CARILION ROCKBRIDGE COMMUNITY HOSPITAL: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: CARILION ROCKBRIDGE COMMUNITY HOSPITAL (EIN 54-0568001)
Tax period: 2020-10-01 to 2021-09-30
Filed: 2022-08-14
IRS object ID: 202232269349300713
Schema version: 2020v4.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-08-14T16:00:53-05:00	ReturnTs
Tax Period End	2021-09-30	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	2020-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	540568001	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Carilion Rockbridge Community Hospital	BusinessNameLine1Txt

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	G ROBERT VAUGHAN JR	PersonNm
Person Title	ASSISTANT TREASURER	PersonTitleTxt
Signature	2022-08-14	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	2022-08-14	PreparationDt

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GREGORY T MADSEN	BusinessNameLine1Txt

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$72,965,392	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	1955	FormationYr
Legal Domicile State	VA	LegalDomicileStateCd
Activity Or Mission	Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	609	TotalEmployeeCnt
Total Volunteers	15	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,253,390	PYContributionsGrantsAmt
CY Contributions Grants	$1,647,901	CYContributionsGrantsAmt
PY Program Service Revenue	$49,238,984	PYProgramServiceRevenueAmt
CY Program Service Revenue	$59,883,363	CYProgramServiceRevenueAmt
PY Investment Income	$2,010,451	PYInvestmentIncomeAmt
CY Investment Income	$3,609,108	CYInvestmentIncomeAmt
PY Other Revenue	$527,939	PYOtherRevenueAmt
CY Other Revenue	$548,453	CYOtherRevenueAmt
PY Total Revenue	$53,030,764	PYTotalRevenueAmt
CY Total Revenue	$65,688,825	CYTotalRevenueAmt
PY Grants And Similar Paid	$36,080	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$296,900	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$20,838,409	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$26,125,669	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$26,469,037	PYOtherExpensesAmt
CY Other Expenses	$32,442,764	CYOtherExpensesAmt
PY Total Expenses	$47,343,526	PYTotalExpensesAmt
CY Total Expenses	$58,865,333	CYTotalExpensesAmt
PY Revenues Less Expenses	$5,687,238	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$6,823,492	CYRevenuesLessExpensesAmt
Total Assets BOY	$70,108,246	TotalAssetsBOYAmt
Total Assets EOY	$80,568,602	TotalAssetsEOYAmt
Total Liabilities BOY	$29,916,547	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$30,374,339	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$40,191,699	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$50,194,263	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	$49,845,815	ExpenseAmt
Grant	$296,900	GrantAmt
Revenue	$60,177,920	RevenueAmt
Desc	See schedule O.	Desc
Total Program Service Expenses	$49,845,815	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	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	false	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	false	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	609	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (true)	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (true)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	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 (28 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Greg Madsen
Director/Hospital VP	50.0	0	Yes (X)	Yes (X)	$207,839	$0	$51,453
Gregory Cavallaro
Director/Secretary/Treasurer	1.2	0.0	Yes (X)	Yes (X)	$0	$576	$0
James Williams Jr
Director/Chair	1.2	0	Yes (X)	Yes (X)	$0	$0	$0
Juliet GIBSON
Director/Vice Chair	1.2	0	Yes (X)	Yes (X)	$0	$0	$0
Richard TEAFF PhD
Director/Chair	2.5	0	Yes (X)	Yes (X)	$0	$0	$0
Alicia Devine MD
Director	1.2	48.8	Yes (X)		$0	$335,371	$45,882
Alvin Hockaday
Director	1.2	0	Yes (X)		$0	$0	$0
Amy DeHart
Director	1.2	0	Yes (X)		$0	$0	$0
Ayesha KELLY MD
Director	1.2	48.8	Yes (X)		$0	$296,034	$60,578
Cheryl Wright
Director	1.2	0	Yes (X)		$0	$0	$0
James Crews MD
Director	1.2	15.0	Yes (X)		$0	$28,570	$0
Lisa Sprinkel
Director	1.2	48.8	Yes (X)		$0	$145,600	$59,088
Matthew Burton MD
Director	2.2	47.8	Yes (X)		$5,767	$320,531	$66,212
P Duaine Fitzgerald
Director	1.2	0	Yes (X)		$0	$0	$0
Sidney Evans
Director	1.2	0	Yes (X)		$0	$0	$0
Tracy Lyons
Director	1.2	0	Yes (X)		$0	$0	$0
David Hagadorn
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$156,550	$43,171
Donald Halliwill
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$810,340	$217,049
G Robert Vaughan Jr
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$328,415	$129,501
Nicholas Conte
Asst. Secretary	1.0	49.0		Yes (X)	$0	$578,993	$169,751
Steven Arner
Asst. Secretary	2.0	48.0		Yes (X)	$0	$843,427	$229,064
Susan Lucas
Asst. Secretary	0.5	49.5		Yes (X)	$0	$56,807	$6,179
Nancy Howell Agee
CEO, Carilion Clinic	2.0	48.0			$0	$1,947,087	$175,699	Yes (X)
Jessica Saville
Pharmacy Manager	46.5	3.5			$147,296	$15,517	$26,042		Yes (X)
Phyllis Snyder
RN Lead	50.0	0			$133,475	$0	$53,766		Yes (X)
Ruby Liwag
Department Director	49.5	0.5			$107,356	$236	$14,444		Yes (X)
TRACY HIGGINS
Unit Director	50.0	0			$150,362	$0	$66,359		Yes (X)
Tracy Kiely
RN Lead	49.5	0.5			$119,471	$571	$41,482		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$871,566	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$5,864,625	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,455,721	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	12	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt	Address Line2ContractorAddress/USAddress/AddressLine2Txt
QUEST DIAGNOSTICS
500 PLAZA DRIVE	SECAUCUS	NJ	07094	LABORATORY SERVICES	$849,177
G J HOPKINS INC
714 FIFTH STREET NE	ROANOKE	VA	24016	CONTRACTOR FEES	$466,450
QUALIVIS LLC
1601 ASSEMBLY ST	COLUMBIA	SC	29201	TEMPORARY STAFFING	$300,831	PO BOX 1180
ACV INC
5115 BERNARD DRIVE SUITE 201	ROANOKE	VA	24018	ANESTHESIOLOGY SERVICES	$118,000

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	4	CntrctRcvdGreaterThan100KCnt
Related Organizations	$1,418,010	RelatedOrganizationsAmt
Government Grants	$197,845	GovernmentGrantsAmt
All Other Contributions	$32,046	AllOtherContributionsAmt
Total Contributions	$1,647,901	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue	622110	$59,507,725	$59,507,725
Rent from affiliates	531120	$66,837	$66,837
Patient Pharmacy Revenue	446110	$308,801	$308,801

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

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

Field	Value	IRS element (for citing)
Total Program Service Revenue	$59,883,363	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$558,025	TotalRevenueColumnAmt
Exclusion	$558,025	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$90,262	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$90,262	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$90,262	TotalRevenueColumnAmt
Exclusion	$90,262	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$10,327,649	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$7,276,567	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$3,051,082	SecuritiesAmt
Other	$0	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,051,083	TotalRevenueColumnAmt
Exclusion	$3,051,083	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
Contract Revenue	900099	$265,669	$265,669
Cafeteria	722514	$163,634		$163,634

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$28,888	TotalRevenueColumnAmt
Related Or Exempt Func Income	$28,888	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$458,191	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$65,688,825	TotalRevenueColumnAmt
Related Or Exempt Func Income	$60,177,920	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$3,863,004	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	$296,900	TotalAmt
Program Services	$296,900	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$298,315	TotalAmt
Management And General	$298,315	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$20,186,193	TotalAmt
Program Services	$19,948,687	ProgramServicesAmt
Management And General	$237,506	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,503,818	TotalAmt
Program Services	$1,486,325	ProgramServicesAmt
Management And General	$17,493	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$3,041,906	TotalAmt
Program Services	$2,976,542	ProgramServicesAmt
Management And General	$65,364	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,095,437	TotalAmt
Program Services	$1,070,257	ProgramServicesAmt
Management And General	$25,180	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$7,188,572	TotalAmt
Management And General	$7,188,572	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$2,378	TotalAmt
Program Services	$2,378	ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$203,125	TotalAmt
Management And General	$203,125	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$6,268,026	TotalAmt
Program Services	$5,477,744	ProgramServicesAmt
Management And General	$790,282	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,149	TotalAmt
Program Services	$1,149	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$719,154	TotalAmt
Program Services	$691,335	ProgramServicesAmt
Management And General	$27,819	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$79,656	TotalAmt
Program Services	$79,656	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$803,242	TotalAmt
Program Services	$803,242	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$25,620	TotalAmt
Program Services	$25,589	ProgramServicesAmt
Management And General	$31	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$733,624	TotalAmt
Program Services	$733,624	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,601,296	TotalAmt
Program Services	$2,601,296	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$549,014	TotalAmt
Program Services	$402,375	ProgramServicesAmt
Management And General	$146,639	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Med Supplies	$5,451,771	$5,451,771
Bad Debt	$5,036,160	$5,036,160
Intercompany Practice Subsidy	$2,619,373	$2,619,373
Dues & Subscriptions	$44,635	$36,839	$7,796

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$115,969	TotalAmt
Program Services	$104,573	ProgramServicesAmt
Management And General	$11,396	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$58,865,333	TotalAmt
Program Services	$49,845,815	ProgramServicesAmt
Management And General	$9,019,518	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,311	BOYAmt
EOY	$1,249	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,904	BOYAmt
EOY	$961	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$9,528,228	BOYAmt
EOY	$11,682,017	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$408,898	BOYAmt
EOY	$580,006	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$126,141	BOYAmt
EOY	$143,952	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$63,845,838	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$44,816,671	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$17,947,701	BOYAmt
EOY	$19,029,167	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$11,496,191	BOYAmt
EOY	$17,246,276	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$20,136,676	BOYAmt
EOY	$22,608,561	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

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

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$10,461,196	BOYAmt
EOY	$9,276,413	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$70,108,246	BOYAmt
EOY	$80,568,602	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$8,394,439	BOYAmt
EOY	$8,189,100	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$6,079,829	BOYAmt
EOY	$2,583,971	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$14,698,381	BOYAmt
EOY	$13,694,413	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$559,646	BOYAmt
EOY	$540,444	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$184,252	BOYAmt
EOY	$5,366,411	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$29,916,547	BOYAmt
EOY	$30,374,339	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$40,191,699	BOYAmt
EOY	$49,194,263	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
EOY	$1,000,000	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$40,191,699	BOYAmt
EOY	$50,194,263	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$70,108,246	BOYAmt
EOY	$80,568,602	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$6,823,492	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$3,856,222	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$677,150	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	$2,378	OtherActivitiesAmt
Total Lobbying Expenditures	$2,378	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

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

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,117,453	OtherCostOrOtherBasisAmt
Book Value	$1,117,453	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$34,073,469	OtherCostOrOtherBasisAmt
Depreciation	$23,189,397	DepreciationAmt
Book Value	$10,884,072	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$663,428	OtherCostOrOtherBasisAmt
Depreciation	$550,940	DepreciationAmt
Book Value	$112,488	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$25,018,826	OtherCostOrOtherBasisAmt
Depreciation	$19,880,963	DepreciationAmt
Book Value	$5,137,863	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,972,662	OtherCostOrOtherBasisAmt
Depreciation	$1,195,371	DepreciationAmt
Book Value	$1,777,291	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$19,029,167	TotalBookValueLandBuildingsAmt

Financial Derivatives FinancialDerivativesGrp

Field	Value	IRS element (for citing)
Book Value	$118,285	BookValueAmt
Method Valuation	F	MethodValuationCd

Other Securities OtherSecuritiesGrp (2 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
Alternative Investments	$22,490,276	F
Investment - Stock

Field	Value	IRS element (for citing)
Total Book Value Securities	$22,608,561	TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
Due From Affiliate	$8,997,559
Assets Held for Foundation
Right of Use Asset	$278,854

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$9,276,413	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
Pension Liability	$91,526
Deferred Comp
Swap Liability	$2,736
Due to Affiliate	$1,958,000
Lease Liability	$3,314,149

Field	Value	IRS element (for citing)
Total Liability	$5,366,411	TotalLiabilityAmt

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

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

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

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

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,090,260	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,090,260	NetCommunityBenefitExpnsAmt
Total Expense	0.0203	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,002,523	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,468,548	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,533,975	NetCommunityBenefitExpnsAmt
Total Expense	0.0285	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	$8,092,783	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,468,548	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,624,235	NetCommunityBenefitExpnsAmt
Total Expense	0.0488	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	77	ActivitiesOrProgramsCnt
Persons Served	5099	PersonsServedCnt
Total Community Benefit Expns	$208,681	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$208,681	NetCommunityBenefitExpnsAmt
Total Expense	0.0039	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

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

Subsidized Health Services SubsidizedHealthServicesGrp

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

Research ResearchGrp

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

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	29	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$242,532	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$225,260	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,272	NetCommunityBenefitExpnsAmt
Total Expense	0.0003	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	106	ActivitiesOrProgramsCnt
Persons Served	5099	PersonsServedCnt
Total Community Benefit Expns	$451,213	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$225,260	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$225,953	NetCommunityBenefitExpnsAmt
Total Expense	0.0042	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	106	ActivitiesOrProgramsCnt
Persons Served	5099	PersonsServedCnt
Total Community Benefit Expns	$8,543,996	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,693,808	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,850,188	NetCommunityBenefitExpnsAmt
Total Expense	0.0529	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

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

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	44	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$9,082	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$9,082	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	37	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$5,210	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,200	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,010	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$2,146	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$146	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

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

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	35	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$2,813	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,813	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$42	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$42	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

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

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

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

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	119	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$19,293	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,200	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$16,093	NetCommunityBenefitExpnsAmt
Total Expense	0.0003	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$5,036,160	BadDebtExpenseAmt
Reimbursed By Medicare	$16,058,827	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$16,300,209	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$241,382	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Carilion Rockbridge Community Hospital	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1 HEALTH CIRCLE	AddressLine1Txt
City	LEXINGTON	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24450	ZIPCd

Field	Value	IRS element (for citing)
Website Address	https://carilionclinic.org//locations/carilion-rockbridge-community-hospital	WebsiteAddressTxt
State License	H 1906	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Carilion Rockbridge Community Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	20	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	https://www.carilionclinic.org/locations/carilion-rockbridge-community-hospital	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	https://www.carilionclinic.org/community-health-assessments#rockbridge-area	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/community-health-assessments#rockbridge-area	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 (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	The publicly available community health needs assessment report details the prioritization process for the community's significant health needs as identified through the CHNA. The Community Health Assessment Team (CHAT), made up of community stakeholders, reviews all data and completes a prioritization survey. Through the survey, each CHAT member selects and ranks the most pertinent community needs. The data are combined, and priorities are selected based on the highest weighted score of each need. Through this process, CHAT members prioritize needs according to the need's perceived burden, scope, severity or urgency; the importance the community places on addressing the need through survey responses and other interactions; and each member's unique perspective on community health.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Carilion Rockbridge Community Hospital. 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 as low-income, are minorities and suffer from chronic diseases. The following organizations served on the CHAT for the 2021 Rockbridge Area Community Health Needs Assessment (RACHNA): City of Lexington, Rockbridge Area Health Center, Rockbridge Baths Community Organization, Trinity United Methodist Church, Project Horizon, Rockbridge Community Health Foundation, Washington & Lee University, Lexington Office on Youth, Rockbridge County Economic Development, Rockbridge Area Relief Association, Southern Virginia University, Virginia Department of Health, Chamber of Commerce Serving Lexington Rockbridge and Buena Vista, Rockbridge Area Transportation System, Natural Bridge State Park, Rockbridge Area Community Services, Rockbridge Area YMCA, Grace Episcopal Church, Anthem Medicaid, and Virginia Cooperative Extension. To obtain input from the community, the RACHNA conducted a focus group among CHAT stakeholders, three focus groups among target populations (African-American) and administered a 40-question community health survey broadly across the service area. This occurred from October 1, 2020, through January 31, 2021. The community health 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 Rockbridge Area residents 18 years of age and older in the following service area: Rockbridge County, Lexington City and Buena Vista City. Special efforts were made to include underserved and 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. 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 6b Facility , 1	Facility , 1 - Carilion Rockbridge Community Hospital. The 2021 Rockbridge Area Community Health Needs Assessment was conducted with: City of Lexington, Rockbridge Area Health Center, Rockbridge Baths Community Organization, Trinity United Methodist Church, Project Horizon, Rockbridge Community Health Foundation, Washington & Lee University, Lexington Office on Youth, Rockbridge County Economic Development, Rockbridge Area Relief Association, Southern Virginia University, Virginia Department of Health, Chamber of Commerce serving Lexington Rockbridge and Buena Vista, Rockbridge Area Transportation System, Natural Bridge State Park, Rockbridge Area Community Services, Rockbridge Area YMCA, Grace Episcopal Church, Anthem Medicaid, and Virginia Cooperative Extension.
Schedule H, Part V, Section B, Line 7 Facility , 1	Facility , 1 - Carilion Rockbridge Community Hospital. The Community Health Assessment Team shared the 2021 Rockbridge Area Community Health Needs Assessment (RACHNA) on partner websites and social media. The RACHNA was also shared through community presentations to groups including Washington & Lee University students and staff, the Rockbridge Area YMCA Board of Directors and staff, the Lexington's Green Infrastructure Workgroup, and others across internal and external audiences.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Carilion Rockbridge Community Hospital. The following information describes the implementation strategy used by Carilion Rockbridge Community Hospital (CRBH) to address the community health needs identified in the 2021 Rockbridge Area Community Health Needs Assessment (RACHNA). The complete implementation strategy is available online at https://www.carilionclinic.org/community-health-assessments#rockbridge-area. 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 20, 2022 and applies for the 2020 tax year (fiscal year 9/30/2021). The top prioritized needs for the 2021 RACHNA were grouped into four overarching categories: mental health, socioeconomic factors, health behaviors 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 hosting Mental health First Aid and Youth Mental Health First Aid trainings; providing a permanent medication drop box in the CRBH emergency department waiting area; supporting an annual prevention conference hosted by and for local student leaders; supporting an annual prevention forum for parents, teachers and other adults who work with youth; hosting REVIVE! trainings; continuing participation with the local crisis intervention team; and conducting an internal assessment/analysis of feasibility of expanding mental health services in the Rockbridge Area. Strategies to address socioeconomic factors include providing Bridges Out of Poverty training to Carilion staff and community partner organizations; targeting health education initiatives toward low-income populations; and supporting and promoting economic development initiatives in the Rockbridge Area through continued involvement with the Chamber of Commerce, Main Street Lexington, Rockbridge County and the cities of Lexington and Buena Vista. Strategies to address health behaviors include supporting a new community center at Rockbridge Area Relief Association (next to the hospital); providing community health education and participating in community events such as health fairs, immunizations and health screenings; implementing and promoting adoption of Unite US, a social resource referral platform that will be integrated with medical records for clinical utilization; and participating in Lexington's Green Infrastructure Workgroup to improve the city's walkability and bikeability. Strategies to address COVID-19 include providing quality care and treatment for COVID patients, disease prevention, providing monoclonal antibody infusion clinics, and aiding in the community's economic recovery. 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; and leveraging internal data to assess health disparities.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - Carilion Rockbridge Community Hospital. An individual with Out of Network insurance is 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.

Field	Value	IRS element (for citing)
Facility	6	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
CARILION CLINIC FAMILY & INTERNAL MEDICINE
108 HOUSTON STREET SUITE A C	LEXINGTON	VA	24450	PHYSICIAN OFFICES
CARILION CLINIC FAMILY MEDICINE-SOUTH MAIN
146 SOUTH MAIN STREET	LEXINGTON	VA	24450	PHYSICIAN OFFICES
CARILION CLINIC FAMILY MEDICINE - BEDFORD
548 BLUE RIDGE AVE	BEDFORD	VA	24523	PHYSICIAN OFFICES
CARILION CLINIC FAMILY MEDICINE - BUCHANAN
18080 MAIN STREET	BUCHANAN	VA	24066	PHYSICIAN OFFICES
CARILION CLINIC FAMILY MEDICINE - CLIFTON FORGE
609 CHURCH STREET	CLIFTON FORGE	VA	24422	PHYSICIAN OFFICES
CARILION CLINIC FAMILY MEDICINE - BUENA VISTA
2252 MAGNOLIA AVENUE	BUENA VISTA	VA	24416	PHYSICIAN OFFICES

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c Other 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 Public Availability of 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	BAD DEBT EXPENSE OF $5,036,160 AS INCLUDED IN PART IX, STATEMENT OF EXPENSES ON LINE 25 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 2 - Economic development: As the largest employer in Southwest Virginia, Carilion impacts economic development by investing in jobs, increased wages for employees and various capital building projects. In addition, Carilion had direct economic development expenses from programming and support of local Chambers of Commerce and pro-business advocacy. We also supported the Alleghany Highlands Economic Development Corporation and Buena Vista Forward, a community planning initiative to create a new vision and strategic plan for Downtown Buena Vista. 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. Through monetary donations and organizational support, Carilion is deeply involved with various health and social determinant-related initiatives. For example, Carilion supported local efforts of the National Child Safety Council, provided in-kind support for the Rockbridge Community Health Foundation grant committee and supported COVID-19 response for local colleges. We also contributed to Project Horizon to help victims of domestic violence and Rockbridge Area Hospice. Line 4 - Environmental improvements: Carilion recognizes the impact of the physical environment on health. We strive to support organizations working to better the environment and encourage spending time outdoors. Carilion's footprint is ripe with opportunities for outdoor activities to improve not only physical health but also mental health and well-being. Through staff time, Carilion supported the grand opening of Natural Bridge State Park's Children's Discovery Area, a section of the park aimed at educating children and families on nature, the environment and creative play. 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 Rockbridge area. We also partner with multiple community and business organizations on initiatives to improve health and wellness for everyone living in the Rockbridge area. Examples includes Carilion's representation and participation in Live Healthy Rockbridge, the Rockbridge Re-Entry Council, Rotary, the Rockbridge Area Prevention Coalition and the Virginia Rural Health Association. Line 7 - Community health improvement advocacy: Advocacy for community health improvement is a critical piece of furthering Carilion's mission to improve the health of the community. Carilion Rockbridge Community Hospital staff were involved in a subcommittee of Rockbridge Outdoors called Park Rx, which focused on advocating for a community-wide walking prescription program.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Carilion Rockbridge Community Hospital 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 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	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 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. Medicare allowable costs are determined from the Medicare cost report using the cost-to-charge ratio.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	When accounts receivable efforts are exhausted, the account may be placed with a collection agency and Extraordinary Collection Actions (ECAs) may be considered. Accounts will not be placed with a collection agency prior to 120 days from the date the first 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	- Carilion Rockbridge Community Hospital: Line 16a URL: https://www.carilionclinic.org/billing/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Carilion Rockbridge Community Hospital: Line 16b URL: https://www.carilionclinic.org/billing/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- Carilion Rockbridge Community Hospital: 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. 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 Rockbridge Area 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 total population of the cities of Lexington and Buena Vista to be 7,241 and 6,484, respectively, and the population of Rockbridge County to be 22,570. The Weldon Cooper Center for Public Service predicts positive future population change for Rockbridge County and Lexington, but a slight population loss in Buena Vista by 2040. Median age in the Rockbridge Area localities ranges from 22.3 in Lexington to 49.0 in Rockbridge County. The ACS finds that for most of the Rockbridge Area, a more significant percentage of the population is White than in the Commonwealth of Virginia. In Rockbridge County, 93.3% of the population is White, 3.3% of the population is Black and 1.9% identify as more than one race. All other races make up just over 1% of the population and 1.9% of Rockbridge residents identify as Hispanic or Latino. (US Census Bureau, ACS. 2015-2019.) Lexington and Buena Vista are slightly more racially and ethnically diverse than Rockbridge County, with populations that are 83.7% and 89.2% White, 8.8% and 7.3% Black, and 3.5% and 1.9% Asian. 2.8% and 0.6%, respectively, represent more than one race and the remainder represents small minorities of American Indian/Alaskan Native, Native Hawaiian/Pacific Islander or some other race. Of the population, 6.1% of Lexington and 1.8% of Buena Vista identify as Hispanic or Latino. (US Census Bureau, ACS. 2015-2019.) The region is divided into urban and rural areas, which vary greatly in the economic means of the residents who live there. The low-income population in the Rockbridge Area is designated as a Medically Underserved Area. The entire Rockbridge service area is designated as a low-income Health Professional Shortage Area for primary care, dental health and mental health. (https://data.hrsa.gov/tools/shortage-area). Carilion Rockbridge Community Hospital (CRBH) is the only hospital located within the service area. The 2015-2019 ACS states that the average income in Rockbridge County is $73,807, whereas in Lexington and Buena Vista it is $57,639 and $55,417 respectively. Rockbridge County has the lowest percentage of the population below the Federal Poverty Level (FPL) at 14.18%. In Lexington and Buena Vista, the percentage of the population below the FPL is 27.35% and 25.5%. All three municipalities have higher poverty rates than Virginia (10.56%) and the United States (13.42%). The ACS also shows that 17% of the population in Rockbridge is receiving Medicaid, and 9% have no insurance coverage (US Census Bureau, ACS. 2015-2019.) Of the patients receiving care at CRBH, 17.6% have Medicaid coverage and 3.3% are self-pay. (Strata internal data)
Schedule H, Part VI, Line 5 Promotion of community health	Carilion Rockbridge Community Hospital 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 Rockbridge Community Hospital (CRBH), founded in 1907, is a nonprofit, critical access hospital dedicated to quality care and patient comfort. Commitment and support through the last century allowed the hospital to grow, expand and in 1954 move across town to its present site. A new structure and enhanced patient care tower were completed on the same site in 2002. Carilion Health System (now Carilion Clinic) purchased 80% of Stonewall Jackson Hospital (now Carilion Rockbridge Community Hospital) in 2006. The other 20% was owned by the community in the trust of the Stonewall Jackson Hospital Community Health Foundation (now the Rockbridge Community Health Foundation). In 2021 Carilion purchased the remaining 20% from the foundation, which continues as a supporting organization for the hospital. The foundation continues to provide monies for grants to local organizations that aim to improve the health of our community. Members of the foundation's Board of Directors sit on a committee of the CRBH Board of Directors to determine which grants to award. For the next three years, all grants will go toward programs and initiatives aimed at addressing needs identified in the Rockbridge Area Community Health Needs Assessment. CRBH provides a full range of top-quality inpatient and outpatient care for Rockbridge Area residents. CRBH's health care professionals provide patients with reliable, safe care to get them on the road to recovery, close to home. For inpatient care, CRBH physicians diagnose and treat illnesses, anticipate problems and rapidly respond to changes in patient conditions. Emergency services are onsite 24/7 and a medical transport helicopter is kept onsite if an advanced level of care is needed. Other onsite services include imaging services, inpatient and outpatient surgical services, sleep studies, swing bed/recovery care, therapy services (PT, OT, ST, RT), and laboratory. CRBH 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 (https://www.carilionclinic.org/locations/carilion-rockbridge-community-hospital).
Schedule H, Part VI, Line 6 Affiliated health care system	Carilion Rockbridge Community Hospital 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. 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 (13 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
(1) Rockbridge Area Transportation System Inc
712 N Main Street	Lexington	VA	244502032	043586915	501(c)(3)	$16,786	Program support
YMCA of Virginia's Blue Ridge
790 N Lee Highway	Lexington	VA	24450	540515736	501(c)(3)	$31,963	Kids in the Kitchen Program
Rockbridge Area Community Services
241 Greenhouse Road	Lexington	VA	24450	541234799	501(c)(3)	$6,286	General support
Virginia Military Institute
233 Cameron Hall	Lexington	VA	24450	546001803	Virginia	$8,525	Sideline Medical Tent
Rockbridge Area Hospice Inc
315 Myers St	Lexington	VA	24450	541288305	501(c)(3)	$20,600	Program support
Washington & Lee University
204 W Washington St	Lexington	VA	24450	540505977	501(c)(3)	$36,071	Program support
Hoofbeats Therapeutic Riding center
39 Maury River Rd	Lexington	VA	24450	541699898	501(c)(3)	$8,260	Program support
Rockbridge Area Relief Association Inc
PO Box 640	Lexington	VA	24450	237303807	501(c)(3)	$12,286	Program support
Samuels Supper
PO Box 132	Fairfield	VA	24435	831702290	501(c)(3)	$9,965	Program support
Community Table of Buena Vista
350 Spotswood Dr	Lexington	VA	24450	274115524	501(c)(3)	$13,714	Program support
Boxerwood Education Association Inc
963 Ross Rd	Lexington	VA	24450	541937944	501(c)(3)	$33,143	Program support
Community Foundation for Rockbridge Bath and Alleghany
7 E Washington St	Lexington	VA	24450	273422429	501(c)(3)	$63,000	Program support
Rockbridge Christmas Baskets Inc
PO Box 1030	Lexington	VA	24450	541194522	501(c)(3)	$14,000	Program Support

Field	Value	IRS element (for citing)
Total501c3 Org	13	Total501c3OrgCnt
Total Other Org	0	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)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Greg Madsen
Director/Hospital VP	$179,111	$0	$25,050	$0	$3,677	$0	$36,041	$0	$15,412	$0	$259,292	$0	$0	$0
Matthew Burton MD
Director	$5,767	$263,477	$0	$54,917	$0	$2,137	$0	$49,257	$0	$16,955	$5,767	$386,744	$0	$0
Alicia Devine MD
Director	$0	$320,019	$0	$11,250	$0	$4,102	$0	$43,785	$0	$2,097	$0	$381,252	$0	$0
Ayesha KELLY MD
Director	$0	$281,227	$0	$12,700	$0	$2,107	$0	$43,683	$0	$16,895	$0	$356,612	$0	$0
Lisa Sprinkel
Director	$0	$133,877	$0	$2,500	$0	$9,223	$0	$49,411	$0	$9,677	$0	$204,688	$0	$0
Steven Arner
Asst. Secretary	$0	$641,621	$0	$75,000	$0	$126,806	$0	$211,048	$0	$18,016	$0	$1,072,492	$0	$121,506
Nicholas Conte
Asst. Secretary	$0	$497,735	$0	$75,000	$0	$6,258	$0	$156,342	$0	$13,409	$0	$748,744	$0	$0
David Hagadorn
Asst. Treasurer	$0	$136,195	$0	$2,830	$0	$17,525	$0	$42,306	$0	$865	$0	$199,721	$0	$0
Donald Halliwill
Asst. Treasurer	$0	$566,317	$0	$75,000	$0	$169,023	$0	$200,333	$0	$16,716	$0	$1,027,389	$0	$164,360
G Robert Vaughan Jr
Asst. Treasurer	$0	$274,535	$0	$30,000	$0	$23,879	$0	$111,529	$0	$17,972	$0	$457,916	$0	$19,407
Nancy Howell Agee
CEO, Carilion Clinic	$0	$1,344,036	$0	$100,000	$0	$503,052	$0	$163,761	$0	$11,938	$0	$2,122,787	$0	$262,135
TRACY HIGGINS
Unit Director	$148,712	$0	$700	$0	$950	$0	$65,755	$0	$604	$0	$216,721	$0	$0	$0
Tracy Kiely
RN Lead	$114,315	$571	$700	$0	$4,456	$0	$23,632	$0	$17,850	$0	$160,953	$571	$0	$0
Jessica Saville
Pharmacy Manager	$136,972	$15,517	$4,570	$0	$5,754	$0	$20,367	$0	$5,675	$0	$173,338	$15,517	$0	$0
Phyllis Snyder
RN Lead	$126,722	$0	$700	$0	$6,053	$0	$41,069	$0	$12,697	$0	$187,242	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 Hospital Vice President, is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee.This Committee is made up of independent Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a 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. Arner, Mr. Conte, Mr. Halliwill, and Mr. Vaughan 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 $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.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (19 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part III, Line 4a PROGRAM ACCOMPLISHMENTS	Carilion Rockridge Community Hospital, part of Carilion Clinic, is a not-for-profit healthcare organization committed to improving health outcomes for every patient while advancing the quality of care in the community it serves. Located in Lexington, Virginia, this 25-bed critical access hospital provides 24 hour emergency care and a full range of inpatient and outpatient services, including imaging, orthopaedic , surgical and therapies. Carilion Rockbridge Community Hospital exists to serve the health care needs of its community, regardless of a patient's ability to pay. The acute hospital admitted 981 patients and provided 4,355 days of care during the year. Hospital programs include the provision of nursing care, swing bed services, extensive outpatient and inpatient surgical and endoscopic services, respiratory therapy, and diagnostic imaging services including CT, MRI, mammography, ultrasound, DEXA scan and nuclear medicine, women's services and sleep medicine. The hospital also offers integrated and comprehensive primary care services through multiple Rural Health Clinics, serving over 41,000 patient visits. The hospital provides several services targeting the specific health needs of its population, including diabetes management, physical, speech, and occupational therapy programs, participation in cardiac rehabilitation and disease management programs. Further, the hospital served 11,530 patient visits in its emergency department, which provides 24-hour care, emergency transportation, and a chest pain program. Emergency services are a critical component of the health safety net in the hospital's service area, acting as a vital health provider for a significant number of uninsured patients, who comprise nearly 6 percent of ED visits. The hospital supports community screenings and education on chronic disease prevention and management, sponsoring 225 events touching over 5,000 people. In furtherance of its mission, the hospital provides extensive uncompensated care and community support. Stated at cost, financial assistance and other community benefits for the year exceeded $2.8 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	1099's are issued on Carilion Rockbridge Community Hospital's behalf by Carilion Services, Inc., a related organization providing management and administrative services, including payment processing.
Form 990, Part VI, Line 1a Material differences in voting rights	Effective November 19, 2020, Carilion Clinic purchased the remaining 20% interest of Carilion Rockbridge Community Hospital from the Foundation that owned it, making Carilion Clinic the sole member. The Articles of Organization & Bylaws were thereafter amended to remove voting by membership class, and the organization no longer has differences in voting rights among members of the governing body.
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, Matthew Burton, Alicia Devine, Ayesha Kelly, Lisa Sprinkel, Jessica Saville, 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, Steve Arner, Nicholas C. Conte, David Hagadorn, Donald B. Halliwill, Susan Lucas, Lisa T. Sprinkel, and G. Robert Vaughan, Jr.
Form 990, Part VI, Line 4 Significant changes to organizational documents	The bylaws were amended for the following significant changes: (1) One of the two members were removed. The sole member is now Carilion Clinic. (2) All directors are elected by the sole member, Carilion Clinic. (3) The board of directors are no longer divided into two classes. (4) A SJH Foundation board director is no longer granted an ex-officio position, with vote. The articles of incorporation were amended for the following changes: (1) One of the two members were removed. The sole member is now Carilion Clinic. (2) The sole member is granted reserved powers including amending the articles of incorporation or bylaws, appointment and removal of the CEO, approving large expenditures or borrowings, and the adoption of strategic plans and budgets.
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 Accounting management and an independent CPA firm. Prior to filing, all Board Members were notified via email of its availability on the entity's Board portal, which is the mechanism used to disseminate meeting materials to the directors, and directors 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 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 11d Other Miscellaneous Revenue	Miscellaneous - Total Revenue: 9967, Related or Exempt Function Revenue: 9967, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Court Cost Recovery - Total Revenue: 4590, Related or Exempt Function Revenue: 4590, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Other Revenue - Total Revenue: 531, Related or Exempt Function Revenue: 531, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Pre-Admission Screen - Total Revenue: 13800, Related or Exempt Function Revenue: 13800, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	CONTRACT LABOR - Total Expense: 2458384, Program Service Expense: 2458384, Management and General Expenses: , Fundraising Expenses: ; BILLING & COLLECTION - Total Expense: 674818, Program Service Expense: , Management and General Expenses: 674818, Fundraising Expenses: ; LAUNDRY & HOUSEKEEPING - Total Expense: 325351, Program Service Expense: 325351, Management and General Expenses: , Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 486139, Program Service Expense: 482751, Management and General Expenses: 3388, Fundraising Expenses: ; CONSULTING - Total Expense: 846836, Program Service Expense: 737841, Management and General Expenses: 108995, Fundraising Expenses: ; REPAIRS & MAINTENANCE - Total Expense: 405302, Program Service Expense: 402221, Management and General Expenses: 3081, Fundraising Expenses: ; REFERENCE LABS - Total Expense: 1071196, Program Service Expense: 1071196, 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 Rockbridge Community Hospital. Required information for the Bonds, including Schedule K, is reported in the Carilion Clinic (EIN: 54-1190771) IRS Form 990.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Pension-related changes other than net periodic pension costs - 46973; Transfer from Affiliates - -34200; Unfunded Grant - -689923;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
CARILION CLINIC
PO BOX 12385	ROANOKE	VA	24025	541190771	SUPPORTING ORGANIZATION	VA	501(c)(3)	Type II	NA	false
CARILION CLINIC FOUNDATION
PO BOX 12385	ROANOKE	VA	24025	541190773	FUNDRAISING	VA	501(c)(3)	7	CARILION CLINIC	Yes (true)
CARILION FRANKLIN MEMORIAL HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	540480606	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION GILES COMMUNITY HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	540549603	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION MEDICAL CENTER
PO BOX 12385	ROANOKE	VA	24025	540506332	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION 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 TAZEWELL COMMUNITY HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	546074580	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
ROCKBRIDGE COMMUNITY HEALTH FOUNDATION
1 HEALTH CIRCLE	LEXINGTON	VA	24450	203592795	SUPPORTING ORGANIZATION	VA	501(c)(3)	Type II	NA	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Address Line2USAddress/AddressLine2Txt
FRANKLIN COUNTY VENTURES LLC
PO BOX 12385	ROANOKE	VA	24025	474365316	REAL ESTATE	VA	NA	N/A
CARILION CLINIC MEDICARE SHARED SAVINGS COMPANY LLC
PO BOX 12385	ROANOKE	VA	24025	455235473	MEDICARE HMO	VA	NA	N/A
RAVEN ASSET-BASED OPPORTUNITY FUND IV LP
110 Greene Street	New York	NY	10012	824119491	PRIVATE EQUITY	DE	NA	N/A	Suite 9G
SOUTHWEST VIRGINA HEALTH PROPERTIES LLC
1102 Jefferson Street SE	Roanoke	VA	24016	010691570	REAL ESTATE	VA	NA	N/A
STARWOOD VEP II CO-INVEST LLC
591 W Putnam Avenue	Greenwich	CT	06830	833262407	INVESTMENTS	DE	NA	N/A
TI PLATFORM CC SMA LP
1160 Battery Street East	San Francisco	CA	94111	842852539	INVESTMENTS	DE	NA	N/A
ROANOKE AMBULATORY SURGERY CENTER LLC
1102 JEFFERSON ST SE	ROANOKE	VA	24016	010691564	SURGERY CENTER	VA	NA	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 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
SCA CREDIT SERVICES INC
PO BOX 12385	ROANOKE	VA	24025	541180398	COLLECTION AGENCY	VA	NA	C Corporation	Yes (true)
MEDKEY INC
PO BOX 12385	ROANOKE	VA	24025	541645357	FINANCING SERVICES	VA	NA	C Corporation	Yes (true)
CHS INC
PO BOX 12385	ROANOKE	VA	24025	541725732	SERVICES	VA	NA	C Corporation	Yes (true)
CARILION HEALTHCARE CORPORATION
PO BOX 12385	ROANOKE	VA	24025	541586601	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)
CARILION CLINIC MEDICARE RESOURCES LLC
PO BOX 12385	ROANOKE	VA	24025	263729975	MEDICARE HMO	VA	NA	C Corporation	Yes (true)
CARILION BEHAVIORAL HEALTH INC
PO BOX 12385	ROANOKE	VA	24025	203136891	HEALTHCARE	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
TANGIBLE SEGREGATED PORTFOLIO OF THE SOUTH AFRICA ALPHA SPC
					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	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	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	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (9 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
CARILION MEDICAL CENTER
A	$961	COST
CARILION HEALTHCARE CORPORATION
A	$15,392	COST
CARILION MEDICAL CENTER
M	$656,784	COST
CARILION SERVICES INC
M	$8,544,262	COST
CHS INC
M	$206,037	COST
CARILION HEALTHCARE CORPORATION
M	$2,412,492	COST
SCA CREDIT SERVICES INC
M	$76,239	COST
CARILION SERVICES INC
A	$50,484	COST
ROCKBRIDGE COMMUNITY HEALTH FOUNDATION
C	$1,418,010	COST