CARILION MEDICAL CENTER: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: CARILION MEDICAL CENTER (EIN 54-0506332)
Tax period: 2018-10-01 to 2019-09-30
Filed: 2020-08-17
IRS object ID: 202022309349302177
Schema version: 2018v3.1
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	2020-08-17T12:31:25-05:00	ReturnTs
Tax Period End	2019-09-30	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	2018-10-01	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	5402245112	PhoneNum

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	G ROBERT VAUGHAN JR	PersonNm
Person Title	TREASURER	PersonTitleTxt
Signature	2020-08-17	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	2018	TaxYr
Build TS	2020-09-23 17:36:50Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	STEVE C 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	24025	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$2,343,468,664	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CARILIONCLINIC.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1899	FormationYr
Legal Domicile State	VA	LegalDomicileStateCd
Activity Or Mission	Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	9502	TotalEmployeeCnt
Total Volunteers	290	TotalVolunteersCnt
Total Gross UBI	$87,020	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$7,200,906	PYContributionsGrantsAmt
CY Contributions Grants	$8,626,043	CYContributionsGrantsAmt
PY Program Service Revenue	$1,330,246,862	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,427,067,490	CYProgramServiceRevenueAmt
PY Investment Income	$20,781,729	PYInvestmentIncomeAmt
CY Investment Income	$28,386,481	CYInvestmentIncomeAmt
PY Other Revenue	$23,426,381	PYOtherRevenueAmt
CY Other Revenue	$25,470,009	CYOtherRevenueAmt
PY Total Revenue	$1,381,655,878	PYTotalRevenueAmt
CY Total Revenue	$1,489,550,023	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,436,845	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$5,882,786	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$639,507,414	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$649,129,750	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$271,435	CYTotalFundraisingExpenseAmt
PY Other Expenses	$679,039,716	PYOtherExpensesAmt
CY Other Expenses	$727,648,180	CYOtherExpensesAmt
PY Total Expenses	$1,319,983,975	PYTotalExpensesAmt
CY Total Expenses	$1,382,660,716	CYTotalExpensesAmt
PY Revenues Less Expenses	$61,671,903	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$106,889,307	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,471,060,258	TotalAssetsBOYAmt
Total Assets EOY	$1,528,858,933	TotalAssetsEOYAmt
Total Liabilities BOY	$811,422,454	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,006,971,123	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$659,637,804	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$521,887,810	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	$1,211,498,867	ExpenseAmt
Grant	$5,882,786	GrantAmt
Revenue	$1,446,208,826	RevenueAmt
Desc	SEE SCHEDULE O.	Desc
Total Program Service Expenses	$1,211,498,867	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
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
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 With Officer Ent	false	BusinessRlnWithOfficerEntInd
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	9502	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (true)	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (true)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	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 (35 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
Steven Arner
Director/Pres./CEO	38.0	12.0	Yes (X)	Yes (X)	$0	$617,874	$97,360
R Steve Blanks
Director/Chair	4.0	2.4	Yes (X)	Yes (X)	$0	$11,650	$0
Damon Williams
Director/Vice Chair	2.0	0	Yes (X)	Yes (X)	$0	$0	$0
Jason Bingham
Director	2.0	2.9	Yes (X)		$0	$0	$0
Nathaniel Bishop DMin
Director	48.8	1.2	Yes (X)		$341,102	$0	$75,153
George Cartledge III
Director	2.0	0	Yes (X)		$0	$1,075	$0
Elizabeth Doughty
Director	2.0	0	Yes (X)		$0	$1,075	$0
James Drougas MD
Director	12.0	0	Yes (X)		$0	$1,030	$0
Katherin Elam
Director	2.0	0	Yes (X)		$0	$0	$0
Janet Frantz
Director	2.0	0	Yes (X)		$0	$717	$0
Jonathan Gleason MD
Director	50.0	0	Yes (X)		$438,257	$0	$41,909
Daniel Harrington MD
Director	50.0	0	Yes (X)		$458,681	$0	-$23,583
Paul Haskins MD
Director	50.0	0	Yes (X)		$390,793	$0	$16,893
Cynda Johnson MD
Director	2.0	48.0	Yes (X)		$0	$312,795	$6,204
Lee Learman MD PhD
Director	2.0	0	Yes (X)		$0	$0	$0
Michael Nussbaum MD
Director	50.0	0	Yes (X)		$620,605	$637	$148,939
Kianna Price Marshall
Director	2.0	0	Yes (X)		$0	$0	$0
Isabel Thornton
Director	2.0	0	Yes (X)		$0	$0	$0
Nicholas Conte
Secretary	3.0	47.0		Yes (X)	$0	$523,989	$136,049
David Hagadorn
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$143,606	$8,062
Donald Halliwill
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$591,117	$93,970
Lauren Schantz
Asst. Secretary	8.0	32.0		Yes (X)	$0	$74,069	$12,875
G Robert Vaughan Jr
Treasurer	0.5	49.5		Yes (X)	$0	$294,528	$26,998
Patrice Weiss MD
Executive Vice President/CMO	46.0	4.0		Yes (X)	$978	$668,072	$167,815
Nancy Howell Agee
CEO, Carilion Clinic	2.0	48.0			$0	$1,733,867	$125,927	Yes (X)
Joseph Moskal MD
SVP/Dept. Chair	50.0	0			$1,197,208	$0	$132,535	Yes (X)
Paul Skolnik MD
SVP/Dept. Chair	50.0	0			$459,487	$0	$144,398	Yes (X)
Jonathan Carmouche MD
Physician	50.0	0			$1,439,752	$0	$21,015		Yes (X)
Gregory Howes MD
Physician	50.0	0			$1,429,995	$0	$30,792		Yes (X)
Eric Marvin MD
Physician	50.0	0			$1,241,301	$0	$45,158		Yes (X)
Jesse Seamon MD
Physician	50.0	0			$1,131,644	$0	$28,441		Yes (X)
Jesse Stem MD
Physician	50.0	0			$1,099,883	$0	$33,794		Yes (X)
Bruce Long MD
Physician	50.0	0			$486,487	$0	$28,456			Yes (X)
Jon Sweet MD
Physician	50.0	0			$307,519	$0	$3,815			Yes (X)
Tracey Criss MD
Physician	50.0	0			$262,638	$0	$32,181			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$11,306,330	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$4,976,101	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,435,156	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	932	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
QUEST DIAGNOSTICS
500 PLAZA DRIVE	SECAUCUS	NJ	07094	LABORATORY SERVICES	$15,058,325
F&S BUILDING INNOVATIONS INC
2944 ORANGE AVE NE	ROANOKE	VA	24012	CONSTRUCTION SERVICES	$4,364,419
SIEMENS MEDICAL
40 LIBERTY BOULEVARD	MALVERN	PA	19355	EQUIPMENT MAINTENANCE	$4,343,231
BLACK BOX CORPORATION
1000 PARK DRIVE	LAWRENCE	PA	150551018	IT infrastructure sERVICES	$3,829,960
TRANE
3600 PAMMEL CREEK RD	LA CROSSE	WI	546017599	CONSTRUCTION SERVICES	$2,918,901

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	127	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Federated Campaigns	$73,475	FederatedCampaignsAmt
Fundraising	$0	FundraisingAmt
Related Organizations	$589,668	RelatedOrganizationsAmt
Government Grants	$6,589,008	GovernmentGrantsAmt
All Other Contributions	$1,373,892	AllOtherContributionsAmt
Total Contributions	$8,626,043	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue	622110	$1,395,318,180	$1,395,318,180
College Tuition/Other	611310	$21,759,476	$21,759,476
Program Related Investments	531120	-$1,737,828	-$1,737,828
Other Patient Revenue	900099	$7,855,141	$7,855,141
Clinical Research	541715	$908,142	$908,142

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,964,379	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,964,379	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,427,067,490	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$13,128,972	TotalRevenueColumnAmt
Unrelated Business Revenue	$87,020	UnrelatedBusinessRevenueAmt
Exclusion	$13,041,952	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,314	TotalRevenueColumnAmt
Exclusion	$12,314	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$2,662,176	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$2,662,176	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,662,176	TotalRevenueColumnAmt
Exclusion	$2,662,176	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$868,989,002	SecuritiesAmt
Other	$174,836	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$853,768,354	SecuritiesAmt
Other	$150,287	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$15,220,648	SecuritiesAmt
Other	$24,549	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$15,245,195	TotalRevenueColumnAmt
Exclusion	$15,245,195	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
Physician & Other Affiliate Income	621111	$9,718,164	$9,718,164
Cafeteria	722514	$3,666,497		$3,666,497
Roanoke City Student Health	621440	$1,987,227	$1,987,227

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,435,945	TotalRevenueColumnAmt
Related Or Exempt Func Income	$7,435,945	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$22,807,833	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,489,550,023	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,446,208,826	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$87,020	UnrelatedBusinessRevenueAmt
Exclusion	$34,628,134	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$5,661,231	TotalAmt
Program Services	$5,661,231	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$221,555	TotalAmt
Program Services	$221,555	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$3,817,983	TotalAmt
Program Services	$3,211,010	ProgramServicesAmt
Management And General	$606,973	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$3,863,268	TotalAmt
Program Services	$3,863,268	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$531,461,402	TotalAmt
Program Services	$530,946,050	ProgramServicesAmt
Management And General	$411,290	ManagementAndGeneralAmt
Fundraising	$104,062	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$33,860,853	TotalAmt
Program Services	$33,834,649	ProgramServicesAmt
Management And General	$26,204	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$41,455,856	TotalAmt
Program Services	$41,326,836	ProgramServicesAmt
Management And General	$102,968	ManagementAndGeneralAmt
Fundraising	$26,052	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$34,670,388	TotalAmt
Program Services	$34,620,309	ProgramServicesAmt
Management And General	$50,079	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$163,051,911	TotalAmt
Management And General	$163,051,911	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$79,360	TotalAmt
Management And General	$79,360	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$10,139	TotalAmt
Management And General	$10,139	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$89,698	TotalAmt
Program Services	$89,698	ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$955,707	TotalAmt
Management And General	$955,707	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$112,542,258	TotalAmt
Program Services	$111,587,970	ProgramServicesAmt
Management And General	$924,508	ManagementAndGeneralAmt
Fundraising	$29,780	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$143,907	TotalAmt
Program Services	$143,671	ProgramServicesAmt
Fundraising	$236	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$18,154,836	TotalAmt
Program Services	$18,005,884	ProgramServicesAmt
Management And General	$135,433	ManagementAndGeneralAmt
Fundraising	$13,519	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$4,424,307	TotalAmt
Program Services	$4,421,271	ProgramServicesAmt
Management And General	$3,036	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$26,985,538	TotalAmt
Program Services	$26,984,620	ProgramServicesAmt
Management And General	$918	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$3,381,309	TotalAmt
Program Services	$3,334,365	ProgramServicesAmt
Management And General	$32,120	ManagementAndGeneralAmt
Fundraising	$14,824	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$13,782,284	TotalAmt
Program Services	$13,782,284	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$47,651,704	TotalAmt
Program Services	$47,651,704	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$15,208,323	TotalAmt
Program Services	$11,168,450	ProgramServicesAmt
Management And General	$4,039,873	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$201,043,056	$201,039,791	$3,265
Bad Debt	$82,037,399	$82,037,399
Assessment Fees	$30,554,944	$30,554,944
College Expenses	$3,020,226	$3,020,226

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,531,274	TotalAmt
Program Services	$3,991,682	ProgramServicesAmt
Management And General	$456,630	ManagementAndGeneralAmt
Fundraising	$82,962	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,382,660,716	TotalAmt
Program Services	$1,211,498,867	ProgramServicesAmt
Management And General	$170,890,414	ManagementAndGeneralAmt
Fundraising	$271,435	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$18,519	BOYAmt
EOY	$17,586	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,387,776	BOYAmt
EOY	$5,005,959	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,795,724	BOYAmt
EOY	$2,463,652	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$214,178,896	BOYAmt
EOY	$246,865,692	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$4,613,638	BOYAmt
EOY	$4,208,444	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$10,125,826	BOYAmt
EOY	$10,573,019	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$4,775,300	BOYAmt
EOY	$9,165,336	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,124,514,920	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$841,499,455	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$279,071,803	BOYAmt
EOY	$283,015,465	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$206,700,376	BOYAmt
EOY	$204,645,171	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$751,359,342	BOYAmt
EOY	$771,035,206	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	-$4,173,533	BOYAmt
EOY	-$8,317,602	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	$141,468	BOYAmt
EOY	$115,882	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,471,060,258	BOYAmt
EOY	$1,528,858,933	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$176,521,109	BOYAmt
EOY	$182,029,352	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$13,410,000	BOYAmt
EOY	$13,240,000	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$6,637,265	BOYAmt
EOY	$3,297,074	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$334,315,681	BOYAmt
EOY	$323,771,290	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
EOY	$223,045	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$280,538,399	BOYAmt
EOY	$484,410,362	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$811,422,454	BOYAmt
EOY	$1,006,971,123	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$639,099,468	BOYAmt
EOY	$501,315,131	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$8,662,427	BOYAmt
EOY	$8,696,770	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$11,875,909	BOYAmt
EOY	$11,875,909	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$659,637,804	BOYAmt
EOY	$521,887,810	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,471,060,258	BOYAmt
EOY	$1,528,858,933	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$106,889,307	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$23,523,273	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$221,116,028	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	$89,698	OtherActivitiesAmt
Total Lobbying Expenditures	$89,698	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	$17,033,643	BeginningYearBalanceAmt
Investment Earnings Or Losses	$803,774	InvestmentEarningsOrLossesAmt
Other Expenditures	$956,361	OtherExpendituresAmt
End Year Balance	$16,881,056	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$16,528,095	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$57,465	InvestmentEarningsOrLossesAmt
Other Expenditures	$764,933	OtherExpendituresAmt
End Year Balance	$15,705,697	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.0	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.7035	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.2965	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	$500,261,401	OtherCostOrOtherBasisAmt
Depreciation	$345,300,077	DepreciationAmt
Book Value	$154,961,324	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$959,463	OtherCostOrOtherBasisAmt
Depreciation	$819,765	DepreciationAmt
Book Value	$139,698	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$592,225,740	OtherCostOrOtherBasisAmt
Depreciation	$488,737,797	DepreciationAmt
Book Value	$103,487,943	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$24,952,029	OtherCostOrOtherBasisAmt
Depreciation	$6,641,816	DepreciationAmt
Book Value	$18,310,213	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$283,015,465	TotalBookValueLandBuildingsAmt

Financial Derivatives FinancialDerivativesGrp

Field	Value	IRS element (for citing)
Book Value	$7,928,042	BookValueAmt
Method Valuation	F	MethodValuationCd

Closely Held Equity Interests CloselyHeldEquityInterestsGrp

Field	Value	IRS element (for citing)
Book Value	$1,584,438	BookValueAmt
Method Valuation	C	MethodValuationCd

Other Securities OtherSecuritiesGrp (2 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
Comingled Funds	$126,139,486	F
Alternative Investments	$635,383,240	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$771,035,206	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Due to Affiliates	$14,833,724
Pension Liability	$403,462,565
Deferred Comp Liability	$26,409,226
Interest Rate Swap Liability	$39,704,847

Field	Value	IRS element (for citing)
Total Liability	$484,410,362	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 indigent care.	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	$32,986,409	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$32,986,409	NetCommunityBenefitExpnsAmt
Total Expense	0.0258	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$198,241,210	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$198,917,270	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	$231,227,619	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$198,917,270	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$32,986,409	NetCommunityBenefitExpnsAmt
Total Expense	0.0258	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7051	ActivitiesOrProgramsCnt
Persons Served	19037	PersonsServedCnt
Total Community Benefit Expns	$2,659,918	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$462,386	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,197,532	NetCommunityBenefitExpnsAmt
Total Expense	0.0017	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1822	ActivitiesOrProgramsCnt
Persons Served	757	PersonsServedCnt
Total Community Benefit Expns	$51,150,227	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,352,375	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$40,797,852	NetCommunityBenefitExpnsAmt
Total Expense	0.0319	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	3538	PersonsServedCnt
Total Community Benefit Expns	$1,035,102	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,035,102	NetCommunityBenefitExpnsAmt
Total Expense	0.0008	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	230	ActivitiesOrProgramsCnt
Persons Served	15162	PersonsServedCnt
Total Community Benefit Expns	$652,106	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$110,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$542,106	NetCommunityBenefitExpnsAmt
Total Expense	0.0004	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9105	ActivitiesOrProgramsCnt
Persons Served	38494	PersonsServedCnt
Total Community Benefit Expns	$55,497,353	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,924,761	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$44,572,592	NetCommunityBenefitExpnsAmt
Total Expense	0.0348	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9105	ActivitiesOrProgramsCnt
Persons Served	38494	PersonsServedCnt
Total Community Benefit Expns	$286,724,972	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$209,842,031	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$77,559,001	NetCommunityBenefitExpnsAmt
Total Expense	0.0606	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	11	ActivitiesOrProgramsCnt
Persons Served	7425	PersonsServedCnt
Total Community Benefit Expns	$210,036	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$210,036	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	59	ActivitiesOrProgramsCnt
Persons Served	1550	PersonsServedCnt
Total Community Benefit Expns	$111,884	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$111,884	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

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

Leadership Development LeadershipDevelopmentGrp

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

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	120	ActivitiesOrProgramsCnt
Persons Served	445	PersonsServedCnt
Total Community Benefit Expns	$34,892	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,962	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$31,930	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	1200	PersonsServedCnt
Total Community Benefit Expns	$26,528	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$645	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$25,883	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	6	ActivitiesOrProgramsCnt
Persons Served	11	PersonsServedCnt
Total Community Benefit Expns	$364,597	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$364,597	NetCommunityBenefitExpnsAmt
Total Expense	0.0003	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

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

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	203	ActivitiesOrProgramsCnt
Persons Served	10631	PersonsServedCnt
Total Community Benefit Expns	$747,937	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,607	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$744,330	NetCommunityBenefitExpnsAmt
Total Expense	0.0006	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$81,310,912	BadDebtExpenseAmt
Reimbursed By Medicare	$271,761,601	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$281,481,729	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$9,720,128	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	0.5056	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; URGENT CARE

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
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	https://www.carilionclinic.org/billing/financial-assistance	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	https://www.carilionclinic.org/billing/financial-assistance	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	https://www.carilionclinic.org/billing/financial-assistance	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	THE 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 VA Medical Center, United Way of Roanoke Valley, and the Virginia Department of Health. In addition to the CHAT, 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 the Stakeholder Survey (print and electronic versions available). This survey provided an additional perspective about the health needs and barriers facing our community. Stakeholder focus groups were conducted 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 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 including: Community Themes and Strengths Assessments, National Association of County and City Health Officials (NACCHO), Mobilizing for Action through Planning and Partnerships (MAPP); Community Healthy Living Index, YMCA; Behavioral Risk Factor Surveillance System, Centers for Disease Control (CDC); National Health Interview Survey, Centers for Disease Control (CDC); Youth Risk Behavior Surveillance System, Centers for Disease Control (CDC); Martin County Community Health Assessment, Martin County, North Carolina; Previous Roanoke Valley Community Health Surveys. English and Spanish versions were available. The CHAT and HRV Data Tracking and Quality Improvement Action Team identified target populations, collection sites, and methods of survey distribution. The population of interest was Roanoke Valley residents 18 years of age and older. The Roanoke Valley included the CHNA service area consisting 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 VA 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 2018 Roanoke Valley CHNA was also shared to be posted to Community Health Assessment Team partner websites and social media.
Schedule H, Part V, Section B, Line 11 Facility A, 1	Facility A, 1 - Group A. Carilion Medical Center's two hospital facilities, Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital, partnered with Healthy Roanoke Valley (HRV) to conduct the 2018 Roanoke Valley Community Health Needs Assessment (RVCHNA) during the 2017 tax year. Healthy Roanoke Valley (HRV), operating under the auspices of the United Way of Roanoke Valley, was formed in 2012 as a community response to needs identified in Carilion Medical Center's triennial Roanoke Valley CHNA. Carilion Clinic is a not-for-profit, integrated healthcare system located in Virginia's Blue Ridge Mountains with its flagship hospital in the heart of the City of Roanoke, the largest urban hub in western Virginia. There, through a comprehensive network of hospitals, primary and specialty physician practices, wellness centers and other complementary services, the system provides quality care close to home for nearly one million Virginians. Carilion's roots go back to 1899 when a group of dedicated citizens came together and built a hospital to meet the healthcare needs of the community. Today, Carilion is a key anchor institution focusing on more than just healthcare; Carilion is dedicated to its mission of improving the health of the communities we serve. With an enduring commitment to the health of our region, Carilion advances care through clinical services, medical education, research and community health investments. Carilion believes in service, collaboration and caring for all. Through ongoing investment in discovering and responding to the health needs of the community comes the understanding that the involvement of additional stakeholders is essential to effectively address community health issues and create change. The purpose of the implementation strategy is to describe what Carilion Medical Center (CMC), comprised of Carilion Roanoke Memorial Hospital (CRMH) and Carilion Roanoke Community Hospital (CRCH), plans to do to address the community health needs identified in the 2018 Roanoke Valley Community Health Needs Assessment (RVCHNA). After all primary and secondary data collection was completed, the CHAT reviewed all data then identified and prioritized the ten most pertinent community needs using the Robert Wood Johnson Foundation framework for what influences health. The data were combined, and overall priorities chosen based on the number of times a category was selected in the top 10, with the average ranking serving as a tiebreaker. Once the priorities were clearly identified, the CHAT rated the feasibility and potential impact of solutions for each health issue. Healthy Roanoke Valley hosted strategic planning and action team tactical planning meetings focused on each identified priority need. The findings of the 2018 RVCHNA revealed 10 priority health-related issues in the community, identified by the CHAT after review of the data collected. (1) Poverty / low average household income, (2) Transportation / transit system, (3) Access to mental / behavioral health services and substance use services, (4) Culture: healthy behaviors not a priority, (5) High uninsured / underinsured population, (6) Affordable / safe housing, (7) Access to dental care, (8) Poor diet, (9) High cost of care, (10) Educational attainment. -CMC Implementation Plan- According to the Robert Wood Johnson Foundation's (RWJF) County Health Rankings , where an individual lives, works and plays is a strong predictor of their health outcomes. Currently, 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 . These factors are so important to our overall health that they were added to the 10-year national Healthy People 2020 objectives to "create social and physical environments that promote good health for all." 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. Carilion Clinic's response strategies are organized by the RWJF framework for what influences health, which include health behaviors, social and economic factors, clinical care access and quality, and physical environment. Commitment to community service is evident at all levels of the organization. Carilion's commitment to community health is evidenced by its commitment to a population health infrastructure including a Community Health and Outreach (CHO) department dedicated to assessing and addressing community needs. The department is responsible for leading and facilitating the Community Health Improvement Plan (CHIP), CHNAs, the system's community grant process, community health education, community benefit collection, and neighborhood health initiatives. CHO has staff at the system level and each community hospital and works with each hospital's Board of Directors and Carilion Clinic's Board of Governors to create health improvement strategies to address community health needs. A Community Benefit Council provides oversight and strategic guidance for Carilion's community health improvement work and for community benefit strategy, collection and submission. -Community Partnerships- Carilion Clinic believes in the power of collaboration and understands community health issues must be addressed in cooperation with the community. To ensure lasting community impact from the health assessment and community health improvement process. Carilion participates in and provides financial and in-kind support to community health coalitions addressing health needs in the Roanoke Valley such as HRV. In addition, Carilion partners with multiple community and business organizations to improve health and wellness and to impact the social determinants of health for all who live in the Roanoke Valley. -Healthy Roanoke Valley- Forming a true community collaborative with lasting impact is no small feat. In 2012, using the Strive Collective Impact model, Carilion and United Way played key convening roles, bringing together strategic community partners to create HRV. An initiative of United Way of Roanoke Valley, HRV is now a partnership of more than 50 organizations striving to enhance health equity related to these priorities as a means to create a "culture of wellness" across the Roanoke Valley. For years, HRV has been serving as a key partner with Carilion Clinic. HRV's strategic framework was updated to align with the triennial Community Health Needs Assessment. This is a community-driven process and a major component of Carilion Clinic'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 both financial and in-kind support to HRV with representatives active on the HRV steering committee and all five action teams: wellness; mental health; primary care; oral health; and coordination of care. Through HRV, multiple programs and strategies have arisen in response to community needs, such as Fresh Foods Rx and the Pathways Community HUB. Carilion provides additional support to implement these strategies in the Roanoke Valley. (Continued in Schedule H, Part VI)

Field	Value	IRS element (for citing)
Facility	91	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (91 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt	Address Line2USAddress/AddressLine2Txt
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 - GILES
159 HARTLEY WAY	PEARISBURG	VA	24134	EMERGENCY PHYSICIANS
CSJH EMERGENCY DEPARTMENT
1 HEALTH CIRCLE	LEXINGTON	VA	24450	EMERGENCY PHYSICIANS
CES - TAZEWELL
388 BEN BOLT AVENUE	TAZEWELL	VA	24651	EMERGENCY PHYSICIANS
CARILION GYN ONCOLOGY
1 RIVERSIDE CIRCLE SUITE 300	ROANOKE	VA	24016	GYNECOLOGICAL ONCOLOGY
CARILION CLINIC DERMATOLGOY & MOHS
1 RIVERSIDE CIRCLE SUITE 300M	ROANOKE	VA	24016	DERMATOLOGY AND MOHS SURGERY
CARILION IMAGING PROFESSIONALS
159 HARTLEY WAY	PEARISBURG	VA	24134	IMAGING SERVICES
CARILION CLINIC DENTISTRY PEDIATRIC
101 ELM AVE SE	ROANOKE	VA	24013	DENTAL SERVICE
CARILION CLINIC OCCUPATIONAL MEDICINE
101 ELM AVE	ROANOKE	VA	24013	OCCUPATIONAL MEDICINE
CARILION WOUND CARE CENTER CARILION
101 ELM AVE	ROANOKE	VA	24013	WOUND CARE
COMMUNITY CARE
101 ELM AVE	ROANOKE	VA	24013	FAMILY MEDICINE
CARILION PRENATAL DIAGNOSTIC CENTER
102 HIGHLAND AVE STE 455	ROANOKE	VA	24013	PRENATAL TESTING
CARILION BREAST CARE CENTER
102 HIGHLAND AVE STE 202	ROANOKE	VA	24013	BREAST CARE CENTER
CARILION PEDIATRIC ENDOCRINOLOGY CLINIC
102 HIGHLAND AVENUE SUITE 455	ROANOKE	VA	24013	ENDOCRINOLOGY
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
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 SLEEP CENTER
1030 JEFFERSON PLAZA STE G100	ROANOKE	VA	24016	SLEEP DISORDER
CARILION ANTICOAGULATION CLINIC
1030 S JEFFERSON ST STE G101	ROANOKE	VA	24016	ANTICOAGULATION CLINIC
CARILION GENERAL PEDIATRIC CLINIC
1030 S JEFFERSON ST STE 106	ROANOKE	VA	24016	GENERAL PEDIATRICS
PEDIATRIC DEVELOPMENTAL CLINIC
1030 S JEFFERSON ST SUITE 201	ROANOKE	VA	24016	PEDIATRIC DEVELOPMENT
CARILION DIABETIC EDUCATION
1030 S JEFFERSON SUITE G101	ROANOKE	VA	24016	DIABETIC EDUCATION
CARILION WELLNESS-BOUTETOURT
105 SUMMERFIELD COURT	ROANOKE	VA	24019	OUTPATIENT THERAPY SERVICES
CARILION CLINIC UROGYNECOLOGY
1107B BROOKDALE STREET	MARTINSVILLE	VA	24112	UROGYNECOLOGY AND CARDIOLOGY SERVICES
CARILION CLINIC UROLOGY CHRISTIANSBURG
120 AKERS FARM ROAD NE	CHRISTIANSBURG	VA	24073	UROLOGY
CARILION REPRODUCTIVE ENDOCRINOLOGY
1231 S JEFFERSON STREET	ROANOKE	VA	24016	REPRODUCTIVE ENDOCRINOLOGY
CARILION CLINIC VASCULAR MCCLANAHAN
127 MCCLANAHAN ST	ROANOKE	VA	24014	VASCULAR SERVICES
CARILION CARDIAC REHAB
127 MCCLANAHAN ST	ROANOKE	VA	24014	CARDIAC REHAB
CARILION HEART FAILURE CLINIC
127 MCCLANAHAN ST	ROANOKE	VA	24014	HEART FAILURE 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
GENERAL SURGERY CLINIC
180 FLOYD AVENUE	ROCKY MOUNT	VA	24151	SURGICAL SERVICES
CARILION CLINIC OBGYN SALEM
1957 W MAIN STREET	SALEM	VA	24153	OBSTETRICS AND GYNECOLOGY
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 HEALTH AGING
2001 CRYSTAL SPRING AVENUE SUITE 30	ROANOKE	VA	24014	GERIATRICS	2
CARILION CLINIC DENTISTRY GENERAL SURGERY
2017 S JEFFERSON ST	ROANOKE	VA	24014	SURGICAL SERVICES
CARILION CLINIC DEPARTMENT OF PSYCHIATRY
2017 S JEFFERSON ST	ROANOKE	VA	24014	BEHAVIORAL HEALTH
CARILION DENTAL CARE
2017 S JEFFERSON ST	ROANOKE	VA	24014	DENTAL SERVICE
CHILD AND ADOLESCENT PSYCHIATRY
2017 S JEFFERSON ST	ROANOKE	VA	24014	CHILD AND ADOLESCENT PSYCHIATRY SERVICES
COMMUNITY PSYCHIATRY
2017 S JEFFERSON ST	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 REHAB
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
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 CLINIC NEUROPSYCHOLOGY CCR3
3 RIVERSIDE CIRCLE	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 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 SERVICES
BRAMBLETON RADIOLOGY SERVICES
3707 BRAMBLETON AVENUE	ROANOKE	VA	24018	RADIOLOGY SERVICES
TAZEWELL VETERANS AFFAIRS COMMUNITY
388 BEN BOLT AVENUE	TAZEWELL	VA	24651	VETERAN AFFAIRS OUTPATIENT CLINIC
CARILION CLINIC ORTHOPAEDICS - FRANKLIN
390 S MAIN STREET SUITE 103	ROCKY MOUNT	VA	24151	ORTHOPAEDICS
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
CARILIION 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	24014	BREAST MAMMOGRAPHY
CARILION CLINIC PEDIATRIC CHILD DEVELOPMENT
1030 S JEFFERSON ST	ROANOKE	VA	24016	CHILD DEVELOPMENT SERVICES
CARILION OBSTETRICS AND GYNECOLOGY CLINIC
902 S JEFFERSON ST UPPER LEVEL	ROANOKE	VA	24016	OBSTETRICS AND GYNECOLOGY
CARILION MATERNAL FETAL MEDICINE
101 ELM AVENUE	ROANOKE	VA	24013	MATERNAL FETAL MEDICINE
CARILION CLINIC UROGYNECOLOGY
101 ELM AVENUE SUITE 400	ROANOKE	VA	24013	OBSTETRICS
CARILION CLINIC FAMILY MEDICINE TAZEWELL
388 BEN BOLT AVENUE	TAZEWELL	VA	24651	FAMILY MEDICINE
PEDIATRIC SUBSPECIALTY CLINIC
1620 GRAVES MILL ROAD	LYNCHBURG	VA	24502	PEDIATRICS

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) -Fresh Foods Rx - Fresh Foods Rx is an 8-week program providing patients with weekly health education, peer and physician support and vouchers for fresh local fruits and vegetables from the LEAP Mobile Market. The program is designed to address both social determinants of health, particularly environments and behaviors linked to healthy nutrition choices and fruit and vegetable consumption, and the clinical care needs of patients. The program works with low-income, uninsured and publicly insured adult patients living in Medically Underserved Areas who are overweight or obese and who have been diagnosed with diabetes. Community partners include: HRV, New Horizons Healthcare, LEAP for Local Food, Virginia Cooperative Extension, and YMCA of Roanoke Valley. -Pathways Community HUB - The Pathways Community HUB is a community-based care coordination system anchored by community health workers strategically located in two Carilion teaching practices in the City of Roanoke, at Carilion Community Care, at Carilion Internal Medicine Riverside 3, and at partners' clinics. The model addresses social determinants of health. Community Health Workers link clients and their families to resources and services. The program works to reduce 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 United Way of Roanoke Valley's HRV. -Community Grants - Carilion is committed to improving the health of the communities we serve by addressing key health priorities identified through our triennial CHNA. Carilion fulfills this commitment in many ways, one of which is through targeted grants for community health improvement programs and those affecting the social determinants of health. Carilion provides a multitude of community grants and community health sponsorships to help local charitable organizations fulfill their missions as they relate 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 2019 fiscal year (2018 tax year), more than $330,000 in grants were awarded to 23 programs to improve mental and dental health access, transportation, disease prevention, literacy services, wellness programming, and to increase the availability of affordable healthy foods, medication and personal rehabilitative 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 MUAs. The City of Roanoke tends to perform worse than other neighboring communities in many health and social determinant indicators. Therefore, efforts are often focused on the MUAs in the Northwest and Southeast areas of the City of Roanoke. CMC is addressing key 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 - Carilion is working with Roanoke City Public Schools and other partners to expand access to health care services and wellness opportunities for children and families and to create a community health center in the updated Fallon Park Elementary School, located in the Southeast area of the city. The first phase of work is programmatic: to address students with chronic conditions such as asthma at the school. The focus was established based on surveys of parents and school staff and through focus groups. The goal is to reduce the number of absences due to illness, decrease Emergency Department visits and hospitalizations, and improve asthma control scores. This partnership will: transform the school nursing program to utilize a more integrated, holistic and proactive approach to health; provide a pediatric, dental, and mental health clinic; make Community Health Workers available to assist families with coordination of care and social determinant of health needs and offer financial counseling for families. Community partners include Roanoke City Public Schools, Carilion Planning and Community Development, Virginia Tech Cooperative Extension, HRV, Big Brothers Big Sisters, Carilion Wellness, Carilion departments of Psychiatry, Pediatrics and Family and Community Medicine, Delta Dental, Freedom First Credit Union, and the Fralin Biomedical Research Institute at VTC. -Significant Health Priorities to be Addressed- -Health Behaviors - Needs include a culture of healthy behaviors not a priority, poor diet. Carilion Clinic continues to address health behavior-related priorities from the 2018 RVCHNA. Improving poor diets and the general health culture served as a start to making healthy behaviors more of a priority. Carilion provides a variety of free health education classes, screenings and flu immunizations in community settings. Community health education is provided by the 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 activity, anti-inflammatory diet, tobacco cessation, infant safe sleep, infant and child safety, wilderness medicine, emergency care in the case of gun wound, exercise for balance and confidence building for seniors, stress management, warning signs for heart attack and stroke, women's health, and other topics as requested. Health educators also lead guided walks and hikes and Carilion supports Roanoke's local Bikeshare program, organized by Ride Solutions, helping improve access to exercise and transportation. Resources committed to these programs include staff time, volunteer hours, and food and giveaway items that encourage healthy behaviors. In fiscal year 2019 (tax year 2018), the Morningside Urban Farm hosted nearly 1,000 people who attended more than 60 events including health education classes to help learn to eat healthily and grow fresh produce for their consumption. Produce grown on the farm's 31 beds yielded 26 varieties of vegetables. The produce benefitted those attending classes and events at Morningside, programs at the Presbyterian Community Center, wellness-focused workshops, and the Smith Mountain Lake Good Neighbors Program. Programs such as Fresh Foods Rx encourage healthy eating through prescription vouchers to access healthy food paired with education and coaching. In addition to community events, Carilion fosters healthy behaviors by offering classes to employees and through partnerships with other employers in the Roanoke Valley. As the largest employer in the region, efforts to engage employees and their families in healthy lifestyles impact community health overall. Carilion offers the Virgin Pulse program to employees. This program enables employees to connect personal activity trackers and include others on the platform to encourage daily healthy behaviors such as exercise, climbing stairs, and planning healthy meals. Support groups also often contribute to wellness. Support groups are offered for grief and loss counseling, cancer treatment and recovery, and attention to diabetes and other chronic conditions. A key to wellness is compliance with safety and preventive behaviors. CMC coordinates child passenger safety training and child safety seat checks to reduce injuries from car accidents. Carilion family practices also 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 as well as a free Sleep Sack, when available. Infants born in Carilion hospitals also receive a free Sleep Sack, when available, to encourage safe sleep practices.
Schedule H, Part V, Section B, Line 11 Addressing Needs Identified in CHNA (Continued)	Carilion remains committed to addressing poor diets. Through the Local Foods Program, Carilion provides hundreds of thousands of dollars of support to improve access to healthy foods. Community grants, such as one doubling the value of Supplemental Nutrition Assistance Program (SNAP) benefits, make healthy wholesome foods more affordable and accessible in the Roanoke Valley. In addition to community grants, CMC makes a Farm Share program available to its employees and their families through payroll deduction. In one season, employees purchased 130 shares, widening the impact of nutritious fresh food and diets to include our Carilion staff. CMC also serves as a convenient pick-up site option for community members participating in the Farm Share. Carilion remains committed to the Healthier Hospital Initiative pledge and continues to work to improve quantities of healthy, local, sustainable foods purchased and served through its cafeterias. Carilion's Morningside Urban Farm brings fresh foods to the Southeast Roanoke City community and offers new opportunities for health education and incentives. -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 important to CMC when addressing community health needs. In addition to providing financial support to qualifying patients who cannot afford care, Carilion is working to improve affordable access to care and resources. To increase access to primary care and resources for adolescents, CMC partners with Roanoke City Public Schools 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 students' ability to pay. -Mental health and substance use services - Through a new program, #AllIn, Carilion is providing additional access to non-traditional services for mental health and substance use. A key component of #AllIn is peer support which has expanded the type of care people in the Roanoke Valley can access. Carilion trained 70 peer recovery specialists in the Roanoke Valley and hired three who provide support groups in community and clinical settings as well as support patients who come to the hospital with conditions related to mental illness or substance use. Peer recovery specialists have a unique perspective and can connect with patients through shared experiences. Carilion's Opioid Task Force brings together expertise from throughout the Carilion system to better understand and address the opioid epidemic in Southwest Virginia. The Opioid Task Force works to address this epidemic internally and in the community. Efforts arising from this task force 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, EPIC; developing 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. Oral health is also prioritized through the HRV Oral Health Action Team with support provided by the DentaQuest Foundation. -High uninsured / underinsured population and high cost of care - Carilion is committed to helping improve access to affordable medical care in our communities. With expansion of Medicaid in the Commonwealth of Virginia in 2019, Carilion worked diligently to develop a plan for outreach and enrollment in Medicaid for newly eligible beneficiaries. Nearly 10,000 people enrolled in medicaid as a result of outreach efforts. Community Health Workers, managed by Healthy Roanoke Valley through the Pathways HUB, and other partners also helped clients complete insurance pathways and to pair them with appropriate services once they are 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 through RX Partnership, which Carilion supports financially. Additionally, Individuals can access regular care and medications as well as coordinate lab services through Carilion financial assistance. - Social and Economic Factors - Needs include poverty, transportation, affordable / safe housing, educational attainment. The City of Roanoke was recently identified as a City of Opportunity by the National League of Cities. With this title comes a wealth of support and guidance as the city, with Carilion as a key partner, works to improve health outcomes for residents. The Cities of Opportunity project improves health by impacting the social determinants of health such as education opportunities, affordable, and safe housing, economic opportunities for residents, transportation, safe neighborhoods, and affordable, healthy foods. Carilion has committed to be a partner in this work as it aligns directly with the findings of the 2018 RVCHNA. The direction of the action plan will guide investments Carilion makes in the social determinants of health. In its commitment to reducing inequities of care, Carilion provides financial support for people who cannot afford insurance or health care. Carilion also makes available a Medication Assistance Program to help people gain access to affordable medication. Carilion also replenishes medication carried aboard emergency medical services vehicles. Support is also provided to a variety of not-for-profit organizations, helping to reduce 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 Pathways HUB model employs community health workers to help people navigate the barriers to good health and find solutions to health care needs. Many of the Pathways are related to social determinants such as education, employment, transportation or affordable/safe housing. This coordination of care model will help people find ways to reduce these types of barriers to good health. One Community Health Worker received a referral about a patient who uses a wheelchair and was living in unsanitary conditions. When the Community Health Worker learned the extent of the patient's situation, he partnered with the patient's caregiver to quickly find a solution. Through outreach and assistance from an area nonprofit and a local church, they were able to find the patient a safer home and a replacement wheelchair. The Virginia Tech Carilion Health Sciences and Technology Campus in the City of Roanoke continued 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. The community, Virginia Western Community College and local universities have partnered to make it possible for local students to access affordable or free education.
Schedule H, Part V, Section B, Line 11 Addressing Needs Identified in CHNA, Continued	- Transportation - Carilion recognizes the impact that lack of reliable transportation can have on health in the community. To improve access to transportation for the purpose of accessing regular health care, Carilion provides support for 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 is home to Virginia Tech Carilion and many Carilion clinical services. Carilion has also forged a partnership with Lyft to pilot a program assisting people with access to safe, reliable transportation to regular primary care appointments. In addition, through support of the local Bikeshare program, Carilion sponsored bike stations that provide community members with an additional transportation option that also lends itself to exercise. - 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. Therefore, efforts continue to make Carilion's 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. In fiscal year 2019 (tax year 2018), Clear Impact software helped develop hospital-specific and project-specific scorecards with appropriate outcome measures. Community health education programs and screenings contained program level outcomes assigned based on the topic. These outcomes were tracked with pre- and post-tests as well as through screening results. Community programs supported by Carilion grants were responsible for regularly reporting program outcomes. Scorecards developed contain key secondary data points which are updated anually to track impact of community health initiatives. Carilion tracked and measured impact on certain aligned indicators contributing to the Robert Wood Johnson Foundation County Health Factors Ranking and County Health Outcomes Ranking. Our goal is to improve County Health Rankings for the entire Roanoke Valley, but we understand that by the nature of County Health Rankings, improvements are relative to progress in other communities in the Commonwealth of Virginia. Another software program, REDCap, enabled internal data to be utilized at the aggregate level to display outcomes of targeted health initiatives for research teams, including through asthma interventions at Fallon Park Elementary School. Outcome results will be utilized for future planning and decision making. Healthy Roanoke Valley also developed outcomes to be measured based on the results of its planning retreat and action team tactical planning following the 2018 Roanoke Valley Community Health Needs Assessment. The strategic goals include reducing barriers to resources that address the social determinants of health, expanding access to quality care and supporting a culture of health, encouraging and supporting lifestyle behaviors tied to improved health and well-being, and supporting environmental initiatives that cultivate vibrant neighborhoods. - Priority Areas Not being Addressed and the Reasons - A community approach to determine and address priority needs as described earlier in this document was used to determine which needs cannot be immediately addressed. Needs not identified as "priority" were not actively addressed during this period. CMC intends to address all identified priority health issues through the aforementioned initiatives, programs and/or grants.
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 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 6b 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	Bad debt expense of $82,037,399 included in Part IX, Statement of Expenses on line 25 was excluded from the calculation of Part I Line 7 Column (f) Percent of total expense.
Schedule H, Part I, Line 7e Community health improvement services and community benefit operations	This line is reported at actual cost. Carilion's commitment to community service is evident at all levels of the organization. Carilion's commitment to community health is evidenced by its population health infrastructure including its Community Health and Outreach (CHO) department dedicated to assessing and addressing community needs. The department is responsible for leading and facilitating the Community Health Improvement Plan, Community Health Needs Assessments, the system's community grants process, community health education, community benefit collection, and neighborhood health initiatives. CHO staff works 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 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 as well as seasonal screenings to detect facial damage due to exposure to the sun. Carilion Medical Center's community health education department serves as host of the local chapter of the National Safe Kids Coalition and provides education on childhood injury prevention to the community and other providers. In addition, Carilion Medical Center's Safe Kids Coalition coordinator provided free training and national certification on proper car seat installation for other health and safety providers. In efforts to increase access to healthcare, Carilion physicians dedicate hours to providing ongoing care for patients of local free clinics and Carilion offers assistance with enrollment in public health care programs such as Medicaid. Interpreter services for non-English speaking patients also makes healthcare more accessible for all community members and reduces inequity. 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 actual 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. 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.
Schedule H, Part I, Line 7i Cash and in-kind contributions for community benefit	At cost. Carilion has long been committed to improving the health of the communities we serve. We know significant change doesn't happen without collaboration, it takes a community of partners working together towards common goals. Carilion's dedication to this mission is evidenced by the support provided annually to various nonprofit partners, furthering its efforts to positively impact health. Financial and in-kind contributions are made each year to dozens of organizations directly impacting the issues identified in our triennial Community Health Needs Assessment and a variety of social determinants that impact people's health. Support provided helps with access to nutrient dense foods, promotion of exercise and healthy activities, chronic disease management, access to mental health services and coordination of care, and a multitude of 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 participates in programming and supports local Chambers of Commerce, the Better Business Bureau, and the Roanoke Regional Partnership to improve economic development efforts through pro-business advocacy. Carilion supported the Partnership's Experience 2019, a one-day conference to develop future leaders for the Roanoke region. Carilion takes an active role in local economic development endeavors by investing in research and technology and communicating with local businesses about the region's current business climate and prospective businesses. Carilion encouraged the growth of local start-up businesses through financial support and providing mentors for cohorts for the RAMP Business Accelerator. Funding provided to the Greater Roanoke Transit Company for the Star Line Trolley provides free transportation around downtown Roanoke and 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 the overall health and well-being of communities. Support is provided in a variety of ways for nonprofit organizations addressing barriers to good health arising from these social determinants. Carilion created a section in the Don and Barbara Smith Children's Museum to engage kids in play in a medical setting and to help them learn about good health and develop interest in health professions. Through the support of local partners, Carilion helps provide better education and opportunities for children and families as well as improved housing, better nutrition and additional resources for its neighbors in need, removing a range of obstacles to good health. In fiscal year 2019 (tax year 2018) Carilion worked with the Rescue Mission homeless shelter in support of the Back to School Blast, which provides around 1,200 area students with new backpacks containing school supplies at the start of the school year, engages Carilion physicians in providing physicals and immunizations, and provides 500 children with new athletic shoes. Time is also dedicated to helping children learn through volunteer business education offered in the classroom coordinated through Junior Achievement of Southwest Virginia. Carilion Medical Center is deeply involved with a variety of other health and social determinant-related initiatives and supports local organizations through coordination of activities and participation as volunteers and board members in addition to providing financial support. Through financial donations, Carilion helps to reduce inequity, promote community development and repair, provide for social needs of veterans and seniors, maintain important community building amenities and support events for organizations like Child Health Investment Partnership (CHIP) of Roanoke Valley. 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 community health issues must be addressed in concert with the community. To ensure lasting community 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. In addition, Carilion partners with multiple community and business organizations around initiatives to improve health and wellness and to impact the social determinants of health for everyone living in the Roanoke Valley. An example is Carilion's representation and participation on the Roanoke Valley Collective Response, a partnership of more than 70 cross-sector organizations working together to respond to the opioid crisis in our region. In addition, Carilion representatives participate in Roanoke Area Youth Substance Abuse Coalition (RAYSAC), a group of concerned citizens, parents, youth, teachers, police officers, business people, judges, and other caring individuals striving to prevent the use of alcohol, tobacco, and drugs by youth in the Roanoke Valley and southwest Virginia. Other coalition-building activities include coordination of and/or participation on the Safe Kids coalition, the Sexual Assault Response Team Advisory Council, VHHA's Trafficking Task Force, the Elder Justice Alliance, the Southwest Virginia Action Alliance for SAFE Babies, the Virginia Attorney General's Sexual Assault Kit Initiative, Roanoke Prevention Alliance's Resiliency Collective, the Total Action for Progress Headstart Health Services Advisory Committee and many more. Line 7 - Community health improvement advocacy - In-kind support was provided for distribution of a newsletter on behalf of adolescent and student health services as well as for the Virginia Health Care Foundation. Line 8 - Workforce development - Carilion partners to provide workforce development efforts and training for community members both to develop a pipeline of future healthcare workers and with the understanding that employment is directly linked to health and wellness. In fiscal year 2019 (tax year 2018) 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 Rehabilitative Services, Blue Ridge Behavioral Health, the Blue Ridge Independent Living Center and parent representatives. Through Virginia Foundation for Independent Colleges, Carilion provided scholarship funds for students who couldn't otherwise afford college tuition. In addition, to improve access to needed care and meet the needs of underserved individuals in the Roanoke Valley, Carilion deploys special recruitment efforts for specific types of providers.
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. For patient accounts receivable resulting from revenue recognized prior to October 1, 2018, an allowance for doubtful accounts was established to reduce the carrying value of such receivables to net relizable value. Susequent to the adoption of 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 rather than an allowance for doubtful accounts.
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, when the billing office becomes aware that a patient is deceased, 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, Carilion 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 departments. Carilion's call center is available for community members to ask questions and to direct callers to community resources as issues are raised. The Planning department monitors data such as self-pay and Medicaid rates, patient origin and travel time, and age and income distributions to drive Carilion's access to care strategies. Carilion Clinic's community health improvement process was adapted from Associates in Process Improvement's Model for Improvement and the Plan-Do-Study-Act (PDSA) 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, on occasion, in key neighborhoods or aligned with community initiatives. Through ongoing collaboration with community stakeholders, regular communication of community needs occurs and partners can respond cohesively. Carilion Clinic fosters community development in its CHNA and community health improvement processes by using the Strive Collective Impact Model for the CHAT. 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 towards shared strategies. Carilion Clinic and Healthy Roanoke Valley (HRV) partnered to conduct the 2018 Roanoke Valley Community Health Needs Assessment. This process was community-driven and focused on high levels of community engagement involving health and human services leaders, stakeholders, and providers; the target populations; and the community as a whole. Healthy Roanoke Valley (HRV), operating under the auspices of United Way of Roanoke Valley, was formed in 2012 as a community response to needs identified in Carilion Clinic's triennial Roanoke Valley CHNA. HRV's mission is to mobilize community resources to improve access to care, coordinate services, and promote a culture of wellness. Using the collective impact model, the partnership includes more than 50 organizations representing cross-sector stakeholders and leaders working to implement cost-effective programs resulting in improved health outcomes.
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 is comprised of 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, the arts, shopping, recreational opportunities, natural beauty and services not available in more rural areas of the region. Key safety net providers in the region in addition to Carilion Clinic include New Horizons, a federally qualified health center; free clinics; local offices of the Virginia Department of Health; and other human service organizations. Despite the presence of these entities, 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 both in health and in social determinants. The 2014-2018 American Community Survey (ACS) found the total population of the Roanoke MSA to be 313,291. (U.S. Census Bureau, 2014-2018 5-year American Community Survey, Table S0101 https://data.census.gov/cedsci/table?q=S0101&tid=ACSST5Y2018.S0101&hidePreview=true) The cities of Roanoke and Salem had 99,621 residents and 25,519 people respectively. The counties of Botetourt, Craig, Franklin and Roanoke had 33,222, 5,113, 56,233 and 93,583 residents respectively. (U.S. Census Bureau, 2014-2018 5-year American Community Survey, Table S0101 https://data.census.gov/cedsci/table?q=S0101&tid=ACSST5Y2018.S0101&hidePreview=true) The U.S. Census Bureau predicts positive population change by 2040 for all communities except Salem City and Craig County, which both may have very slight population loss. (Virginia Employment Commission Community Profiles (2020) https://virginiaworks.com/community-profiles) Median age in the MSA localities ranges from 38.7 in the City of Roanoke to 48.3 in Craig County, all above the state median of 38.1. (U.S. Census Bureau, 2014-2018 5-year American Community Survey, Table S0101 https://data.census.gov/cedsci/table?q=S0101&tid=ACSST5Y2018.S0101&hidePreview=true) The ACS finds that for most of the Roanoke MSA, a larger percentage of the population is White than in the Commonwealth of Virginia as a whole, with percentages ranging all the way up to 99.6% in Craig County. (U.S. Census Bureau, 2014-2018 5-year estimates, American Community Survey, Table DP05 https://data.census.gov/cedsci/table?tid=ACSDP5Y2018.DP05&hidePreview=true) Roanoke Valley's urban hub, the City of Roanoke, is more racially and ethnically diverse than the rest of the MSA, with a population that is 62.5% White, 28.7% Black, and 3.1% Asian with 3.6% representing more than one race and the remainder representing small minorities of American Indian/Alaskan Native, Native Hawaiian/Pacific Islander or some other race. Of the population, 6.1% are Hispanic or Latino.(U.S. Census Bureau, 2014-2018 5-year estimates, American Community Survey, Table DP05 https://data.census.gov/cedsci/table?tid=ACSDP5Y2018.DP05&hidePreview=true) The City is divided into quadrants (Northwest, Northeast, Southwest and Southeast) separated geographically by railroad tracks, the Roanoke River, and the Interstate 581. These quadrants vary greatly in the demographic and economic make-up of the residents. Specifically, two of the quadrants - the Northwest and Southeast quadrants - have federal designations as Medically Underserved Areas (MUAs) and are home to a large proportion of the low-income individuals and families in the city who may be uninsured, underinsured and/or Medicaid recipients who often 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 with its flagship hospital in the heart of the City of Roanoke, the largest metropolitan hub in western Virginia. Nearly one million individuals receive quality care through Carilion's 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 crucial anchor institution focusing on more than just health care; Carilion is dedicated to its mission of improving the health of the communities it serves. With an enduring commitment to the health of our region, care is advanced through clinical services, medical education, research and community health investments. Patients served by Carilion receive care regardless of their ability to pay. Carilion believes in service, collaboration and caring for all. Through ongoing investments in discovering and responding to the health needs of its community, Carilion understands additional stakeholders must be involved to address community health issues and create change effectively. Carilion Medical Center (CMC) includes Carilion Clinic's flagship facility, Carilion Roanoke Memorial Hospital (CRMH). 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 it 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 is governed by a board of directors elected annually. The majority of board members live and work in the hospital's service region and are not employed by the hospital, nor are they contractors. Medical staff members are qualified professionals who have privileges to provide a full range of services at the hospital. Surplus funds reinvested benefit patients through new technology, specialty services, clinical initiatives, education and charitable efforts. Reinvestments include providing free, discounted and subsidized care and critical medical services that would not otherwise be offered in our region and operate at a loss. (https://www.carilionclinic.org/locations/carilion-roanoke-memorial-hospital)
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 health of the region, Carilion also seeks to advance care through medical education and research, help its community stay healthy and inspire 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. It was a courageous move. In every moment since, Carilion has worked to evolve further-developing a multi-specialty physician group, transforming our primary care practices into patient-centered medical homes, implementing electronic health records system-wide, creating a robust partnership with Virginia Tech, and opening a medical school and research institute. Each decision, each adaptation, has fundamentally changed the way Carilion collaborates and provides care. (https://www.carilionclinic.org/about-carilion-clinic) Carilion's Community Health and Outreach (CHO) department is the health system's engine for providing collaborative opportunities to improve and promote the health of the community. The department's Community Health Assessments process helps identify the strengths and barriers impacting health. It's 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. CHO is also the driving force for the health systems many partnerships with cross-sector organizations that create a collaborative culture of community health and wellness. To advance the education of health professionals, Carilion Medical Center operated Jefferson College of Health Sciences a private higher education institution within the hospital that "prepares, within a scholarly environment, ethical, knowledgeable, competent and caring healthcare professionals." Jefferson College provided more than 1,100 students with opportunities to become part of the health care profession, serving communities ranging from southwest Virginia to the Shenandoah Valley and beyond. Jefferson College merged with Radford University July 1, 2019 and remains in partnership with Carilion Clinic, teaching students in our clinical setting on the campus of Carilion Medical Center to continue to meet the healthcare workforce needs in the community and beyond. Through a unique public-private partnership between Virginia Tech and Carilion Clinic, the Virginia Tech Carilion School of Medicine within Virginia Tech educates physician thought leaders through inquiry, research, and discovery on Carilion Clinic's main campus in Roanoke. Virginia Tech students learn, train, and work side by side with Carilion's highly experienced medical staff. This innovative approach stresses the importance of research, quality, safety, evidence-based medicine, interdisciplinary and interprofessional teamwork, chronic disease management, wellness and prevention and public health.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (59 entries)

Address Line1USAddress/AddressLine1Txt	Address Line2USAddress/AddressLine2Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
(1) Alzheimer's Association
355 Rio Rd West	Ste 102	Charlottesville	VA	22901	133039601	501(c)(3)	$10,000	Event Sponsorship
American Cancer Society
2840 Electric Rd	Ste 106A	Roanoke	VA	24018	131788491	501(c)3	$11,000	Event Sponsorships
American Heart Association
PO Box 50045		Prescott	AZ	863045045	135613797	501(c)3	$17,250	Event Sponsorships
Boys & Girls Clubs
1714 9th Street SE		Roanoke	VA	24013	541867366	501(c)3	$12,783	Event Sponsorships
Bradley Free Clinic
1240 Third St SW		Roanoke	VA	24016	237380491	501(c)3	$11,000	substance use disorders
Feeding America Southwest Virginia
1025 Electric Road		Salem	VA	24153	541939556	501(c)3	$40,000	General Support
The First Tee of Roanoke Valley
3707 Densmore Road NW		Roanoke	VA	24017	201237999	501(c)3	$10,000	Event Sponsorship
Freedom First Enterprises
5240 Valleypark Blvd		Roanoke	VA	24019	813904720	501(c)3	$100,000	General support
JDRF
3959 Electric Rd Ste 222		Roanoke	VA	24018	231907729	501(c)3	$21,500	Event Sponsorships
Jefferson Center Foundation
541 Luck Ave		Roanoke	VA	24016	621392982	501(c)3	$5,000	Community sponsorship
(11) Junior Achievement of Southwest Virginia
3433 Brambleton Ave SW	Ste 202B	Roanoke	VA	24018	540628293	501(c)3	$10,800	Event Sponsorship
Legal Aid Society of the Roanoke Valley
132 Campbell Ave		Roanoke	VA	24011	540856327	501(c)3	$5,000	Community Sponsorship
Lewis Gale Foundation dba Health Focus of SW VA
1902 Braeburn Drive		Salem	VA	24153	546051298	501(c)3	$7,550	Event Sponsorship
Medical Society of VA Foundation
2924 Emerywood Parkway		Richmond	VA	23294	521394768	501(c)3	$5,000	Event Sponsorship
Mill Mountain Theatre
One Market Square SE		Roanoke	VA	24011	540792067	501(c)3	$10,000	Event Sponsorship
National Center for Healthcare Leadership
17 N State Street	Suite 1530	Chicago	IL	60602	364483505	501(c)3	$15,000	Event Sponsorship
National Quality Forum
1030 15th Street NW	Suite 800	Washington	DC	20005	522175544	501(c)3	$10,000	Event Sponsorship
Opera Roanoke
20 East Church Ave	3rd Floor	Roanoke	VA	24011	510213334	501(c)3	$5,000	Community Sponsorship
Presbyterian Community Center
1828 Jamison Ave SE		Roanoke	VA	24013	541610899	501(c)3	$5,000	Event Sponsorship
NAACP-Roanoke Branch
PO Box 12362		Roanoke	VA	24025	546070115	501(c)4	$7,000	Event Sponsorship
Roanoke Symphony Orchestra
128 East Campbell Ave		Roanoke	VA	24011	546019736	501(c)3	$20,520	Corporate Sponsorship
Roanoke Valley Alleghany Regional Commission
PO Box 2569		Roanoke	VA	24010	540722734	VIRGINIA	$9,000	Bike Sponsorship
Virginia Blue Ridge Affiliate of Susan G Komen
4910 Valley View Blvd	Suite 212	Roanoke	VA	24012	562619425	501(c)3	$20,000	Event sponsorships
TAP
302 Second Street SW		Roanoke	VA	24011	546057095	501(c)3	$6,100	Dental Care Support
Taubman Museum of Art
110 Salem Avenue SE		Roanoke	VA	24011	546026841	501(c)3	$8,500	Event sponsorships
Virginia Foundation for Independent Colleges
901 East Byrd St	Suite 1625	Richmond	VA	23219	540554396	501(c)3	$10,000	Science Research Fellowships
Virginia Growth and Opportunity Foundation
1108 East Main St	Suite 1100	Richmond	VA	23219	811586667	501(c)3	$25,000	General support
Virginia Tech Carilion School of Medicine
2 Riverside Circle		Roanoke	VA	24016	546001805	VIRGINIA	$8,000	Virginia State Science & Engineering Fair
Virginia Tech Carilion Research Institute
2 Riverside Circle		Roanoke	VA	24016	546001805	Virginia	$30,000	CTRHB Research Project
Virginia Tech
702 University City Blvd		Blacksburg	VA	24060	546001805	Virginia	$9,036	Event Sponsorship
The Roanoke-Blacksburg Innovation Network
1700 Kraft Dr	Suite 2155	Blacksburg	VA	24060	462975294	501(c)3	$115,000	General Operations and Programs
Center in the Square
1 Market Square		Roanoke	VA	24011	510238900	501(c)3	$100,000	General support
United Way of Roanoke Valley
325 Campbell Ave SW		Roanoke	VA	24016	540535302	501(c)3	$28,312	Healthy Roanoke Valley Health collaborative
YMCA of Virginia's Blue Ridge Inc
108 Orange Avenue		Roanoke	VA	24016	540515736	501(c)3	$5,500	Group exercise and healthy diet classes
National Multiple Sclerosis Society
733 Third Avenue	3rd Floor	New York	NY	10017	135661935	501(c)3	$15,000	Event Sponsorship
Ronald McDonald House Charities of SW VA
2224 S Jefferson St		Roanoke	VA	24014	541244769	501(c)3		Donated Rent	$259,778	FMV	Donated Rent
Greater Roanoke Transit Company
1108 Campbell Avenue		Roanoke	VA	24013	540982022	City of Roanoke	$59,885	General Support
City of Roanoke
215 Church Ave	Room 254	Roanoke	VA	24011	546001569	City of Roanoke	$45,000	General Support
Apple Ridge Farms
541 Luck Ave	No 304	Roanoke	VA	24016	541409250	501(c)3	$20,000	Community urban farm paired w/health education programs
Bedford Ride
1613 Oakwood Street		Bedford	VA	24523	510189604	501(c)3	$5,000	Non-emergency medical transportation
Children's Assistive Technology Service
PO Box 121		Union Hall	VA	24176	464866068	501(c)3	$5,000	Refurbish used children's rehab equipment
Family Service of Roanoke Valley
360 Campbell Ave		Roanoke	VA	24016	540505946	501(c)3	$5,000	Access to counseling for community members
Foundation for Rehab Equipment & Endowment
PO Box 8873		Roanoke	VA	24014	541934695	501(c)3	$5,000	Access to used rehab equipment
Grandin Theatre
1310 Grandin Road SW		Roanoke	VA	24015	010557881	501(c)3	$75,000	Community support and health education
Kiwanis Foundation of Roanoke
3511 Mudlick Road		Roanoke	VA	24018	546038865	501(c)3	$10,000	All-abilities playground in underserved community
Local Environmental Agricultural Project
PO Box 3249		Roanoke	VA	24015	271050909	501(c)3	$18,323	Healthy food incentive program at farmers markets
LovABLE Services
5637 Lowland Lane SW		Roanoke	VA	24018	204993419	501(c)3	$10,000	Custard shop in underserved area training and employing people with disabilities
Mental Health America
10 Church Ave	Suite 300	Roanoke	VA	24011	540703132	501(c)3	$25,000	Access to mental health care
The Rescue Mission of Roanoke Inc
PO Box 11525		Roanoke	VA	24022	540573900	501(c)3	$10,000	Efforts to provide peer recovery and trauma informed care
Roanoke Community Garden Association
PO Box 4326		Roanoke	VA	24015	262082150	501(c)3	$10,000	Community garden and education
Kids Soar
305 Mountain Ave SW		Roanoke	VA	24016	010583325	501(c)3	$8,500	Community Literacy initiative
West End Center
1223 Patterson Ave		Roanoke	VA	24016	541150320	501(c)3	$10,000	West End Center - wellness program and healthy eating
Public Health Institute attn Carol Emmott Fellowship
555 12th St	10th Floor	Oakland	CA	94607	941646278	501(c)3	$40,000	Sponsorship
Children's Trust Roanoke Valley
541 Luck Avenue	Ste 308	Roanoke	VA	24016	510235891	501(c)3	$60,000	General Support
CHIP of Roanoke Valley
1201 Third Street		Roanoke	VA	24016	541566451	501(c)3	$50,000	General Support
Radford University
East Main Street		Radford	VA	24141	546001789	501(c)3		General Support	$978,895	Book	Medical and Office Equipment
2019 Commemoration Inc
PO Box 1607		Williamsburg	VA	23187	810703911	501(c)3	$125,000	Sponsorship
Virginia Tech Carilion School of Medicine
2 Riverside Circle		Roanoke	VA	24016	546001805	Virginia	$2,969,284	Medical School Support
Carilion Clinic Patient Transportation LLC
431 McClanahan		Roanoke	VA	24014	541864693	501(c)3	$50,000	Neonatal Pediatrics Transportation

Field	Value	IRS element (for citing)
Total501c3 Org	58	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt

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

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
PATIENTS	22	$212,555
SCHOLARSHIPS	7	$9,000

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule I, Part III Line 1	Grant requests for indigent patients are evaluated for eligibility based on the restriction criteria placed by the grantor of the endowment, account payment status and funds available under the grant.
Schedule I, Part III Line 2	Scholarship applications are evaluated and awards made by an independent committee according to prescribed guidelines.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	The hospital donates funds to other 501(c)3 charitable organizations with a similar mission. Such organizations also have community boards which oversee the expenditure of such funds. Carilion Medical Center also has a program under which funds are granted to community organizations with a focus on chidren'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. One mid-year project report, a site visit and a final program evaluation reports on the program's services, outcomes and budget. 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. 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.

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (23 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/Pres./CEO	$0	$539,549	$0	$73,492	$0	$4,833	$0	$80,224	$0	$17,136	$0	$715,234	$0	$0
Nathaniel Bishop DMin
Director	$291,503	$0	$42,731	$0	$6,868	$0	$72,099	$0	$3,054	$0	$416,255	$0	$0	$0
Jonathan Gleason MD
Director	$326,508	$0	$109,167	$0	$2,582	$0	$23,290	$0	$18,619	$0	$480,166	$0	$0	$0
Daniel Harrington MD
Director	$379,606	$0	$70,329	$0	$8,746	$0	-$37,548	$0	$13,965	$0	$435,098	$0	$0	$0
Paul Haskins MD
Director	$330,588	$0	$56,641	$0	$3,564	$0	-$1,629	$0	$18,522	$0	$407,686	$0	$0	$0
Cynda Johnson MD
Director	$0	$308,140	$0	$0	$0	$4,655	$0	$0	$0	$6,204	$0	$318,999	$0	$0
Michael Nussbaum MD
Director	$529,187	$637	$80,442	$0	$10,976	$0	$138,343	$0	$10,596	$0	$769,544	$637	$0	$0
Tracey Criss MD
Physician	$215,996	$0	$43,654	$0	$2,988	$0	$14,250	$0	$17,931	$0	$294,819	$0	$0	$0
Nicholas Conte
Secretary	$0	$455,282	$0	$62,409	$0	$6,298	$0	$118,913	$0	$17,136	$0	$660,038	$0	$0
David Hagadorn
Asst. Treasurer	$0	$133,333	$0	$1,800	$0	$8,473	$0	$7,243	$0	$819	$0	$151,668	$0	$0
Donald Halliwill
Asst. Treasurer	$0	$515,337	$0	$70,983	$0	$4,797	$0	$78,134	$0	$15,836	$0	$685,087	$0	$0
G Robert Vaughan Jr
Treasurer	$0	$259,842	$0	$30,582	$0	$4,104	$0	$10,275	$0	$16,723	$0	$321,526	$0	$0
Patrice Weiss MD
Executive Vice President/CMO	$978	$575,614	$0	$85,948	$0	$6,510	$0	$149,196	$0	$18,619	$978	$835,887	$0	$0
Bruce Long MD
Physician	$427,445	$0	$43,789	$0	$15,253	$0	$9,837	$0	$18,619	$0	$514,943	$0	$0	$0
Jon Sweet MD
Physician	$226,342	$0	$77,876	$0	$3,301	$0	-$7,005	$0	$10,820	$0	$311,334	$0	$0	$0
Nancy Howell Agee
CEO, Carilion Clinic	$0	$1,242,837	$0	$285,745	$0	$205,285	$0	$114,597	$0	$11,330	$0	$1,859,794	$0	$0
Joseph Moskal MD
SVP/Dept. Chair	$1,057,221	$0	$130,176	$0	$9,811	$0	$113,916	$0	$18,619	$0	$1,329,743	$0	$0	$0
Paul Skolnik MD
SVP/Dept. Chair	$398,350	$0	$51,316	$0	$9,821	$0	$135,202	$0	$9,196	$0	$603,885	$0	$0	$0
Jonathan Carmouche MD
Physician	$1,294,434	$0	$142,722	$0	$2,596	$0	$4,784	$0	$16,231	$0	$1,460,767	$0	$0	$0
Gregory Howes MD
Physician	$1,031,642	$0	$395,970	$0	$2,383	$0	$13,473	$0	$17,319	$0	$1,460,787	$0	$0	$0
Eric Marvin MD
Physician	$946,062	$0	$292,726	$0	$2,513	$0	$27,839	$0	$17,319	$0	$1,286,459	$0	$0	$0
Jesse Seamon MD
Physician	$620,429	$0	$508,852	$0	$2,363	$0	$15,457	$0	$12,984	$0	$1,160,085	$0	$0	$0
Jesse Stem MD
Physician	$696,748	$0	$400,302	$0	$2,833	$0	$29,011	$0	$4,783	$0	$1,133,677	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments	Employees are occasionally awarded small gifts or prizes which are grossed up for taxes at management's discretion and included in taxable compensation. During the reporting period, Dr. Criss received such benefit.
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	All Directors are offered a free family or individual membership to a health club owned by a related organization if they choose to accept it. Dr. Nussbaum received this benefit and its value was included in taxable compensation from the organization.
Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses	Management determines tax gross-up decisions based on IRS requirements, amount, and the non-cash status of the benefits. 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 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, Dr. Bishop, 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 2018 are included on the Form 990 as "retirement and other deferred compensation." No distributions were made 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 a deferred vesting date 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. No distributions of prior deferred amounts were made 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 Compensation Committee, although it is based on the scorecard measures.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
BRUCE JOHNSON MD
FAMILY MEMBER OF CYNDA JOHNSON, DIRECTOR	$72,199	EMPLOYEE	false
MARY SWEET MD
FAMILY MEMBER OF JON SWEET, FORMER KEY EMPLOYEE	$527,100	EMPLOYEE	false

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (19 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part I, Line 6 Volunteers	The hospital operates a Customer Service-based program for volunteers and we strive to make our patients and patient 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.
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 37,883 patients and provided 193,187 days of care during the year of 2019. Hospital programs and accomplishments include the new organization of our 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 (3,176 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 87,855 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 14 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 9,308 events touching over 49,125 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, charity and unreimbursed Medicaid costs for the year exceeded $32 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, Cynda Johnson, Lauren Schantz, 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, Lauren Schantz, G. Robert Vaughan, Jr., and Patrice Weiss.
Form 990, Part VI, Line 4 Significant changes to organizational documents	The organization's Articles of Incorporation and Bylaws were revised to eliminate the provision that the President or Chair of the Board of the Jefferson College of Health Sciences would serve as an ex officio member of the organization's Board of Directors.
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. The return was also reviewed with the Carilion Clinic Board of Directors Audit Committee. 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, which list 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 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: 2964379, Related or Exempt Function Revenue: 2964379, 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: 7435945, Related or Exempt Function Revenue: 7435945, 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 to Affiliates - -29704384; Pension-related changes other than net periodic pension costs - -XXX-XX-XXXX;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

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

US Address USAddress

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

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

Direct Controlling Entity Name DirectControllingEntityName

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

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

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

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	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	$136	$197,794	false	false	0.1
COMMUNITY MEDICAL ASSOCIATES LLP
PO BOX 12385	ROANOKE	VA	24025	541517662	REAL ESTATE	VA	CARILION CLINIC	Related	$5,456,438	$0	false	false	0.473
CARILION CLINIC MEDICARE SHARED SAVINGS COMPANY LLC
PO BOX 12385	ROANOKE	VA	24025	455235473	MEDICARE HMO	VA	CARILION CLINIC	Related	-$4,114,685	$0	false	false	0.5
SOUTHWEST VIRGINIA HEALTH PROPERTIES LLC
1102 Jefferson Street SE	Roanoke	VA	24016	010691570	REAL ESTATE	VA	Carilion Clinic	Related	$104,485	$608,049	false	false	0.5056
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	06930	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 (24 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Carilion Clinic Foundation
A	$37,615	COST
Carilion Emergency Service
A	$94,524	COST
Carilion Healthcare Corporation
A	$26,592	COST
Carilion Services Inc
A	$1,267,090	COST
CHS Inc
A	$56,340	COST
Carilion Emergency Services
L	$296,538	COST
Carilion Franklin Memorial Hospital
L	$2,325,562	COST
Carilion Giles Community Hospital
L	$1,373,337	COST
Carilion Healthcare Corporation
L	$334,510	COST
Carilion New River Valley Medical Center
L	$3,832,149	COST
Carilion Services Inc
L	$1,237,064	COST
Carilion Stonewall Jackson Hospital
L	$1,791,987	COST
Carilion Tazewell Community Hospital
L	$1,906,577	COST
Carilion Behavioral Health
M	$133,281	COST
CHS Inc
K	$1,707,093	COST
CHS Inc
M	$5,669,361	COST
Carilion New River Valley Medical Center
K	$162,360	COST
Carilion Services Inc
K	$56,533	COST
Carilion Services Inc
M	$184,489,888	COST
Carilion Tazewell Community Hospital
K	$149,763	COST
MedKey Inc
L	$1,020,720	COST
SCA Credit Services Inc
M	$834,445	COST
Carilion Services Inc
R	$29,704,393	Cash
Carilion Clinic Foundation
C	$589,668	COST