CARILION MEDICAL CENTER: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization: CARILION MEDICAL CENTER (EIN 54-0506332)
Tax period: 2023-10-01 to 2024-09-30
Filed: 2025-08-15
IRS object ID: 202522279349303772
Schema version: 2023v6.0
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2025-08-15T18:29:20+00:00	ReturnTs
Tax Period End	2024-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	440160260	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	FORVIS MAZARS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1201 WALNUT ST SUITE 1700	AddressLine1Txt
City	KANSAS CITY	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	641062246	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2023-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	540506332	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Carilion Medical Center	BusinessNameLine1Txt

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	G ROBERT VAUGHAN	PersonNm
Person Title	TREASURER	PersonTitleTxt
Phone	5402245102	PhoneNum
Signature	2025-08-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MIKE ENGLE	PreparerPersonNm
PTIN	P00482834	PTIN
Phone	8162216300	PhoneNum
Preparation	2025-08-15	PreparationDt

Field	Value	IRS element (for citing)
Tax	2023	TaxYr
Build TS	2025-03-06 01:10:19Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

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

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$2,166,394,119	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CARILIONCLINIC.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1899	FormationYr
Legal Domicile State	VA	LegalDomicileStateCd
Activity Or Mission	Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	10319	TotalEmployeeCnt
Total Volunteers	301	TotalVolunteersCnt
Total Gross UBI	$20,149	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$18,680,033	PYContributionsGrantsAmt
CY Contributions Grants	$10,677,232	CYContributionsGrantsAmt
PY Program Service Revenue	$1,677,450,373	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,881,826,902	CYProgramServiceRevenueAmt
PY Investment Income	$20,993,797	PYInvestmentIncomeAmt
CY Investment Income	$65,422,108	CYInvestmentIncomeAmt
PY Other Revenue	$25,698,737	PYOtherRevenueAmt
CY Other Revenue	$25,536,306	CYOtherRevenueAmt
PY Total Revenue	$1,742,822,940	PYTotalRevenueAmt
CY Total Revenue	$1,983,462,548	CYTotalRevenueAmt
PY Grants And Similar Paid	$6,051,197	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$6,123,879	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$759,154,812	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$840,704,812	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$279,403	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,004,361,607	PYOtherExpensesAmt
CY Other Expenses	$1,071,810,306	CYOtherExpensesAmt
PY Total Expenses	$1,769,567,616	PYTotalExpensesAmt
CY Total Expenses	$1,918,638,997	CYTotalExpensesAmt
PY Revenues Less Expenses	-$26,744,676	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$64,823,551	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,989,095,314	TotalAssetsBOYAmt
Total Assets EOY	$2,217,235,562	TotalAssetsEOYAmt
Total Liabilities BOY	$1,033,618,621	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,198,187,751	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$955,476,693	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,019,047,811	NetAssetsOrFundBalancesEOYAmt
Mission	Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$1,646,234,721	ExpenseAmt
Grant	$6,123,879	GrantAmt
Revenue	$1,898,003,377	RevenueAmt
Desc	SEE SCHEDULE O.	Desc
Total Program Service Expenses	$1,646,234,721	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	10319	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (true)	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

Field	Value	IRS element (for citing)
Phone	5402245021	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	213 S JEFFERSON ST	AddressLine1Txt
City	ROANOKE	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24011	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Damon Williams
Director/Chair	2.0	4.5	Yes (X)	Yes (X)	$0	$10,748	$0
Steven Arner
Director/President/CEO	42.0	8.0	Yes (X)	Yes (X)	$0	$1,410,192	$209,618
Ann Hoff PhD
Director	2.0	0.0	Yes (X)		$0	$1,123	$0
Cathy Jo Swanson MD
Director / Chief of Medical Staff	2.0	0	Yes (X)		$90,000	$0	$0
Daniel Tershak MD
Director/Chief of Medical Staff	50.0	0	Yes (X)		$530,882	$0	$31,520
Isabel Thornton
Director	2.0	0	Yes (X)		$0	$0	$0
Jamie Greenawalt
Director	2.0	0	Yes (X)		$0	$0	$0
Janet Frantz
Director	2.0	0.0	Yes (X)		$0	$1,123	$0
Katherin Elam
Director	2.0	0	Yes (X)		$0	$0	$0
Kianna Price Marshall
Director	2.0	0.0	Yes (X)		$0	$1,123	$0
Lee Learman MD PhD
Director/Physician	4.6	0	Yes (X)		$8,655	$0	$0
Michael Nussbaum MD
Director/SVP/Surgical Services Chair	50.0	0	Yes (X)		$976,550	$0	$41,513
Paul Haskins MD
Director/Physician	50.0	0	Yes (X)		$382,001	$0	$85,501
Donald Halliwill
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$1,119,248	$167,911
G Robert Vaughan Jr
Treasurer	0.5	49.5		Yes (X)	$0	$458,008	$71,002
J Harrison Lapuasa
Asst. Treasurer	0.5	39.5		Yes (X)	$0	$34,109	-$1,202
Julie Smith-Hamilton
Asst. Secretary	0.5	39.5		Yes (X)	$0	$60,728	$18,375
Nicholas Conte
Secretary	3.0	47.0		Yes (X)	$0	$1,023,717	$174,893
Daniel Harrington MD
Interim Chief Medical Officer/EVP	50.0	2.0			$0	$330,239	$2,444	Yes (X)
John Jane MD
SVP, Chair Neurosurgery	50.0	0			$654,291	$0	$72,718	Yes (X)
Jon Sweet MD
SVP/Chair, Dept. of Medicine	50.0	0			$596,807	$0	$82,527	Yes (X)
Joseph Moskal MD
SVP/Chair, Dept. of Orthopedics	50.0	0			$1,421,697	$0	$24,727	Yes (X)
Michael Abbott
Senior Vice President	50.0	0			$361,790	$0	$100,258	Yes (X)
Nancy Howell Agee
CEO, Carilion Clinic	2.0	48.0			$0	$3,830,705	$1,792	Yes (X)
Adeolu Olasunkanmi MD
Physician	50.0	0			$1,352,897	$0	$21,026		Yes (X)
Cara Rogers MD
Physician	50.0	0			$1,111,647	$0	$24,505		Yes (X)
Eric Marvin MD
Physician	50.0	0			$1,546,060	$0	$20,234		Yes (X)
Gregory Howes MD
Physician	50.0	0			$1,476,712	$0	$31,500		Yes (X)
Jonathan Carmouche MD
Physician	50.0	0			$1,620,383	$0	$26,135		Yes (X)
David Hagadorn
Former Officer	0.0	0.0			$0	$159,104	$25,072			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$12,130,372	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$8,440,167	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,232,069	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	1373	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
ROBINS & MORTON BRANCH BUILDS
400 SHADES CREEK PARKWAY	BIRMINGHAM	AL	35209	CONSTRUCTION SERVICES	$124,261,584
QUALIVIS LLC
1601 ASSEMBLY STREET	COLUMBIA	SC	29201	TEMPORARY STAFFING	$65,336,017
QUEST DIAGNOSTICS
500 PLAZA DRIVE	SECAUCUS	NJ	07094	LABORATORY SERVICES	$29,014,877
GE MEDICAL SYSTEMS
5517 COLLECTION CENTER DRIVE	CHICAGO	IL	60693	EQUIPMENT MAINTENANCE	$13,040,273
MB CONTRACTORS INC
3825 BLUE RIDGE DRIVE	ROANOKE	VA	24018	CONTRACTOR SERVICES	$6,982,766

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	116	CntrctRcvdGreaterThan100KCnt
Related Organizations	$458,222	RelatedOrganizationsAmt
Government Grants	$7,705,065	GovernmentGrantsAmt
All Other Contributions	$2,513,945	AllOtherContributionsAmt
Total Contributions	$10,677,232	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue	622110	$1,819,335,512	$1,819,335,512
Program Related Investments	621999	$690,157	$690,157
Patient Pharmacy Revenue	446110	$56,630,647	$56,630,647
Affiliate Rent Income	531120	$914,363	$914,363
Clinical Research	541715	$1,582,042	$1,582,042

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,674,181	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,674,181	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,881,826,902	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$22,620,032	TotalRevenueColumnAmt
Unrelated Business Revenue	$20,149	UnrelatedBusinessRevenueAmt
Exclusion	$22,599,883	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,609	TotalRevenueColumnAmt
Exclusion	$5,609	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$5,651,344	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$5,651,344	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,651,344	TotalRevenueColumnAmt
Exclusion	$5,651,344	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$224,682,688	SecuritiesAmt
Other	$1,045,350	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$181,936,781	SecuritiesAmt
Other	$994,790	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$42,745,907	SecuritiesAmt
Other	$50,560	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$42,796,467	TotalRevenueColumnAmt
Exclusion	$42,796,467	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
Affiliate Subsidy & Other Income	621111	$4,707,602	$4,707,602
Dining Services	722514	$3,708,487		$3,708,487
Roanoke City Student Health	621400	$2,470,103	$2,470,103

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,998,770	TotalRevenueColumnAmt
Related Or Exempt Func Income	$8,998,770	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$19,884,962	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,983,462,548	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,898,003,377	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$20,149	UnrelatedBusinessRevenueAmt
Exclusion	$74,761,790	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$6,076,280	TotalAmt
Program Services	$6,076,280	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$47,599	TotalAmt
Program Services	$47,599	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$5,144,712	TotalAmt
Program Services	$4,691,952	ProgramServicesAmt
Management And General	$452,760	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$2,829,749	TotalAmt
Program Services	$2,829,749	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$714,556,134	TotalAmt
Program Services	$714,007,665	ProgramServicesAmt
Management And General	$493,180	ManagementAndGeneralAmt
Fundraising	$55,289	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$16,722,541	TotalAmt
Program Services	$16,710,999	ProgramServicesAmt
Management And General	$11,542	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$53,994,566	TotalAmt
Program Services	$53,855,900	ProgramServicesAmt
Management And General	$125,242	ManagementAndGeneralAmt
Fundraising	$13,424	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$47,457,110	TotalAmt
Program Services	$47,398,598	ProgramServicesAmt
Management And General	$58,512	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$237,416,050	TotalAmt
Management And General	$237,416,050	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$40,362	TotalAmt
Management And General	$40,362	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$131,261	TotalAmt
Program Services	$131,261	ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$1,654,796	TotalAmt
Management And General	$1,654,796	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$190,574,570	TotalAmt
Program Services	$168,444,110	ProgramServicesAmt
Management And General	$22,127,978	ManagementAndGeneralAmt
Fundraising	$2,482	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$32,119	TotalAmt
Program Services	$32,062	ProgramServicesAmt
Fundraising	$57	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$27,462,773	TotalAmt
Program Services	$27,152,724	ProgramServicesAmt
Management And General	$290,582	ManagementAndGeneralAmt
Fundraising	$19,467	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$4,650,521	TotalAmt
Program Services	$4,650,521	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$36,053,464	TotalAmt
Program Services	$36,032,619	ProgramServicesAmt
Management And General	$20,845	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$3,199,434	TotalAmt
Program Services	$3,186,695	ProgramServicesAmt
Management And General	$4,832	ManagementAndGeneralAmt
Fundraising	$7,907	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$9,396,554	TotalAmt
Program Services	$9,396,554	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$43,613,345	TotalAmt
Program Services	$43,613,345	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$15,186,766	TotalAmt
Program Services	$5,835,147	ProgramServicesAmt
Management And General	$9,351,619	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
Medical Supplies	$285,166,461	$285,166,461
Bad Debt	$103,100,138	$103,100,138
Assessment Fees	$99,109,668	$99,109,668
Affiliate Practice Subsidy	$8,006,490	$8,006,490

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$7,015,534	TotalAmt
Program Services	$6,758,184	ProgramServicesAmt
Management And General	$76,573	ManagementAndGeneralAmt
Fundraising	$180,777	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,918,638,997	TotalAmt
Program Services	$1,646,234,721	ProgramServicesAmt
Management And General	$272,124,873	ManagementAndGeneralAmt
Fundraising	$279,403	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$14,997	BOYAmt
EOY	$14,720	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$5,570,330	BOYAmt
EOY	$6,029,263	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$939,228	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$303,785,103	BOYAmt
EOY	$364,382,883	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$3,175	BOYAmt
EOY	$93,228	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$11,148,391	BOYAmt
EOY	$13,565,513	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$15,661,346	BOYAmt
EOY	$24,832,907	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,760,195,004	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,017,978,560	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$573,445,329	BOYAmt
EOY	$742,216,444	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$359,987,021	BOYAmt
EOY	$383,201,443	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$703,053,540	BOYAmt
EOY	$669,442,369	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$11,002,032	BOYAmt
EOY	$11,167,187	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$383,150	BOYAmt
EOY	$341,728	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$4,101,672	BOYAmt
EOY	$1,947,877	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,989,095,314	BOYAmt
EOY	$2,217,235,562	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$292,809,367	BOYAmt
EOY	$304,535,156	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$472,500	BOYAmt
EOY	$176,250	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$3,206,100	BOYAmt
EOY	$30,506,778	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$604,039,951	BOYAmt
EOY	$593,434,651	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$273,000	BOYAmt
EOY	$182,000	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$132,817,703	BOYAmt
EOY	$269,352,916	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,033,618,621	BOYAmt
EOY	$1,198,187,751	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	$929,713,842	BOYAmt
EOY	$989,520,655	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$25,762,851	BOYAmt
EOY	$29,527,156	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$955,476,693	BOYAmt
EOY	$1,019,047,811	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,989,095,314	BOYAmt
EOY	$2,217,235,562	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$64,823,551	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$103,844,798	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$105,097,231	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	$131,261	OtherActivitiesAmt
Total Lobbying Expenditures	$131,261	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

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

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$20,046,508	BeginningYearBalanceAmt
Contributions	$190,750	ContributionsAmt
Investment Earnings Or Losses	$3,550,303	InvestmentEarningsOrLossesAmt
Other Expenditures	$769,623	OtherExpendituresAmt
End Year Balance	$23,017,938	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

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

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.0	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.5159	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.4841	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

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

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$557,804,831	OtherCostOrOtherBasisAmt
Depreciation	$429,631,596	DepreciationAmt
Book Value	$128,173,235	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,523,055	OtherCostOrOtherBasisAmt
Depreciation	$1,040,445	DepreciationAmt
Book Value	$482,610	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$690,536,680	OtherCostOrOtherBasisAmt
Depreciation	$580,207,189	DepreciationAmt
Book Value	$110,329,491	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$504,262,683	OtherCostOrOtherBasisAmt
Depreciation	$7,099,330	DepreciationAmt
Book Value	$497,163,353	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$742,216,444	TotalBookValueLandBuildingsAmt

Financial Derivatives FinancialDerivativesGrp

Field	Value	IRS element (for citing)
Book Value	$8,704,722	BookValueAmt
Method Valuation	F	MethodValuationCd

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	Alternative Investments	Desc
Book Value	$660,737,647	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$669,442,369	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
Due to Affiliates	$42,306,993
Pension Liability	$156,059,106
Deferred Comp Liability	$49,263,477
Interest Rate Swap Liability	$10,977,480
Lease Liability Total	$10,745,860

Field	Value	IRS element (for citing)
Total Liability	$269,352,916	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

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

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

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

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,283,679	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$12,283,679	NetCommunityBenefitExpnsAmt
Total Expense	0.0068	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$347,567,599	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$459,073,403	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

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

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$359,851,278	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$459,073,403	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,283,679	NetCommunityBenefitExpnsAmt
Total Expense	0.0068	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,009,133	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$779,072	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,230,061	NetCommunityBenefitExpnsAmt
Total Expense	0.0023	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$61,370,646	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,074,045	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$51,296,601	NetCommunityBenefitExpnsAmt
Total Expense	0.0282	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,002,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$17,754,066	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,247,934	NetCommunityBenefitExpnsAmt
Total Expense	0.0018	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,690,204	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,690,204	NetCommunityBenefitExpnsAmt
Total Expense	0.0015	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,027,878	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$110,140	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$917,738	NetCommunityBenefitExpnsAmt
Total Expense	0.0005	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$91,099,861	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$28,717,323	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$62,382,538	NetCommunityBenefitExpnsAmt
Total Expense	0.0343	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$450,951,139	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$487,790,726	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$74,666,217	NetCommunityBenefitExpnsAmt
Total Expense	0.0410	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,867	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,867	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$220,662	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$220,662	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$109,371	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$109,371	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

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

Leadership Development LeadershipDevelopmentGrp

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

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,164	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$16,164	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$83,184	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$83,184	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$488,907	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$488,907	NetCommunityBenefitExpnsAmt
Total Expense	0.0003	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

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

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$923,155	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$923,155	NetCommunityBenefitExpnsAmt
Total Expense	0.0005	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$103,403,345	BadDebtExpenseAmt
Reimbursed By Medicare	$237,803,614	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$262,410,915	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$24,607,301	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
ROANOKE AMBULATORY SURGERY CENTER LLC
AMBULATORY SURGERY	0.5292	0.0418	0.338
SOUTHWEST VIRGINIA HEALTH PROPERTIES LLC
REAL ESTATE	0.5257	0.0365	0.3573

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

Hospital Facilities HospitalFacilitiesGrp (2 entries)

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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Facility	2	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	23	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	https://www.carilionclinic.org/cho-community-health-assessments#reports	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	https://issuu.com/carilionclinic/docs/2024_cmc_cha_final_report	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	24	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	https://www.carilionclinic.org/cho-community-health-assessments#reports	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	300.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	500.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	https://www.carilionclinic.org/billing/financial-assistance	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	https://www.carilionclinic.org/billing/financial-assistance	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	https://www.carilionclinic.org/billing/financial-assistance	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	The publicly available Community Health Needs Assessment (CHNA) report details the prioritization process for the community's significant health needs identified through the CHNA. The Community Health Assessment Team (CHAT), comprised of community stakeholders, reviews all data and completes a prioritization survey. Through the survey, each CHAT member selects the most pertinent community needs. Following the survey, CHAT members can further refine the priorities through a consensus-building activity. CHAT members prioritize needs according to the perceived burden, scope, severity or urgency; the importance the community places on addressing the need through survey responses and other interactions; and each member's unique perspective on community health.
Schedule H, Part V, Section B, Line 5 Facility A, 1	Facility A, 1 - GROUP A. Carilion Clinic's Community Health Needs Assessments (CHNAs) are community-driven projects. Their success depends highly 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 dynamic and include health and human service agency leaders, people with exceptional knowledge of, or expertise in, public health, and local health department officials. Each CHAT also includes other individuals or organizations serving or representing the community's medically underserved, low-income and minority populations. The following organizations served on the CHAT for the 2024 Roanoke Valley Community Health Needs Assessment (RVCHNA): Adult Care Center of the Roanoke Valley, Black Father Family, Blue Blaze Consulting, Botetourt County Library, Bradley Free Clinic, CHIP of Roanoke Valley, City of Roanoke, Collective Response, Commonwealth Catholic Charities, Council of Community Services, Craig County Public Schools, Craig County, Family Services of Roanoke Valley, Feeding Southwest Virginia, Financial Empowerment Center, FREE Foundation, Freedom First Credit Union, Goodwill, Habitat for Humanity of Roanoke Valley, Harm Reduction Coalition, HCA LewisGale, Healthy Homes Roanoke, LEAP, Leffel Consulting Group, Legal Aid Society of Roanoke Valley, New Horizons Healthcare, Presbyterian Community Center, Rescue Mission, Restoration Housing, Roanoke City & Alleghany Health Districts, Roanoke City Public Schools, Roanoke Fire/EMS, Roanoke Redevelopment and Housing Authority, Roanoke Regional Chamber of Commerce, Roanoke Valley-Alleghany Regional Commission, Radford University Carilion, Salem City Public Schools, and United Way of Roanoke Valley. To obtain input from the community, the RVCHNA conducted a listening session among CHAT stakeholders, held multiple listening sessions with community members, and administered a 27-question community health survey broadly across the service area. These efforts occurred from October 1, 2023, through December 31, 2023. The survey was developed in English and Spanish and asked questions about access to care and other services, health status, community strengths, quality of life, subjective well-being 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 the Centers for Disease Control and Prevention. Community members were invited to participate in Community Listening Sessions to collect qualitative data to understand health-related needs better. Roanoke City and Alleghany Health District staff facilitated sessions with Virginia Harm Reduction Coalition clients and Virginia Western Community College students. Attendees of a Black Father Family Fireside Chat also had the opportunity to provide their input. CHAT members could offer additional perspectives on the needs and barriers to health facing our community during a Healthy Roanoke Valley all-partner meeting that included other community stakeholders. Carilion staff from across the organization facilitated small group discussions. Participants could complete the Stakeholder Survey to quantify focus group data. Community stakeholders, leaders and providers were encouraged to complete the Stakeholder Survey after participating in a listening session. Carilion representatives shared the online survey at the CHAT meetings and via email. The CHAT assisted with survey distribution to reach particular target populations. The survey focused on Roanoke Valley residents 18 years of age and older in the following service area: Bedford, Botetourt, Craig and Roanoke counties, Roanoke City, and Salem City. There were special efforts to include underserved/vulnerable populations disproportionately impacted by social determinants of health such as poverty, race/ethnicity, education and lack of insurance. Specific populations served by CHAT representatives include people who are uninsured or underinsured; people experiencing low income, homelessness, and/or food insecurity; and families with young children. The survey was also available online to all residents living in the Roanoke Valley.
Schedule H, Part V, Section B, Line 6a Facility A, 1	Facility A, 1 - Group A. Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital, owned by Carilion Medical Center and serving the same area, jointly conducted their Community Health Needs Assessment.
Schedule H, Part V, Section B, Line 6b Facility A, 1	Facility A, 1 - GROUP A. The 2024 (tax year 2023) Roanoke Valley CHNA was conducted with: Adult Care Center of the Roanoke Valley, Black Father Family, Blue Blaze Consulting, Botetourt County Library, Bradley Free Clinic, CHIP of Roanoke Valley, City of Roanoke, Collective Response, Commonwealth Catholic Charities, Council of Community Services, Craig County Public Schools, Craig County, Family Services of Roanoke Valley, Feeding Southwest Virginia, Financial Empowerment Center, FREE Foundation, Freedom First Credit Union, Goodwill, Habitat for Humanity of Roanoke Valley, Harm Reduction Coalition, HCA LewisGale, Healthy Homes Roanoke, LEAP, Leffel Consulting Group, Legal Aid Society of Roanoke Valley, New Horizons Healthcare, Presbyterian Community Center, Rescue Mission, Restoration Housing, Roanoke City & Alleghany Health Districts, Roanoke City Public Schools, Roanoke Fire/EMS, Roanoke Redevelopment and Housing Authority, Roanoke Regional Chamber of Commerce, Roanoke Valley-Alleghany Regional Commission, Radford University Carilion, Salem City Public Schools, and United Way of Roanoke Valley.
Schedule H, Part V, Section B, Line 7 Facility A, 1	Facility A, 1 - Group A. The Community Health Assessment Team shared the 2024 Roanoke Valley Community Health Needs Assessment (RVCHNA) on partner websites, social media, and regional news coverage. The RVCHNA was shared through multiple internal presentations for staff and presentations to partner organizations and collaboratives.
Schedule H, Part V, Section B, Line 11 Facility A, 1	Facility A, 1 - Group A. The following information describes the implementation strategy used by Carilion Medical Center (CMC)-comprised of Carilion Roanoke Memorial Hospital (CRMH) and Carilion Roanoke Community Hospital (CRCH)-to address the community health needs identified in the 2024 Roanoke Valley Community Health Needs Assessment (RVCHNA). The complete implementation strategy is available online at https://issuu.com/carilionclinic/docs/implementation_strategy_final_cmc. The hospital is working to address all significant health needs prioritized through the CHNA . The top prioritized needs for the 2024 RVCHNA were grouped into three overarching categories: chronic disease, mental health and substance use, and injury/violence. We also focus on layered interventions that address multiple priority areas through place-based strategies. We are addressing prioritized needs with the following strategies and committing financial resources, staff time and leadership. Strategies to address mental health and substance use include implementing evidence-based mental health education and well-being programs, expanding Carilion's peer support specialist workforce, and supporting the development and implementation of transitional and/or recovery housing options in the service area. Strategies to address chronic disease include implementing the Healthy Heart Ambassadors program, fruit and vegetable prescription program, and other evidence-based health and nutrition programs. Strategies to address injury/violence include working with the forensic nursing program to support transitioning patients from acute care to the community, sustaining the Violent Injury Recovery and Support program, and participating in the Group Violence Intervention Program and other Roanoke City-led initiatives on violence prevention. Place-based strategies addressing multiple priority areas include expanding Carilion's community health workforce, developing an employee volunteer program to support the capacity of local organizations working to address CHA-identified needs, evaluating a pop-up clinic model supporting safety net partnerships, evaluating additional sites for the LIFT Center model, and implementing health and wellness programming at Melrose Plaza.

Field	Value	IRS element (for citing)
Facility	33	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (32 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
Carilion Clinic Riverside 1 Medical Office Building
1 Riverside Circle	Roanoke	VA	24016	Physician and Ancillary Services
Carilion Roanoke Community Hospital Medical Office Building
102 Highland Ave	Roanoke	VA	24013	Physician and Ancillary Services
Carilion Clinic Outpatient Therapy
105 Summerfield Court	Roanoke	VA	24019	Ancillary Services
Roanoke Ambulatory Surgery Center LLC
1102 Jefferson St SE	Roanoke	VA	24016	Outpatient Surgery Center
Carilion Clinic Cardiology
1229 Third Street SW	Roanoke	VA	24016	Physician Services
Carilion Clinic Diabetes Management & Prevention
1231 S Jefferson Street	Roanoke	VA	24016	Ancillary Services
Carilion Clinic Cardiology
127 McClanahan Street	Roanoke	VA	24014	Physician and Ancillary Services
Carilion Clinic Family Medicine
1314 Peters Creek Road	Roanoke	VA	24017	Physician Services
Carilion Clinic Medical Office Building
150 Market Ridge Lane	Daleville	VA	24083	Physician and Ancillary Services
Carilion Clinic Pediatric Subspecialty Clinic
1620 Graves Mill Road	Lynchburg	VA	24502	Physician Services
Carilion Clinic Outpatient Therapy
1935 West Main Street	Salem	VA	24153	Ancillary Services
Carilion Clinic OBGYN
1957 West Main Street	Salem	VA	24153	Physician Services
Carilion Clinic Crystal Springs Medical Office Building
2001 Crystal Spring Ave SW	Roanoke	VA	24014	Physician and Ancillary Services
Carilion Mental Health
2017 S Jefferson Street	Roanoke	VA	24014	Physician and Ancillary Services
Carilion Clinic Family Medicine
2145 Mount Pleasant Boulevard	Roanoke	VA	24014	Physician Services
Carilion Clinic Institute for Orthopedics and Neurosciences
2331 Franklin Road	Roanoke	VA	24014	Physician and Ancillary Services
Carilion Clinic Riverside 3 Medical Office Building
3 Riverside Circle	Roanoke	VA	24016	Physician and Ancillary Services
Carilion Clinic Family Medicine
3 Westwood Medical Park	Bluefield	VA	24605	Physician Services
Carilion Clinic Westlake Medical Office Building
35 Medical Court	Hardy	VA	24101	Physician and Ancillary Services
Carilion Clinic Imaging
3707 Brambleton Avenue	Roanoke	VA	24018	Ancillary Services
Carilion Clinic Veterans Administration Clinic
388 Ben Bolt Avenue	Tazewell	VA	24651	Physician Services
Carilion Franklin Memorial Hospital Medical Office Building
390 S Main Street	Rocky Mount	VA	24151	Physician Services
Carilion Clinic Vascular Surgery and Urology
4064 Postal Drive	Roanoke	VA	24018	Physician Services
Carilion Children's -Tanglewood Center
4348 Electric Road	Roanoke	VA	24018	Physician and Ancillary Services
Carilion Dental Care
4348 Electric Rd Entr 3 2nd Fl	Roanoke	VA	24018	Dental Services
Carilion Mental Health and Center for Healthy Aging
4434 Electric Road	Roanoke	VA	24018	Physician and Ancillary Services
Carilion Clinic Vascular Surgery
4437 Starkey Road SW Suite A	Roanoke	VA	24018	Physician Services
Carilion Clinic Outpatient Therapy
4508 Starkey Road	Roanoke	VA	24018	Ancillary Services
Carilion Clinic Pediatric Medicine
490 S Main St	Rocky Mount	VA	24151	Physician Services
Carilion Clinic Urology
5372 Fallowater Lane	Roanoke	VA	24018	Physician Services
Carilion Clinic Breast Care Center
6415 Peters Creek Road	Roanoke	VA	24019	Ancillary Services
Carilion Clinic Obstetrics and Gynecology
902 South Jefferson St Upper Level	Roanoke	VA	24016	Physician Services

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c Financial Assistance Eligibility Criteria	Financial assistance policy in effect for fiscal year 2024: families with family income equal or below 300% of the Federal Poverty Guidelines and countable assets equal or below $25,000 receive 100% adjustment under FAP. Families with family income greater than 300% of the Federal Poverty Guidelines but less than or equal to 500% of the Federal Poverty Guidelines or countable assets above $25,000 and less than or equal to $100,000 receive a partial adjustment under FAP. The partial adjustment matches the highest AGB percentage determined for all facilities.
Schedule H, Part I, Line 6a Community Benefit Report	Information on community benefit is reported annually through a consolidated report prepared by Carilion Clinic (EIN 54-1190771). Printed copies of this report are distributed throughout communities served by hospitals affiliated with Carilion Clinic. Additionally, the community benefit report is available on Carilion Clinic's website: https://www.carilionclinic.org/cho-community-health-assessments#community-impact-reports
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	103403345
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	Line 7a and 7b: For activities reported on the Medicaid Cost Report, a cost-to-charge ratio as determined from the Medicaid Cost Report was used. For all other activities, a cost to charge ratio derived from Worksheet 2 of the 990 instructions was used. Lines 7e and 7f are reported at actual cost. Line 7g: A combination of Cost Accounting and Actual Costs per service line financial statement was used. Lines 7h and 7i are reported at actual cost.
Schedule H, Part II Community Building Activities	Line 1 - Physical improvements and housing: Carilion acknowledges the impact of housing on health and is involved with housing-focused activities. Carilion has worked with various community partners to discuss collaborations around housing, including convening partners to fill a community gap in substance use treatment/recovery housing for pregnant and parenting women in the Roanoke Valley. Line 2 - Economic development: As the largest employer in Southwest Virginia, Carilion impacts economic development by investing in jobs, higher wages for employees and various capital construction projects. In addition, Carilion had economic development expenses from supporting the GO Virginia Foundation and the Virginia Chamber Foundation. Carilion is also active in many local economic development endeavors, including supporting the Roanoke Regional Partnership and local chambers of commerce, investing in research and technology, and communicating with local businesses about the region's current business climate and prospective companies. These initiatives promote the community's health by improving economic vitality and making the region a vibrant place to live, work and play. Line 3 - Community support: Research demonstrates the strong connection between social determinants of health-such as income, transportation, and education-and communities' overall health and well-being. Carilion supports nonprofit organizations addressing barriers to good health arising from these social determinants in various ways. Carilion also collaborates with local partners to support better education and opportunities for children and families, as well as improved housing and better nutrition for our neighbors in need. These efforts help to remove a range of obstacles to good health for our region's residents. Examples include the Presbyterian Community Center, the West End Center for Youth, and Goodwill Industries of the Valley. Through monetary donations and organizational support, Carilion promotes mental health through local arts and culture, reduces inequity, promotes youth development, and supports events for organizations like the Humble Hustle Company, the Harrison Museum of African American Culture, the Ronald McDonald House Charities, the Taubman Museum of Art, the Grandin Theatre, SWVA Pride, Inc., and the local chapter of the Southern Christian Leadership Conference. 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. Carilion participates in coalitions that address health, safety and social determinant needs in the Roanoke Valley to ensure lasting impact from the health assessment and community health improvement process. We also partner with multiple community and business organizations on initiatives to improve health and wellness for everyone in the Roanoke Valley. These coalition-building activities include participation with local substance use prevention coalitions, the Neighborhoods of Opportunity Initiative, the Child Health Investment Partnership of the Roanoke Valley, and Children's Trust of Roanoke Valley. Line 7 - Community health improvement advocacy: Carilion's mission of community health improvement focuses not only on what the organization does directly but also on supporting the advocacy efforts of other organizations. Carilion supported the Virginia Health Care Foundation and the Virginia Public Access Project and started a group of community health stewards to raise awareness on specific community health improvement topics and projects. These efforts promote better health by advocating for particular causes under the larger umbrella of health, safety, and the social determinants of health. Line 8 - Workforce development: With the understanding that employment is directly linked to health and wellness, Carilion partners to provide workforce development and training for community members. These efforts also develop a pipeline for future healthcare workers. Carilion again partnered to offer Project SEARCH, a one-year high school transition program providing employment and educational opportunities for individuals with significant disabilities. This collaborative program includes Goodwill Industries of the Valleys, the Virginia Department of Aging and Rehabilitative Services, and local school systems. Carilion continues to convene the Blue Ridge Partnership for Health Science Careers, a program that will increase awareness of health science careers in elementary, middle and high school children and create pipelines for students to enter specific higher education health science programs. Carilion is involved in the Virginia Business Higher Education Council, promoting reform and reinvestment in the higher education system, and supports Virginia Western Community College and the Virginia Western Community College Education Foundation. Carilion also supported the Virginia Ready Initiative, which works to retrain unemployed community members for in-demand jobs.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Carilion Medical Center estimates bad debt expense by reserving a percentage of all self-pay patient accounts receivable by aging category, based on collection history, adjusted for expected recoveries and, if present, anticipated changes in trends.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Patient accounts receivable are stated at net realizable amounts due from patients, third-party payors, and other insurers for which Carilion Medical Center expects to be entitled in exchange for providing patient care. In accordance with Accounting Standards Update (ASU) No. 2014-09, Revenue from Contracts with Customers (Topic 606) (ASU 2014-09), the estimated uncollectible amounts are generally considered implicit price concessions that are a direct reduction to patient accounts receivable.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Medicare allowable costs are determined from the Medicare cost report using the cost-to-charge ratio. The Hospital believes our Medicare shortfall is a cost we incur as a benefit to the community. IRS Rev. Rul. 69-545 provides that one of the factors demonstrating community benefit is caring for patients who pay their bills through public programs such as Medicare. In order to operate for the benefit of the broad community that we serve we must include our significant Medicare population, even if we are required to subsidize care to our Medicare patients due to being reimbursed at less than cost by Medicare's nonnegotiable rates.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	When accounts receivable efforts are exhausted, the account may be placed with a collection agency and extraordinary collection actions (ECAs) may be considered. Accounts will not be placed with a collection agency prior to 120 days from the date the first post-discharge billing statement is provided except when mailings are returned with no forwarding address and combining multiple accounts of varying age with those already transferred or for legal verification regarding other liabilities. Reasonable efforts will be made to identify appropriate forwarding addresses. When a financial assistance application (FAA) is received during the application period (within 240 days after the date the first post-discharge billing statement is provided), but after initiation of ECAs, all ECAs will be suspended. Best efforts will be made to process completed applications within 30 days of receipt of the application; financial assistance eligibility will be determined and communicated to the individual. Incomplete applications must be completed within 30 days of the initial notification of additional items required; otherwise, the application will be deemed incomplete and closed. If an individual is eligible for financial assistance, ECAs, other than the sale of debt, will be reversed and any payments related to eligible care refunded to the extent no longer owed. ECAs will be reinstated if the individual is not eligible for financial assistance or does not complete the FAA by the deadline. At least 30 days before initiating an ECA, Carilion will send the patient written notice of intended ECA(s), a plain language summary explaining financial assistance available and the process for determining eligibility, and the deadline for applying for assistance. Carilion will also attempt to call individuals at least 30 days before initiating an ECA to make them aware of the financial assistance available and how to obtain assistance with the application process. Carilion shall enter into a written contract with any collection agency to which it refers bad debt. The contract will obligate the collection agency to observe and comply with Carilion's obligations under this policy and the Financial Assistance Policy. A collection agency to which bad debt is referred for collection may not engage in any ECAs without the prior written consent of Carilion. After making reasonable efforts to determine if a patient qualifies for financial assistance and the patient either does not qualify for financial assistance or fails to submit an application as requested, within 240 days from the date the first post-discharge billing statement is provided, Carilion may engage in one or more of the following ECAs: 1. Place a lien on an individual's property; 2. Attach or seize an individual's bank account or any other personal property; 3. Commence a civil action against an individual; 4. Garnish an individual's wages; 5. Sell an individual's debt to another party; or 6. Report the account to credit agencies. Individual account balances greater than $5,000 are not sent to a collection agency. These are handled through the Debt Recovery Department (DRD) for verification of financial assistance status before further collection activity occurs. DRD will also investigate any accounts that require special handling. For example, in cases of a deceased patient, auto accident, or any other unique circumstances requiring special handling, the accounts are placed with the DRD. When all collection efforts have been exhausted, all hospital accounts will be returned and closed as uncollectible. No further collection activity is taken at that time. Accounts with satisfactory payment arrangements, legal activity or accounts with pending payment will be considered active and are not returned.
Schedule H, Part V, Section B, Line 16a FAP website	A - CARILION MEDICAL CENTER -DBA CRMH: Line 16a URL: https://www.carilionclinic.org/billing/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	A - CARILION MEDICAL CENTER -DBA CRMH: Line 16b URL: https://www.carilionclinic.org/billing/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	A - CARILION MEDICAL CENTER -DBA CRMH: Line 16c URL: https://www.carilionclinic.org/billing/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessment	In addition to conducting regular Community Health Needs Assessments (CHNAs), Carilion Clinic closely monitors community health indicators and responds to needs as they arise. Each year, Carilion updates scorecards with refreshed health data from various secondary sources and County Health Rankings indicators provided by the Robert Wood Johnson Foundation. Carilion also responds to needs identified through clinical data and internal departments, including data collected through social determinants of health screenings. A health equity and social determinants of health steering committee exists to provide oversight and guidance related to health equity and screenings, and a resource navigation subcommittee tackles more nuanced topics around current community needs as seen in the patient population. Carilion's call center, Carilion Direct, allows community members to ask questions and connect with community resources. Community Health Workers (CHWs) help address needs, and data is reviewed periodically to identify trends in the healthcare needs of patients served by CHWs. Healthcare needs are also identified through current collaborative relationships and community partnerships, including collaboration with the Virginia Department of Health and local safety net partners. Ongoing collaboration with stakeholders allows for regular communication and gives our partners opportunities to respond cohesively. Carilion has adapted its community health improvement process from Associates in Process Improvement's Model for Improvement and the Plan-Do-Study-Act cycle developed by Walter Shewhart. It consists of five steps: (1) conducting the CHNA, (2) strategic planning, (3) creating the implementation strategy, (4) program implementation and (5) evaluation. This cycle repeats every three years. Continuous quality improvement is a key principle of the process. The Strive Collective Impact Model for the Community Health Assessment Team helps Carilion foster community development in its CHNA and community health improvement processes. 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) can 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 billing statement and patient financial responsibility letter includes information on the Financial Assistance policy including who to contact for additional information and location of in-person assisters. The Application, the Policy, and the plain language summary are available free of charge to the patient. They are available by mail and on the web site if the patient did not receive written information at the time of service. Financial Assistance policy and application are also distributed to community partners through electronic mailing groups. Carilion Clinic employs an Eligibility staff that counsel patients on federal and state programs. The staff completes applications for Medicaid and provides information on Social Security, Social Security Disability and Medicare. The staff provides support services ensuring the applications are processed correctly based on federal and state policy. In addition, Eligibility staff are trained as Certified Application Counselors and will assist patients in enrollment in the Marketplace. Eligibility staff will also complete Carilion's financial assistance application and counsel patients on the requirements for financial assistance.
Schedule H, Part VI, Line 4 Community information	The Roanoke Metropolitan Statistical Area (MSA), home to Carilion Clinic's flagship hospital Carilion Roanoke Memorial Hospital, is commonly known as the Roanoke Valley. It comprises the independent cities of Roanoke and Salem and the counties of Bedford, Botetourt, Craig, Franklin and Roanoke. The Valley is mostly rural, nestled among the Blue Ridge Mountains with the City of Roanoke at its heart. Roanoke is a destination rich in cultural diversity, the arts, shopping, recreational opportunities, natural beauty and services unavailable in the region's more rural areas. The Roanoke Valley comprises distinct communities with significant disparities in size, population and social determinants of health. The 2019-2023 American Community Survey (ACS) found the Roanoke MSA's total population to be 394,915. The cities of Roanoke and Salem had 98,677 and 25,477 residents, respectively. Bedford, Botetourt, Craig, Franklin and Roanoke Counties had 80,254, 33,875, 4,881, 54,958 and 96,793 residents, respectively. The average household income ranges from a low of $76,775 in Roanoke City to a high of $107,156 in Roanoke County. In contrast, the median income ranges from $52,671 to $82,931 in the same localities. Across the Roanoke Valley localities, 11.34% of the population has a household income below the federal poverty guideline. Similarly, 19.79% of the insured population receives Medicaid, and 6.39% of the population have no health insurance. The highest rates of Medicaid patients are in Roanoke City at 29.76% (US Census Bureau, ACS, 2019-2023). Specific to Carilion Medical Center inpatients and outpatients in fiscal year 2024, 22.28% received Medicaid while 4.66% were self-pay (Strata internal data). The median age in the service area ranges from 38.0 in the city of Roanoke to 48.5 in Franklin County, and all other counties are above the state median of 38.8. Most of the population across the service area is White, with rates ranging up to 95.23% in Craig County (US Census Bureau, ACS, 2019-2023). Roanoke City is the most racial and ethnically diverse locality, with 58% of the population identifying as White and 29% Black. The Weldon Cooper Center for Public Service predicts positive population change by 2040 for all communities except Craig County, which may have a slight population loss. Roanoke City is divided into quadrants (Northwest, Northeast, Southwest and Southeast) separated geographically by railroad tracks, the Roanoke River and Interstate 581. These quadrants vary significantly in the demographic and economic make-up of their residents. -The Northwest and Southeast quadrants are designated as federal Medically Underserved Areas (MUAs). These areas are home to a larger proportion of the low-income individuals and families in the city who may be uninsured, underinsured or Medicaid recipients facing additional barriers due to societal and cultural differences. Bedford County, Botetourt County, Craig County and Franklin County also contain MUAs. (https://data.hrsa.gov/tools/shortage-area) In addition to Carilion Medical Center, two other hospitals serve the area: the Salem Veterans Affairs Medical Center and LewisGale Medical Center. Key safety net providers in the region include the Veteran Affairs Medical Center, a federally qualified health center, free clinics, local Virginia Department of Health offices and other service organizations.
Schedule H, Part VI, Line 5 Promotion of community health	Carilion Medical Center is part of the non-profit Carilion Clinic integrated healthcare system located in 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 125 years, when a group of dedicated citizens came together and built a hospital to meet the community's healthcare needs. Today, Carilion is a vital anchor institution focused on healthcare and dedicated to our mission of improving the health of the communities we serve. With an enduring commitment to our region's health, care is advanced through clinical services, medical education, research and community health investments. Carilion believes in service, collaboration and caring for all. Carilion invests in discovering and responding to local and regional health needs, understanding that we must involve additional stakeholders to address community health issues and create change effectively. Carilion recognizes the impact the environment has on the health of our communities. Efforts continue to make our hospitals and other facilities more energy-efficient, increase recycling and use of recyclable or bio-degradable materials, reduce waste materials and serve local, sustainable foods to patients and in our cafeterias. Carilion has an office of sustainability that leads these efforts and empowers employees to be involved in environmental health-related projects. Carilion Medical Center (CMC) includes Carilion's flagship facility, Carilion Roanoke Memorial Hospital (CRMH). CRMH includes a Level 1 Trauma Center, a Neonatal Intensive Care Unit, Carilion Children's Hospital and 718 patient beds. Offering a wide range of inpatient and outpatient care, specialty care, medical education, and fellowships, CRMH has gained recognition as Virginia's top six hospital by U.S. News and World Report. CRMH provides access to the region's most experienced providers and specialty services while teaching and developing tomorrow's medical leaders through residencies and fellowships sponsored by the Virginia Tech Carilion School of Medicine. Additionally, Carilion Roanoke Community Hospital houses a highly skilled inpatient rehabilitation unit, a wound healing center, endoscopy services, outpatient surgery, and an occupational medicine practice. Women's services have two practice sites at this facility, including urogynecology and maternal-fetal medicine. CMC serves all patients regardless of their ability to pay. The hospital's governing board members reside in the region and are elected to 3-year terms, with board officers elected annually. The majority of members are neither hospital employees nor contractors. Medical staff privileges are extended to qualified providers. Surplus funds are reinvested in new technology, clinical initiatives, education, staff development, and charitable efforts. Reinvestments include providing free, discounted and subsidized care and critical medical services not otherwise offered in our region.
Schedule H, Part VI, Line 6 Affiliated health care system	Carilion Medical Center is wholly owned by Carilion Clinic, a not-for-profit healthcare organization based in Roanoke, Virginia. Carilion Clinic includes a comprehensive network of hospitals, primary and specialty physician practices, and complementary services comprising six hospital entities, 86 specialties and 295 practice sites across Southwest Virginia. All are centered on a common mission and shared values. In the mid-2000s, Carilion decided to transform from a collection of hospitals to a physician-led, integrated healthcare system. Advances include developing a multi-specialty physician group, transforming our primary care practices into patient-centered medical homes, implementing electronic health records system-wide creating a robust partnership with Virginia Tech, including developing the Virginia Tech Carilion (VTC) School of Medicine and the Fralin Biomedical Research Institute at VTC, and hosting Radford University Carilion's healthcare professional educational offerings on our Carilion Roanoke Community Hospital campus. Each decision and adaptation have fundamentally changed how Carilion collaborates and provides care (https://www.carilionclinic.org/about-carilion-clinic). Carilion's community and population health infrastructure is the health system's engine for providing collaborative opportunities to improve and promote the community's health. Carilion's Community Health Assessment process helps identify the strengths and barriers impacting health. Our community-based programs reflect the Robert Wood Johnson Foundation's framework of four main influences of health: health behaviors, social and economic factors, clinical care access and quality, and physical environment. Our many partnerships with cross-sector organizations create a collaborative culture of health and wellness.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (31 entries)

Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
American Cancer Society
131788491	501(c)(3)	$10,000	Program support
American Heart Association
135613797	501(c)(3)	$15,050	Event sponsorships
Bradley Free Clinic of Roanoke
237380491	501(c)3	$28,000	Behavioral Health Services
Family Service of Roanoke Valley
540505946	501(c)(3)	$11,000	Mental Health Wellness
Grandin Theatre Foundation Inc
010557881	501(c)(3)	$25,000	Sponsorship
Junior Achievement of SW VA
540628293	501(c)(3)	$6,750	Event sponsorship
National Multiple Sclerosis Society
135661935	501(c)(3)	$6,500	Sponsorship
Opera Roanoke
510213334	501(c)(3)	$9,000	Sponsorship
Radford University
546001789	Virginia	$243,442	Assoc Provost Health Sci
Ronald McDonald House Charities SWVA
541244769	501(c)(3)	$1,500	Donated rent prog support	$285,327	FMV	Donated Rent
Science Museum of Western Virginia
541023953	501(c)(3)	$25,000	Program support
Taubman Museum of Art
546026841	501(c)(3)	$22,500	Sponsorship
The Virginia Foundation for Community College Education
237004354	501(c)(3)	$7,500	Event Sponsorship
Valleys Innovation Council Verge
462975294	501(c)(3)	$100,000	Program support
Virginia Growth and Opportunity Foundation
811586667	501(c)(3)	$100,000	Program support
Virginia Health Care Foundation
541639924	501(c)(3)	$75,000	Program support
One Valley Inc
274543707	501(c)(3)	$10,000	Urban farming initiative
Blue Ridge Literacy
541377063	501(c)(3)	$10,000	English and Health literacy classes
City of Roanoke
546001569	City of Roanoke	$10,000	Financial Empowerment Center
Commonwealth Catholic Charities
540505877	501(c)(3)	$10,000	Refugee medical service access
Virginia Harm Reduction Coalition
832479145	501(c)(3)	$10,364	Program support
Feeding Southwest Virginia
541939556	501(c)(3)	$7,500	Nutrition education and resources
Planned Parenthood South Atlantic
561282557	501(c)(3)	$7,500	Informed Health Decision support
The Rescue Mission of Roanoke Inc
540573900	501(c)(3)	$14,000	Recovery coach
Roanoke Symphony Orchestra
546019736	501(c)(3)	$15,000	Sponsorship
United Way of Roanoke Valley
540535302	501(c)(3)	$50,000	Health collaborative
Virginia Chamber Foundation
510193842	501(c)(3)	$50,000	Program support
Virginia Business Higher Education Council
541827038	501(c)(3)	$25,000	Program support
Virginia Ready Initiative
851103573	501(c)(3)	$62,500	Program support
Virginia Tech Carilion School of Medicine
264556177	Virginia	$4,422,046	Medical School Support
Carilion Clinic Properties LLC
205231645	501(c)(3)	$258,407	Pediatric Behavioral Health

Field	Value	IRS element (for citing)
Total501c3 Org	29	Total501c3OrgCnt
Total Other Org	2	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	Endowment Funded Patient Care	GrantTypeTxt
Recipient	5	RecipientCnt
Cash Grant	$47,599	CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Steven Arner
Director/President/CEO	$0	$1,044,670	$0	$164,317	$0	$201,205	$0	$184,622	$0	$24,996	$0	$1,619,810	$0	$195,888
Paul Haskins MD
Director/Physician	$349,372	$0	$26,661	$0	$5,968	$0	$59,134	$0	$26,367	$0	$467,502	$0	$0	$0
Michael Nussbaum MD
Director/SVP/Surgical Services Chair	$789,374	$0	$101,259	$0	$85,917	$0	$23,702	$0	$17,811	$0	$1,018,063	$0	$0	$0
Daniel Tershak MD
Director/Chief of Medical Staff	$470,339	$0	$41,990	$0	$18,553	$0	$8,465	$0	$23,055	$0	$562,402	$0	$0	$0
David Hagadorn
Former Officer	$0	$120,679	$0	$0	$0	$38,425	$0	$13,363	$0	$11,709	$0	$184,176	$0	$0
Nicholas Conte
Secretary	$0	$731,687	$0	$111,366	$0	$180,664	$0	$156,813	$0	$18,080	$0	$1,198,610	$0	$172,601
Donald Halliwill
Asst. Treasurer	$0	$767,976	$0	$117,511	$0	$233,761	$0	$142,915	$0	$24,996	$0	$1,287,159	$0	$227,735
G Robert Vaughan Jr
Treasurer	$0	$353,161	$0	$41,359	$0	$63,488	$0	$46,006	$0	$24,996	$0	$529,010	$0	$57,282
Michael Abbott
Senior Vice President	$318,357	$0	$36,299	$0	$7,134	$0	$90,491	$0	$9,767	$0	$462,048	$0	$0	$0
Nancy Howell Agee
CEO, Carilion Clinic	$0	$1,718,407	$0	$353,685	$0	$1,758,613	$0	-$14,700	$0	$16,492	$0	$3,832,497	$0	$1,500,000
Daniel Harrington MD
Interim Chief Medical Officer/EVP	$0	$320,000	$0	$0	$0	$10,239	$0	$0	$0	$2,444	$0	$332,683	$0	$0
John Jane MD
SVP, Chair Neurosurgery	$541,806	$0	$75,000	$0	$37,485	$0	$62,500	$0	$10,218	$0	$727,009	$0	$0	$0
Joseph Moskal MD
SVP/Chair, Dept. of Orthopedics	$1,179,271	$0	$157,985	$0	$84,441	$0	$0	$0	$24,727	$0	$1,446,424	$0	$0	$0
Jon Sweet MD
SVP/Chair, Dept. of Medicine	$512,329	$0	$78,578	$0	$5,900	$0	$69,392	$0	$13,135	$0	$679,334	$0	$0	$0
Jonathan Carmouche MD
Physician	$1,471,439	$0	$145,830	$0	$3,114	$0	$3,080	$0	$23,055	$0	$1,646,518	$0	$0	$0
Gregory Howes MD
Physician	$1,217,439	$0	$256,440	$0	$2,833	$0	$8,445	$0	$23,055	$0	$1,508,212	$0	$0	$0
Eric Marvin MD
Physician	$1,090,939	$0	$451,228	$0	$3,893	$0	-$2,821	$0	$23,055	$0	$1,566,294	$0	$0	$0
Adeolu Olasunkanmi MD
Physician	$847,992	$0	$501,380	$0	$3,525	$0	$11,756	$0	$9,270	$0	$1,373,923	$0	$0	$0
Cara Rogers MD
Physician	$746,233	$0	$363,121	$0	$2,293	$0	$15,235	$0	$9,270	$0	$1,136,152	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments	EMPLOYEES ARE OCCASIONALLY PROVIDED SMALL GIFTS, PRIZES OR AWARDS WHICH MAY BE INCLUDED IN TAXABLE COMPENSATION AT AMOUNTS GROSSED UP FOR TAXES. DURING THE REPORTING PERIOD, Dr. NUSSBAUM, DR. LEARMAN, DR. SWEET, AND DR. MOSKAL RECEIVED SUCH BENEFIT.
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	All Directors are offered a free family or individual membership to a health club owned by a related organization if they choose to accept it. Two reported individuals received this benefit, the value of which is included in reported compensation.
Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses	Provision of the health club benefit is documented in Board meeting minutes and Carilion internally tracks the memberships and pays the health club directly. MANAGEMENT MAKES TAX GROSS-UP DECISIONS AT ITS DISCRETION FOR NON-ROUTINE SMALL GIFTS, PRIZES OR AWARDS CONSIDERING IRS REQUIREMENTS, AMOUNT, AND NON-CASH STATUS.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The Carilion Clinic Board of Directors Compensation Committee reviews the compensation of the Carilion Clinic Board of Governors annually, which includes Carilion Medical Center's President/CEO. 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. 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	Mr. Abbott, Mr. Arner, Mr. Conte, Mr. Halliwill, Dr. Moskal, Dr. Nussbaum, Dr. Haskins, Dr. Jane, Dr. Sweet and Mr. Vaughan participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP). Contributions to the plan are at the discretion of Carilion Clinic's Compensation Committee. Amounts vest and become non-forfeitable and payable upon the first of the following (1) attainment of scheduled vesting date (2) attainment of age and years of service requirements (3) disability or death while an eligible employee or (4) entitlement to severance benefits from an involuntary termination without reasonable cause or resignation with good reason. Unvested contributions made to the DC SERP in the reporting period are included in Part II, Column C of this schedule with "retirement and other deferred compensation," while vested contributions paid out during the year are included in Part II, Column B(iii). The following distributions were made to these individuals under this plan in the reporting year. Deferred in prior year and paid out in current year: $227,735 - Donald Halliwill $195,888 - Steven Arner $57,282 - G. Robert Vaughan, Jr. $172,601 - Nicholas Conte Vested and paid in current year: $75,000 - Joseph Moskal $72,352 - Michael Nussbaum Ms. Agee participates in an Executive Flexible Benefit Plan, under which she receives an allowance which can be used to obtain certain benefits, with the excess deferred until the applicable vesting date. Amounts received under this plan now vest immediately and thus are no longer deferred. $245,365 was distributed under this plan in the reporting year. In the current year 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 and physicians 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 or physicians 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.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Patricia Abbott
Family member of Michael Abbott, key employee	$181,047	Employee	false
Mary Sweet MD
Family member of Jon Sweet, key employee	$333,129	Employee	false
Andrew Maslich
Family member of Steven Arner, Director	$63,877	Employee	false

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (19 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part I, Line 6 Volunteers	The hospital operates a Customer Service-based program for volunteers, going above and beyond to make our patients and their families comfortable in very uncomfortable circumstances. Tasks include delivering mail and flowers, greeting and escorting patients, offering refreshments through our Hospitality cart, conducting pet-assisted therapy visits, and generally supporting the Guest Services Staff. CMC volunteers also support our patient units by performing these tasks in addition to volunteer work that supports the nursing staff, such as organizing supplies and visiting patients who do not have family present. Through Hospice, volunteers provide respite support for caregivers, visits for socialization and comforting presence, check in calls, care for patients' pets, help in the hospice office, plant/harvest/deliver fresh veggies, offer Virtual Reality experiences, sing in the hospice choir to patients, provide honoring ceremonies for military veteran patients, offer pet therapy and Reiki therapy, provide visits from a Santa Claus with a real beard, offer end of life Doula support including Vigil planning, assist with fundraisers, assist with bereavement support activities, make fidget quilts for dementia patients and sew dignity patient gowns, deliver birthday gifts, craft holiday gifts and record patient's life stories. Volunteer licensed cosmetologist provided patients with fresh haircuts.
Form 990, Part III, Line 4a Program Service Description	Carilion Medical Center (CMC) is an affiliate of Carilion Clinic, a not-for-profit health system headquartered in Roanoke, Virginia. CMC includes Carilion Roanoke Memorial Hospital, Carilion Roanoke Community Hospital and surrounding clinics and practices. Carilion Roanoke Memorial Hospital's commitment to improving the health of its community is recognized through its ranking among the elite 11% of Best Hospitals nationally and among the top three hospitals in Virginia by U.S. News and World Report. CMC also has earned five Magnet designations for nursing excellence, placing it in the top 1% of hospitals globally and the only one in Virginia to earn the honor. Committed to innovation and clinical excellence and supported by education and research, Carilion operates a regional cancer center, the region's only Level I Trauma Center, and the region's only pediatric center of excellence, with an inpatient unit within Carilion Roanoke Memorial Hospital that includes a pediatric intensive care unit, Virginia's third largest neonatal ICU, trauma care and western Virginia's only pediatric Level I Trauma Center. CMC admitted over 35,253 patients, delivered 3,274 babies, and provided 211,891 days of care in fiscal year 2024. With nearly 85,000 visits, CMC's emergency services are a critical component of the health safety net in its service area, acting as a key health provider for a significant number of uninsured patients, who comprise about 7 percent of ED visits. More than a dozen pediatric sub-specialties are housed at Carilion Children's freestanding outpatient clinic. They include physical, occupational and speech therapies, and ENT/audiology, mental health and dentistry services. In addition, CMC physicians provide care in a range of specialties at numerous clinic practice sites on and near its Roanoke hospital campuses as well as throughout the Western Virginia region. To meet the growing need for care in Southwest Virginia, in Summer 2025 Carilion opened a $500 million tower addition to Carilion Roanoke Memorial Hospital. The 12-story, 500,000-square-foot Crystal Spring Tower is home to the Carilion Clinic Cardiovascular Institute and a significantly expanded Emergency Department. In addition to providing medical care, Carilion invests significantly in medical education. The health system's Graduate Medical Education program, based at Carilion Roanoke Memorial Hospital, trains more than 300 residents and fellows in 29 programs with nearly half of program graduates remaining in Southwest Virginia to care for patients in the region. Through partnerships with premier institutions like Virginia Tech and Radford University, Carilion also provides undergraduate medical education and training at CMC for physicians, nurses and a range of allied health professionals. In addition, CMC provides numerous community health screenings and education on chronic disease prevention and management, invests in an internal community health workforce, and partners with community organizations to identify and address health needs. To advance its not-for-profit mission, Carilion cares for all patients regardless of their ability to pay. Stated at cost, in fiscal year 2024, CMC provided nearly $76 million in uncompensated care and other community support . Carilion Medical Center's achievements in patient care, education, and community support demonstrate its steadfast commitment to meeting the needs of the communities it serves.
Form 990, Part IV, Line 11f Disclosure of Uncertain Tax Positions	Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.
Form 990, Part V, Line 1a FORMS 1099	1099s are issued on Carilion Medical Center's behalf by Carilion Services, Inc., a related supporting organization providing management and administrative services, including payment processing.
Form 990, Part VI, Line 1a Delegate broad authority to a committee	Carilion Medical Center has an Executive Committee authorized to act when the Board is not in session. The Executive Committee has 4 members, made up of the Carilion Medical Center President and Chair of the Board, CAPS Committee, and Nominating Committee. The Executive Committee meets at times that the Board cannot meet and if the need arises to act on behalf of the Board, except to elect directors or Committee members, amend governing documents, approve a plan of merger, or other actions that are required to be approved by Board members.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	Nancy Howell Agee, Steven Arner, Nicholas Conte, Daniel Harrington, Donald Halliwill, G. Robert Vaughan Jr., J. Harrison Lapausa and Julie Smith-Hamilton - Business relationship
Form 990, Part VI, Line 3 Delegation of management duties	Certain management and related services for the organization are provided by the management and employees of Carilion Services, Inc., a related and supporting organization of the filing organization. Some or all of the compensation of the following individuals listed in Part VII, Section A was provided by Carilion Services Inc.: Nancy Howell Agee, Steven Arner, Nicholas Conte, David Hagadorn, Donald Halliwill, Julie Smith-Hamilton, J. Harrison Lapausa, and G. Robert Vaughan, Jr.
Form 990, Part VI, Line 6 Classes of members or stockholders	The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the board that may occur for any reason.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO; approval of borrowings, budgets, and strategic plans; and amendments of Articles of Incorporation and Bylaws, among others. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia, certain extraordinary actions require member approval, such as mergers, consolidations, liquidations, and the sale of substantially all of the assets of the organization. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a.
Form 990, Part VI, Line 11b Review of form 990 by governing body	The Form 990 was prepared by Carilion's internal Tax Department with input from various other Carilion departments as applicable, and reviewed by internal management and an independent CPA firm. Management reviewed a draft of the Form 990 at the August meeting of the Carilion Clinic Board of Directors Audit Committee and was available to answer questions. Several days 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 of Carilion Medical Center who are the physician Chairs of the Clinical Departments. Certain of these same individuals also hold roles as officers and key employees of Carilion Medical Center, including its President/CEO. 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 including Carilion Medical Center's Treasurer, Executive Vice Presidents, and the CEO, as well as the compensation philosophy for employed physicians. 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 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. In the case of the interim Chief Medical Officer, compensation was reviewed with the CEO and clinical department Chairs. Certain assistant 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 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	Other - Total Revenue: 2674181, Related or Exempt Function Revenue: 2674181, 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: 8998770, Related or Exempt Function Revenue: 8998770, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part X, Line 20 Tax Exempt Bond Liabilities	The amount reported as Tax-Exempt Bonds is the portion of Carilion Clinic Bonds allocated to Carilion Medical Center. Required information for the Bonds, including Schedule K, is reported in the Carilion Clinic (EIN: 54-1190771) IRS Form 990.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Transfers from/(to) Affiliates - -2938536; Pension-related changes other than net periodic pension costs - -XXX-XX-XXXX;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	RMH EMERGENCY SERVICES LLC	BusinessNameLine1Txt

US Address USAddress

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

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

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CARILION MEDICAL CENTER	BusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
CARILION CLINIC
PO BOX 12385	ROANOKE	VA	24025	541190771	SUPPORTING ORGANIZATION	VA	501(c)(3)	Type II	NA	false
CARILION CLINIC FOUNDATION
PO BOX 12385	ROANOKE	VA	24025	541190773	FUNDRAISING	VA	501(c)(3)	7	CARILION CLINIC	Yes (true)
CARILION FRANKLIN MEMORIAL HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	540480606	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION GILES COMMUNITY HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	540549603	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION NEW RIVER VALLEY MEDICAL CENTER
PO BOX 12385	ROANOKE	VA	24025	540553805	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION SERVICES INC
PO BOX 12385	ROANOKE	VA	24025	541190879	SUPPORTING ORGANIZATION	VA	501(c)(3)	Type II	CARILION CLINIC	Yes (true)
CARILION ROCKBRIDGE COMMUNITY HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	540568001	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION TAZEWELL COMMUNITY HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	546074580	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION BIOMEDICAL INSTITUTE
PO BOX 12385	ROANOKE	VA	24025	541965057	SUPPORTING ORGANIZATION	VA	501(c)(3)	Type I	CARILION CLINIC	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (15 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
Franklin County Ventures LLC
PO Box 12385	Roanoke	VA	24025	474365316	Real estate	VA	Carilion Clinic	Related	-$17	$53,814	false	false	0.1
Carilion Clinic Medicare Shared Savings Company LLC
PO Box 12385	Roanoke	VA	24025	455235473	Medicare ACO	VA	Carilion Clinic	Related	$643,349	$9,728,291	false	false	0.5
Roanoke Ambulatory Surgery Center LLC
1102 Jefferson Street SE	Roanoke	VA	24016	010691564	Surgery	VA	Carilion Medical Center	Related	$310,909	$1,353,919	false	false	0.5292
Southwest Virginia Health Properties LLC
1102 Jefferson Street SE	Roanoke	VA	24016	010691570	Real estate	VA	Carilion Medical Center	Related	$139,587	$1,211,565	false	false	0.5292
Raven Asset-Based Opportunity Fund IV LP
75 Spring Street 6th Floor	New York	NY	10012	824119491	Private equity	DE	NA	N/A
Starwood VEP II Co-Invest LLC
591 W Putman Ave	Greenwich	CT	06830	833262407	Investments	DE	NA	N/A
TI Platform CC SMA LP
4304 18th Street 14427	San Francisco	CA	941149991	842852539	Investments	DE	NA	N/A
TI FBV GR LP
4304 18th Street 14427	San Francisco	CA	941149991	862597246	Investments	DE	NA	N/A
TI Platform DCI SPV LP
4304 18th Street 14427	San Francisco	CA	941149991	871897835	Investments	DE	NA	N/A
Transpose Platform Zippedi SPV LP
4304 18th Street 14427	San Francisco	CA	941149991	873425361	Investments	DE	NA	N/A
Transpose Platform Gorgias SPV LP
4304 18th Street 14427	San Francisco	CA	941149991	874563291	Investments	DE	NA	N/A
Transpose Platform Fintech Fund II LP
4304 18th Street 14427	San Francisco	CA	941149991	873126138	Investments	DE	NA	N/A
Opera Investment Two SCSP
					Investments		NA	N/A						412F Route dEsch	Luxembourg	LU	LU
VTC Innovation Fund III LP
c/o Middleand Capital 709 S Jeffers	Roanoke	VA	24016	921362795	Investments	DE	NA	N/A
Pacific North of South Em All CAP Equity Fund
c/o Global Trust Company 12 Gill St	Woburn	MA	01801	842642916	Investments	DE	NA	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 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
CHS INC
PO BOX 12385	ROANOKE	VA	24025	541725732	SERVICES	VA	NA	C Corporation	Yes (true)
CARILION BEHAVIORAL HEALTH INC
PO BOX 12385	ROANOKE	VA	24025	203136891	HEALTHCARE	VA	NA	C Corporation	Yes (true)
CARILION EMERGENCY SERVICES INC
PO BOX 12385	ROANOKE	VA	24025	542033006	HEALTHCARE	VA	NA	C Corporation	Yes (true)
SCA CREDIT SERVICES INC
PO BOX 12385	ROANOKE	VA	24025	541180398	COLLECTION AGENCY	VA	NA	C Corporation	Yes (true)
CARILION HEALTHCARE CORPORATION
PO BOX 12385	ROANOKE	VA	24025	541586601	HEALTHCARE	VA	NA	C Corporation	Yes (true)
MEDKEY INC
PO BOX 12385	ROANOKE	VA	24025	541645357	FINANCING SERVICES	VA	NA	C Corporation	Yes (true)
Carilion DTC Services Inc
PO Box 12385	Roanoke	VA	24025	872635239	Healthcare	VA	NA	C Corporation	Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	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	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (26 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Carilion Clinic Foundation
A	$42,516	Cost
Carilion Services Inc
A	$255,010	Cost
CHS Inc
A	$73,370	Cost
Carilion Emergency Services Inc
A	$109,610	Cost
Carilion Healthcare Corporation
A	$29,592	Cost
Carilion New River Valley Medical Center
L	$1,939,789	Cost
Carilion Giles Community Hospital
L	$708,531	Cost
Carilion Franklin Memorial Hospital
L	$940,966	Cost
Carilion Rockbridge Community Hospital
L	$959,967	Cost
Carilion Tazewell Community Hospital
L	$2,389,757	Cost
Carilion Services Inc
L	$445,560	Cost
Carilion Emergency Services Inc
L	$312,338	Cost
Carilion Healthcare Corporation
L	$359,617	Cost
Carilion New River Valley Medical Center
K	$251,237	Market Rate
CHS Inc
K	$1,502,954	Market Rate
Carilion Tazewell Community Hospital
M	$299,105	Cost
Carilion Services Inc
M	$265,572,108	Cost
Carilion Behavioral Health Inc
M	$217,966	Cost
CHS Inc
M	$3,516,058	Cost
SCA Credit Services Inc
M	$143,107	Cost
Carilion Healthcare Corporation
M	$745,557	Cost
Medkey Inc
M	$81,135	Cost
Carilion Services Inc
R	$2,938,536	Cash
Carilion Clinic
B	$258,407	Cost
Carilion Clinic Foundation
C	$458,222	cost
Carilion Clinic Foundation
R	$103,171	cash