003 0 0.0 137 3999 865071 1423 863648 0.0006 true 77324377 244280685 266039063 -21758378 X true true ROANOKE AMBULATORY SURGERY CENTER LLC AMBULATORY SURGERY 0.5054 0.4571 SOUTHWEST VIRGINIA HEALTH PROPETIES LLC REAL ESTATE 0.5085 0.4571 2 1 CARILION MEDICAL CENTER -DBA CRMH 1906 BELLEVIEW AVE ROANOKE VA 24014 HTTPS://CARILIONCLINIC.ORG/LOCATIONS/CARILION-ROANOKE-MEMORIAL-HOSPITAL H 1840 X X X X X X A 2 CARILION MEDICAL CENTER -DBA CRCH 101 ELM AVE ROANOKE VA 24013 HTTPS://CARILIONCLINIC.ORG/LOCATIONS/CARILION-ROANOKE-COMMUNITY-HOSPITAL H 1839 X REHABILITATION UNIT A A false false true X X X X X X X X X 20 true true true true X https://www.carilionclinic.org /locations/carilion-roanoke-memorial-hospital https://www.carilionc X https://www.carilionclinic.org/community-health-assessments#roanoke-valley X X true 20 true https://www.carilionclinic.org/community-health-assessments#roanoke-valley false true X 300.0 500.0 X X X X true true X X X true X HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE X HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE X HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE X X X X X X true X false X X X X true X false false 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): 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/community-health-assessments#roanoke-valley. 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 other organizations in addressing recovery and transitional housing; providing community grants to mental health safety net providers; increasing CMC's internal capacity to address substance use through community mental health programming; continuing an addiction task force; providing mental health services at Fallon Park Elementary School; and supporting the Virginia Harm Reduction Coalition in efforts to expand comprehensive harm reduction services in Roanoke. Strategies to address socioeconomic factors include supporting employees through an elevated minimum wage; developing a high school health science careers education pipeline; assisting in the development of a Healthy Homes initiative; investing in local housing-focused organizations; assisting in the development of the United Way's Black Father Family initiative; assisting in the creation of a community leadership development program; and implementing Unite Us, a social resource referral platform that will be integrated with medical records for clinical utilization. Strategies to address access to care include enlarging the family medicine residency program; enhancing accessibility of virtual visits; growing physician staffing pools; and opening the LIFT health center at Fallon Park Elementary School. 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. Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - Group A. Individuals with Out of Network insurance are not eligible for Financial Assistance unless the plan does not meet minimum essential coverage as defined in the Patient Protection and Affordable Care Act (PPACA) or it is a governmental plan. 104 Carilion Roanoke Memorial Rehab 2017 South Jefferson Street Roanoke VA 24014 Psychiatry Services CNRV Emergency Services 2900 Lamb Circle Christiansburg VA 24073 Emergency Physicians CES - Franklin 180 Floyd Avenue Rocky Mount VA 24151 Emergency Physicians CES - Tazewell 388 Ben Bolt Avenue Tazewell VA 24651 Emergency Physicians Carilion Clinic Pain Management 1 Riverside Circle Roanoke VA 24016 Pain Management Carilion Clinic Genetic Counseling 1 Riverside Circle Roanoke VA 24016 Genetic Counseling Carilion GYN Oncology 1 Riverside Circle Suite 300 Roanoke VA 24016 Gynecological Oncology Carilion Clinic Dermatology & Mohs Surgery 1 Riverside Circle Suite 300M Roanoke VA 24016 Dermatology and Mohs Surgery Carilion Clinic Occupational Medicine Elm Ave 101 Elm Avenue SE Roanoke VA 24013 Occupational Medicine Carilion Wound Care Center Carilion Roanoke Community Hospital 101 Elm Avenue SE Roanoke VA 24013 Wound Care Carilion Dentistry Pediatric Surgery 101 Elm Avenue SE Roanoke VA 24013 Dental Service Community Care 101 Elm Avenue SE Roanoke VA 24013 Family Medicine Carilion Maternal Fetal Medicine 101 Elm Avenue Suite 400 Roanoke VA 24013 Maternal Fetal Medicine Carilion Clinic Urogynecology 101 Elm Avenue Suite 400 Roanoke VA 24013 Obstetrics Carilion Prenatal Diagnostic Center 102 Highland Ave Suite 455 Roanoke VA 24013 Prenatal Testing Carilion Breast Care Diagnostic Center 102 Highland Ave Ste 202 Roanoke VA 24013 Breast Care Center Pediatric Cardiology Clinic 102 Highland Avenue Suite 101 Roanoke VA 24013 Cardiology Carilion Genetics 102 Highland Avenue Suite 104 Roanoke VA 24013 Genetic Counseling Carilion Pediatric Neurology 102 Highland Avenue Suite 104 Roanoke VA 24013 Neurosciences Carilion Pediatric Pulmonology and Allergy Clinic 102 Highland Avenue Suite 203 Roanoke VA 24013 Pulmonology Carilion GYN Clinic 102 Highland Avenue Suite 303 Roanoke VA 24013 Gynecological Services Pediatric Gastroenterology 102 Highland Avenue Suite 305 Roanoke VA 24013 Gastroenterology Carilion Clinic Pediatric Surgery Clinic 102 Highland Avenue Suite 404 Roanoke VA 24013 Surgical Services Carilion Pediatric Endocrinology Clinic 102 Highland Avenue Suite 455 Roanoke VA 24013 Endocrinology Carilion Sleep Center 1030 S Jefferson St Ste G100 Roanoke VA 24016 Sleep Disorder Carilion Anticoagulation Clinic 1030 S Jefferson St Ste G101 Roanoke VA 24016 Anticoagulation Clinic Carilion Clinic Pediatric Child Developmental Clinic 1030 S Jefferson Street Roanoke VA 24016 Child Development Services Carilion General Pediatric Clinic 1030 S Jefferson Street Suite 106 Roanoke VA 24016 General Pediatrics Pediatric Developmental Clinic 1030 S Jefferson Street Suite 201 Roanoke VA 24016 Pediatric Development Carilion Diabetic Education 1030 S Jefferson Suite G101 Roanoke VA 24016 Diabetic Education Carilion Uro-Gynecology Associates 1030 S Jefferson St Ste 109 Roanoke VA 24016 Urogynecology Carilion Wellness-Botetourt 105 Summerfield Court Roanoke VA 24019 Outpatient Therapy Services Carilion Clinic Urology Christiansburg 120 Akers Farm Road NE Christiansburg VA 24073 Urology Carilion Clinic Reproductive Medicine and Fertility 1231 S Jefferson Street Roanoke VA 24016 Reproductive Endocrinology Carilion Clinic Vascular McClanahan 127 McClanahan Street Roanoke VA 24014 Vascular Services Carilion Cardiac Rehab 127 McClanahan Street Roanoke VA 24014 Cardiac Rehab Carilion Heart Failure Clinic 127 McClanahan Street Roanoke VA 24014 Heart Failure Services Physical Therapy Westlake 12970 Booker T Washington HWY Hardy VA 24101 Physical Therapy Services CFM Roanoke Salem 1314 Peters Creek Road Roanoke VA 24017 Family Practice Carilion Clinic OBGYN Daleville 150 Market Ridge Lane Daleville VA 24083 Obstetrics and Gynecology Daleville Imaging 150 Market Ridge Lane Daleville VA 24083 Imaging Services Pediatric Subspecialty Clinic 1620 Graves Mill Road Lynchburg VA 24502 Pediatrics General Surgery Clinic 180 Floyd Avenue Rocky Mount VA 24151 Surgical Services Carilion Clinic Cardiology Services - Rocky Mount 180 Floyd Avenue Rocky Mount VA 24151 Cardiology Physical Therapy West Salem 1955 West Main Street Salem VA 24153 Physical Therapy Services Carilion Clinic OBGYN Salem 1957 W Main Street Salem VA 24153 Obstetrics and Gynecology Carilion Clinic Imaging - Crystal Spring 2001 Crystal Spring Ave SW Roanoke VA 24014 Imaging Services Carilion Cardiothoracic Surgery 2001 Crystal Spring Avenue Suite 20 1 Roanoke VA 24014 Cardiac Surgery Services Carilion Clinic Cardiology 2001 Crystal Spring Avenue Suite 20 3 Roanoke VA 24014 Cardiology Services Carilion Clinic Pulmonary and Sleep Medicine 2001 Crystal Spring Avenue Suite 30 0 Roanoke VA 24014 Pulmonary and Sleep Services Carilion Infectious Disease Clinic 2001 Crystal Spring Avenue Suite 30 1 Roanoke VA 24014 Infectious Disease Carilion Center for Healthy Aging 2001 Crystal Spring Avenue Suite 30 2 Roanoke VA 24014 Geriatrics Carilion Clinic Dentistry General Surgery Jefferson 2017 S Jefferson St Roanoke VA 24014 Surgical Services Carilion Clinic Department of Psychiatry and Behavioral Medicine Adult Outp atient 2017 S Jefferson Street Roanoke VA 24014 Behavioral Health Carilion Dental Care 2017 S Jefferson Street Roanoke VA 24014 Dental Service Child and Adolescent Psychiatry 2017 S Jefferson Street Roanoke VA 24014 Child and Adolescent Psychiatry Services Community Psychiatry 2017 S Jefferson Street Roanoke VA 24014 Psychiatry Services CFM Southeast 2145 Mount Pleasant Boulevard Roanoke VA 24014 Family Practice Carilion Clinic Imaging ION 2331 Franklin Road Roanoke VA 24014 Imaging Services Carilion Clinic Neurosurgery - ION 2331 Franklin Road Roanoke VA 24014 Neurosurgery Carilion Clinic Pain Management - ION 2331 Franklin Road Roanoke VA 24014 Pain Management Carilion Physical Medicine and Rehabilitation 2331 Franklin Road Roanoke VA 24014 Physical Medicine Carilion Clinic Orthopaedics - ION 2331 Franklin Road SW Roanoke VA 24014 Orthopaedics Carilion Clinic Department of Psychiatry and Behavioral Medicine 2900 Lamb Circle Christiansburg VA 24073 Psychiatry and Behavioral Health Services CNRVMC - Neurosciences 2900 Lamb Circle Christiansburg VA 24073 Neurology CNRVMC - Radiology 2900 Lamb Circle Christiansburg VA 24073 Radiology Services Carilion Children's Pediatrics - New River 2900 Lamb Circle Christiansburg VA 24073 Pediatrics Carilion Clinic Sleep Center - New River Valley 2900 Lamb Circle Suite 7-700A Christiansburg VA 24073 Sleep Medicine Carilion Clinic Genetics - Lynchburg 2900 Old Forest Rd Lynchburg VA 24501 Pediatric Genetics Carilion Clinic Neuropsychology CCR3 3 Riverside Cir Roanoke VA 24016 Neuropsychology Services Carilion Clinic General Surgery 3 Riverside Circle Roanoke VA 24016 Surgical Services Carilion Clinic Internal Medicine 3 Riverside Circle Roanoke VA 24016 Internal Medicine Carilion Clinic Neurology 3 Riverside Circle Roanoke VA 24016 Neurology Carilion Clinic Orthopaedics Trauma 3 Riverside Circle Roanoke VA 24016 Orthopaedic Trauma Carilion Clinic TraumaCritical Care 3 Riverside Circle Roanoke VA 24016 Surgical Services Carilion Imaging 3 Riverside Circle Roanoke VA 24016 Imaging Services Carilion OBGYN - Riverside 3 Riverside Circle Roanoke VA 24016 Obstetrics and Gynecology CRMH Rheumatology Clinic 3 Riverside Circle Roanoke VA 24016 Rheumatology Carilion Clinic Gastroenterology 3 Riverside Circle Roanoke VA 24016 Gastroenterology Carilion Clinic Orthopaedics 3 Riverside Circle Roanoke VA 24016 Orthopaedics Carilion Clinic Endocrinology 3 Riverside Circle Roanoke VA 24016 Endocrinology Carilion OtolaryngologyENT 3 Riverside Circle 4th Floor Roanoke VA 24016 Otolaryngology and ENT Services Carilion Pediatric OtolaryngologyENT 3 Riverside Circle 4th Floor Roanoke VA 24016 Pediatric Otolaryngology and ENT Services Carilion Plastic and Reconstructive Surgery 3 Riverside Circle Suite 400 Roanoke VA 24016 Plastic and Reconstructive Surgery Carilion Cardiology Westlake 35 Medical Court Hardy VA 24101 Cardiology Services Carilion Sleep Center Westlake 35 Medical Court Hardy VA 24101 Sleep Disorder Carilion Surgery Westlake 35 Medical Court Hardy VA 24101 Surgical Services Urogynecology Westlake 35 Medical Court Hardy VA 24101 Urogynecology Carilion Clinic Dermatology and Mohs Surgery - Westlake 35 Medical Court Hardy VA 24101 Dermatology and Mohs Surgery Carilion Clinic Orthopaedic Surgery - Westlake 35 Medical Court Hardy VA 24101 Orthopaedics Carilion Clinic Otolaryngology and Audiology - Westlake 35 Medical Court Hardy VA 24101 Otolaryngology and ENT Services Carilion Clinic Imaging - Westlake 35 Medical Court Hardy VA 24101 Imaging Services Brambleton Radiology Services 3707 Brambleton Avenue Roanoke VA 24018 Radiology Services Carilion Clinic Family Medicine Tazewell 388 Ben Bolt Avenue Tazewell VA 24651 Family Medicine Carilion Clinic Orthopaedics - Franklin 390 S Main Street Suite 103 Rocky Mount VA 24151 Orthopaedics Carilion Clinic Plastic and Reconstructive Surgery 390 S Main Street Suite 103 Rocky Mount VA 24151 Plastic and Reconstructive Surgery General Surgery Rocky Mount 390 South Main Street Rocky Mount VA 24151 Surgical Services Carilion Wellness - Roanoke 4508 Starkey Road Roanoke VA 24018 Physical Therapy Services Carilion Clinic Allergy and Immunology 46 Wesley Road Daleville VA 24083 Allergy and Immunology Services Carilion Clinic Pediatric Medicine Rocky Mount 490 S Main St Rocky Mount VA 24151 Pediatric Medicine Breast Mammography - North 6415 Peters Creek Road Roanoke VA 24019 Breast Mammography Carilion Children's Pediatric Behavioral Medicine 902 Jefferson St Roanoke VA 24016 Pediatric Child Development Carilion Obstetrics and Gynecology Clinic 902 South Jefferson Street Upper Le vel Roanoke VA 24016 Obstetrics and Gynecology Carilion Children's -Tanglewood Center 4348 Electric Road Roanoke VA 24018 Pediatric Medicine Schedule H, Part I, Line 3c Financial Assistance Eligibility Criteria Patients' eligibility is determined by family size, family income, real property equity and liquid assets. Financial assistance policy (FAP) in effect for October 1, 2020 until January 31, 2021: Families with family income equal or below 200% of the Federal Poverty Guidelines (FPG) and assets equal or below $15,000 receive 100% adjustment under FAP. Families with family income greater than 200% of the FPG but less than or equal to 400% of the FPG or assets above $15,000 and less than or equal to $100,000 receive a partial adjustment under FAP. The partial adjustment matches the AGB percentage for each service area. 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/news/supporting-our-community/ Schedule H, Part I, Line 7 Col (F) Percent of Total Expense Patient-related bad debt expense of $77,324,377 for Carilion Medical Center and its joint venture was excluded from the calculation of Part I Line 7 Column (f) Percent of total expense. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Line 7a and 7b: For activities reported on the Medicaid cost report, a cost-to-charge ratio as determined from the Medicaid cost report was used. For all other activities, a cost to charge ratio derived from Worksheet 2 of the 990 instructions was used. Lines 7e through 7i are reported at actual cost. Schedule H, Part II Community Building Activities Line 1 - Physical improvements and housing: Carilion acknowledges the impact of housing on health and is becoming increasingly more involved with housing-focused activities. Through Points of Diversity-a group promoting equity and inclusion across the Roanoke Valley-Carilion participated in a community conversation surrounding fair housing, bias and discrimination in the housing market, and neighborhoods of opportunity. Line 2 - Economic development: As the largest employer in Southwest Virginia, Carilion impacts economic development by investing in jobs, increased wages for employees and various capital building projects. In addition, Carilion had direct economic development expenses from programming and support of the Virginia Chamber Foundation, the Future of Piedmont Foundation, the Roanoke Regional Partnership and pro-business advocacy. We also supported the Partnership's Accelerate 2022 campaign by leveraging livability, the outdoors and higher education to achieve job growth, investment, qualified workforce and economic impact. Carilion is active in many local economic development endeavors, including supporting the Valleys Innovation Council, investing in research and technology, and communicating with local businesses about the region's current business climate and prospective companies. Funding provided to the Greater Roanoke Transit Company for the Star Line Trolley offers free transportation around downtown Roanoke. This service is a critical link to the Carilion and Virginia Tech Carilion locations in Roanoke's Innovation Corridor along Jefferson Street. 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 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 and the Southwest Virginia Ballet. Line 6 - Coalition building: Carilion believes in the power of collaboration and understands that we must address our most significant health issues in concert with the community. To ensure lasting impact from the health assessment and community health improvement process, Carilion participates in coalitions that address health, safety and social determinant needs in the Roanoke Valley. We also partner with multiple community and business organizations on initiatives to improve health and wellness for everyone living in the Roanoke Valley. An example is Carilion's representation and participation on the Roanoke Gun Violence Prevention Commission, a group of community stakeholders working to decrease gun violence caused by systemic issues. Carilion also leads the Safe Kids Southwest Virginia coalition, which focuses on reducing unintentional injuries in children. Other coalition-building activities include participation with the Child Health Investment Partnership of the Roanoke Valley, Goodwill, New Horizons Healthcare and Children's Trust of Roanoke Valley. 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 National League of Cities and Health Systems partnership. 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 is also spearheading 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 Growth4VA coalition, promoting reform and reinvestment in the higher education system. In addition, Carilion deploys special recruitment efforts for specific types of providers to improve access to needed care and meet the needs of underserved individuals in the Roanoke Valley. 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 operating an emergency room open to all persons regardless of ability to pay and providing other hospital care for all patients able to pay, including those 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 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 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 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 2015-2019 American Community Survey (ACS) found the Roanoke MSA's total population to be 313,009. The cities of Roanoke and Salem had 99,229 residents and 25,317 people, respectively. The counties of Botetourt, Craig, Franklin and Roanoke had 33,343, 5,110, 56,187 and 93,823 residents, respectively. The median household income ranges from a low of $44,230 in Roanoke City to a high of $71,110 in Botetourt County. Across the Roanoke Valley localities, 12.05% of the population has a household income below the federal poverty guideline. (US Census Bureau, ACS. 2015-2019.) Similarly, 14.5% of the population are receiving Medicaid, and 4.6% have no health insurance at all. (US Census Bureau, Small Area Health Insurance Estimates. 2019.) The highest rates of Medicaid patients are in Roanoke City (25.27%). Specific to CMC inpatients and outpatients in fiscal year 2021, 21% received Medicaid while 3.3% were self-pay. (Strata internal data) The median age in the MSA localities ranges from 37.8 in the city of Roanoke to 47.2 in Craig and Franklin counties, all above the state median of 38.2. 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 98.6% in Craig County. (US Census Bureau. American Community Survey. 2015-2019.) 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 Roanoke Valley's urban hub, the city of Roanoke, is more racially and ethnically diverse than the rest of the MSA. Roanoke's population is 62.4% White, 29.0% Black and 3.0% Asian, with 4.4% 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, 6.3% are Hispanic or Latino. (US Census Bureau, ACS. 2015-2019.) 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. true CHIP of Roanoke Valley 1201 Third Street Roanoke VA 24016 541566451 501(c)(3) 106101 Program support American Heart Association 4217 Park Place Court Glen Allen VA 23060 135613797 501(c)(3) 12000 Event sponsorships Roanoke Higher Education Center 108 N Jefferson St Roanoke VA 24016 541905635 501(c)(3) 10000 General support Roanoke Regional Partnership 111 Franklin Plaza Roanoke VA 24011 521327998 501(c)(6) 100000 Promote economic develop American Cancer Society PO Box 4110 Glen Allen VA 23058 131788491 501(c)(3) 12000 Event sponsorships Roanoke Cultural Endowment PO Box 22 Roanoke VA 24002 472754436 501(c)(3) 300000 Community sponsorships (7) National Center for HealthCare Leadership 17 North State Street Chicago IL 60602 364483505 501(c)(3) 7500 Event sponsorship (8) Virginia Business Higher Educational Council 1108 East Main Street Richmond VA 23219 541827038 501(c)(3) 50000 Program Support The Virginia Chamber Foundation 919 East Main Street Richmond VA 23219 510193842 501(c)(3) 50000 Program Support Future of the Piedmont Foundation PO Box 191 Danville VA 24543 541842627 501(c)(3) 10000 Program Support (11) Ronald McDonald House Charities of SW VA 2224 S Jefferson Street Roanoke VA 24014 541244769 501(c)(3) 1000 263675 FMV Donated rent Program support The Aspen Group 2000 16th Street Denver CO 80202 300855877 501(c)(3) 6000 Program support United Way of Roanoke Valley 325 Campbell Ave SW Roanoke VA 24016 540535302 501(c)(3) 300000 Health collab operations Blue Ridge Literacy 706 S Jefferson Street Roanoke VA 24016 541961045 501(c)(3) 10000 English/Health Literacy Class Program Boys & Girls Club of Southwest Virginia Inc 1714 9th Street SE Roanoke VA 24013 541867366 501(c)(3) 6800 Triple Play/Project Learn Program Blue Ridge Parkway Foundation PO Box 21852 Roanoke VA 24018 311512730 501(c)(3) 6000 Two new track trails Bradley Free Clinic 1240 3rd Street SW Roanoke VA 24016 237380491 501(c)(3) 20000 Behavioral Health Services City of Roanoke 215 Church Avenue Roanoke VA 24011 546001569 City of Roanoke 20000 Community program support Commonwealth Catholic Charities 1601 Rolling Hills Drive Richmond VA 23229 540505877 501(c)(3) 15000 Healthcare/Education for refugees Family Service of Roanoke Valley 360 Campbell Avenue SW Roanoke VA 24016 540505946 501(c)(3) 15000 Behavioral Health Services LEAP PO Box 3249 Roanoke VA 24015 271050909 501(c)(3) 15000 Access to healthy food Cardinal Productions Inc 2301 Laburnum Avenue Roanoke VA 24015 871532828 501(C)(3) 100000 Sponsorship Greater Roanoke Transit Company 1108 Campbell Avenue Roanoke VA 24013 540982022 City of Roanoke 9882 Community transportation Renovation Alliance 530 8th Street SW Roanoke VA 24016 541961045 501(c)(3) 10000 Americorps Vista Volunteer Initiative Children's Trust Roanoke Valley 541 Luck Avenue Roanoke VA 24016 510235891 501(c)(3) 120000 General support Freedom First Enterprises 5240 Valley Park Drive Roanoke VA 24019 813904720 501(c)(3) 50000 LIFT Project - Fallon Park Elem School 26 0 ENDOWMENT FUNDED PATIENT CARE 3 50007 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. 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. X false true false true false false false false false true false Steven Arner Director/President/CEO 0 641621 0 75000 0 126806 0 211048 0 18016 0 1072492 0 121506 Paul Haskins MD Director 273131 0 71201 0 4171 0 71664 0 19403 0 439570 0 0 0 Neil Macdonald MD Director 294454 0 10000 0 6735 0 55145 0 17035 0 383369 0 0 0 Michael Nussbaum MD Director 566623 0 30040 0 10653 0 128427 0 14892 0 750636 0 0 0 Tracey Criss MD Physician/Former Officer 265567 0 47075 0 4968 0 91423 0 17019 0 426052 0 0 0 Nicholas Conte Secretary 0 497735 0 75000 0 6258 0 156342 0 13409 0 748744 0 0 David Hagadorn Asst. Treasurer 0 136195 0 2830 0 17525 0 42306 0 865 0 199721 0 0 Donald Halliwill Asst. Treasurer 0 566317 0 75000 0 169023 0 200333 0 16716 0 1027389 0 164360 G Robert Vaughan Jr Treasurer 0 274535 0 30000 0 23879 0 111529 0 17972 0 457916 0 19407 Patrice Weiss MD Chief Medical Officer/EVP 11749 576006 0 50240 0 121419 0 189168 0 19499 11749 956332 0 113484 Bruce Long MD Physician/Former Key Employee 360630 0 20795 0 15253 0 79615 0 12504 0 488797 0 0 0 Jon Sweet MD Physician/Former Key Employee 240954 0 39660 0 3285 0 60867 0 11468 0 356234 0 0 0 Michael Abbott Senior Vice President 234074 0 30330 0 23647 0 74739 0 7422 0 370212 0 0 0 Nancy Howell Agee CEO, Carilion Clinic 0 1344036 0 100000 0 503052 0 163761 0 11938 0 2122787 0 262135 Joseph Moskal MD SVP/Chair, Dept. of Orthopedics 1040282 0 30000 0 88659 0 72309 0 16792 0 1248042 0 0 0 Paul Skolnik MD SVP/Chair, Dept. of Medicine 456278 0 30000 0 11197 0 50515 0 6787 0 554777 0 0 0 Jonathan Carmouche MD Physician 1437334 0 112979 0 3038 0 48393 0 11661 0 1613405 0 0 0 Gregory Howes MD Physician 1096803 0 302363 0 2833 0 33312 0 15811 0 1451122 0 0 0 Eric Marvin MD Physician 972553 0 312396 0 2567 0 59144 0 15811 0 1362471 0 0 0 ADEOLU OLASUNKANMI MD Physician 743302 0 379357 0 2833 0 31413 0 7106 0 1164010 0 0 0 Jesse Stem MD Physician 834266 0 232125 0 3553 0 36956 0 17111 0 1124011 0 0 0 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 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 detailed 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. Nussbaum, Dr. Skolnik, Mr. Vaughan, and Dr. Weiss participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP) in which the employer, at the discretion of Carilion Clinic's Compensation Committee, makes a contribution to an account established on its books for each eligible participant. If a participant ceases to be a participant prior to the vesting date, the account shall be forfeited. A lump sum distribution shall be made upon the participant's vesting date, death, or disability. Unvested contributions made to the DC SERP in the reporting period are included in Part II of this schedule with "retirement and other deferred compensation." The following distributions were made to these individuals under this plan in the reporting year. $121,506 - Steven Arner $164,360 - Donald Halliwill $113,484 - Patrice Weiss $19,407 - G. Robert Vaughan, Jr. Ms. Agee participated in an executive flexible benefit plan, in which an allowance is provided annually 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. $262,135 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. Patricia Abbott Family member of Michael Abbott, key employee 245605 Employee false Mary Sweet MD Family member of Jon Sweet, former key employee 429799 Employee false 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 1,343. Note: The volunteer program was suspended on March 16, 2020 due to the Covid pandemic which affected the amount of volunteer hours worked. Form 990, Part III, Line 4a Program Service Description Carilion Medical Center (CMC), comprised of Carilion Roanoke Memorial Hospital, Carilion Roanoke Community Hospital and a collaborative network of physician specialists, exists to serve the health care needs of its communities and region, regardless of the patient's ability to pay. Carilion Roanoke Memorial Hospital (CRMH) has been consistently ranked among the nation's top 100 hospitals by Becker's Hospital Review, among the top in Virginia by U.S. News and World Report, and it is the region's preferred hospital according to surveys conducted by National Research Corporation (NRC) Health. CMC admitted 28,945 patients and provided 187,918 days of care during fiscal year 2021. CMC is known for tertiary level care with expertise in Level 1 trauma for adults and pediatric patients, primary and comprehensive stroke care, neurosurgery for adults and children, and women's services for obstetrics (2,935 babies delivered), high-risk pregnancy, urogynecology, gynecologic oncology and fertility and reproductive care. Hospital programs include the Cardiovascular Institute which provides extensive expertise in cardiology for advanced heart failure, structural heart disease, electrophysiology labs for complex arrhythmias and a robust cardiothoracic surgery program with advanced procedures for complex aortic and vascular disease. Our vascular program remains a leader in treatment and surgical intervention. Another area of surgical excellence is orthopaedics. It includes joint replacement, ortho spine surgery, sports medicine, trauma surgery, foot and ankle, hand and upper extremity and pediatrics. Other medical programs include specialized intensive care units for neurotrauma, cardiac care and cardiac surgery, vascular, medical intensive care, and dedicated units for oncology and thoracic surgery patients. The programs are supported by our acclaimed Magnet nursing program, receiving four Magnet designations over the years. Additional programs include the region's only neonatal intensive care unit, 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 and nuclear medicine procedures and ultrasound and provide screening mammography and diagnostic breast imaging. Carilion Children's is our region's only pediatric center of excellence with an inpatient hospital within CMC, a pediatric intensive care unit, NICU, and trauma care. Pediatric sub-specialists support the facility in surgery, pulmonology, oncology, cardiology, gastroenterology, behavioral health, orthopaedics, neurosurgery, dentistry, neurology, and endocrinology. To better serve our young patients and their families, outpatient pediatric services were expanded and brought together all in one location at our new Carilion Children's Tanglewood facility in September 2021. 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. Supporting our communities is our 24/7 Level 1 trauma center, full-service emergency department, three medical service helicopters and a highly advanced medical communications center to support the region's emergency transportation needs. With 70,154 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, sponsoring 10,233 events touching over 44,586 people. 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 for the year exceeded $62 million. Form 990, Part IV, Line 11f Disclosure of Uncertain Tax Positions Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. Form 990, Part V, Line 1a 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 Susan Lucas - 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, Susan Lucas, G. Robert Vaughan, Jr., and Patrice Weiss. Form 990, Part VI, Line 4 Significant changes to organizational documents The bylaws were amended to include the following significant changes. (1) The board of directors makeup was changed to exclude the Chairman of the Board of the Jefferson College of Health Sciences as an ex officio director with a vote. (2) And removed the age limit that no director may be reelected to a full three-year term if he or she has reached the age of 72. 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. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia, certain extraordinary actions require member approval, such as mergers, consolidations, liquidations, and the sale of substantially all of the assets of the organization. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a. Form 990, Part VI, Line 11b Review of form 990 by governing body The Form 990 was prepared by Carilion's internal Tax Department with input from various Carilion departments as applicable, and reviewed by internal management and an independent CPA firm. Prior to filing, management reviewed a draft of the Form 990 with the Carilion Clinic Board of Directors Audit Committee members and answered questions at that meeting. Prior to filing, all Board Members were notified by email of its availability on Carilion'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 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 detailed minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives. Form 990, Part VI, Line 15b Process to establish compensation of other employees See response to line 15A. Form 990, Part VI, Line 19 Required documents available to the public The organization's governing documents, conflict of interest statement, and financial statements are released from time to time during the tax year upon request. The conflict of interest policy is included in our Code of Excellence which is available to the public on our website. The Articles of Incorporation are available from the Virginia State Corporation Commission. Limited financial information is available on our website. Form 990, Part VIII, Line 2f Other Program Service Revenue Other - Total Revenue: 2975282, Related or Exempt Function Revenue: 2975282, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Revenue - Total Revenue: 8994962, Related or Exempt Function Revenue: 8994962, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; 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. 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