2025-08-15T18:16:41+00:00 2024-09-30 440160260 FORVIS MAZARS LLP 1201 WALNUT ST SUITE 1700 KANSAS CITY MO 641062246 990 2023-10-01 541190879 Carilion Services Inc CARI 5402245102 PO BOX 12385 Roanoke VA 240252385 G ROBERT VAUGHAN JR TREASURER 5402245102 2025-08-15 true MIKE ENGLE P00482834 8162216300 2025-08-15 2023 2025-03-06 01:10:19Z NANCY HOWELL AGEE PO BOX 12385 Roanoke VA 240252385 457638131 false X WWW.CARILIONCLINIC.ORG X 1982 VA Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost. 4 0 2855 0 -20095 0 134616 679330 377336282 409171271 3496656 15420372 1634999 1799978 382602553 427070951 0 0 217718774 239815133 0 0 158306245 172326545 376025019 412141678 6577534 14929273 1131010157 1225982731 156899481 198297807 974110676 1027684924 Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost. false false 383502819 410971249 See Schedule O. 383502819 true true false true false false false false false true true true false true false false true false false false false false false false false false false false true false false false true false false true false false false false false true true true true false false true 474 0 true 2855 true true true false false false false false false false false false true false X 4 0 true false false false true true true true false false false true true true true true true true true false X MATTHEW BARR 5402245021 213 S JEFFERSON ST ROANOKE VA 24011 Donald Halliwill Director/Asst. Treasurer 42.5 7.5 X X 1119248 0 167911 G Robert Vaughan Jr Director/Treasurer/SVP 44.5 5.5 X X 458008 0 71002 Nancy Howell Agee Director/President/CEO, Carilion Clinic 39.0 11.0 X X 3830705 0 1792 Jeanne Armentrout Director 46.0 4.0 X 1093617 0 47026 J Harrison Lapuasa Asst. Treasurer 36.5 3.5 X 34109 0 -1202 Julie Smith-Hamilton Asst. Secretary 36.0 4.0 X 60728 0 18375 Nicholas Conte Secretary 34.0 16.0 X 1023717 0 174893 Steven Arner Vice President/COO, Carilion Clinic 0.0 50.0 X 1410192 0 209618 Matthew Barr VP Accounting Services/Revenue Cycle 50.0 0 X 344943 0 31993 Paul Hudgins Senior Vice President/CHRO 50.0 0 X 566125 0 111355 R Keith Perry Senior Vice President/CIO 50.0 0 X 595777 0 88226 Donna Littlepage Senior Vice President 50.0 0 X 417109 0 77483 Fred Greear Vice President 50.0 0 X 572943 0 177036 Nathaniel Bishop DMin Senior Vice President 50.0 0.0 X 405958 0 4086 Stephen Morgan MD Senior Vice President/CMIO 50.0 0 X 704037 0 82804 Tom Hill Senior Vice President 50.0 0 X 437104 0 43434 David Hagadorn Former Officer 0.0 0.0 X 159104 0 25072 13233424 0 1330904 386 true true false NORDIC CONSULTING PARTNERS INC 2601 W BELTINE HIGHWAY SUITE 600 MADISON WI 53715 CONSULTING SERVICES 5830435 EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 SOFTWARE SERVICES 5190774 SIRIUS COMPUTER SOLUTIONS INC 804 GREEN VALLEY ROAD 104 GREENSBORO NC 27408 SOFTWARE SERVICES 4060089 FIRSTSOURCE SOLUTIONS USA LLC 10400 LINN STATION ROAD SUITE 100 LOUISVILLE KY 40223 SOFTWARE SERVICES 3908884 MAINLINE INFORMATION SYSTEMS 1700 SUMMIT LAKE DR SUITE 201 TALLAHASSEE FL 32317 SOFTWARE SERVICES 3453974 159 10485 629902 38943 679330 Net Patient Revenue 804905 18376469 18376469 Carilion Patient Transportation 621910 15265156 15265156 Management Fees 561110 369989053 369989053 Affiliate Insurance Premium Revenue 525190 5439318 5439318 Research Income 561110 96466 96466 4809 4809 0 0 409171271 6667180 -20095 6687275 0 0 39308119 12253 30566532 648 8741587 11605 8753192 8753192 Purchase Discounts 900099 1002095 1002095 Health Education Support 561110 393676 393676 HIM Operations 561110 225359 225359 178848 178848 0 0 1799978 427070951 410971249 -20095 15440467 X 9765323 2423922 7341401 326890 326890 188389269 186803569 1585700 6489683 6434534 55149 21822157 20550398 1271759 13021811 12464861 556950 279311 279311 1094420 1094420 816445 816445 83079 83079 1511799 1511799 54465629 47702828 6762801 0 2380890 2375768 5122 9494858 7570336 1924522 60358322 60358322 13792779 13409370 383409 853691 756324 97367 12867 12867 11321793 11321793 3061349 1112924 1948425 Dues & Subscriptions 3180722 1522724 1657998 Recruitment 2524411 2514723 9688 Education & Training 1972426 1971411 1015 Bad Debt 1687446 1687446 3434308 2098730 1335578 0 412141678 383502819 28638859 0 2070 1770 18585409 17490947 4621907 11442715 3167 0 25000 5048110 6086991 27184588 28829373 220926031 178214293 39406732 42711738 140011528 154901332 124978056 108030679 749883901 801469242 21287856 54989777 1131010157 1225982731 87721360 104061404 69091 138875 641164 974812 0 0 68467866 93122716 156899481 198297807 X 974110676 1027684924 974110676 1027684924 1131010157 1225982731 X 14929273 20511894 18133081 X false true X true true true X X 7 CARILION MEDICAL CENTER 540506332 3 true 0 237687175 CARILION NEW RIVER VALLEY MEDICAL CENTER 540553805 3 true 0 44744289 CARILION GILES COMMUNITY HOSPITAL 540549603 3 true 0 10443569 CARILION FRANKLIN MEMORIAL HOSPITAL 540480606 3 true 0 12481571 CARILION ROCKBRIDGE COMMUNITY HOSPITAL 540568001 3 true 0 10993129 CARILION TAZEWELL COMMUNITY HOSPITAL 546074580 3 true 0 4234653 CARILION CLINIC FOUNDATION 541190773 7 true 0 0 7 0 320584386 true false false false false false false false false false false false false false false false Schedule A, Part I, Line 12g Description of Support Carilion Services, Inc. (CSI) supports Carilion Clinic's mission to improve the health of the communities it serves by providing shared management services and administrative functions to Carilion Clinic subsidiaries with an emphasis on cost effectiveness, compliance, and quality. CSI supports Carilion Clinic's core hospital business and related activities by providing technology, human resources, legal services, patient billing, accounting and finance, internal audit and compliance, materials management, executive leadership, and strategic planning services. Schedule A, Part IV, Section C, Line 1 Majority director detail The filing organization is supervised or controlled in connection with its supported organizations consistent with the Type II supporting organization requirements because a majority of the officers or directors who control or manage the filing organization also serve as a majority of the officers or directors of its supported organizations. Therefore, the same people who control or manage the filing organization also control or manage its supported organizations. Further, the filing organization's bylaws require that a majority of its directors or officers, as the case may be, must be serving concurrently as directors or officers of at least one of the filing organization's supported organizations. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 91591 false true 4105 95696 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY A portion of dues paid to various healthcare industry associations is attributable to lobbying activities. Carilion employs an individual to monitor and inform management about legislative activity regarding health care. A portion of the individual's time is spent on lobbying. 1471728 1471728 7321682 6864801 456881 302763 244483 58280 191464330 170614308 20850022 20365528 490701 19874827 42711738 Investments Interest Investment Minority Alternative Investments 108030679 F Commingled Funds 108030679 Investments in Affiliates 801469242 C 801469242 Pension Liability 45735971 BRIC Claims Payable 25838999 Deferred Compensation Payable 12695709 Due to Affiliates 4739139 Lease Liability 4112898 93122716 X X false true false true false false false false false true false Nancy Howell Agee Director/President/CEO, Carilion Clinic 1718407 0 353685 0 1758613 0 -14700 0 16492 0 3832497 0 1500000 0 Donald Halliwill Director/Asst. Treasurer 767976 0 117511 0 233761 0 142915 0 24996 0 1287159 0 227735 0 G Robert Vaughan Jr Director/Treasurer/SVP 353161 0 41359 0 63488 0 46006 0 24996 0 529010 0 57282 0 Jeanne Armentrout Director 823698 0 124081 0 145838 0 30054 0 16972 0 1140643 0 0 0 David Hagadorn Former Officer 120679 0 0 0 38425 0 13363 0 11709 0 184176 0 0 0 Steven Arner Vice President/COO, Carilion Clinic 1044670 0 164317 0 201205 0 184622 0 24996 0 1619810 0 195888 0 Nicholas Conte Secretary 731687 0 111366 0 180664 0 156813 0 18080 0 1198610 0 172601 0 Matthew Barr VP Accounting Services/Revenue Cycle 273778 0 59272 0 11893 0 8425 0 23568 0 376936 0 0 0 Paul Hudgins Senior Vice President/CHRO 446405 0 51488 0 68232 0 93275 0 18080 0 677480 0 60168 0 R Keith Perry Senior Vice President/CIO 477910 0 54582 0 63285 0 78315 0 9911 0 684003 0 57291 0 Nathaniel Bishop DMin Senior Vice President 325165 0 36399 0 44394 0 1506 0 2580 0 410044 0 0 0 Fred Greear Vice President 328942 0 236113 0 7888 0 153099 0 23937 0 749979 0 99123 0 Tom Hill Senior Vice President 260235 0 33649 0 143220 0 29813 0 13621 0 480538 0 0 0 Donna Littlepage Senior Vice President 322050 0 37054 0 58005 0 59458 0 18025 0 494592 0 50021 0 Stephen Morgan MD Senior Vice President/CMIO 396885 0 45448 0 261704 0 64724 0 18080 0 786841 0 0 0 Schedule J, Part I, Line 1a Tax indemnification and gross-up payments EMPLOYEES ARE OCCASIONALLY PROVIDED SMALL GIFTS, PRIZES OR AWARDS WHICH MAY BE INCLUDED IN TAXABLE COMPENSATION AT AMOUNTS GROSSED UP FOR TAXES. DURING THE REPORTING PERIOD MS. ARMENTROUT, Mr. BISHOP AND MR. HALLIWILL RECEIVED SUCH BENEFIT. Schedule J, Part I, Line 1a Health or social club dues or initiation fees Directors of Carilion Clinic and its related hospital and foundation organizations are offered a free family or individual membership to a health club owned by a related organization if they choose to accept it. Mr. Arner received this benefit and the value was included in taxable compensation from the organization. Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses Provision of the health club benefit is documented in Board meeting minutes and Carilion internally tracks the memberships and pays the health club directly. MANAGEMENT MAKES TAX GROSS-UP DECISIONS AT ITS DISCRETION FOR NON-ROUTINE SMALL GIFTS, PRIZES OR AWARDS CONSIDERING IRS REQUIREMENTS, AMOUNT, AND NON-CASH STATUS. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Executive compensation is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee, which 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. The Compensation Committee reviews the compensation of the Board of Governors annually, which includes the individual serving as Carilion Services, Inc.'s President. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for certain select positions and the prior year's report on all the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, which list was reviewed by the Compensation Committee. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Select members of management participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP) in which the employer, at the discretion of the Carilion Clinic Board of Directors 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 scheduled vesting date, attainment of certain age and years of service, death, disability, or certain separations from service. Vested contributions paid out during the year are included in Part II, Column B(iii). Select team members are eligible for department-level incentive compensation featuring a bonus deferral to the following 2 years. Amounts are determined based on a scorecard and at the discretion of the Carilion Clinic Board of Directors Finance Committee, and vest upon payment after the end of the applicable fiscal year. Unvested amounts are subject to forfeiture upon separation of employment. Vested amounts paid out during the year are included in Part II, Column B(ii). Unvested deferrals applicable to the current reporting period are included in Part II of this schedule with "Retirement and Other Deferred Compensation". The following distributions of amounts under these arrangements were made in the reporting year: Deferred in prior year and paid out in current year: $57,291 - R. Keith Perry $172,601 - Nicholas Conte $60,168 - Paul Hudgins $195,888 - Steven Arner $57,282 - G. Robert Vaughan, Jr. $227,735 - Donald Halliwill $50,021 - Donna Littlepage $ 99,123 - Fred Greear Both vested and paid in current year: $135,774 - Jeanne Armentrout $35,497 - Nathaniel Bishop $136,940 - Tom Hill $253,641 - Stephen Morgan Ms. Agee participates in an Executive Flexible Benefit Plan, in which an allowance is provided to the participant for use in obtaining certain insurance benefits, with the excess credited to a capital accumulation account with various deferred vesting dates and distribution requirements until certain age and years of service thresholds are met. Deferrals no longer occur under this plan. In the reporting year, the amount distributed under this plan was $245,365. Ms. Agee also received $1,500,000 per a retention agreement that had been previously reported in Part II Col. C. 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 applicable scorecard metrics. 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 determined in the discretion of the Carilion Clinic Board of Directors and its compensation committee. Matt Barr Key Employee Education benefit X 9500 3167 false false true 3167 Jessica Lemons Family Member of Jeanne Armentrout, Director 118217 Employee false David Danco Family member of G. Robert Vaughan, Officer 208652 Employee false Schedule L, Part II Loan was initiated prior to becoming a key employee. Form 990, Part III, Line 4a Program Service Accomplishments Carilion Services, Inc. (CSI) is an affiliate of Carilion Clinic, a not-for-profit health system headquartered in Roanoke, Virginia serving a population of approximately 1 million Virginians and West Virginians. Carilion is the largest private employer west of Richmond, Virginia with nearly 15,000 employees, including more than 800 physicians and 500 Advanced Practice Professionals across 86 medical specialties at nearly 300 practice sites and seven hospitals (1,026 beds) over a 200-mile geography in western Virginia. CSI assists in fulfilling Carilion's mission to improve the health of the communities it services by providing management and administrative support services to Carilion affiliates. Its centralized services enhance our core hospital and physician business for cost-effectiveness, compliance, and quality. CSI provides management leadership and oversight for information technology, human resources, legal services, patient billing, accounting and finance, internal audit, privacy and compliance, materials management, marketing & communications, community health and outreach, market planning and development and overall wellness services. In addition, through its ownership of Carilion Clinic Patient Transportation, LLC, CSI staffs medical air transport helicopters which flew 1,765 patients and operates a ground service which provided 16,735 medical transports during the year. It also provides medical staffing to its supported affiliate hospitals through its Carilion Professional Services, LLC division. CSI's support assisted the Clinic's hospitals in admitting 48,209 patients, serving 174,201 emergency visits, and providing 270,789 days of care during the year, supporting patient services at physician practices, and providing programs designed to serve the health needs of the area. Such programs led or supported by CSI include community health screenings, education on chronic disease prevention and management, a community health workforce, collaboration with community organizations to identify and address health needs, and providing patients with financial assistance. To advance its mission to improve health regardless of patient ability to pay, Carilion provides extensive uncompensated care and community benefits. Stated at cost, the Carilion Clinic system together provided nearly $87 million in uncompensated care and other community support in fiscal year 2024. 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 VI, Line 2 Family/business relationships amongst interested persons Nancy Howell Agee, Jeanne Armentrout, Nicholas Conte, Donald Halliwill, G. Robert Vaughan, Jr, J. Harrison Lapuasa, Julie Smith-Hamilton and Paul Hudgins - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the Board that may occur for any reason. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO; approval of borrowings, budgets, and strategic plans; and amendments of Articles of Incorporation and Bylaws, among others. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia, certain extraordinary actions require member approval, such as mergers, consolidations, liquidations, and the sale of substantially all of the assets of the organization. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a. Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body The filing organization has no committees. Form 990, Part VI, Line 11b Review of form 990 by governing body The Form 990 was prepared by Carilion's internal Tax Department with input from various Carilion departments as applicable, and reviewed by internal management and an independent CPA firm. Prior to filing, all Board Members were notified via email that the final Form 990 was available for their access on the organization's Board portal and were provided contact information to reach out to for any questions. 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. The Carilion Clinic Board of Directors Compensation Committee reviews the compensation of the Carilion Clinic Board of Governors annually, which includes the Carilion Clinic President and Chief Executive Officer, Executive Vice Presidents (Chief Financial Officer, Chief Physician Executive, Chief Operating Officer, Chief Administrative Officer and Chief Legal Officer), and select Senior Vice Presidents who are the physician Chairs of the Clinical Departments. Certain of these same individuals also hold roles as officers of Carilion Services, Inc., including its President. The Compensation 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. The Compensation Committee also annually reviews the compensation philosophy for all executive leaders in the health system, which includes Vice Presidents, Senior Vice Presidents, Executive Vice Presidents, and the CEO, among them Carilion Services, Inc.'s Treasurer and key employees. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for certain select positions and the prior year's report on all the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, which list was reviewed by the Compensation Committee. The Compensation Committee maintained minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives. For officers and key employees who are not directly reviewed by the Compensation Committee, the independent external compensation consultant conducts the same analysis and shares the data/findings with the system EVP/COO. Assistant officers 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 or consultant review but are compared to market benchmarks by the Human Resources department. 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 consolidated 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 consolidated financial information is available on our website. Form 990, Part VIII, Line 2f Other Program Service Revenue Rent from Affiliates - Total Revenue: 4809, Related or Exempt Function Revenue: 4809, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Revenue - Total Revenue: 178848, Related or Exempt Function Revenue: 178848, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees Physician/Professional/Staffing Services - Total Expense: 5102929, Program Service Expense: 5102929, Management and General Expenses: , Fundraising Expenses: ; Billing & Collection Services - Total Expense: 6738238, Program Service Expense: , Management and General Expenses: 6738238, Fundraising Expenses: ; Other Purchased Services - Total Expense: 4633871, Program Service Expense: 4616912, Management and General Expenses: 16959, Fundraising Expenses: ; Contract Fees/Consulting - Total Expense: 33420634, Program Service Expense: 33416478, Management and General Expenses: 4156, Fundraising Expenses: ; Repairs and Maintenance - Total Expense: 4329284, Program Service Expense: 4325836, Management and General Expenses: 3448, Fundraising Expenses: ; Reference Labs - Total Expense: 240673, Program Service Expense: 240673, Management and General Expenses: , Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Pension-related changes other than net periodic pension costs - -29939471; Transfers to/from Affiliates - Net - 48072552; BLUE RIDGE INDEMNITY COMPANY LLC 76 ST PAUL STREET SUITE 500 BURLINGTON VT 05401 270927178 INSURANCE VT 18454878 97316227 CARILION SERVICES INC CARILION CLINIC PATIENT TRANSPORTATION LLC PO BOX 12385 ROANOKE VA 24025 541864693 TRANSPORTATION VA 13761313 6475272 CARILION SERVICES INC CARILION PROFESSIONAL SERVICES LLC PO BOX 12385 ROANOKE VA 24025 542030773 HEALTHCARE VA 18210882 261408 CARILION SERVICES INC 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