CARILION MEDICAL CENTER: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: CARILION MEDICAL CENTER (EIN 54-0506332)
Tax period: 2019-10-01 to 2020-09-30
Filed: 2021-08-16
IRS object ID: 202142289349303194
Schema version: 2019v5.0
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	2021-08-16T16:01:09-05:00	ReturnTs
Tax Period End	2020-09-30	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	BKD 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	2019-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	540506332	EIN

Business Name BusinessName

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

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	G ROBERT VAUGHAN JR	PersonNm
Person Title	TREASURER	PersonTitleTxt
Signature	2021-08-16	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	2020-08-14	PreparationDt

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	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	$3,588,090,333	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	13	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	9680	TotalEmployeeCnt
Total Volunteers	271	TotalVolunteersCnt
Total Gross UBI	$60,241	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$8,626,043	PYContributionsGrantsAmt
CY Contributions Grants	$38,181,365	CYContributionsGrantsAmt
PY Program Service Revenue	$1,427,067,490	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,378,831,131	CYProgramServiceRevenueAmt
PY Investment Income	$28,386,481	PYInvestmentIncomeAmt
CY Investment Income	$67,040,275	CYInvestmentIncomeAmt
PY Other Revenue	$25,470,009	PYOtherRevenueAmt
CY Other Revenue	$24,159,089	CYOtherRevenueAmt
PY Total Revenue	$1,489,550,023	PYTotalRevenueAmt
CY Total Revenue	$1,508,211,860	CYTotalRevenueAmt
PY Grants And Similar Paid	$5,882,786	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$4,561,677	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$649,129,750	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$649,613,528	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$143,848	CYTotalFundraisingExpenseAmt
PY Other Expenses	$727,648,180	PYOtherExpensesAmt
CY Other Expenses	$749,272,389	CYOtherExpensesAmt
PY Total Expenses	$1,382,660,716	PYTotalExpensesAmt
CY Total Expenses	$1,403,447,594	CYTotalExpensesAmt
PY Revenues Less Expenses	$106,889,307	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$104,764,266	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,528,858,933	TotalAssetsBOYAmt
Total Assets EOY	$1,930,321,569	TotalAssetsEOYAmt
Total Liabilities BOY	$1,006,971,123	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,347,521,886	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$521,887,810	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$582,799,683	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	$1,200,505,343	ExpenseAmt
Grant	$4,561,677	GrantAmt
Revenue	$1,395,317,352	RevenueAmt
Desc	SEE SCHEDULE O.	Desc
Total Program Service Expenses	$1,200,505,343	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	9680	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	13	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (true)	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THE CORPORATION ATTN H KRK	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5402245102	PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (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	$2,175	$0
Steven Arner
Director/President/CEO	36.0	14.0	Yes (X)	Yes (X)	$0	$877,942	$363,619
George Cartledge III
Director	2.0	0.0	Yes (X)		$0	$1,075	$0
Isabel Thornton
Director	2.0	0	Yes (X)		$0	$0	$0
James Drougas MD
Director	4.3	0	Yes (X)		$12,646	$0	$0
Janet Frantz
Director	2.0	0.0	Yes (X)		$0	$1,075	$0
Jason Bingham
Director	2.0	2.9	Yes (X)		$0	$8,075	$0
Katherin Elam
Director	2.0	0	Yes (X)		$0	$0	$0
Kianna Price Marshall
Director	2.0	0	Yes (X)		$0	$1,075	$0
Lee Learman MD PhD
Director	2.0	0	Yes (X)		$0	$0	$0
Michael Nussbaum MD
Director	50.0	0	Yes (X)		$687,909	$0	$170,451
Neil Macdonald MD
Director	2.0	0	Yes (X)		$0	$0	$0
Paul Haskins MD
Director	50.0	0	Yes (X)		$371,019	$0	$241,634
David Hagadorn
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$149,339	$99,463
Donald Halliwill
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$774,298	$360,873
G Robert Vaughan Jr
Treasurer	0.5	49.5		Yes (X)	$0	$353,112	$316,295
Nicholas Conte
Secretary	3.0	47.0		Yes (X)	$0	$709,682	$182,512
Patrice Weiss MD
Chief Medical Officer/EVP	46.0	4.0		Yes (X)	$0	$817,383	$253,428
Joseph Moskal MD
SVP/Chair, Dept. of Orthopedics	50.0	0			$1,511,003	$0	$141,652	Yes (X)
Michael Abbott
Senior Vice President	50.0	0			$248,244	$0	$30,084	Yes (X)
Nancy Howell Agee
CEO, Carilion Clinic	2.0	48.0			$0	$2,254,723	$341,866	Yes (X)
Paul Skolnik MD
SVP/Chair, Dept. of Medicine	50.0	0			$539,031	$0	$88,390	Yes (X)
ADEOLU OLASUNKANMI MD
Physician	50.0	0			$1,100,363	$0	$47,716		Yes (X)
Eric Marvin MD
Physician	50.0	0			$1,429,798	$0	$135,761		Yes (X)
Gregory Howes MD
Physician	50.0	0			$1,647,368	$0	$77,090		Yes (X)
Jesse Stem MD
Physician	50.0	0			$1,296,861	$0	$62,355		Yes (X)
Jonathan Carmouche MD
Physician	50.0	0			$1,845,598	$0	$142,278		Yes (X)
Bruce Long MD
Physician	50.0	0			$447,580	$0	$195,325			Yes (X)
Jon Sweet MD
Physician	50.0	0			$323,855	$0	$209,773			Yes (X)
Tracey Criss MD
Physician	50.0	0			$326,080	$0	$290,935			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$11,787,355	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$5,949,954	TotReportableCompRltdOrgAmt
Total Other Compensation	$3,751,500	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	997	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt	Address Line2ContractorAddress/USAddress/AddressLine2Txt
QUEST DIAGNOSTICS
500 PLAZA DRIVE	SECAUCUS	NJ	07094	LABORATORY SERVICES	$28,894,269
GE MEDICAL SYSTEMS
5517 COLLECTION CENTER DRIVE	CHICAGO	IL	60693	EQUIPMENT MAINTENANCE	$6,268,513
F&S BUILDING INNOVATIONS INC
2944 ORANGE AVE NE	ROANOKE	VA	24012	CONSTRUCTION SERVICES	$4,480,203
SIEMENS MEDICAL SOLUTIONS USA INC
40 LIBERTY BOULEVARD	MALVERN	PA	19355	EQUIPMENT MAINTENANCE	$4,223,851
EARL SWENSSON ASSOCIATES INC
1033 DEMONBREUN STREET	NASHVILLE	TN	37203	PROFESSIONAL SERVICES	$3,387,983	SUITE 800

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	171	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$78,460	FederatedCampaignsAmt
Related Organizations	$505,223	RelatedOrganizationsAmt
Government Grants	$35,705,281	GovernmentGrantsAmt
All Other Contributions	$1,892,401	AllOtherContributionsAmt
Total Contributions	$38,181,365	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue	622110	$1,329,031,130	$1,329,031,130
Program Related Investments	621999	$6,498,658	$6,498,658
Clinical Research	541715	$914,411	$914,411
Other Patient Revenue	900099	$38,610,407	$38,610,407
Affiliate Rent Income	531120	$938,906	$938,906

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,837,619	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,837,619	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,378,831,131	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$15,115,978	TotalRevenueColumnAmt
Unrelated Business Revenue	$60,241	UnrelatedBusinessRevenueAmt
Exclusion	$15,055,737	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$318,939	TotalRevenueColumnAmt
Exclusion	$318,939	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$4,783,437	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$4,783,437	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,783,437	TotalRevenueColumnAmt
Exclusion	$4,783,437	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$2,131,072,448	SecuritiesAmt
Other	$411,383	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$2,079,815,416	SecuritiesAmt
Other	$63,057	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$51,257,032	SecuritiesAmt
Other	$348,326	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$51,605,358	TotalRevenueColumnAmt
Exclusion	$51,605,358	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
Physician & Other Affiliate Income	621111	$6,739,826	$6,739,826
Cafeteria	722514	$2,889,431		$2,889,431
Roanoke City Student Health	621440	$1,817,098	$1,817,098

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,929,297	TotalRevenueColumnAmt
Related Or Exempt Func Income	$7,929,297	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$19,375,652	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,508,211,860	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,395,317,352	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$60,241	UnrelatedBusinessRevenueAmt
Exclusion	$74,652,902	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$4,300,548	TotalAmt
Program Services	$4,300,548	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$261,129	TotalAmt
Program Services	$261,129	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$4,084,457	TotalAmt
Program Services	$3,426,887	ProgramServicesAmt
Management And General	$657,570	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$3,584,898	TotalAmt
Program Services	$3,584,898	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$514,020,524	TotalAmt
Program Services	$513,595,657	ProgramServicesAmt
Management And General	$374,878	ManagementAndGeneralAmt
Fundraising	$49,989	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$53,690,160	TotalAmt
Program Services	$53,651,003	ProgramServicesAmt
Management And General	$39,157	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$38,881,928	TotalAmt
Program Services	$38,767,214	ProgramServicesAmt
Management And General	$101,217	ManagementAndGeneralAmt
Fundraising	$13,497	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$35,351,561	TotalAmt
Program Services	$35,288,835	ProgramServicesAmt
Management And General	$62,726	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$178,278,116	TotalAmt
Management And General	$178,278,116	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$256,819	TotalAmt
Management And General	$256,819	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$98,107	TotalAmt
Program Services	$98,107	ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$1,275,815	TotalAmt
Management And General	$1,275,815	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$117,663,791	TotalAmt
Program Services	$99,826,364	ProgramServicesAmt
Management And General	$17,823,126	ManagementAndGeneralAmt
Fundraising	$14,301	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$341,383	TotalAmt
Program Services	$339,759	ProgramServicesAmt
Fundraising	$1,624	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$18,475,396	TotalAmt
Program Services	$18,390,459	ProgramServicesAmt
Management And General	$82,353	ManagementAndGeneralAmt
Fundraising	$2,584	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$4,920,330	TotalAmt
Program Services	$4,919,516	ProgramServicesAmt
Management And General	$814	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$26,896,900	TotalAmt
Program Services	$26,891,345	ProgramServicesAmt
Management And General	$5,555	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$2,140,639	TotalAmt
Program Services	$2,097,045	ProgramServicesAmt
Management And General	$41,322	ManagementAndGeneralAmt
Fundraising	$2,272	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$16,162,902	TotalAmt
Program Services	$16,162,902	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$46,395,824	TotalAmt
Program Services	$46,395,824	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$15,106,033	TotalAmt
Program Services	$11,578,682	ProgramServicesAmt
Management And General	$3,527,351	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Medical Supplies	$194,377,992	$194,375,127	$2,865
Bad Debt	$81,549,017	$81,549,017
Assessment Fees	$39,872,605	$39,872,605
Dues and Subscriptions	$2,275,649	$2,016,026	$200,042	$59,581

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,185,071	TotalAmt
Program Services	$3,116,394	ProgramServicesAmt
Management And General	$68,677	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,403,447,594	TotalAmt
Program Services	$1,200,505,343	ProgramServicesAmt
Management And General	$202,798,403	ManagementAndGeneralAmt
Fundraising	$143,848	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$17,586	BOYAmt
EOY	$17,411	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$5,005,959	BOYAmt
EOY	$18,923,445	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$2,463,652	BOYAmt
EOY	$1,423,906	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$246,865,692	BOYAmt
EOY	$265,679,526	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	$4,208,444	BOYAmt
EOY	$1,349,460	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$10,573,019	BOYAmt
EOY	$12,775,422	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$9,165,336	BOYAmt
EOY	$4,300,243	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,195,916,839	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$885,967,227	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$283,015,465	BOYAmt
EOY	$309,949,612	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$204,645,171	BOYAmt
EOY	$591,629,581	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$771,035,206	BOYAmt
EOY	$725,926,201	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	-$8,317,602	BOYAmt
EOY	-$1,880,475	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$65,123	BOYAmt
EOY	$65,123	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$115,882	BOYAmt
EOY	$162,114	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,528,858,933	BOYAmt
EOY	$1,930,321,569	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$182,029,352	BOYAmt
EOY	$211,803,738	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$13,240,000	BOYAmt
EOY	$7,877,994	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$3,297,074	BOYAmt
EOY	$160,540,791	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$323,771,290	BOYAmt
EOY	$467,470,376	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	$223,045	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$484,410,362	BOYAmt
EOY	$499,828,987	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,006,971,123	BOYAmt
EOY	$1,347,521,886	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	$501,315,131	BOYAmt
EOY	$561,406,380	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$20,572,679	BOYAmt
EOY	$21,393,303	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$521,887,810	BOYAmt
EOY	$582,799,683	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,528,858,933	BOYAmt
EOY	$1,930,321,569	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$104,764,266	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$31,286,438	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$12,565,955	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	$98,107	OtherActivitiesAmt
Total Lobbying Expenditures	$98,107	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 hospital industry associations is attributable to lobbying activities.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$17,033,643	BeginningYearBalanceAmt
Investment Earnings Or Losses	$803,774	InvestmentEarningsOrLossesAmt
Other Expenditures	$956,361	OtherExpendituresAmt
End Year Balance	$16,881,056	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$15,801,516	BeginningYearBalanceAmt
Investment Earnings Or Losses	$1,914,128	InvestmentEarningsOrLossesAmt
Other Expenditures	$983,681	OtherExpendituresAmt
End Year Balance	$16,731,963	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$15,705,697	BeginningYearBalanceAmt
Investment Earnings Or Losses	$904,944	InvestmentEarningsOrLossesAmt
Other Expenditures	$809,125	OtherExpendituresAmt
End Year Balance	$15,801,516	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.0	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.7071	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.2929	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	$6,116,287	OtherCostOrOtherBasisAmt
Book Value	$6,116,287	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$516,136,612	OtherCostOrOtherBasisAmt
Depreciation	$362,967,459	DepreciationAmt
Book Value	$153,169,153	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$960,828	OtherCostOrOtherBasisAmt
Depreciation	$840,573	DepreciationAmt
Book Value	$120,255	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$623,292,886	OtherCostOrOtherBasisAmt
Depreciation	$515,469,748	DepreciationAmt
Book Value	$107,823,138	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$49,410,226	OtherCostOrOtherBasisAmt
Depreciation	$6,689,447	DepreciationAmt
Book Value	$42,720,779	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$309,949,612	TotalBookValueLandBuildingsAmt

Financial Derivatives FinancialDerivativesGrp

Field	Value	IRS element (for citing)
Book Value	$9,628,700	BookValueAmt
Method Valuation	F	MethodValuationCd

Closely Held Equity Interests CloselyHeldEquityInterestsGrp

Field	Value	IRS element (for citing)
Book Value	$1,347,596	BookValueAmt
Method Valuation	C	MethodValuationCd

Other Securities OtherSecuritiesGrp (2 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
Comingled Funds
Alternative Investments	$714,949,905	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$725,926,201	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Due to Affiliates	$22,698,903
Pension Liability	$405,755,618
Deferred Comp Liability	$30,200,579
Interest Rate Swap Liability	$41,173,887

Field	Value	IRS element (for citing)
Total Liability	$499,828,987	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
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	false	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,736,919	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$14,736,919	NetCommunityBenefitExpnsAmt
Total Expense	0.0112	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$245,705,831	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$271,565,484	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	$260,442,750	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$271,565,484	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$14,736,919	NetCommunityBenefitExpnsAmt
Total Expense	0.0112	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9481	ActivitiesOrProgramsCnt
Persons Served	22990	PersonsServedCnt
Total Community Benefit Expns	$4,865,308	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$788,640	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,076,668	NetCommunityBenefitExpnsAmt
Total Expense	0.0031	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	295	PersonsServedCnt
Total Community Benefit Expns	$45,970,550	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,339,384	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$37,631,166	NetCommunityBenefitExpnsAmt
Total Expense	0.0285	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

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

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	1032	PersonsServedCnt
Total Community Benefit Expns	$1,903,006	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,903,006	NetCommunityBenefitExpnsAmt
Total Expense	0.0014	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	65	ActivitiesOrProgramsCnt
Persons Served	5562	PersonsServedCnt
Total Community Benefit Expns	$618,205	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$110,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$508,205	NetCommunityBenefitExpnsAmt
Total Expense	0.0004	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9551	ActivitiesOrProgramsCnt
Persons Served	29879	PersonsServedCnt
Total Community Benefit Expns	$53,357,069	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,238,024	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$44,119,045	NetCommunityBenefitExpnsAmt
Total Expense	0.0334	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9551	ActivitiesOrProgramsCnt
Persons Served	29879	PersonsServedCnt
Total Community Benefit Expns	$313,799,819	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$280,803,508	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$58,855,964	NetCommunityBenefitExpnsAmt
Total Expense	0.0446	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

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

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	15	ActivitiesOrProgramsCnt
Persons Served	5000	PersonsServedCnt
Total Community Benefit Expns	$247,918	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$247,918	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	20	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$36,380	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$36,380	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	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)
Activities Or Programs	81	ActivitiesOrProgramsCnt
Persons Served	357	PersonsServedCnt
Total Community Benefit Expns	$30,279	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,246	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$28,033	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$18,873	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$18,873	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	11	ActivitiesOrProgramsCnt
Persons Served	10	PersonsServedCnt
Total Community Benefit Expns	$600,615	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$600,615	NetCommunityBenefitExpnsAmt
Total Expense	0.0005	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	134	ActivitiesOrProgramsCnt
Persons Served	5367	PersonsServedCnt
Total Community Benefit Expns	$934,065	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,246	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$931,819	NetCommunityBenefitExpnsAmt
Total Expense	0.0007	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$81,553,905	BadDebtExpenseAmt
Reimbursed By Medicare	$232,055,867	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$264,524,668	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$32,468,801	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	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
ROANOKE AMBULATORY SURGERY CENTER LLC
AMBULATORY SURGERY	0.492	0.4648
SOUTHWEST VIRGINIA HEALTH PROPETIES LLC
REAL ESTATE	0.5112	0.4648

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

Hospital Facilities HospitalFacilitiesGrp (2 entries)

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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	17	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/LOCATIONS/CARILION-ROANOKE-MEMORIAL-HOSPITAL HTTPS://WWW.CARILIONCLIN	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	HTTPS://WWW.CARILIONCLINIC.ORG/COMMUNITY-HEALTH-ASSESSMENTS#ROANOKE-VALLEY	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	17	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	HTTPS://WWW.CARILIONCLINIC.ORG/COMMUNITY-HEALTH-ASSESSMENTS#ROANOKE-VALLEY	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	200.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT PRIORITIZES THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED BY THE ASSESSMENT, AND EXPLAINS HOW THE HEALTH NEEDS WERE PRIORITIZED.
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 and success is highly dependent on engaging citizens, health and human service agencies, businesses, and community leaders. Community stakeholder collaborations known as "Community Health Assessment Teams" (CHAT) lead the CHNA projects. The CHAT consists of health and human service agency leaders; persons with special knowledge of, or expertise in, public health; the local health department; and leaders, representatives, or members of populations who are medically underserved, low-income, minority, and suffer from chronic diseases. The following organizations served on the CHAT for the 2018 (tax year 2017) Roanoke Valley Community Health Needs Assessment (RVCHNA): Blue Blaze Consulting, Blue Ridge Behavioral Healthcare, Bradley Free Clinic, Carilion Clinic, CHIP of Roanoke Valley, City of Roanoke - Lead Safe Roanoke, Family Service of Roanoke Valley, Freedom First Credit Union, Healthy Roanoke Valley (HRV), High Street Baptist Church, Jefferson College of Health Sciences, Local Environmental Agricultural Project (LEAP), New Horizons Healthcare, Rescue Mission Ministries, Inc., Roanoke College, Roanoke Redevelopment and Housing Authority, Roanoke Regional Chamber of Commerce, Salem Veteran Affairs Medical Center, United Way of Roanoke Valley, and the Virginia Department of Health. To further obtain input from the community, the RVCHNA conducted focus groups among stakeholders and target populations and administered a community health survey. During the CHNA process, community stakeholders, leaders, and providers were encouraged to complete a Stakeholder Survey (print and electronic versions were available) to provide additional perspectives about our community's health needs and barriers. CHATs conducted stakeholder focus groups with the City of Roanoke (Fire/EMS Station #5 & #6, and Police Department), HRV partners and friends (brought together for a Stakeholder Forum), and the Roanoke Valley Palliative Care Partnership. Target population focus groups were conducted to capture the story of needs and barriers to health for the uninsured, underinsured, low-income, minority, senior, and chronically ill populations. Focus group locations were chosen based on their proximity and convenience to target populations. Ten target population focus groups were held and participants discussed health needs and barriers to health, as well as access to primary, oral, and mental health care. Target population focus groups were conducted with AARP members, a women's group comprised of former immigrants to the United States, a Blue Ridge Literacy English for Speakers of Other Languages (ESOL) class, Bradley Free Clinic patients, residents of Roanoke Redevelopment Housing Authority's Melrose Towers (in the NW Roanoke City Medically Underserved Area (MUA)) and Morningside Manor (in the SE Roanoke City MUA), certified peer recovery specialists, Presbyterian Community Center parents and staff, and Roanoke Rescue Mission guests. A 39-question survey was developed (in English and Spanish) including questions about socioeconomic factors, access to medical, dental, and mental health care, health behaviors, physical environment, health outcomes, and demographics. The survey included commonly used questions and metrics from previously validated community surveys conducted by organizations such as National Association of County and City Health Officials (NACCHO), and Centers for Disease Control and Prevention. The CHAT and HRV Data Tracking and Quality Improvement Action Team identified target populations, collection sites and survey distribution methods. The survey focused on Roanoke Valley residents 18 years of age and older in the following service area of Bedford, Botetourt, Craig and Roanoke counties, Roanoke City, and Salem City. Special efforts were made to include the subpopulations of underserved/vulnerable populations disproportionately impacted by the social determinants of health including Income, race/ethnicity, education, and insurance status. The survey was also made available to all residents living in the Roanoke Valley, and oversampling of the target populations occurred through targeted outreach efforts. In total, 2,308 surveys were collected.
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 (Group A), both owned by Carilion Medical Center and serving the same area, jointly conducted their CHNA. The Salem Veteran Affairs Medical Center also participated on the Community Health Assessment Team.
Schedule H, Part V, Section B, Line 6b Facility A, 1	Facility A, 1 - GROUP A. Blue Blaze Consulting, Blue Ridge Behavioral Healthcare, Bradley Free Clinic, Carilion Clinic, CHIP of Roanoke Valley, City of Roanoke - Lead Safe Roanoke, Family Service of Roanoke Valley, Freedom First Credit Union, Healthy Roanoke Valley (HRV), High Street Baptist Church, Jefferson College of Health Sciences, Local Environmental Agricultural Project (LEAP), New Horizons Healthcare, Rescue Mission Ministries, Inc., Roanoke College, Roanoke Redevelopment and Housing Authority, Roanoke Regional Chamber of Commerce, Salem VA Medical Center, United Way of Roanoke Valley, Virginia Department of Health.
Schedule H, Part V, Section B, Line 7 Facility A, 1	Facility A, 1 - Group A. The Community Health Assessment Team (CHAT) shared the 2018 Roanoke Valley CHNA on partner websites and social media. The RVCHNA was also shared through community forums, community presentations and media interviews.
Schedule H, Part V, Section B, Line 11 Facility A, 1	Facility A, 1 - Group A. The following information describes the implementation strategies 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 2018 Roanoke Valley Community Health Needs Assessment (RVCHNA). The complete implementation strategies are available online at https://www.carilionclinic.org/community-health-assessments#roanoke-valley According to the Robert Wood Johnson Foundation's (RWJF) County Health Rankings (http://www.countyhealthrankings.org), where an individual lives, works and plays is a strong predictor of their health outcomes. In the United States, a person's zip code can help predict their life expectancy due to its direct link to the social determinants of health such as poverty, race/ethnicity, education and employment status in these areas. (https://www.rwjf.org/en/library/interactives/whereyouliveaffectshowlongyoulive.html). These factors, part of the 10-year national Healthy People 2030 objectives, are crucial to our overall health because they "create social and physical environments that promote good health for all." (https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health) Carilion responds to community health needs in innovative ways- making sure our regions have access to state-of-the-art health care close to home, providing community grants and sponsorships to extend our mission and support other organizations addressing health needs, creating and implementing community-wide strategies to reduce barriers, coordinate resources and enhance community strengths, and providing community-based health and wellness programs. Commitment to community health is evident at all levels of the organization. Carilion's infrastructure includes a Planning and Community Development division dedicated to assessing and addressing community needs. The division is responsible for leading and facilitating the Community Health Improvement Plan (CHIP), CHNAs, Carilion's community grant process, community health education, community benefit collection, and neighborhood health initiatives. There are Community Health and Outreach (CHO) staff at the system level and each community hospital. They work with hospital Board of Directors and Carilion Clinic's Board of Governors to create health improvement strategies. A Community Benefit Council provides oversight and strategic guidance for Carilion's community health improvement work and for community benefit strategy, collection and submission. Carilion's response strategies follow the RWJF framework for what influences health, health behaviors, social and economic factors, clinical care access and quality and physical environment. With the onset of COVID-19, Carilion immediately recognized the prominent role we would play in both prevention and treatment for our region. The pandemic demanded a shift in operations and priorities. While some of our implementation strategies were delayed or altered, Carilion quickly responded to the new and unique health-related social needs arising from COVID-19. An addendum to the CMC implementation strategies was approved in July 2020 to reflect the organization's planning and response to the pandemic. The complete addendum is available online at https://www.carilionclinic.org/sites/default/files/2020-10/CMC%20IS%20COVID%20Addendum_0.pdf. -COVID-19 Community Response- Carilion worked with local media partners to provide expert advice and guidance to the community for COVID-19 prevention, detection and recovery. In a historic collaborative effort, competing hospitals and broadcasting organizations publicized a community town hall. We coordinated efforts to ensure the public received the most accurate and up-to-date information about the pandemic. We developed the COVID-19 Community Hotline as a dedicated phone line to answer community member questions about COVID-19 signs and symptoms, Carilion guidelines, and resources. We also established a recovery support phone line to ensure employees, patients, and community members have access to mental health and recovery support. Peer Recovery Specialists created five virtual peer support community groups. These provide options for individuals in recovery to maintain recovery-oriented support during stay-at-home orders. Carilion is actively providing counsel to community partners, businesses, universities and colleges regarding COVID-19 through consultation with our infectious disease physicians and our management team. This service, offered free of charge, aims to promote safety and reduces hospitalizations and deaths. -Home Alone and Patient Outreach- Because older adults are especially vulnerable to COVID-19, accessing essential resources presented another serious challenge for them during the pandemic. Amid stay-at-home orders, business closures and medical appointment cancellations, we made it our mission to check on seniors in need who were living alone. Carilion's Planning and Community Development, Geriatric Medicine, Home Care and Hospice and Accountable Care Organization departments coordinated efforts to establish Home Alone. Through this initiative, Carilion made more than 1,200 phone calls to provide up-to-date information and connect seniors with local governments and community resources. From delivering masks to offering support over the phone, the program helped meet a wide-range of needs head-on. Seniors were able to stay home safely, reduce their exposure to COVID and avoid the hospital -Community Partnerships- Carilion Clinic believes in the power of collaboration. Carilion also understands the most significant health issues are addressed through cooperation with the community. Carilion participates in and provides financial and in-kind support to community health coalitions addressing the Roanoke Valley health needs. We also partner with multiple community and business organizations to improve health and wellness and to impact the social determinants of health for everyone we serve. -Healthy Roanoke Valley (HRV)- Forming a true community collaborative with lasting impact is no small feat. In 2012, using the Strive Collective Impact model, Carilion and United Way brought together strategic community partners to create HRV. An initiative supported by United Way of Roanoke Valley, HRV is now a partnership of more than 50 organizations striving to enhance health equity and create a "culture of wellness" across our region. For years, HRV has been serving as a valuable partner with Carilion Clinic. The collaborative updated HRV's strategic framework to align with the triennial Community Health Needs Assessment (CHNA), a community-driven process and a significant component of Carilion's Health Improvement Implementation Strategy for the Roanoke Valley. Through strategic planning in response to the 2018 Roanoke Valley Community Health Needs Assessment priorities, HRV identified four goals- 1. Reduce barriers to resources that address the social determinants of health, 2. Expand access to quality care and support a culture of health, 3. Encourage and support lifestyle behaviors that result in improved health and wellbeing, 4. Support and advocate for natural and built environments that cultivate vibrant neighborhoods. Carilion provides in-kind support to HRV with representatives active on the HRV steering committee and action teams focused on wellness, mental health, primary care, oral health and coordination of care. In response to the COVID-19 pandemic, HRV focused on engaging partners and supporting the United Way of Roanoke Valley-led community response effort. HRV staff members were deeply involved in supporting community efforts around health care access and resources, personal protective equipment shortages and sourcing, community food resources, and financial education and literacy. HRV's Mental Health & Substance Use and Wellness Action Teams developed a shared message to address behavioral health issues in the community related to the pandemic and racial unrest. Meanwhile, the Healthy Start initiative pivoted its focus from family education to providing emergency supplies of fresh produce to families with children. (Continued in Schedule H, Part VI)
Schedule H, Part V, Section B, Line 13 Facility A, 1	Facility A, 1 - Group A. Individuals with Out of Network insurance are not eligible for Financial Assistance unless the plan does not meet minimum essential coverage as defined in PPACA or it is a governmental plan.

Field	Value	IRS element (for citing)
Facility	103	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (103 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt	Address Line2USAddress/AddressLine2Txt	Business Name Line2BusinessName/BusinessNameLine2Txt
Carilion Roanoke Memorial Rehab
2017 South Jefferson Street	Roanoke	VA	24014	Psychiatry Services
CNRV Emergency Services
2900 Lamb Circle	Christiansburg	VA	24073	Emergency Physicians
CES - Franklin
180 Floyd Avenue	Rocky Mount	VA	24151	Emergency Physicians
CES - Tazewell
388 Ben Bolt Avenue	Tazewell	VA	24651	Emergency Physicians
Carilion Clinic Pain Management
1 Riverside Circle	Roanoke	VA	24016	Pain Management
Carilion Clinic Genetic Counseling
1 Riverside Circle	Roanoke	VA	24016	Genetic Counseling
Carilion GYN Oncology
1 Riverside Circle Suite 300	Roanoke	VA	24016	Gynecological Oncology
Carilion Clinic Dermatology & Mohs Surgery
1 Riverside Circle Suite 300M	Roanoke	VA	24016	Dermatology and Mohs Surgery
Carilion Clinic Occupational Medicine Elm Ave
101 Elm Avenue SE	Roanoke	VA	24013	Occupational Medicine
Carilion Wound Care Center Carilion Roanoke Community Hospital
101 Elm Avenue SE	Roanoke	VA	24013	Wound Care
Carilion Dentistry Pediatric Surgery
101 Elm Avenue SE	Roanoke	VA	24013	Dental Service
Community Care
101 Elm Avenue SE	Roanoke	VA	24013	Family Medicine
Carilion Maternal Fetal Medicine
101 Elm Avenue Suite 400	Roanoke	VA	24013	Maternal Fetal Medicine
Carilion Clinic Urogynecology
101 Elm Avenue Suite 400	Roanoke	VA	24013	Obstetrics
Carilion Prenatal Diagnostic Center
102 Highland Ave Suite 455	Roanoke	VA	24013	Prenatal Testing
Carilion Breast Care Diagnostic Center
102 Highland Ave Ste 202	Roanoke	VA	24013	Breast Care Center
Pediatric Cardiology Clinic
102 Highland Avenue Suite 101	Roanoke	VA	24013	Cardiology
Carilion Genetics
102 Highland Avenue Suite 104	Roanoke	VA	24013	Genetic Counseling
Carilion Pediatric Neurology
102 Highland Avenue Suite 104	Roanoke	VA	24013	Neurosciences
Carilion Pediatric Pulmonology and Allergy Clinic
102 Highland Avenue Suite 203	Roanoke	VA	24013	Pulmonology
Carilion GYN Clinic
102 Highland Avenue Suite 303	Roanoke	VA	24013	Gynecological Services
Pediatric Gastroenterology
102 Highland Avenue Suite 305	Roanoke	VA	24013	Gastroenterology
Carilion Clinic Pediatric Surgery Clinic
102 Highland Avenue Suite 404	Roanoke	VA	24013	Surgical Services
Carilion Pediatric Endocrinology Clinic
102 Highland Avenue Suite 455	Roanoke	VA	24013	Endocrinology
Carilion Sleep Center
1030 S Jefferson St Ste G100	Roanoke	VA	24016	Sleep Disorder
Carilion Anticoagulation Clinic
1030 S Jefferson St Ste G101	Roanoke	VA	24016	Anticoagulation Clinic
Carilion Clinic Pediatric Child Developmental Clinic
1030 S Jefferson Street	Roanoke	VA	24016	Child Development Services
Carilion General Pediatric Clinic
1030 S Jefferson Street Suite 106	Roanoke	VA	24016	General Pediatrics
Pediatric Developmental Clinic
1030 S Jefferson Street Suite 201	Roanoke	VA	24016	Pediatric Development
Carilion Diabetic Education
1030 S Jefferson Suite G101	Roanoke	VA	24016	Diabetic Education
Carilion Uro-Gynecology Associates
1030 S Jefferson St Ste 109	Roanoke	VA	24016	Urogynecology
Carilion Wellness-Botetourt
105 Summerfield Court	Roanoke	VA	24019	Outpatient Therapy Services
Carilion Clinic Urology Christiansburg
120 Akers Farm Road NE	Christiansburg	VA	24073	Urology
Carilion Clinic Reproductive Medicine and Fertility
1231 S Jefferson Street	Roanoke	VA	24016	Reproductive Endocrinology
Carilion Clinic Vascular McClanahan
127 McClanahan Street	Roanoke	VA	24014	Vascular Services
Carilion Cardiac Rehab
127 McClanahan Street	Roanoke	VA	24014	Cardiac Rehab
Carilion Heart Failure Clinic
127 McClanahan Street	Roanoke	VA	24014	Heart Failure Services
Physical Therapy Westlake
12970 Booker T Washington HWY	Hardy	VA	24101	Physical Therapy Services
CFM Roanoke Salem
1314 Peters Creek Road	Roanoke	VA	24017	Family Practice
Carilion Clinic OBGYN Daleville
150 Market Ridge Lane	Daleville	VA	24083	Obstetrics and Gynecology
Daleville Imaging
150 Market Ridge Lane	Daleville	VA	24083	Imaging Services
Pediatric Subspecialty Clinic
1620 Graves Mill Road	Lynchburg	VA	24502	Pediatrics
General Surgery Clinic
180 Floyd Avenue	Rocky Mount	VA	24151	Surgical Services
Carilion Clinic Cardiology Services - Rocky Mount
180 Floyd Avenue	Rocky Mount	VA	24151	Cardiology
Physical Therapy West Salem
1955 West Main Street	Salem	VA	24153	Physical Therapy Services
Carilion Clinic OBGYN Salem
1957 W Main Street	Salem	VA	24153	Obstetrics and Gynecology
Carilion Clinic Imaging - Crystal Spring
2001 Crystal Spring Ave SW	Roanoke	VA	24014	Imaging Services
Carilion Cardiothoracic Surgery
2001 Crystal Spring Avenue Suite 20	Roanoke	VA	24014	Cardiac Surgery Services	1
Carilion Clinic Cardiology
2001 Crystal Spring Avenue Suite 20	Roanoke	VA	24014	Cardiology Services	3
Carilion Clinic Pulmonary and Sleep Medicine
2001 Crystal Spring Avenue Suite 30	Roanoke	VA	24014	Pulmonary and Sleep Services	0
Carilion Infectious Disease Clinic
2001 Crystal Spring Avenue Suite 30	Roanoke	VA	24014	Infectious Disease	1
Carilion Center for Healthy Aging
2001 Crystal Spring Avenue Suite 30	Roanoke	VA	24014	Geriatrics	2
Carilion Clinic Dentistry General Surgery Jefferson
2017 S Jefferson St	Roanoke	VA	24014	Surgical Services
Carilion Clinic Department of Psychiatry and Behavioral Medicine Adult Outp
2017 S Jefferson Street	Roanoke	VA	24014	Behavioral Health		atient
Carilion Dental Care
2017 S Jefferson Street	Roanoke	VA	24014	Dental Service
Child and Adolescent Psychiatry
2017 S Jefferson Street	Roanoke	VA	24014	Child and Adolescent Psychiatry Services
Community Psychiatry
2017 S Jefferson Street	Roanoke	VA	24014	Psychiatry Services
CFM Southeast
2145 Mount Pleasant Boulevard	Roanoke	VA	24014	Family Practice
Carilion Clinic Imaging ION
2331 Franklin Road	Roanoke	VA	24014	Imaging Services
Carilion Clinic Neurosurgery - ION
2331 Franklin Road	Roanoke	VA	24014	Neurosurgery
Carilion Clinic Pain Management - ION
2331 Franklin Road	Roanoke	VA	24014	Pain Management
Carilion Physical Medicine and Rehabilitation
2331 Franklin Road	Roanoke	VA	24014	Physical Medicine
Carilion Clinic Orthopaedics - ION
2331 Franklin Road SW	Roanoke	VA	24014	Orthopaedics
Carilion Clinic Department of Psychiatry and Behavioral Medicine
2900 Lamb Circle	Christiansburg	VA	24073	Psychiatry and Behavioral Health Services
CNRVMC - Neurosciences
2900 Lamb Circle	Christiansburg	VA	24073	Neurology
CNRVMC - Radiology
2900 Lamb Circle	Christiansburg	VA	24073	Radiology Services
Carilion Children's Pediatrics - New River
2900 Lamb Circle	Christiansburg	VA	24073	Pediatrics
Carilion Clinic Sleep Center - New River Valley
2900 Lamb Circle Suite 7-700A	Christiansburg	VA	24073	Sleep Medicine
Carilion Clinic Genetics - Lynchburg
2900 Old Forest Rd	Lynchburg	VA	24501	Pediatric Genetics
Carilion Clinic Neuropsychology CCR3
3 Riverside Cir	Roanoke	VA	24016	Neuropsychology Services
Carilion Clinic General Surgery
3 Riverside Circle	Roanoke	VA	24016	Surgical Services
Carilion Clinic Internal Medicine
3 Riverside Circle	Roanoke	VA	24016	Internal Medicine
Carilion Clinic Neurology
3 Riverside Circle	Roanoke	VA	24016	Neurology
Carilion Clinic Orthopaedics Trauma
3 Riverside Circle	Roanoke	VA	24016	Orthopaedic Trauma
Carilion Clinic TraumaCritical Care
3 Riverside Circle	Roanoke	VA	24016	Surgical Services
Carilion Imaging
3 Riverside Circle	Roanoke	VA	24016	Imaging Services
Carilion OBGYN - Riverside
3 Riverside Circle	Roanoke	VA	24016	Obstetrics and Gynecology
CRMH Rheumatology Clinic
3 Riverside Circle	Roanoke	VA	24016	Rheumatology
Carilion Clinic Gastroenterology
3 Riverside Circle	Roanoke	VA	24016	Gastroenterology
Carilion Clinic Orthopaedics
3 Riverside Circle	Roanoke	VA	24016	Orthopaedics
Carilion Clinic Endocrinology
3 Riverside Circle	Roanoke	VA	24016	Endocrinology
Carilion OtolaryngologyENT
3 Riverside Circle 4th Floor	Roanoke	VA	24016	Otolaryngology and ENT Services
Carilion Pediatric OtolaryngologyENT
3 Riverside Circle 4th Floor	Roanoke	VA	24016	Pediatric Otolaryngology and ENT Services
Carilion Plastic and Reconstructive Surgery
3 Riverside Circle Suite 400	Roanoke	VA	24016	Plastic and Reconstructive Surgery
Carilion Cardiology Westlake
35 Medical Court	Hardy	VA	24101	Cardiology Services
Carilion Sleep Center Westlake
35 Medical Court	Hardy	VA	24101	Sleep Disorder
Carilion Surgery Westlake
35 Medical Court	Hardy	VA	24101	Surgical Services
Urogynecology Westlake
35 Medical Court	Hardy	VA	24101	Urogynecology
Carilion Clinic Dermatology and Mohs Surgery - Westlake
35 Medical Court	Hardy	VA	24101	Dermatology and Mohs Surgery
Carilion Clinic Orthopaedic Surgery - Westlake
35 Medical Court	Hardy	VA	24101	Orthopaedics
Carilion Clinic Otolaryngology and Audiology - Westlake
35 Medical Court	Hardy	VA	24101	Otolaryngology and ENT Services
Carilion Clinic Imaging - Westlake
35 Medical Court	Hardy	VA	24101	Imaging Services
Brambleton Radiology Services
3707 Brambleton Avenue	Roanoke	VA	24018	Radiology Services
Carilion Clinic Family Medicine Tazewell
388 Ben Bolt Avenue	Tazewell	VA	24651	Family Medicine
Carilion Clinic Orthopaedics - Franklin
390 S Main Street Suite 103	Rocky Mount	VA	24151	Orthopaedics
Carilion Clinic Plastic and Reconstructive Surgery
390 S Main Street Suite 103	Rocky Mount	VA	24151	Plastic and Reconstructive Surgery
General Surgery Rocky Mount
390 South Main Street	Rocky Mount	VA	24151	Surgical Services
Carilion Wellness - Roanoke
4508 Starkey Road	Roanoke	VA	24018	Physical Therapy Services
Carilion Clinic Allergy and Immunology
46 Wesley Road	Daleville	VA	24083	Allergy and Immunology Services
Carilion Clinic Pediatric Medicine Rocky Mount
490 S Main St	Rocky Mount	VA	24151	Pediatric Medicine
Breast Mammography - North
6415 Peters Creek Road	Roanoke	VA	24019	Breast Mammography
Carilion Children's Pediatric Behavioral Medicine
902 Jefferson St	Roanoke	VA	24016	Pediatric Child Development
Carilion Obstetrics and Gynecology Clinic
902 South Jefferson Street Upper Le	Roanoke	VA	24016	Obstetrics and Gynecology	vel

Supplemental Information Detail SupplementalInformationDetail (24 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 11 Addressing Needs Identified in CHNA	(Continued From Part V Section C) Through HRV, multiple programs and strategies have arisen in response to community needs, such as the Pathways Community HUB. This community-based care coordination system is anchored by Community Health Workers strategically located in two Carilion teaching practices in the City of Roanoke, at Carilion Community Care and Carilion Internal Medicine Riverside 3, and partners' clinics. Through a model addressing social determinants of health, Community Health Workers link clients and their families to resources and services. The program reduces barriers to good health for uninsured adults who regularly visit the CRMH Emergency Department and have chronic disease diagnoses. Community partners include Bradley Free Clinic, the Rescue Mission's G. Wayne Fralin Free Clinic, Mental Health America of Roanoke Valley, New Horizons Healthcare and HRV. -Community Grants - Carilion fulfills our commitment to addressing key health priorities through targeted grants for community health improvement programs and those affecting the social determinants of health. Carilion provides many community grants and community health sponsorships to help local charitable organizations fulfill their missions related to the health and well-being of our communities. Community grant dollars are allocated across the entire Carilion Clinic service area based on requests received. During the fall cycle of 2020 fiscal year (2019 tax year), $85,000 in grants were awarded to nine programs in the Roanoke Valley to improve mental health access, transportation, disease prevention, literacy services and to increase the availability of affordable healthy foods. Carilion's COVID-19 Community Health Fund replaced the traditional spring grant process, focusing on acute COVID-related health care needs and health-related social needs in our region. In the Roanoke Valley, we awarded $69,500 in funding to support a facility for people experiencing homelessness and recovering from COVID-19 to live and quarantine, programs addressing food insecurity throughout various Southwest Virginia communities, medication access and delivery for free clinic patients in Southwest Virginia, expanded access to mental health care through the free clinic and access to refurbished rehabilitation equipment. -Targeted Neighborhood Initiatives - CMC's community health goal is to improve health and well-being for the Roanoke Valley, especially for those individuals living in medically underserved areas (MUAs). The City of Roanoke tends to perform worse than other neighboring communities in many health and social determinant indicators. Efforts often focused on the Northwest and Southeast quadrants of the city-the MUAs most in need. CMC is addressing essential community health needs identified in the 2018 assessment by focusing additional investment in the Southeast MUA, located adjacent to CRMH. Through greater access to clinical care and community outreach programs, creative community partnerships and focused financial and in-kind support of initiatives, CMC is improving community health in the Southeast neighborhood. Key focus areas of this health improvement project include access to services, coordination of care and wellness. -LIFT Project- Carilion is working with Roanoke City Public Schools (RCPS) and other partners to expand access to health care services for families through Local Impact for Tomorrow (LIFT). LIFT is a partnership between Carilion, RCPS, Freedom First Credit Union, Delta Dental of Virginia and Roanoke Women's Foundation. Plans are underway to create a community health center in Southeast's Fallon Park Elementary School. The community health center will provide physical, mental and oral health care services and financial wellness programs for local students and families. Groundbreaking for the facility is scheduled for 2021. Additionally, LIFT's Asthma in Schools program at Fallon Park Elementary allows school nurses to administer medication to students with asthma. Roanoke City provided funding to extend care into the home, working with the Child Health Investment Partnership during the COVID-19 pandemic. -Significant Health Priorities to be Addressed- -Health Behaviors - Needs include a culture of healthy behaviors not a priority, and poor diet. Carilion Clinic continues to address health behavior-related priorities from the 2018 RVCHNA. To improve overall health culture and promote healthy diets, Carilion provides various free health education classes, screenings and flu immunizations in community settings. In fiscal year 2020, Carilion provided 393 health education, screening and immunization opportunities/events in the Roanoke Valley, serving 8,593 people. Community health education is provided by the Community Health and Outreach (CHO) department as well as by Trauma Outreach, dieticians, Carilion Wellness, homecare, hospice and select other departments. Health and wellness education topics include general wellness, healthy eating and exercise, stress management, and infant and child safety. During the COVID-19 pandemic, CHO transitioned to "Take a Break" virtual education sessions providing timely, relevant tips focused on improving well-being and maintaining a healthy lifestyle during an uncertain time. As the year progressed, we added well-being support groups, cooking videos, online gardening classes, guided walks and hikes, and limited in-person outdoor education. Resources committed to these programs include staff time, volunteer hours, and food and giveaway items that encourage healthy behaviors. Carilion remains committed to addressing poor diets. Through the Local Foods Program, Carilion provides hundreds of thousands of dollars of support to improve healthy food access. Community grants make healthy, wholesome foods more affordable and accessible in the Roanoke Valley, including one that doubles the value of the Supplemental Nutrition Assistance Program (SNAP) benefit. Carilion's Morningside Urban Farm brings fresh foods to the Southeast Roanoke City community. The farm offers health education and incentives to adopt healthy lifestyles. The farm's programs focused on wellness through gardening, nutrition, physical activity/movement, the arts and music. Produce grown at the farm is donated to those attending Morningside classes and events and community groups such as the Presbyterian Community Center, Boys and Girls Club, and the Rescue Mission. In addition to community events, Carilion fosters healthy behaviors by offering classes to employees and through partnerships with other Roanoke Valley employers. As the largest employer in the region, efforts to engage our employees and their families in healthy lifestyles impact community health overall. Carilion offers Virgin Pulse. The program enables employees to connect personal activity trackers and a platform to encourage daily healthy behaviors such as exercise, climbing stairs, and planning healthy meals. Additionally, CMC makes a Farm Share program available to employees and their families through payroll deduction. Farm Share widens the impact of nutritious fresh food and diets for our Carilion staff. Carilion remains committed to the Healthier Hospital Initiative pledge and continues to improve quantities of healthy, local, sustainable foods purchased and served through its cafeterias. Wellness comprises a multitude of factors, from mental and social support to prevention and safety. We offer support groups for grief and loss counseling, cancer treatment and recovery, and attention to diabetes and other chronic conditions. CMC also coordinates child passenger safety training and child safety seat checks to reduce injuries from car accidents. Carilion family practices offer gun locks for free to members of the community to encourage gun safety. As part of infant safe sleep classes, Carilion provides participants with a free Pack and Play and free Sleep Sack to promote safe sleep practices. Infants born in Carilion hospitals also receive a free Sleep Sack when available.
Schedule H, Part V, Section B, Line 11 Addressing Needs Identified in CHNA (Continued)	-Clinical Care - Needs include access to mental health and substance use services, access to dental care, high uninsured/underinsured population, high cost of care. Issues with access to care are essential to CMC when addressing community health needs. In addition to providing financial support to qualifying patients who cannot afford care, Carilion works to improve affordable access to care and resources. -Mental health and substance use services - Through the #AllIn program, Carilion provides additional access to non-traditional mental health and substance use services. A key component of #AllIn is peer support which has expanded the type of care people in the Roanoke Valley can access. Peer recovery specialists have a unique perspective and can connect with patients through shared experiences. In fiscal year 2020, Carilion trained 90 peer recovery specialists in the Roanoke Valley and taught more than 150 laypeople to utilize Narcan through the REVIVE program. We formed five peer recovery center groups pre-COVID. We also convened virtual groups for individuals in recovery to maintain support during the stay-at-home order. Carilion's Addiction Task Force brings together expertise from throughout the Carilion system to better understand and address the opioid epidemic in Southwest Virginia. Efforts include developing system-wide guidelines and a system dashboard for opioid prescriptions, developing treatment pathways for opioid addiction in specific high-risk groups, developing best practices for risk assessment, treatment and standard orders in Carilion's electronic medical record system, growing an inventory of community resources related to prevention, treatment and recovery services for patients and community members, and providing locations for free, safe, prescription drug returns or deactivation bags. Carilion provides both financial and in-kind support for the Bradley Free Clinic Mental Health Collaborative program to increase access to psychiatric care and medication for people without health insurance in the Roanoke Valley. Carilion psychiatry residents and physicians volunteer their time and provide in-kind services through this program. Physicians and residents also provide in-kind services to individuals through the Rescue Mission's Fralin Free Clinic. -Dental care - Carilion hosts pediatric and adult dental clinics in Roanoke and operates a dental residency program. Dental residents provide in-kind dental services through the Rescue Mission's Fralin Free Clinic. Located in Southeast Roanoke, the Rescue Mission is a comprehensive crisis intervention center for men, women and children. Additionally, oral health is also prioritized through the HRV Oral Health Action Team with the DentaQuest Foundation's support. -High uninsured / underinsured population and high cost of care - Carilion is committed to helping improve access to affordable medical care in our communities. Since the expansion of Medicaid in the Commonwealth of Virginia in 2019, Carilion has worked diligently on outreach and enrollment for newly eligible beneficiaries. By the end of fiscal year 2020 (tax year 2019), more than 15,754 people were newly enrolled in Medicaid in the Roanoke Valley. Community Health Workers and other partners also helped clients complete insurance pathways pairing them with appropriate services once they were enrolled. Carilion physicians regularly serve uninsured people through hours donated in-kind to the Bradley Free Clinic. Medication access for Bradley Free Clinic patients is improved by the RX Partnership, which Carilion supports financially. Additionally, Individuals can access regular care and medications as well as coordinate lab services through Carilion financial assistance. To increase access to primary care and resources for adolescents, CMC partners with RCPS to operate adolescent health clinics in Patrick Henry High School and William Fleming High School in the City of Roanoke, plus a stand-alone clinic in downtown Roanoke. Through parent waivers signed at the start of the school year, students can visit health professionals as needed at clinics conveniently located in the schools, regardless of their ability to pay. - Social and Economic Factors - Needs include poverty, transportation, affordable / safe housing, educational attainment. In its commitment to reducing inequities in care, Carilion provides financial support for people who cannot afford insurance or health care. Carilion also manages a Medication Assistance Program to increase access to affordable medication and replenishes medication carried aboard emergency medical services vehicles. Support is provided to various not-for-profit organizations. Our support reduces the impact of poverty on health through investments in social determinants such as housing, transportation, employment, education, access to healthy foods and many other worthwhile causes. Each year, Carilion Clinic coordinates a system-wide United Way campaign through which employees can provide additional support to these causes. The Virginia Tech Carilion (VTC) Health Sciences and Technology Campus is located in the City of Roanoke. The VTC partnership continues to spur economic growth for the region through job growth, spending at the campus, student populations and research grant funds. Growth is expected to continue through at least 2026. Community partners, including Carilion, start early outreach in schools to inspire future health care workers and to create educational pathways for all. Virginia Western Community College and local universities have partnered with the community to make it possible for local students to access affordable or no-cost education. - Transportation - Carilion recognizes the impact that lack of reliable transportation can have on health. To improve access to transportation for patients in need of regular health care, Carilion supports the City of Roanoke's trolleys. The trolleys provide free transportation from downtown Roanoke to Carilion Roanoke Memorial Hospital and points in between, including the Riverside Center campus that houses the Virginia Tech Carilion School of Medicine, the Fralin Biomedical Research Institute at Virginia Tech Carilion and many Carilion clinical services.
Schedule H, Part V, Section B, Line 11 Addressing Needs Identified in CHNA, Continued	- Physical Environment - While physical environment did not necessarily arise as a top priority in the 2018 RVCHNA, Carilion still 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 the use of recyclable or bio-degradable materials, reduce waste materials and serve local, sustainable foods to patients and in our cafeterias. - Implementation and Measurement - Carilion has invested in multiple systems to manage data and track outcomes of our community work. We assessed program-level outcomes for community health education classes and screening events. We tracked these outcomes using pre- and post-tests for education and screening results such as blood pressure, cholesterol, diabetes risk assessments and glucose readings. Community programs supported by Carilion grants were responsible for regularly reporting program outcomes. Scorecards developed contain key secondary data points. They are updated annually to track the community health initiatives' impact. Specifically, Carilion tracked and measured impact on specific aligned indicators contributing to the RWJF County Health Factors Rankings and County Health Outcomes Rankings. Our goal is to improve County Health Rankings for the entire Roanoke Valley. Still, we understand that improvements are relative to progress in other communities in the Commonwealth of Virginia by these rankings' nature. The REDCap software program enabled internal data to be utilized at the aggregate level to display outcomes of targeted health initiatives for research teams. The initiatives included asthma interventions at Fallon Park Elementary School. The results will be used for future planning and decision-making. - Priority Areas Not being Addressed and the Reasons - Earlier, we described using a community approach to determine and address priority needs. We used a similar approach to determine which needs cannot be immediately addressed. We considered several needs during the prioritization process. However, we did not actively address these needs during this period due to low feasibility or low potential impact. These needs are alcohol and drug use, lack of exercise, lack of health literacy, lack of understanding of healthy behaviors, lack of knowledge of community resources, risky sexual activity, tobacco use, access to primary care, access to specialty care (general), communication barriers with providers, coordination of care, quality of care, child abuse/neglect, community safety/violence, domestic violence, lack of family / social support systems, unemployment, air quality, injury prevention/safety of the environment, outdoor recreation, water quality, high prevalence of chronic disease (general).
Schedule H, Part I, Line 3c Financial Assistance Eligibility Criteria	Patients' eligibility is determined by family size, family income, real property equity and liquid assets. Families with family income equal or below 200% of the Federal Poverty Guidelines (FPG) and assets equal or below $15,000 are eligible to receive 100% adjustment under the financial assistance policy (FAP). Families with family income greater than 200% of the FPG but less than or equal to 400% of the FPG or assets above $15,000 and less than or equal to $100,000 are eligible to receive a partial adjustment under FAP. The partial adjustment matches the amounts generally billed (AGB) percentage for each service area.
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://carilionclinic.org/about-carilion-clinic#our-values
Schedule H, Part I, Line 7 Col (F) Percent of Total Expense	Patient -related bad debt expense of $81,553,905 was excluded from the calculation of Part I Line 7 Column (f) Percent of total expense.
Schedule H, Part I, Line 7e Community health improvement services and community benefit operations	This line is reported at actual cost. Carilion's commitment to community health is evident at all levels of the organization. Our infrastructure includes a Planning and Community Health division dedicated to assessing and addressing community needs. The division leads and facilitates the Community Health Improvement Plan, Community Health Needs Assessments, community grants, community health education, collection of community benefit data and neighborhood health initiatives. Some Community Health and Outreach staff work with the hospital's Board of Directors and Carilion Clinic's Board of Governors to create health improvement strategies to address community health needs. The hospital also has a Community Benefit Council providing oversight for Carilion's community health improvement work and for community benefit strategy, data collection and submission. Carilion Medical Center educates the public about health risks and steps that can be taken to improve health. Events include regularly scheduled health screenings for blood pressure, blood glucose and cholesterol and seasonal screenings to detect facial damage due to sun exposure. Carilion Medical Center's community health education department hosts the local chapter of the National Safe Kids Coalition. The department also offers guidance about childhood injury prevention to the community and other providers. Carilion Medical Center's Safe Kids Coalition coordinator also provides free training and national certification on proper car seat installation for other health and safety providers. Due to COVID-19, work shifted from the typical health education and improvement programming to education and outreach aimed at lessening the impact of the pandemic. For many months, representatives across the organization were involved in the Home Alone program-an outreach effort to connect vulnerable patients to community resources and help them overcome any barriers caused by supply shortages, business closures, and cancellation of medical appointments. Carilion received federal relief funding that will offset the Community Benefit expenses generated by this and other similar work. In efforts to increase access to health care, Carilion physicians dedicate hours to providing ongoing care for patients of local free clinics. Carilion also connects patients to resources for enrollment in public health care programs such as Medicaid. Following the rollout of Medicaid expansion in Virginia, Carilion began contracting with MedAssist for Medicaid enrollment outreach, ensuring access to a wide range of health services across the community. MedAssist screens uninsured patients to identify eligibility and helps them with the application process, including documentation and substantiation of eligibility. Greater coverage increases access to benefits not only for general health, but for dental and mental health services as well. The increase in scope for Medicaid eligibility and enrollment led to an increase in Community Benefit dollars invested in this category. Community benefit operations include expenses associated with tracking community health improvement activities, and the cost associated with coordinating responses to community health needs identified through the most recent Roanoke Valley Community Health Assessment. This coordination includes participation in various community partnerships such as Healthy Roanoke Valley, a collaboration of health and human service agencies developing initiatives to address prioritized community health needs.
Schedule H, Part I, Line 7f Health professions education	This line is reported at actual cost. Carilion Medical Center mentors nursing students, provides continuing education opportunities for local providers and operates a residency program.
Schedule H, Part I, Line 7g Subsidized Health Services	N/A
Schedule H, Part I, Line 7h Research	This line is reported at cost. Carilion Medical Center participates in clinical research projects and provides a Human Research Protections Office, which includes the Institutional Review Board. The Human Research Protections Office is designed to protect the rights, dignity and welfare of individuals who are the subject of research conducted by the organization's clinicians, staff or students. The Health Analytics Research Team provides accurate and timely reporting, informatics and actionable analytics to forward the mission of Carilion, including clinical, financial, research, and claims data. Additionally, community research is provided through a cancer registry to assist public health professionals in understanding and addressing the cancer burden more effectively. The information collected is used to develop programs on cancer prevention, early detection, and successful treatment and care. Another example is an at-home pulmonary rehabilitation program developed to help patients with high-risk chronic obstructive pulmonary disease in rural areas improve health outcomes and healthy behaviors by engaging in at-home self-care.
Schedule H, Part I, Line 7i Cash and in-kind contributions for community benefit	At cost. Carilion's dedication to our mission of improving the health of the communities we serve is evidenced by the annual financial and in-kind contributions we provide to dozens of nonprofit partners. Our support directly impacts the issues identified in our triennial Community Health Needs Assessment and various social determinants that impact health. This support helps provide access to nutrient dense foods, promotion of exercise and healthy activities, chronic disease management, access to mental health services and coordination of care, and many other community health improvement goals.
Schedule H, Part II Community Building Activities	Line 1 - Physical improvements and housing - N/A Line 2 - Economic development - As the largest employer in Southwest Virginia, Carilion impacts economic development by investing in jobs, increased wages for employees and various capital building projects. In addition, Carilion had direct economic development expenses from programming and support of local Chambers of Commerce, the Better Business Bureau, and the Roanoke Regional Partnership, improving economic development efforts through pro-business advocacy. We supported the Partnership's Accelerate 2022 campaign to quicken the region's growth through leveraging livability, the outdoors, and higher education to achieve job growth, investment, qualified workforce and economic impact. Carilion is active in local economic development endeavors, including supporting the Valleys Innovation Council, investing in research and technology and communicating with local businesses about the region's current business climate and prospective companies. Funding provided to the Greater Roanoke Transit Company for the Star Line Trolley offers free transportation around downtown Roanoke. It serves as a critical link to the Carilion and Virginia Tech Carilion locations in Roanoke's Innovation Corridor along Jefferson Street. Line 3 - Community support - Research demonstrates the strong connection between social determinants of health such as transportation, housing and education, and communities' overall health and well-being. Carilion supports nonprofit organizations addressing barriers to good health arising from these social determinants in various ways. Carilion also collaborates with local partners to support better education and opportunities for children and families and improved housing, better nutrition and additional resources for its neighbors in need. These efforts make progress in removing a range of obstacles to good health for residents of our region. In fiscal year 2020 (tax year 2019), Carilion worked with the Rescue Mission homeless shelter to support the Back to School Blast, which provides around 1,000 area students with new backpacks containing school supplies at the start of the school year and engages Carilion physicians in providing physicals and immunizations. Through monetary donations and organizational support, Carilion reduces inequity, promotes community development and repair, provides for veterans and seniors' social needs, maintains essential community-building amenities, and supports events for organizations like the Boys and Girls Club of Southwest Virginia, the NAACP and Local Colors of Western Virginia. Line 4 - Environmental improvements - N/A Line 5 - Leadership development and training for community members - N/A Line 6 - Coalition building - Carilion believes in the power of collaboration and understands that we must address our most significant health issues in concert with the community. To ensure lasting impact from the health assessment and community health improvement process, Carilion participates in community health coalitions that address health, safety and social determinant needs in the Roanoke Valley. Also, we partner with multiple community and business organizations around initiatives to improve health and wellness for everyone living in the Roanoke Valley. An example is Carilion's representation and participation on the Injury and Violence Prevention Collaborative Network, a group of organizations across Virginia working to strengthen injury and violence prevention efforts and enforce positive change on one of the leading causes of hospitalizations and deaths for both children and adults. Carilion also works with Children's Trust on coalition-building efforts to decrease child abuse and neglect. Other coalition-building activities include board participation with the Child Health Investment Partnership of the Roanoke Valley, Feeding Southwest Virginia, the Boys and Girls Club of Southwest Virginia, DePaul Community Resources, the Virginia Rural Health Association, and many more. 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 advocacy through other organizations' work. During fiscal year 2020 (2019 tax year), Carilion worked with various groups. These included Equality Virginia, an organization focused on ensuring protection in legislation for LGBTQ Virginians and providing advocacy for transgender Virginians. We also worked with the Virginia Tech Carilion School of Medicine's Inclusivity Task Force, which advances inclusivity across all aspects of the student experience. Financial support also furthers our advocacy efforts. We contribute to many causes, including the Children's Trust "Save Jane" campaign, which brings awareness to child abuse in the Roanoke Valley; the Humble Hustle Company, which empowers black youth and connects diverse communities; and Girls on the Run, an organization that promotes running as a method of empowering young girls. Line 8 - Workforce development - With the understanding that employment is directly linked to health and wellness, Carilion partners to provide workforce development and training for community members. These efforts also develop a pipeline of future health care workers. In fiscal year 2020 (tax year 2019), Carilion Medical Center 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 was a founding partner in VA Ready. This new initiative focuses on helping Virginians impacted by the pandemic return to work through training for in-demand jobs in high-growth sectors. Carilion is involved in the Virginia Business Higher Education Council Growth4VA coalition, promoting reform and reinvestment in the higher education system. Through the Virginia Foundation for Independent Colleges, Carilion provided fellowship funds to help students strengthen their research experience and prepare them for a career in the sciences. In addition, Carilion deploys special recruitment efforts for specific types of providers to improve access to needed care and meet the needs of underserved individuals in the Roanoke Valley.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Carilion Medical Center estimates bad debt expense by reserving a percentage of all self-pay patient accounts receivable by aging category, based on collection history, adjusted for expected recoveries and, if present, anticipated changes in trends.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Accounts receivable are stated at net realizable amounts due from patients, third-party payors, and other insurers for which Carilion Medical Center expects to be entitled in exchange for providing patient care. In accordance with Accounting Standards Update (ASU) No. 2014-09, Revenue from Contracts with Customers (Topic 606) (ASU 2014-09), the estimated uncollectible amounts are generally considered implicit price concessions that are a direct reduction to patient accounts receivable.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Medicare allowable costs are determined from the Medicare cost report using the cost-to-charge ratio. The Hospital believes our Medicare shortfall is a cost we incur as a benefit to the community. IRS Rev. Rul. 69-545 provides that one of the factors demonstrating community benefit is operating an emergency room open to all persons regardless of ability to pay and providing other hospital care for all patients able to pay, including those who pay their bills through public programs such as Medicare. In order to operate for the benefit of the broad community that we serve we must include our significant Medicare population, even if we are required to subsidize care to our Medicare patients due to being reimbursed at less than cost by Medicare's nonnegotiable rates.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	When accounts receivable efforts are exhausted, the account may be placed with a collection agency and extraodinary collection actions (ECAs) may be considered. Accounts will not be placed with a collection agency prior to 120 days from the date the first billing statement is provided except when mailings are returned with no forwarding address and combining multiple accounts of varying age with those already transferred or for legal verification regarding other liabilities. Reasonable efforts will be made to identify appropriate forwarding addresses. When a Financial Assistance Application (FAA) is received during the application period (within 240 days after the date the first billing statement is provided), but after initiation of ECAs, all ECAs will be suspended. Best efforts will be made to process completed applications within 30 days of receipt of the application; financial assistance eligibility will be determined and communicated to the individual. Incomplete applications must be completed within 30 days of the initial notification of additional items required; otherwise, the application will be deemed incomplete and closed. If an individual is eligible for financial assistance, ECAs, other than the sale of debt, will be reversed and any payments related to eligible care refunded to the extent no longer owed. ECAs will be reinstated if the individual is not eligible for financial assistance or does not complete the FAA by the deadline. At least 30 days before initiating an ECA, Carilion will send the patient written notice of intended ECA(s), a plain language summary explaining financial assistance available and the process for determining eligibility, and the deadline for applying for assistance. Carilion will also attempt to call individuals at least 30 days before initiating an ECA to make them aware of the financial assistance available and how to obtain assistance with the application process. Carilion shall enter into a written contract with any collection agency to which it refers bad debt. The contract will obligate the collection agency to observe and comply with Carilion's obligations under this Policy and the Financial Assistance Policy. A collection agency to which bad debt is referred for collection may not engage in any ECAs without the prior written consent of Carilion. After making reasonable efforts to determine if a patient qualifies for Financial Assistance and the patient either does not qualify for Financial Assistance or fails to submit an application as requested, within 240 days from the date the first billing statement is provided, Carilion may engage in one or more of the following ECAs: 1. Place a lien on an individual's property; 2. Attach or seize an individual's bank account or any other personal property; 3. Commence a civil action against an individual; 4. Garnish an individual's wages; 5. Sell an individual's debt to another party; or 6. Report the account to credit agencies. Individual account balances greater than $5,000 are not sent to a collection agency. These are handled through the Debt Recovery Department (DRD) for verification of Financial Assistance status before further collection activity occurs. DRD will also investigate any accounts that require special handling. For example, in cases of a deceased patient, auto accident, or any other unique circumstances requiring special handling, the accounts are placed with the DRD. When all collection efforts have been exhausted, all hospital accounts will be returned and closed as uncollectible. No further collection activity is taken at that time. Accounts with satisfactory payment arrangements, legal activity or accounts with pending payment will be considered active and are not returned.
Schedule H, Part V, Section B, Line 16a FAP website	A - CARILION MEDICAL CENTER -DBA CRMH: Line 16a URL: HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE;
Schedule H, Part V, Section B, Line 16b FAP Application website	A - CARILION MEDICAL CENTER -DBA CRMH: Line 16b URL: HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	A - CARILION MEDICAL CENTER -DBA CRMH: Line 16c URL: HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE;
Schedule H, Part VI, Line 2 Needs assessment	In addition to conducting regular Community Health Needs Assessments (CHNA), Carilion Clinic closely monitors community health indicators and responds to needs as they arise. Each year, Carilion updates scorecards with refreshed County Health Rankings indicators provided by the Robert Wood Johnson Foundation. Carilion is also responsive to needs identified through clinical data and internal departments. Carilion's call center, Carilion Direct, is available for community members to ask questions and connect with community resources. The Planning and Community Development department studies chronic disease incidence and prevalence rates, monitors health status indicators and assesses health disparities. Carilion adapted its community health improvement process from Associates in Process Improvement's Model for Improvement and the Plan-Do-Study-Act cycle developed by Walter Shewhart. It consists of five steps: (1) conducting the CHNA, (2) strategic planning, (3) creating the implementation strategy, (4) program implementation, and (5) evaluation. This cycle is repeated every three years. Needs are also identified through advisory boards and focus groups conducted in key neighborhoods or aligned with community initiatives. Ongoing collaboration with community stakeholders allows for regular communication of community needs and gives our partners opportunities to respond cohesively. Carilion fosters community development in its CHNA and community health improvement processes through the Strive Collective Impact Model for the Community Health Assessment Team. This evidence-based model focuses on "the commitment of a group of important players from different sectors to a common agenda for solving a specific social problem(s)" and has been proven to lead to large-scale changes. It focuses on relationship-building between organizations and the progress toward shared strategies.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Information on Financial Assistance is provided to the patient at hospital admission and ambulatory areas in the form of signage, a plain language summary which includes contact information, financial assistance application and documentation in the inpatient handbook. Patient Access staff, Hospital social workers and customer service representatives verbally inform patients on availability of assistance. Each patient statement and patient financial responsibility letter includes information on the Financial Assistance policy including who to contact for additional information and location of in-person assisters. The Application, the Policy, and the plain language summary are available free of charge to the patient. They are available by mail and on the web site if the patient did not receive written information at the time of service. Financial Assistance policy and application are also distributed to community partners through electronic mailing groups. Carilion Clinic employs an Eligibility staff that counsel patients on federal and state programs. The staff completes applications for Medicaid, 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, the Eligibility staff is trained as Certified Application Counselors and will assist patients in enrollment in the insurance exchange Marketplace. Eligibility staff will also complete Carilion's financial assistance application and counsel patient on the requirements for financial assistance.
Schedule H, Part VI, Line 4 Community information	The Roanoke Metropolitan Statistical Area (MSA) is home to Carilion Clinic's flagship hospital, Carilion Roanoke Memorial Hospital. The MSA is commonly known as the Roanoke Valley and comprises the independent cities of Roanoke and Salem and the counties of Botetourt, Craig, Franklin and Roanoke. It is nestled among the Blue Ridge Mountains with the City of Roanoke at its heart. Roanoke is a destination venue rich in cultural diversity, arts, shopping, recreational opportunities, natural beauty and services not available in the region's more rural areas. In addition to Carilion, key safety net providers in the region include Veterans Administrations; New Horizons, a federally qualified health center; free clinics; local offices of the Virginia Department of Health; and other human service organizations. Despite these entities' presence, however, thousands of low-income, uninsured and underinsured residents do not have access to affordable health care services. The 2018 RVCHNA revealed distinct communities with significant differences in size and population and significant disparities in health and social determinants. The 2015-2019 American Community Survey (ACS) found the Roanoke MSA's total population to be 313,009. The cities of Roanoke and Salem had 99,229 residents and 25,317 residents, respectively. The counties of Botetourt, Craig, Franklin and Roanoke had 33,343, 5,110, 56,187 and 93,823 residents, respectively. The median age in the MSA localities ranges from 37.8 in the City of Roanoke to 47.2 in Craig and Franklin Counties, all above the state median of 38.2 (U.S. Census Bureau, 2015-2019 5-year American Community Survey, Table S0101, https://data.census.gov/cedsci/table?q=S0101&tid=ACSST5Y2019.S0101&hidePreview=true). The Weldon Cooper Center for Public Service predicts positive population change by 2040 for all communities except Craig County, which may have very slight population loss (Weldon Cooper Center for Public Service, https://demographics.coopercenter.org/virginia-population-projections). The ACS finds that for most of the Roanoke MSA, a more significant percentage of the population is White than in the Commonwealth of Virginia as a whole, with rates ranging up to 98.6% in Craig County (U.S. Census Bureau, 2015-2019 5-year estimates, American Community Survey, Table DP05, https://data.census.gov/cedsci/table?tid=ACSDP5Y2019.DP05&hidePreview=true). The Roanoke Valley's urban hub, the City of Roanoke, is more racially and ethnically diverse than the rest of the MSA. Roanoke's population is 62.4% White, 29.0% Black, and 3.0% Asian, with 4.4% representing more than one race. The remainder represents small minorities of American Indian/Alaskan Native, Native Hawaiian/Pacific Islander or some other race. Of the population, 6.3% are Hispanic or Latino (U.S. Census Bureau, 2015-2019 5-year estimates, American Community Survey, Table DP05, https://data.census.gov/cedsci/table?tid=ACSDP5Y2019.DP05&hidePreview=true). The city is divided into quadrants (Northwest, Northeast, Southwest and Southeast) separated geographically by railroad tracks, the Roanoke River and Interstate 581. These quadrants vary significantly in the demographic and economic make-up of their residents. Specifically, two of the quadrants- Northwest and Southeast-have federal designations as Medically Underserved Areas. The quadrants are home to a large proportion of the low-income individuals and families in the city who may be uninsured, underinsured or are Medicaid recipients who face additional barriers due to cultural differences.
Schedule H, Part VI, Line 5 Promotion of community health	Carilion Clinic is a not-for-profit, integrated health care system located among the Blue Ridge Mountains. Our flagship hospital in the heart of the City of Roanoke, the largest urban hub in western Virginia. Carilion provides quality care for nearly one million individuals through a comprehensive network of hospitals, primary and specialty physician practices, wellness centers, and other complementary services. Carilion's roots go back more than a century when a group of dedicated citizens came together and built a hospital to meet the community's health care needs. Today, Carilion is a vital anchor institution focused on health care and dedicated to our mission of improving the health of the communities we serve. With an enduring commitment to our region's health, care is advanced through clinical services, medical education, research and community health investments. Carilion believes in service, collaboration and caring for all. Carilion invests in discovering and responding to local and regional health needs, understanding that we must involve additional stakeholders to address community health issues and create change effectively. Carilion Medical Center (CMC) includes Carilion's flagship facility, Carilion Roanoke Memorial Hospital (CRMH) (https://www.carilionclinic.org/locations/carilion-roanoke-memorial-hospital). A 703-bed hospital, CRMH consists of a Neonatal Intensive Care Unit, Carilion Children's Hospital, specialty and advanced clinical care, and the region's only Level 1 Trauma Center and Level 1 Pediatric Trauma Center. U.S. News & World Report ranks CRMH among Virginia's top five hospitals. 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. CMC serves patients regardless of their ability to pay. The hospital's governing board members are elected annually and reside in the region. The majority of members are neither hospital employees nor contractors. Medical staff privileges are extended to qualified providers. Surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. Reinvestments include providing free, discounted and subsidized care and critical medical services not otherwise offered in our region.
Schedule H, Part VI, Line 6 Affiliated health care system	Carilion Medical Center is wholly owned by Carilion Clinic, a not-for-profit health care organization based in Roanoke, Virginia. Through a comprehensive network of hospitals, primary and specialty physician practices, and complementary services, Carilion provides exceptional care for nearly one million Virginians. With an enduring commitment to the region's health, Carilion advances care through medical education and research, helps its community stay healthy and inspires the region to grow stronger. In the mid-2000s, Carilion made the strategic decision to transform from a collection of hospitals to a physician-led, integrated health care system. Advances include developing a multi-specialty physician group, transforming our primary care practices into patient-centered medical homes, implementing electronic health records system-wide, and creating a robust partnership with Virginia Tech, including developing the Virginia Tech Carilion (VTC) School of Medicine and the Fralin Biomedical Research Institute at VTC. In addition, Carilion continues to evolve its long relationship with what is now Radford University Carilion to assist with educating students in various health professions. Each decision and adaptation have fundamentally changed the way Carilion collaborates and provides care (https://www.carilionclinic.org/about-carilion-clinic). Carilion's community and population health infrastructure is the health system's engine for providing collaborative opportunities to improve and promote the community's health. Carilion's Community Health Assessments process helps identify the strengths and barriers impacting health. Its 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. The health system's many partnerships with cross-sector organizations create a collaborative culture of community health and wellness.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (29 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Address Line2USAddress/AddressLine2Txt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
American Heart Association
4217 PARK PLACE COURT	GLEN ALLEN	VA	23060	135613797	501(c)3	$18,500	Event Sponsorship
ARCH Roanoke
404 Elm Ave SW	Roanoke	VA	24016	237064477	501(c)3	$17,000	COVID Isolation Center
Center in the Square
1 Market Square	Roanoke	VA	24011	510238900	501(c)3	$50,000	Children's Museum
Children's Trust Roanoke Valley
541 Luck Avenue	Roanoke	VA	24016	510235891	501(c)3	$70,000	General Support
Family Service of Roanoke Valley
360 Campbell Ave SW	Roanoke	VA	24016	540505946	501(c)3	$12,000	Mental Health Support
Roanoke Symphony Orchestra
128 East Campbell Ave	Roanoke	VA	24011	546019736	501(c)3	$20,000	Corporate Sponsorship
(7) Virginia Blue Ridge Affiliate of Susan G Komen
4910 Valley View Blvd	Roanoke	VA	24012	562619425	501(c)3	$20,000	Event sponsorship
(8) Virginia Foundation for Independent Colleges
901 East Byrd St	Richmond	VA	23219	540554396	501(c)3	$10,000	General Support
Virginia Health Care Foundation
707 E Main St	Richmond	VA	23219	541639924	501(c)3	$50,000	Leadership Partner Support
Virginia Tech Foundation Inc
902 Prices Fork Rd	Blacksburg	VA	24061	540721690	501(c)3	$8,403	Regional Leadership Forum
Virginia Tech
300 Turner St NW	Blacksburg	VA	24061	546001805	Virginia	$52,500	COVID Innovation
United Way of Roanoke Valley
325 Campbell Ave SW	Roanoke	VA	24016	540535302	501(c)3	$15,000	Family Self-Sufficiency
2019 Commemoration Inc
PO Box 1607	Williamsburg	VA	23187	810703911	501(c)3	$25,000	Event Sponsorship
National Academy of Sciences
500 Fifth Street NW	Washington	DC	20001	530196932	501(c)3	$25,000	General Support	Keck Ctr Rm 731
The Roanoke-Blacksburg Innovation Network
1700 Kraft Dr	Blacksburg	VA	24060	462975294	501(c)3	$100,000	General Support
VA Business Higher Education
1108 East Main Street	Richmond	VA	23219	541827038	501(c)3	$50,000	General Support
Virginia Ready Initiative
107 S West Street	Alexandria	VA	22314	851103573	501(c)3	$62,500	General Support
Ronald McDonald House Charities of SW VA
2224 S Jefferson St	Roanoke	VA	24014	541244769	501(c)3		Donated Rent		$263,675	FMV	Donated Rent
CHIP of Roanoke Valley
1201 Third Street	Roanoke	VA	24016	541566451	501(c)3	$50,000	General Support
Blue Ridge Literacy
706 S Jefferson Street	Roanoke	VA	24016	541377063	501(c)3	$10,000	English and Health Literacy Class
Boys and Girls Club of SWVA
1714 9th Street SE	Roanoke	VA	24013	541867366	501(c)3	$35,000	Food Access Program and Van
Bradley Free Clinic
1240 Third Street SW	Roanoke	VA	24016	237380491	501(c)3	$25,000	Continuity of Care & Behavioral Health Services
City of Roanoke
215 Church Ave	Roanoke	VA	24011	546001569	City of Roanoke	$20,000	Financial Empowerment Center
Kid's Soar
305 Mountain Ave SW	Roanoke	VA	24016	010583325	501(c)3	$8,500	Literacy initiative
Local Environmental Agricultural Project
PO Box 3249	Roanoke	VA	24015	271050909	501(c)3	$15,000	Healthy Foods Incentive
Greater Roanoke Transit Company
1108 Campbell Avenue	Roanoke	VA	24013	540982022	City of Roanoke	$43,831	General Support
Renovation Alliance
530 Eighth St SW	Roanoke	VA	24016	541961045	501(c)3	$10,000	Repairs for Low Income Homeowners
Virginia Tech Carilion School of Medicine
2 Riverside Circle	Roanoke	VA	24016	264556177	501(c)3	$3,126,044	Medical School Support
Radford University
232 Cook Hall	Radford	VA	24142	237219782	VIRGINIA	$10,200	Transfusion Project

Field	Value	IRS element (for citing)
Total501c3 Org	29	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
PATIENTS	8	$252,129
SCHOLARSHIPS	5	$9,000

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 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. A grant cycle specifically addressing needs resulting from the impacts of COVID-19 was held in fiscal year 2020 (tax year 2019) and due to the nature of the funding, awardees were required to submit only one, final report. 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, 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. Carilion Medical Center also has a program under which endowment funds are granted to community organizations with a focus on children's health and well-being. A committee of Carilion Medical Center employees reviews the applications and selects the recipients. Recipients sign a letter of agreement that delineates the terms and objectives of the project. Recipients submit a mid-year report, and a final program evaluation to report on the program's services, outcomes and budget. Site visits may be made to grantees as needed.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
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 (20 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	$647,421	$0	$225,708	$0	$4,813	$0	$345,071	$0	$18,548	$0	$1,241,561	$0	$0
Paul Haskins MD
Director	$300,894	$0	$65,545	$0	$4,580	$0	$221,683	$0	$19,951	$0	$612,653	$0	$0	$0
Michael Nussbaum MD
Director	$561,198	$0	$116,870	$0	$9,841	$0	$155,196	$0	$15,255	$0	$858,360	$0	$0	$0
Tracey Criss MD
Physician	$247,516	$0	$74,302	$0	$4,262	$0	$273,662	$0	$17,273	$0	$617,015	$0	$0	$0
Nicholas Conte
Secretary	$0	$501,457	$0	$201,967	$0	$6,258	$0	$163,964	$0	$18,548	$0	$892,194	$0	$0
David Hagadorn
Asst. Treasurer	$0	$138,561	$0	$2,000	$0	$8,778	$0	$98,598	$0	$865	$0	$248,802	$0	$0
Donald Halliwill
Asst. Treasurer	$0	$568,290	$0	$201,281	$0	$4,727	$0	$343,625	$0	$17,248	$0	$1,135,171	$0	$0
G Robert Vaughan Jr
Treasurer	$0	$270,749	$0	$78,415	$0	$3,948	$0	$297,970	$0	$18,325	$0	$669,407	$0	$0
Patrice Weiss MD
Chief Medical Officer/EVP	$0	$592,094	$0	$218,870	$0	$6,419	$0	$233,397	$0	$20,031	$0	$1,070,811	$0	$0
Bruce Long MD
Physician	$381,683	$0	$60,544	$0	$5,353	$0	$177,682	$0	$17,643	$0	$642,905	$0	$0	$0
Jon Sweet MD
Physician	$235,870	$0	$84,626	$0	$3,359	$0	$198,007	$0	$11,766	$0	$533,628	$0	$0	$0
Michael Abbott
Senior Vice President	$203,065	$0	$43,438	$0	$1,741	$0	$23,249	$0	$6,835	$0	$278,328	$0	$0	$0
Nancy Howell Agee
CEO, Carilion Clinic	$0	$1,292,284	$0	$555,922	$0	$406,517	$0	$329,565	$0	$12,301	$0	$2,596,589	$0	$195,503
Joseph Moskal MD
SVP/Chair, Dept. of Orthopedics	$1,059,011	$0	$242,434	$0	$209,558	$0	$121,621	$0	$20,031	$0	$1,652,655	$0	$195,000	$0
Paul Skolnik MD
SVP/Chair, Dept. of Medicine	$420,042	$0	$109,178	$0	$9,811	$0	$78,752	$0	$9,638	$0	$627,421	$0	$0	$0
Jonathan Carmouche MD
Physician	$1,348,131	$0	$494,365	$0	$3,102	$0	$124,635	$0	$17,643	$0	$1,987,876	$0	$0	$0
Gregory Howes MD
Physician	$1,053,523	$0	$591,012	$0	$2,833	$0	$60,747	$0	$16,343	$0	$1,724,458	$0	$0	$0
Eric Marvin MD
Physician	$968,562	$0	$458,733	$0	$2,503	$0	$119,418	$0	$16,343	$0	$1,565,559	$0	$0	$0
ADEOLU OLASUNKANMI MD
Physician	$747,581	$0	$344,332	$0	$8,450	$0	$28,514	$0	$19,202	$0	$1,148,079	$0	$0	$0
Jesse Stem MD
Physician	$756,856	$0	$536,452	$0	$3,553	$0	$44,712	$0	$17,643	$0	$1,359,216	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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. Five reported individuals received this benefit, the value of which is included in reported compensation.
Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses	Provision of the health club benefit is documented in Board meeting minutes and Carilion internally tracks the memberships and pays the health club directly.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation, including that of the organization's Chief Executive Officer, is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of Board members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, "at-risk" and other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, the list of which was reviewed by the Compensation Committee. The Compensation Committee maintained detailed minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	Mr. Arner, Mr. Conte, Mr. Halliwill, Dr. Moskal, Dr. Nussbaum, Dr. Skolnik, Mr. Vaughan, and Dr. Weiss participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP) in which the employer, at the discretion of Carilion Clinic's Compensation Committee, makes a contribution to an account established on its books for each eligible participant. If a participant ceases to be a participant prior to the vesting date, the account shall be forfeited. A lump sum distribution shall be made upon the participant's vesting date, death, or disability. Unvested contributions made to the DC SERP in the reporting period are included in Part II of this schedule with "retirement and other deferred compensation." $195,000 of prior year deferrals were paid to Dr. Moskal under this plan in the reporting year. Ms. Agee participated in an executive flexible benefit plan, in which an allowance is provided annually to the participant for use in obtaining certain insurance benefits. In prior years, the amount of allowance in excess of elected benefits was credited to a capital accumulation account (CAA) with various deferred vesting dates of at least two years from the first day of the plan year, distributable upon vesting while employed by a Carilion Clinic affiliate, death, disability, or 24 months following certain qualifying separations from service. Deferrals no longer occur under this plan. $195,503 was distributed under this plan in the reporting year.
Schedule J, Part I, Line 7 Non-fixed payments	The organization pays annual "at-risk" compensation to certain members of management based on performance of an applicable scorecard. While the scorecard contains a formula as a basis for determining overall performance, in certain cases, senior managers have discretion to include additional elements in their assessment of managers reporting to them. In addition, for top management, the actual non-fixed payment awarded is in the discretion of the Carilion Clinic Board of Directors and its Compensation Committee.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MARY SWEET MD	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship Description	FAMILY MEMBER OF JON SWEET, FORMER KEY EMPLOYEE	RelationshipDescriptionTxt
Transaction	$374,284	TransactionAmt
Transaction	EMPLOYEE	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part I, Line 6 Volunteers	The hospital operates a Customer Service-based program for volunteers and we do anything to make our patients and patients families comfortable in very uncomfortable circumstances. Tasks include delivering mail, delivering flowers, greeting and escorting patients and providing snacks in the hospital waiting rooms. Through Hospice, volunteers provide respite support for caregivers, visits for socialization and comforting presence, check in calls, take care of patients' pets, sing to patients, pet therapy, deliver supplies, help in the hospice office, assist with fundraisers, assist with bereavement support activities, facilitate children's grief support groups, deliver birthday gifts, make holiday gifts and memory quilts and record patient's life stories. Total volunteer hours worked were 12,170. NOTE: THE VOLUNTEER PROGRAM WAS SUSPENDED ON MARCH 16,2020 DUE TO COVID WHICH AFFECTED THE AMOUNT OF VOLUNTEER HOURS WORKED.
Form 990, Part III, Line 4a Program Service Description	Carilion Medical Center (CMC) d/b/a Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital exists to serve the health care needs of its communities and region, regardless of the patient's ability to pay. CMC admitted 31,269 patients and provided 179,750 days of care during fiscal year 2020. Hospital programs and accomplishments include the Cardiovascular Institute. It includes extensive expertise in cardiology for advanced heart failure, structural heart disease, electrophysiology labs for complex arrhythmias and a robust cardiothoracic surgery program with advanced procedures for complex aortic and vascular disease. Our vascular program remains a leader in treatment and surgical intervention. CMC is known for tertiary level care with expertise in Level 1 trauma for adults and pediatric patients, primary and comprehensive stroke care, neurosurgery for adults and children, and women's services for obstetrics (3,070 babies delivered), high-risk pregnancy, urogynecology, gynecologic oncology and fertility and reproductive care. Another area of surgical excellence is orthopaedics. It includes joint replacement, ortho spine surgery, sports medicine, trauma surgery, foot and ankle, hand and upper extremity and pediatrics. Other medical programs include specialized intensive care units for neurotrauma, cardiac care and cardiac surgery, vascular, medical intensive care, and dedicated units for oncology and thoracic surgery patients. The programs are supported by our acclaimed Magnet nursing program, receiving four Magnet designations over the years. Additional programs include the region's only neonatal intensive care unit, advanced diagnostics and expertise for gastroenterology conditions, inpatient and outpatient psychiatric services, a comprehensive inpatient rehabilitation unit, and inpatient and outpatient surgical care utilizing advanced techniques in robotic and endovascular procedures. Diagnostic testing capabilities in radiology support all CMC programs, including advanced imaging in CT, MRI and PET/CT. We've expanded our field of experts in molecular imaging and nuclear medicine procedures and ultrasound and provide screening mammography and diagnostic breast imaging. Carilion Children's is our region's only pediatric center of excellence with an inpatient hospital within CMC, a pediatric intensive care unit, NICU, and trauma care. Pediatric sub-specialists support the facility in surgery, pulmonology, oncology, cardiology, gastroenterology, psychiatry, orthopaedics, neurosurgery, dentistry, neurology, and endocrinology. CMC provides several services and programs to target the specific health needs of the area, including diabetes management, medically supervised weight loss, urgent care, physical, speech and occupational therapy programs, cardiac and pulmonary rehab and home health and hospice care. Supporting our communities is our 24/7 Level 1 trauma center, full-service emergency department, three medical service helicopters and a highly advanced medical communications center to support the region's emergency transportation needs. Carilion Roanoke Memorial Hospital (CRMH) has been consistently ranked among the nation's top 100 hospitals by Becker's Hospital Review, among the top three hospitals in Virginia by U.S. News and World Report, and it is the region's preferred hospital according to surveys conducted by National Research Corporation (NRC) Health. With 75,712 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 nearly 9 percent of ED visits. The urgent care centers also provide access points for cost effective care at an appropriate level. CMC also supports community screenings and education on chronic disease prevention and management, sponsoring 9,685 events touching over 35,246 people. CMC supports a cancer registry program, and participates in a number of other research projects. In furtherance of its mission, CMC provides extensive uncompensated care. Stated at cost, financial assistance for the year exceeded $14 million.
Form 990, Part IV, Line 11f Disclosure of Uncertain Tax Positions	Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.
Form 990, Part V, Line 1a FORMS 1099	1099s are issued on Carilion Medical Center's behalf by Carilion Services, Inc., a related supporting organization providing management and administrative services, including payment processing.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	Nancy Howell Agee, Steve Arner, Nicholas Conte, David Hagadorn, Donald Halliwill, G. Robert Vaughan, Jr., and Patrice Weiss. - 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, G. Robert Vaughan, Jr., and Patrice Weiss.
Form 990, Part VI, Line 6 Classes of members or stockholders	The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the board that may occur for any reason.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO; approval of borrowings, budgets, and strategic plans; and amendments of Articles of Incorporation and Bylaws. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia, certain extraordinary actions require member approval, such as mergers, consolidations, liquidations, and the sale of substantially all of the assets of the organization. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a.
Form 990, Part VI, Line 11b Review of form 990 by governing body	The Form 990 was prepared by Carilion's internal Tax Department with input from various Carilion departments as applicable, and reviewed by internal Accounting Management and an independent CPA firm. Several days prior to filing, all Board Members were notified by email of its availability on Carilion's Board portal, which is the mechanism used to disseminate meeting materials to the directors, and were encouraged to call with any questions they might have.
Form 990, Part VI, Line 12c Conflict of interest policy	Our organization monitors and reviews proposed and current transactions for conflicts of interest in a variety of ways. At the governing board level, we have board members complete an initial (upon appointment) and annual conflict of interest questionnaire to disclose actual or potential conflicts. Board members are required to update their disclosure as needed in between questionnaires. All disclosures are reviewed by the Organizational Integrity & 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 Organizational Integrity & Compliance Office and other key management team members. As needed, the governing board leaders are notified of any conflicts which may impact board proceedings.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. With respect to Carilion Clinic, the Compensation Committee reviews the compensation of the Board of Governors annually, which includes the President and Chief Executive Officer, the Executive Vice Presidents (Chief Financial Officer, Chief Medical Officer, Chief Operating Officer, Chief Administrative Officer and Chief Legal Officer), and select Senior Vice Presidents who are the physician Chairs of the Clinical Departments. For the fiscal year covered by this return, the Compensation Committee also used the same process to review the compensation of other Disqualified Individuals, including the Hospital Vice Presidents. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders, which includes Vice Presidents, Senior Vice Presidents, Executive Vice Presidents, and the CEO, as well as the compensation philosophy for employed physicians. Some officers of the organization who are not compensated in their capacity as an officer but rather in their role as employee in a position not mentioned above are not subject to Committee review. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk' and other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, the list of which was reviewed by the Compensation Committee. The Compensation Committee maintained detailed minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	See response to line 15A
Form 990, Part VI, Line 19 Required documents available to the public	The organization's governing documents, conflict of interest statement, and financial statements are released from time to time during the tax year upon request. The conflict of interest policy is included in our Code of Excellence which is available to the public on our website. The Articles of Incorporation are available from the Virginia State Corporation Commission. Limited financial information is available on our website.
Form 990, Part VIII, Line 2f Other Program Service Revenue	Other - Total Revenue: 2837619, Related or Exempt Function Revenue: 2837619, 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: 7929297, Related or Exempt Function Revenue: 7929297, 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 - -9290109; Pension-related changes other than net periodic pension costs - -3078245; Transfer Accumulated FCV LLC Investment from Carilion Clinic - -197601;

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 STONEWALL JACKSON 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 (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
FRANKLIN COUNTY VENTURES LLC
PO BOX 12385	ROANOKE	VA	24025	474365316	REAL ESTATE	VA	CARILION CLINIC	Related	-$1,497	$201,189	false	false	0.1
CARILION CLINIC MEDICARE SHARED SAVINGS COMPANY LLC
PO BOX 12385	ROANOKE	VA	24025	455235473	MEDICARE HMO	VA	CARILION CLINIC	Related	$6,471,910	$0	false	false	0.5
SOUTHWEST VIRGINIA HEALTH PROPERTIES LLC
1102 Jefferson Street SE	Roanoke	VA	24016	010691570	REAL ESTATE	VA	Carilion Medical Center	Related	$86,256	$1,299,766	false	false	0.5112
RAVEN ASSET BASED OPPORTUNITY FUND IV LP
110 Greene St Suite 9G	New York	NY	10012	824119491	Private Equity	DE	NA	N/A
TI PLATFORM CC SMA LP
1160 Battery Street East	San Francisco	CA	94111	842852539	Investments	DE	NA	N/A
STARWOOD VEP II CO-INVEST LLC
591 W Putman Avenue	Greenwich	CT	06830	833262407	Investments	DE	NA	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
CHS INC
PO BOX 12385	ROANOKE	VA	24025	541725732	SERVICES	VA	NA	C Corporation	Yes (true)
CARILION CLINIC MEDICARE RESOURCES LLC
PO BOX 12385	ROANOKE	VA	24025	263729975	MEDICARE HMO	VA	NA	C Corporation	Yes (true)
CARILION BEHAVIORAL HEALTH INC
PO BOX 12385	ROANOKE	VA	24025	203136891	HEALTHCARE	VA	NA	C Corporation	Yes (true)
CARILION EMERGENCY SERVICES INC
PO BOX 12385	ROANOKE	VA	24025	542033006	HEALTHCARE	VA	NA	C Corporation	Yes (true)
SCA CREDIT SERVICES INC
PO BOX 12385	ROANOKE	VA	24025	541180398	COLLECTION AGENCY	VA	NA	C Corporation	Yes (true)
CARILION HEALTHCARE CORPORATION
PO BOX 12385	ROANOKE	VA	24025	541586601	HEALTHCARE	VA	NA	C Corporation	Yes (true)
MEDKEY INC
PO BOX 12385	ROANOKE	VA	24025	541645357	FINANCING SERVICES	VA	NA	C Corporation	Yes (true)
SPROTT PRIVATE RESOURCE LENDING (C-CO-INVEST) LP
				981378742	INVESTMENTS		NA	C Corporation	Yes (true)	CA
BLACKMOOR OWNERSHIP HOLDINGS LIMITED
					INVESTMENTS		NA	C Corporation	Yes (true)	CJ
MAGNITUDE SYSTEMATIC LONG SHORT FUND
					INVESTMENTS		NA	C Corporation	Yes (true)	CJ
TANGIBLE SEGREGATED PORTFOLIO OF THE SOUTH AFRICA ALPHA SPC
					INVESTMENTS		NA	C Corporation	Yes (true)	CJ

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

Transactions Related Org TransactionsRelatedOrgGrp (22 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
CARILION CLINIC FOUNDATION
A	$38,784	COST
CARILION EMERGENCY SERVICES
A	$95,940	COST
CARILION HEALTHCARE CORPORATION
A	$27,000	COST
CHS INC
A	$56,392	COST
CARILION SERVICES INC
A	$720,790	COST
CARILION EMERGENCY SERVICES
L	$302,902	COST
CARILION FRANKLIN MEMORIAL HOSPITAL
L	$1,943,999	COST
CARILION GILES COMMUNITY HOSPITAL
L	$487,032	COST
CARILION HEALTHCARE CORPORATION
L	$252,764	COST
CARILION NEW RIVER VALLEY MEDICAL CENTER
L	$2,919,690	COST
CARILION SERVICES INC
L	$79,638	COST
CARILION STONEWALL JACKSON HOSPITAL
L	$709,341	COST
CARILION TAZEWELL COMMUNITY HOSPITAL
L	$1,996,945	COST
CARILION BEHAVIORAL HEALTH
M	$133,062	COST
CHS INC
K	$1,773,512	COST
CHS INC
M	$5,237,442	COST
CARILION NEW RIVER VALLEY MEDICAL CENTER
K	$215,495	COST
CARILION SERVICES INC
M	$199,125,574	COST
CARILION TAZEWELL COMMUNITY HOSPITAL
K	$152,009	COST
SCA CREDIT SERVICES INC
M	$883,791	COST
CARILION SERVICES INC
R	$9,294,593	CASH
Carilion Clinic Foundation
C	$505,223	CASH