2018-08-16T16:57:22-05:00 2017-09-30 440160260 BKD LLP 1201 WALNUT ST SUITE 1700 KANSAS CITY MO 641062246 990 2016-10-01 540506332 CARILION MEDICAL CENTER CARI 5402245112 PO BOX 12385 ROANOKE VA 240252385 G Robert Vaughan Jr Treasurer 5402245137 2018-08-16 1 P00482834 8162216300 2016 2022-09-23 18:48:47Z Steve C Arner PO BOX 12385 ROANOKE VA 240252385 2341391023 0 X www.carilionclinic.org X 1899 VA Our mission is to improve the health of the communities we serve. 14 7 9075 293 45394 0 5236580 4903889 1213958161 1289394956 11550416 45622224 25472814 24468825 1256217971 1364389894 6838575 1903445 0 0 576424275 602537979 0 0 272461 601695854 665517973 1184958704 1269959397 71259267 94430497 1292474198 1382902654 900982606 857339778 391491592 525562876 X 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. 0 0 1113377477 1903445 1308688351 See Schedule O.We are committed to a common purpose of better patient care, better community health, and lower cost. Through our comprehensive network of hospitals, primary and specialty physician practices, and other complementary services, we work together to provide quality care close to home for nearly 1 million Virginians. With an enduring commitment to the health of our region, we also seek to advance care through medical education and research, help our community stay healthy, and inspire our region to grow stronger.Carilion Medical Center (CMC) exists to serve the health care needs of its community and region, regardless of patient ability to pay. CMC admitted 38,503 patients and provided 199,366 days of care during the year. Hospital programs include provision of nursing care; an extensive cardiac and vascular program, including cardiac surgery, implants, angioplasty and heart failure programs; neurology, neurosurgery and stroke programs; labor and delivery services (delivering 3,064 babies); the areas only neonatal intensive care unit; inpatient and outpatient psychiatric services; a comprehensive rehabilitation unit; extensive outpatient and inpatient surgical and endoscopic services; endovascular services; oncology services; geriatric services; and diagnostic imaging services including CT, MRI, PET, and mammography. Housing a children's specialty wing, CMC provides specialists in pediatric neurosurgery, cardiology, oncology, gastroenterology, pulmonology, and child development, among others. CMC is a Level I trauma center, providing full trauma services to the region. CMC provides a number of services targeting the specific health needs of the area, including diabetes management; home health and hospice; physical, speech, and occupational therapy programs; and cardiac and respiratory rehab. CMC also provides an emergency department with 24-hour care, emergency transportation, a pediatric department, and chest pain and stroke protocol programs. With 82,196 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 19% percent of ED visits. The urgent care centers also provide access points for cost effective care at an appropriate level. CMC employs a number of specialty physicians to ensure an effective, integrated approach to serving its patients; including pulmonologists, oncologists, obstetricians, orthopedic surgeons, cardiologists, neurosurgeons, general surgeons, and psychiatrists. As a teaching hospital with over 350 full-time faculty members, CMC hosts residency programs in family medicine, internal medicines, obstetrics and gynecology, psychiatry, general surgery, neurosurgery. In addition, the Jefferson College of Health Sciences, a division of CMC, offers nursing, physician assistant, occupational therapy, and other high-need programs. CMC also supports community screenings and education on chronic disease prevention and management, sponsoring 7,563 events touching over 64,931 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 $69 million. 1113377477 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 X 0 0 1 9075 1 1 1 0 0 0 0 0 0 0 0 0 X 14 7 1 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 VA X The Corporation Attn H Kirk 5402245102 213 S Jefferson St Roanoke VA 24011 Nancy Howell Agee Director 3.00 47.00 X 0 1793622 2375890 Nathaniel L Bishop D Min Director, SVP, President-JCOHS 48.80 1.20 X 397994 0 183967 John H Burton MD Director, SVP, Medical Chair 50.00 0.00 X 586853 0 91692 George B Cartledge III Director 2.00 0.00 X 0 1075 0 Elizabeth S Doughty Director 2.00 0.00 X 0 1075 0 Katherin A Elam Director 2.00 0.00 X 0 0 0 Janet D Frantz Director 2.00 0.00 X 0 0 0 Cynda A Johnson MD Director 2.00 48.00 X 0 598510 102198 Stephen A Musselwhite Director 2.00 0.00 X 0 0 0 Clifford A Nottingham MD Director 2.00 48.00 X 0 340074 207060 Hirenkumar Patel MD Director 2.00 0.00 X 0 806 0 Patrice M Weiss MD Director, EVP 46.00 4.00 X 0 693728 177008 Ralph E WhatleyIII MD Director, SVP 49.50 0.50 X 548558 0 130762 Damon Williams Director 2.00 0.00 X 0 0 0 Steve C Arner Director/President/CEO/COO 48.80 1.20 X X 0 529972 206940 R Steve Blanks Director/Vice Chair 3.00 4.50 X X 0 13575 0 Victor Iannello ScD Director/Chair 4.00 2.40 X X 0 14775 0 Nicholas C Conte Secretary 1.50 48.50 X 0 452911 69180 David S Hagadorn Assistant Treasurer 0.10 49.90 X 0 139069 62000 Donald B Halliwill Assistant Treasurer/CFO 1.50 48.50 X 0 575607 209478 Lauren J Schantz Assistant Secretary 8.00 42.00 X 0 73461 19376 G Robert Vaughan Jr Treasurer 0.30 49.70 X 0 356998 182289 Bruce A Long MD Physician, Interim Medical Chair 50.00 0.00 X 742042 0 113202 Joseph T Moskal MD SVP, Medical Chair 50.00 0.00 X 1292828 0 117019 Paul R Skolnik MD SVP, Medical Chair 50.00 0.00 X 237528 0 17798 Jonathan J Carmouche MD Physician 50.00 0.00 X 1636807 0 57482 Caleb J Behrend MD Physician 50.00 0.00 X 1237163 0 28985 Eric A Marvin MD Physician 50.00 0.00 X 1129401 0 38028 Gregory A Howes MD Physician 50.00 0.00 X 1048726 0 57980 Cay M Mierisch MD Physician 50.00 0.00 X 1022615 0 95353 Tracy W Criss MD Physician, Former Officer 50.00 0.00 X 267139 0 161355 Thomas D Denberg MD PhD Former Officer 0.00 3.00 X 0 299868 0 10147654 5885126 4705042 822 1 1 0 Solstas Lab Partners Group LLC PO Box 751337 Charlotte NC 282751337 Laboratory Services 29580901 Siemens Medical 51 Valley Stream Parkway Malvern PA 19355 Equipment Maintenance Contracts 10559377 Moore's Electrical & Mechanical PO Box 13851 Roanoke VA 24037 Construction Services 2079698 MB Contractors Inc 3825 Blue Ridge Drive SW Roanoke VA 24018 Construction Services 2013048 Anesthesiology Consultants of VA PO Box 13306 Roanoke VA 240323306 Anesthesiology Services 1837268 172 15189 322257 4223551 342892 12077 4903889 Net Patient Revenue 622110 1261045387 1261045387 College Tuition/Other 611310 27449563 27449563 Clinical Research 541700 1026890 1026890 Other Health Education 611710 612235 612235 Program-related Investments 531120 -739119 -739119 1289394956 8251411 45394 8206017 5576 5576 1664047 0 1664047 1664047 1664047 1014313821 27912 976959232 17264 37354589 10648 37365237 37365237 24963 15189 22436 2527 2527 2595 2197 398 398 Physician & Other Affil. Income 621111 8697654 8697654 Cafeteria Revenue 722514 3508458 3508458 Roanoke City Student Health 622110 1990487 1990487 8605254 8605254 22801853 1364389894 1308688351 45394 50752260 1666020 1666020 237425 237425 4751363 4751363 641954 641954 478535039 478151335 277767 105937 47477552 47449994 27558 39467226 39353526 82329 31371 31664845 31646670 18175 147542386 147542386 259287 259287 24651 24651 76070 76070 610817 610817 111962314 109418387 2514092 29835 301093 298487 2606 15822826 15626882 187050 8894 4174121 3297881 876240 27606557 27564978 9997 31582 3148668 3115246 25158 8264 14494247 14494247 42685663 42685663 15521494 11871152 3650342 Medical Supplies 181066821 181066794 27 Bad Debt 89796742 89796742 College Expense 4879541 4879541 Dues & Subscriptions 1972842 1781729 191113 3571833 3505391 12470 53972 1269959397 1113377477 156309459 272461 19570 18089 3627349 3506032 1456995 1507672 177015218 199058024 5893651 5225425 6242898 9411070 6303745 5204187 1017832271 752288048 272442642 265544223 362634724 349277504 438797664 543186650 1000 -3318749 65123 65123 17973619 4217404 1292474198 1382902654 149801878 154396596 500000 400000 6406627 6615370 352778501 343709740 1626435 595030 389869165 351623042 900982606 857339778 X 372346875 505584530 7268808 8102437 11875909 11875909 391491592 525562876 1292474198 1382902654 X 94430497 46019095 -6378308 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 76070 76070 0 Part II-B, Line 1: A portion of dues paid to various hospital industry associations is attributable to lobbying activities. 15801517 0 1914128 0 -983681 0 16731964 15705697 0 904944 0 -809124 0 15801517 16528095 0 -57465 0 -764933 0 15705697 15977886 0 1448538 0 -898329 0 16528095 14955835 0 1798131 0 -776080 0 15977886 0.00000 0.70980 0.29020 0 0 6116287 6116287 461438642 312272541 149166101 928237 779003 149234 527201519 432706651 94494868 22147586 6529853 15617733 265544223 5815334 F Investments in Affiliates 1759350 C Investment - Stock 4990104 C Non-Publicly Traded Investments 530621862 F 543186650 Pension Liability 296970144 Interest Rate Swap Liability 27603607 Deferred Compensation Liability 27051037 Due To Affiliate -1746 351623042 X Part V, Line 4: Income from endowment funds are used for the following. (1) Pediatric programs- both internal and external- and/or pediatric equipment. (2) Patient indigent care. Part X, Line 2: Carilion recognizes a tax liability or asset for the estimated taxes payable or refundable on tax returns for current and prior years. Deferred tax assets and liabilities are recognized for the estimated future tax effects attributable to temporary differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. A tax benefit from an uncertain tax position is recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. Uncertain tax positions may include the characterization of income, such as a characterization of income as passive, a decision to exclude reporting taxable income in a tax return, or a decision to classify a transaction, entity, or other position in a tax return as tax exempt. Heels for Healing 40152 15189 24963 12077 6259 4100 40152 15189 24963 12077 6259 4100 22436 2527 1 1 X 1 X 1 X 0 1 1 0 1 1 51930816 51930816 0.04440 124282378 107106889 17175489 0.01470 176213194 107106889 69106305 0.05910 7192 35958 5139700 490449 4649251 0.00400 24 1075 39362570 9834995 29527575 0.02530 2 2751 991828 991828 0.00080 79 12022 2100303 110000 1990303 0.00170 7297 51806 47594401 10435444 37158957 0.03180 7297 51806 223807595 117542333 106265262 0.09090 2 7 3545 3545 0.00000 12 7425 59752 59752 0.00010 68 1200 81827 81827 0.00010 2 15281 15281 0.00000 1 3000 3000 0.00000 169 1035 36350 5061 31289 0.00000 7 3450 1578 1212 366 0.00000 5 8 161041 161041 0.00010 266 13125 362374 6273 356101 0.00030 0 89796742 254166556 271229342 -17062786 X 1 1 1 Roanoke Ambulatory Surgery Center LLC Ambulatory surgery 0.48720 0.47670 2 Southwest Virginia Health Properties LLC Real estate 0.48720 0.47670 2 1 Carilion Medical Center- DBA CRMH 1906 Belleview Avenue Roanoke VA 24014 See Schedule O. H 1840 X X X X X X A 2 Carilion Medical Center- DBA CRCH 101 Elm Avenue Roanoke VA 24013 See Schedule O. H 1839 X Rehabilitation Unit; Urgent Care A Facility Group A 0 0 1 X X X X X X X X X 14 1 1 1 1 X See Part V, Section C X See Part V, Section C X X 1 15 1 See Part V, Section C 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X 1 X 0 X X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Carilion Medical Center- DBA CRMH, - Facility 2: Carilion Medical Center- DBA CRCH Part V, Section B, line 5: The following explanation applies to both Facility 1 and Facility 2.Carilion Clinic's CHNAs are community-driven projects and success is highly dependent on the involvement of citizens, health and human service agencies, businesses, and community leaders. Community stakeholder collaborations known at "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 medically underserved populations, low-income persons, minority populations, and populations with chronic disease.The following organizations served on the CHAT for the 2015 (tax year 2014) Roanoke Valley CHNA (RVCHNA): Blue Ridge Behavioral Healthcare, Bradley Free Clinic, Carilion Cancer Center, Carilion Clinic, Carilion Clinic Dept. of Family & Community Medicine, CHIP of Roanoke Valley, City of Roanoke, City of Roanoke - Department of Human Services, Council of Community Services, First Citizens Bank, Freedom First Credit Union, Goodwill Industries, Healthy Roanoke Valley, Jefferson College of Health Sciences, LEAP for Local Food, LewisGale Medical Center, Loudon Avenue Christian Church, Mental Health America of Roanoke Valley, Neighborhood Services - City of Roanoke, New Horizons Healthcare - Federally Qualified Health Centers (FQHC), Planned Parenthood South Atlantic, Presbyterian Community Center, Project Access, Roanoke Alleghany Health District- VA Department of Health, Roanoke City Public Schools, Roanoke County Public Schools, Roanoke Redevelopment & Housing Authority, Roanoke Regional Chamber of Commerce, Roanoke Valley- Alleghany Regional Commission, Roanoke Valley Convention & Visitors Bureau, Salem VA Medical Center, Total Action for Progress, United Way of Roanoke Valley, Virginia Tech Fralin Translational Obesity Research Center, and Virginia Tech Carilion School of Medicine. In addition to the CHAT, the RVCHNA conducted stakeholder focus groups, target population focus groups, and a community health survey. Stakeholder focus groups were conducted with the City of Roanoke (Code Enforcement Officers, Fire/EMS Station #5 & #6, & Solid Waste Management), Healthy Roanoke Valley (Coordination of Care Action Team, Medical Action Team, Mental Health Action Team, Oral Health Action Team, & Wellness Action Team), the Neighborhood President's Council and the Roanoke Neighborhood Advocates. Target population focus groups were conducted with a caregiver support group at the Adult Care Center of the Roanoke Valley, a patient focus group at the Bradley Free Clinic, the Residents Council at McCray Court Senior Living, the Pathway's Parents Meeting at the Presbyterian Community Center, the Women's and Children's Center at the Rescue Mission, Roanoke Redevelopment & Housing Authority Melrose Towers and Morningside Manor, Parents Council at Total Action for Progress Head Start and Family Night at the West End Center. The community health survey was made available to all residents living in the Roanoke Valley, and oversampling of the target populations occurred through targeted outreach efforts. In total, 1,990 surveys were collected. Part V, Section B, line 6a: The following explanation applies to both Facility 1 and Facility 2.Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital, both owned by Carilion Medical Center and serving the same area, jointly conducted their CHNA. HCA-LewisGale Medical Center also participated on the Community Health Assessment Team. Part V, Section B, line 6b: The following explanation applies to both Facility 1 and Facility 2.Blue Ridge Behavioral Healthcare, Bradley Free Clinic, Carilion Cancer Center, Carilion Clinic, Carilion Clinic Department of Family & Community Medicine, CHIP of Roanoke Valley, City of Roanoke, City of Roanoke - Department of Human Services, Council of Community Services, First Citizens Bank, Freedom First Credit Union, Goodwill Industries, Healthy Roanoke Valley, Jefferson College of Health Sciences, LEAP for Local Food, LewisGale Medical Center, Loudon Avenue Christian Church, Mental Health America of Roanoke Valley, Neighborhood Services- City of Roanoke, New Horizons Healthcare - (FQHC) , Planned Parenthood South Atlantic, Presbyterian Community Center, Project Access, Roanoke Alleghany Health District- VA Dept. of Health, Roanoke City Public Schools, Roanoke County Public Schools, Roanoke Redevelopment & Housing Authority, Roanoke Regional Chamber of Commerce, Roanoke Valley- Alleghany Regional Commission, Roanoke Valley Convention & Visitors Bureau, Salem VA Medical Center, Total Action for Progress, United Way of Roanoke Valley, Virginia Tech Fralin Translational Obesity Research Center, and Virginia Tech Carilion School of Medicine. Part V, Section B, line 7d: The following explanation applies to both Facility 1 and Facility 2.Line 7a, Facility 1: https://www.carilionclinic.org/locations/carilion-roanoke-memorial-hospital.Line 7a, Facility 2: https://www.carilionclinic.org/locations/carilion-roanoke-community-hospital.Line 7b: https://www.carilionclinic.org/community-health-assessments.Line 7d: The 2015 Roanoke Valley CHNA was also posted to CHAT partner websites and social media.Line 10a: https://www.carilionclinic.org/community-health-assessments. Part V, Section B, line 11: The following explanation applies to both Facility 1 and Facility 2.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 FY 2015 Roanoke Valley CHNA during the 2014 tax year. Healthy Roanoke Valley (HRV), housed under 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.In June 2015, the CHAT participated in a prioritization activity to determine the greatest needs in the service area based on the primary and secondary data collected during the assessment period. To quantitatively determine health needs, CHAT members were asked to rank the top ten pertinent community needs, with one being the most pertinent. Next, on a scale of 1-5, CHAT members were asked to assign a feasibility and potential impact score for each of the ranked needs. This information was used for the CHAT strategic planning retreat held in August 2015.The top ten priority areas that emerged from these findings include:1. Poor eating habits / lack of nutrient dense foods in diet 2. Access to mental health counseling / substance abuse 3. Access to adult dental care 4. Access to dental care for children 5. Lack of exercise / physical activity 6. Value not placed on preventive care and chronic disease management 7. Access to primary care 8. High prevalence of obesity / overweight individuals 9. Lack of knowledge of community resources 10. Improved coordination of care across the health and human sectorThe CHAT participated in strategic planning on August 31, 2015. It reviewed and accepted the priority areas of access to services (primary care, mental health & substance abuse, and oral health), coordination of care, and wellness. Expected outcomes were approved by the CHAT and will be used by Carilion Medical Center (CMC) to measure impact around the priority areas. Significant Health Needs to be AddressedCMC plans to address key community health needs identified in the 2015 assessment by focusing its efforts on a particular community, one that emerged with the greatest need. Through greater access to clinical care, enhanced community outreach programs, creative community partnerships and focused financial and in-kind support of initiatives, CMC plans to improve community health in the South East neighborhood of Roanoke City. Key focus areas of this health improvement project over the next three years include access to services, coordination of care and wellness.A. Access to Services:CMC will explore the development of a community health center in South East with the goal of increasing access to primary care, urgent care and dental services in the neighborhood. The center may also include a mix of services to address social determinants of health, such as job training, health education and wellness services. This offering will be planned with and provided by community partners, including the City of Roanoke, safety net providers and private businesses.B. Coordination of Care:Carilion's family practices have adopted the medical home model and have added care coordinators to proactively work with its high risk, chronic care patients. Carilion will take a focused approach on the South East patients, integrating medical home approaches with a planned community coordination hub being developed by Healthy Roanoke Valley. C. Wellness:Carilion's Community Outreach staff will provide education, flu shots, and community health screenings to the target population in the South East community. Education includes free interactive presentations on the topics of cancer prevention, diabetes prevention, fitness/exercise, food safety, health/stroke, healthy lifestyles, nutrition, smoking cessation, and stress. Poor eating habits were identified as a key concern in the 2015 RVCHNA. The Carilion Clinic Healthy Food Program (formed to respond to the 2012 RVCHNA) is designed to address this need by promoting healthy, local (when possible), and nutrient-dense food to patients and employees and to encourage healthy eating in the community. Fresh Foods RX, is a partnership with HRV, a program which includes a physician's prescription for healthy food, and a waiver for free local fruits and vegetables was successfully piloted in 2015 with a second pilot expanding the program to three sites in 2016. The Healthier Hospital Healthy Food Initiative, the Carilion Farm Share program, and funding of community programs that address increased access to healthy food will continue.Exercise and fitness opportunities will be a key focus for South East, particularly in relation to childhood obesity. Through a partnership with a local soccer club, Carilion will help build fields in the South East neighborhood and provide scholarships to local children. Carilion also helped to build a community kayak launch on the Roanoke River with access in that neighborhood. Funding of community programs that address increased access to physical activity opportunities will continue.D. Focused Community Grants and Partnerships:Carilion Clinic funds health safety-net providers and causes identified through the RVCHNA and will focus on providing financial support to community health improvement initiatives in the South East neighborhood through community grants and sponsorships.In-kind assistance is also provided through community partnerships that align with the RVCHNA. Carilion actively looks for opportunities to support by providing outreach and educational support. Partnerships include HRV, Anchor of Hope's Community Health Promoter Program, West End Freedom First, Roanoke Regional Housing Authority, Kohl's Cares, the PATH Coalition, Safe Kids, Leap for Local Foods, the Feeding America of SWVA Veggie Mobile, as well as many others. E. Implementation and Measurement:HRV is serving as a key partner in the implementation of health improvement initiatives emerging from the CHNA. The findings of this assessment are key in measuring the progress of HRV initiatives and their impact in the community. The HRV Strategic Action Framework to better meet the needs of our target population includes data driven, evidence-based goals and strategies which address access to care (mental health, oral health, primary care); coordination of care; and wellness. As a result of the 2015 RVCHNA, HRV underwent strategic planning with both its Steering Committee and Action Team members to update the Governance Guidelines, Operations Structure, and Strategic Action Framework to ensure HRV continues to align with the priorities identified in the needs assessment. HRV completed this process in 2016 and began implementation of the 2016-2019 Strategic Action Framework in the summer of 2016.Priority Areas Not being Addressed and the ReasonsA community approach to determine and address priority needs as described above was used in determining which needs cannot be addressed immediately. The needs not identified as "priority" are those that will not be actively addressed in this time period. Part V, Section B, Line 13h: Presumptive eligibility Part V, Section B, Line 16 Line 16a: https://www.carilionclinic.org/billing/financial-assistance.Line 16b: https://www.carilionclinic.org/billing/financial-assistance.Line 16c: https://www.carilionclinic.org/billing/financial-assistance. 88 1 - Carilion Roanoke Memorial Rehab 2017 South Jefferson Street Roanoke VA 24014 Psych Unit, Outpatient Rehabilitation 2 - Brambleton Radiology Services 3707 Brambleton Avenue Roanoke VA 24018 Radiology Services 3 - Breast Mammography - North 6415 Peters Creek Road Roanoke VA 24019 Breast Mammography 4 - Carilion Anticoagulation Clinic 1030 S Jefferson St Ste G101 Roanoke VA 24014 Anticoagulation Clinic 5 - Carilion Breast Care Center 102 Highland Ave Ste 202 Roanoke VA 24014 Breast Care Center 6 - Carilion Cardiac Rehab 127 McClanahan Street Roanoke VA 24016 Cardiac Rehab 7 - Carilion Cardiology Westlake 35 Medical Court Hardy VA 24101 Cardiology Services 8 - Carilion Cardiothoracic Surgery 2001 Crystal Spring Avenue Suite 201 Roanoke VA 24014 Cardiac Surgery Services 9 - Carilion Center for Healthy Aging 2001 Crystal Spring Avenue Suite 302 Roanoke VA 24014 Geriatrics 10 - Carilion Clinic Allergy & Immunology 46 Wesley Road Daleville VA 24083 Allergy and Immunology Services 11 - Carilion Clinic Cardiology 2001 Crystal Spring Ave Suite 300 Roanoke VA 24014 Cardiology Services 12 - Carilion Clinic Cardiology 2001 Crystal Spring Avenue Suite 203 Roanoke VA 24014 Cardiology Services 13 - Carilion Clinic Dept of Psychiatry 2900 Lamb Circle Christiansburg VA 24073 Psychiatry and Behavioral Health Services 14 - Carilion Clinic Dept of Psychiatry 2900 Tyler Road Christiansburg VA 24073 Psychiatry and Behavioral Health Services 15 - Carilion Clinic Psychiatry & Behavioral 2017 S Jefferson Street Roanoke VA 24014 Behavioral Health 16 - Carilion Clinic DermatologyMohs Surg 1 Riverside Circle Suite 300 Roanoke VA 24016 Dermatology and Mohs Surgery 17 - Carilion Clinic Family Med Tazewell 388 Ben Bolt Avenue Tazewell VA 24651 Family Medicine 18 - Carilion Clinic Gastroenterology 3 Riverside Circle Roanoke VA 24016 Gastroenterology 19 - Carilion Clinic General Surgery 3 Riverside Circle Roanoke VA 24016 Surgical Services 20 - Carilion Clinic Imaging ION 2331 Franklin Road Roanoke VA 24014 Imaging Services 21 - Carilion Clinic Internal Medicine 3 Riverside Circle Roanoke VA 24016 Internal Medicine 22 - Carilion Clinic Neurology 3 Riverside Circle Roanoke VA 24016 Neurology 23 - Carilion Clinic Neurosurgery - ION 2331 Franklin Road Roanoke VA 24014 Neurosurgery 24 - Carilion Clinic OBGYN and Cardiology Mart 1107B Brookdale Street Martinsville VA 24112 OB, Gynecological, and Cardiology Services 25 - Carilion Clinic OBGYN Botetourt 150 Market Ridge Lane Daleville VA 24083 Obstetrics and Gynecology 26 - Carilion Clinic OBGYN Spartan Drive 150 Spartan Drive Salem VA 24153 Obstetrics and Gynecology 27 - Carilion Clinic Orthopaedics 3 Riverside Circle Roanoke VA 24016 Orthopaedics 28 - Carilion Clinic Orthopaedics-Franklin 390 S Main Street Suite 103 Rocky Mount VA 24151 Orthopaedics 29 - Carilion Clinic Orthopaedics - ION 2331 Franklin Road SW Roanoke VA 24014 Orthopaedics 30 - Carilion Clinic Orthopaedics Trauma 3 Riverside Circle Roanoke VA 24014 Orthopaedic Trauma 31 - Carilion Clinic Pain Management - ION 2331 Franklin Road Roanoke VA 24014 Pain Management 32 - Carilion Clinic Pediatric Surgery 102 Highland Avenue Suite 404 Roanoke VA 24013 Surgical Services 33 - Carilion Clinic Pulmonary & Sleep Med 2001 Crystal Spring Avenue Suite 300 Roanoke VA 24014 Pulmonary and Sleep Services 34 - Carilion Clinic TraumaCritical Care 3 Riverside Circle Roanoke VA 24016 Surgical Services 35 - Carilion Clinic Urogynecology 101 Elm Avenue Suite 400 Roanoke VA 24013 Obstetrics 36 - Carilion Clinic Urology Christiansburg 120 Akers Farm Road NE Christiansburg VA 24073 Urology 37 - Carilion Dental Care 2017 S Jefferson Street Roanoke VA 24014 Dental Service 38 - Carilion Dentistry Pediatric Surgery 101 Elm Avenue Roanoke VA 24013 Dental Service 39 - Carilion Diabetic Education 1030 S Jefferson Suite G101 Roanoke VA 24016 Diabetic Education 40 - Carilion General Pediatric Clinic 1030 S Jefferson Street Suite 106 Roanoke VA 24016 General Pediatrics 41 - Carilion Genetics 102 Highland Avenue Suite 104 Roanoke VA 24013 Genetic Counseling 42 - Carilion GYN Clinic 102 Highland Avenue Suite 303 Roanoke VA 24013 Gynecolgical Services 43 - Carilion GYN Oncology 1 Riverside Circle Suite 300 Roanoke VA 24016 Gynecolgical Oncology 44 - Carilion Heart Failure Clinic 127 McClanahan Street Roanoke VA 24016 Heart Failure Services 45 - Carilion Imaging 3 Riverside Circle Roanoke VA 24016 Imaging Services 46 - Carilion Imaging Professionals 1 Taylor Avenue Pearisburg VA 24134 Imaging Services 47 - Carilion Infectious Disease Clinic 2001 Crystal Spring Avenue Suite 301 Roanoke VA 24014 Infectious Disease 48 - Carilion Maternal Fetal Medicine 101 Elm Avenue SW Suite 400 Roanoke VA 24013 Maternal Fetal Medicine 49 - Carilion OBGYN - Riverside 3 Riverside Circle Roanoke VA 24016 Obsetrics and Gynecology 50 - Carilion ObstetricsGynecology Clinic 902 South Jefferson Street Upper Level Roanoke VA 24016 Obsetrics and Gynecology 51 - Carilion OtolaryngologyENT 3 Riverside Circle 4th Floor Roanoke VA 24016 Otolaryngology and ENT Services 52 - Carilion Pediatric Endocrinology Clinic 102 Highland Avenue MOB Suite 455 Roanoke VA 24013 Endocrinology 53 - Carilion Pediatric Neurology 102 Highland Avenue Suite 104 Roanoke VA 24013 Neurosciences 54 - Carilion Pediatric OtolaryngologyENT 3 Riverside Circle 4th Floor Roanoke VA 24016 Pediatric Otolaryngology and ENT Services 55 - Carilion Pediatric PulmonologyAllergy 102 Highland Avenue Suite 203 Roanoke VA 24013 Pulmonology 56 - Carilion Physical Medicine and Rehab 2331 Franklin Road SW Roanoke VA 24014 Physical Medicine 57 - Carilion PlasticReconstructive Surg 3 Riverside Circle Suite 400 Roanoke VA 24016 Plastic and Reconstructive Surgery 58 - Carilion Prenatal Diagnostic Center 102 Highland Ave Ste 455 Roanoke VA 24013 Prenatal Testing 59 - Carilion Reproductive Endocrinology 102 Highland Avenue Suite 304 Roanoke VA 24013 Reproductive Endocrinology 60 - Carilion Roanoke IP Psychiatry 2017 S Jefferson Street 1st Floor Roanoke VA 24014 Psychiatry Services 61 - Carilion Sleep Center 1030 Jefferson Plaza Ste G100 Roanoke VA 24016 Sleep Disorder 62 - Carilion Sleep Center Westlake 35 Medical Court Hardy VA 24101 Sleep Disorder 63 - Carilion Surgery Westlake 35 Medical Court Hardy VA 24101 Surgical Services 64 - Carilion Wellness- Botetourt 105 Summerfield Court Roanoke VA 24019 Outpatient Therapy Services 65 - Carilion Wellness- Roanoke 4508 Starkey Road Roanoke VA 24018 Physical Therapy Services 66 - Carilion Wound Care Center 101 Elm Ave SE Roanoke VA 24013 Wound Care 67 - CES - Franklin 180 Floyd Avenue Rocky Mount VA 24151 Emergency Physicians 68 - CES - Giles 1611 Wenonah Avenue Pearisburg VA 24134 Emergency Physicians 69 - CES - Tazewell 388 Ben Bolt Avenue Tazewell VA 24651 Emergency Physicians 70 - CFM - Salem 2102 West Main Street Salem VA 24153 Family Practice 71 - CFM Roanoke Salem 1314 Peters Creek Road Roanoke VA 24017 Family Practice 72 - CFM Southeast 2145 Mount Pleasant Boulevard Roanoke VA 24014 Family Practice 73 - Child and Adolescent Psychiatry 2017 S Jefferson Street 2nd Floor Roanoke VA 24014 Child and Adolescent Psychiatry Services 74 - CNRV Emergency Services 2900 Lamb Circle Christiansburg VA 24073 Emergency Physicians 75 - CNRVMC - Neurosciences 2900 Lamb Circle Christiansburg VA 24073 Neurology 76 - CNRVMC - Radiology 2900 Lamb Circle Christiansburg VA 24073 Radiology Services 77 - Community Care 101 Elm Avenue SE Roanoke VA 24013 Family Medicine 78 - Community Psychiatry 2017 S Jefferson Street Roanoke VA 24014 Psychiatry Services 79 - CRMH Rheumatology Clinic 3 Riverside Circle Roanoke VA 24016 Rheumatology 80 - CSJH Emergency Department 1 Health Circle Lexington VA 24450 Emergency Physicians 81 - Daleville Imaging 46 Wesley Road Daleville VA 24083 Imaging Services 82 - General Surgery Clinic 180 Floyd Avenue Rocky Mount VA 24151 Surgical Services 83 - General Surgery Rocky Mount 390 South Main Street Rocky Mount VA 24151 Surgical Services 84 - Northwest Internal Medicine 615 McDowell Avenue Roanoke VA 24016 Internal Medicine 85 - Pediatric Cardiology Clinic 102 Highland Avenue Suite 101 Roanoke VA 24013 Cardiology 86 - Pediatric Developmental Clinic 1030 S Jefferson Street Suite 201 Roanoke VA 24016 Pediatric Development 87 - Pediatric Gastroenterology 102 Highland Avenue Suite 305 Roanoke VA 24013 Gastronenterology 88 - Tazewell Veterans Affairs Community 388 Ben Bolt Avenue Tazewell VA 24651 Veteran Affairs Outpatient Clinic Part I, Line 3c: Patients' eligibility is determined by family size, family income, real property equity and liquid assets, and status as uninsured or underinsured. Families with family income below 200% of the FPG and assets below $15,000 receive 100% adjustment under FAP. Families with family income greater than 200% of the FPG but less than 400% of the FPG or assets above $15,000 receive a partial adjustment under FAP. The partial adjustment matches the AGB percentage for each service area. Part I, Line 6a: 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/community-health-assessments. Part I, Line 7: Part I, Line 7 a-b: The ratio of cost-to-charges was used to calculate the expense.Part I, Line 7:Column f calculation-The organization's bad debt expense of $89,796,742 is subtracted from total expenses for the calculation.Part I, Line 7e:Community Health Improvement:This line is reported at actual cost. Carilion Medical Center provides education to the public about health risks and steps that can be taken to improve health. Events include regularly scheduled health screenings such as blood pressure, blood glucose and cholesterol as well as seasonal stroke, vascular and facial sun damage detection screenings. 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 training and national certification on proper car seat installation for other health and safety providers free of charge. Additional health improvement services include physician coverage at the Bradley Free Clinic and the Roanoke Rescue Mission, blood drives, assistance with enrollment in public medical programs such as Medicaid, and interpreter services for non-English speaking patients. Community benefit operations includes expenses related to support of Healthy Roanoke Valley, a collaboration of health and human service agencies developing initiatives to address prioritized community health needs, the cost associated with tracking community health improvement activities, and the cost associated with conducting a Community Health Needs Assessment.Part I, Line 7f: Health professions education - This line is reported at actual cost. Carilion Medical Center provides in-kind support to Radford University's Bachelor of Science Nursing Program and mentors nursing students within Carilion Roanoke Memorial Hospital. Part I, Line 7g: Subsidized Health Services - n/aPart I, Line 7h: Research - This line is reported at actual cost. Carilion Medical Center participates in clinical research projects which includes internal review board oversight. Additionally, community research is provided through a cancer registry to assist public health professionals in understanding and addressing the cancer burden more effectively. Information obtained is used in development of programs on cancer prevention, early detection, and successful treatment and care. Part I, Line 7i: Cash and In-Kind Contributions: At cost.Carilion has long been committed to improving the health of the communities we serve. We know that significant change doesn't happen alone, but takes a community of partners working together towards common goals. Our dedication to this mission is evidenced by the support we provide to various nonprofit partners, furthering their efforts to positively impact health. Contributions of various amounts, both financial and in-kind, are made each year to dozens of organizations directly impacting the issues identified in our triennial Community Health Needs Assessment as well as to organizations addressing a variety of social determinants that impact people's health. Support provided helps with access to nutrient dense foods, promotion of exercise and healthy activity, chronic disease management, access to mental health services and coordination of care, in addition to a multitude of other community health improvement goals. Part II, Lines 1-8 Part II, Line 1: Physical improvements and housing- Support was provided to Habitat for Humanity and the Roanoke Regional Housing Network for an Educational Symposium.Part II, Line 2:Economic development- Carilion Medical Center actively participates with and supports local Chambers of Commerce in the Roanoke Valley which improves economic development through support and advocacy for business. Carilion takes an active role in local economic development through investment in research and technology and conversations with local businesses regarding the region's development. Support was also provided for Virginia's Blue Ridge, focusing on economic development through tourism. Funding was provided to the Greater Roanoke Transit Company for the Star Line Trolley providing free transportation around downtown Roanoke. Support was also provided for the Better Business Bureau and the Roanoke Blacksburg Technology Council.Part II, 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 non-profit organizations that address barriers to good health that arise from these social determinants. Though support of local partners, Carilion is able to help provide better education and opportunities for children and families as well as housing, nutrition and resources for our neighbors in need, removing obstacles to good health.Part II, Line 4:Environmental improvements- Carilion Medical Center partnered with Ride Solutions to make available a Bikeshare program in Roanoke, making it easier for people to bike to and from work, school and activities. Support was also provided to Pathfinders for Greenways for our local greenway.Part II, Line 5:Leadership development and training for community members- Support was provided to DePaul Community Resources for a leadership conference.Part II, Line 6:Coalition building- In addition to financial support, Carilion Medical Center is deeply involved with a variety of health-related initiatives and supports local organizations through coordination of activities and participation as volunteers and on boards. In-kind support was provided through representation on Roanoke Area Youth Substance Abuse Coalition and Roanoke Prevention Alliance, a group of concerned citizens, parents, youth, teachers, police officers, business people, judges, and other caring individuals that strive to keep the youth of the Roanoke Valley and southwest Virginia alcohol-, tobacco- and drug-free; Safe Kids coalition, a multidisciplinary team, working to eliminate infant injury and deaths due to abusive head trauma and sudden infant death syndrome (SIDS); Virginia Highway Safety Board representation; Roanoke City School Health Advisory Board representation; and YOVASO, a statewide youth leadership program, dedicated to saving the lives of teenage drivers through educating, encouraging and empowering teenagers to be traffic safety advocates in their schools and communities. In-kind support was also provided through participation and volunteering with the following organizations: Healthy Youth VA, EMS2020 meeting, Ronald McDonald House, Roanoke City Health Department, CityWorks Expo, United Way of Roanoke Valley, Local Agency on Aging, Roanoke City Libraries, Botetourt County, Compress and Shock Foundation, Roanoke Community Garden Association, Happy Healthy Cooks, Healing Arts Garden, Rescue Mission, American Red Cross, Invest Health Coalition, Bradley Free Clinic, Big Brothers Big Sisters, Roanoke Star Soccer, YMCA, Ride Solutions, Family Service, New Horizons, Recovery Coalition, Roanoke Children's Theater, Virginia Peer Recovery Specialist Network, Suicide Prevention Council of Roanoke Valley, and the Healthy Families initiative. Part II, Line 7:Community health improvement advocacy - In-kind support was provided for distribution of a newsletter on behalf of adolescent and student health services.Part II, Line 8:Workforce development -Carilion Medical Center partnered with Goodwill Industries of the Roanoke Valley, the Department of Rehabilitative Services, Blue Ridge Behavioral Health, Blue Ridge Independent Living Center and local parent representatives to offer Project SEARCH, a one year high school transition program that provides employment and educational opportunities for individuals with significant disabilities and assists with finding long term employment in skilled positions for its participants. Additional expenses include recruitment of providers to meet the needs of underserved individuals in the Roanoke Valley. Support was also provided for the Virginia Tech Foundation Educational Fund, Virginia Foundation of Community College Education, Virginia Health Workforce Development Authority, Junior League Leadership for a Healthier Tomorrow and Virginia Business Higher Education. Part III, Line 2: 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. Part III, Line 4: Accounts receivable are reduced by an allowance for amounts that could become uncollectible in the future. Carilion Medical Center estimates the allowance for doubtful accounts 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. Carilion Medical Center collects substantially all of its third-party insured receivables, which include receivables from governmental agencies and commercial insurers. Part III, Line 8: Medicare allowable costs are determined from the Medicare cost report using the cost-to-charges ratio. The Hospital does not consider a Medicare shortfall as a community benefit. Part III, Line 9b: When accounts receivable efforts are exhausted, the account may be placed with a collection agency and Extraordinary Collection Actions (ECA) 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 Debt Recovery Department.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. Part VI, Line 2: Needs Assessment:Carilion Clinic's community health improvement process was adapted from Associates in Process Improvement's the Model for Improvement and the Plan-Do-Study-Act (PDSA) cycle developed by Walter Shewhart. It consists of five distinct 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 to comply with IRS requirements. Carilion Clinic fosters community development in its CHNA process and community health improvement process 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 2015 Roanoke Valley CHNA. This process was community-driven and focused on high levels of community engagement involving health and human services leaders, stakeholders, and providers; the target population; and the community as a whole. Healthy Roanoke Valley (HRV), housed under the 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, coordination of services, and promote a culture of wellness. Using the collective impact model, the partnership boasts more than 160 individuals representing cross-sector stakeholders and leaders who are working to implement cost-effective programs resulting in improved health outcomes. Part VI, Line 3: Availability of 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. Part VI, Line 4: Community Information:Carilion Medical Center (CMC), comprised of two hospitals, Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital, is located in Roanoke, Virginia. The following community data comes from the 2015 Roanoke Valley Community Health Assessment. Roanoke is a 1,186 square mile valley located in southwest Virginia near the Blue Ridge and Allegheny Mountains. In fiscal year 2014, CMC served 121,168 unique patients. Patient origin data revealed that in fiscal year 2014, 72.77% of patients served by CMC lived in the following localities: Roanoke City (30.80%), Roanoke County (19.97%), Franklin County (8.78%), Botetourt County (6.94%), Salem City (5.61%), and Craig County (0.68%). The Roanoke Metropolitan Statistical Area (MSA), commonly known as the Roanoke Valley, is composed of the independent cities of Roanoke and Salem and the counties of Botetourt, Craig, Franklin and Roanoke.According to the 2010 Census, the total population of the Roanoke MSA is 308,707. 78.5% of residents are 18 years old or over and 16.3% are 65 years old or over. The MSA is 82.2% white and 12.8% black. According to the 2011-2015 American Community Survey 5-Year Estimates, 38.01% of MSA residents are not in the labor force, the median household income is $50,340, 10.8% of residents have no health insurance coverage, 13.9% of all people and 20.5% of people under 18 years old live below the federal poverty level, 87.9% of residents have graduated high school, and 26.7% of residents have a bachelor's degree or higher. Craig County and Franklin County are designated Medically Underserved Areas (MUA) as are portions of northern Botetourt County. In the city of Roanoke, nine census tracts are designated MUA's - seven are located in the northwest (NW) quadrant (Census Tracts 1, 9-11, 23-25) and two in the southeast (SE) quadrant (Census Tracts 26 and 27). Health Professional Shortage Areas (HPSA) are present in the portions of the Roanoke MSA for Primary Care, Dental, and Mental Health providers. Part VI, Line 5: Community Health Promotion:Carilion Medical Center includes Carilion Clinic's flagship facility, Carilion Roanoke Memorial Hospital (CRMH). The 703-bed hospital includes a Neonatal Intensive Care Unit, Carilion Children's Hospital, specialty and advanced clinical care and the region's only Level 1 Trauma Center. U.S. News & World Report ranks it among Virginia's top five; it is one of only 43 in the country ranked at the top for nine adult procedures and conditions. 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. Carilion Medical Center serves all patients regardless of their ability to pay. The Hospital's governing Board is elected annually and the majority of members are neither employees nor contractors of the Hospital. Medical staff privileges are extended to qualified providers. Any surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. This includes providing free, discounted and subsidized care as well as critical medical services that operate at a loss. Part VI, Line 6: Our 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 our comprehensive network of hospitals, primary and specialty physician practices, and complementary services, we provide exceptional care for over 700,000 Virginians. Our enduring commitment is to a healthier region. We advance care through medical education and research,help our community stay healthy, and inspire it to grow stronger.To advance education of health professionals, Jefferson College of Health Sciences is a private higher education institution that "prepares, within a scholarly environment, ethical, knowledgeable, competent and caring healthcare professionals." The College focuses on providing healthcare education and is a part of Carilion Clinic. Founded in 1914 as the Jefferson Hospital School of Nursing, Jefferson College now provides more than 1,100 students with opportunities to become part of the healthcare profession, serving communities from southwest Virginia to the Shenandoah Valley and beyond. The school's graduates are building healthier tomorrows in our region and across the country every day. More information is available at www.jchs.edu.The Virginia Tech Carilion School of Medicine joins the basic science, life science, bioinformatics, and engineering strengths of Virginia Tech with the medical practice and medical education experience of Carilion Clinic to develop the next generation of physician thought leaders. The school uses an innovative patient-centered curriculum that focuses on small-group learning and hands-on experiences, with extensive research and inter-professionalism training.Part VI, Line 7: N/A 1 Alzheimer's Assoication 1160 Pepsi Place Ste 306 Charlottesville VA 22901 133039601 501(c)(3) 8000 General Support American Cancer Society 2840 Electric Rd Ste 106A Roanoke VA 24018 131788491 501(c)(3) 18700 Event Sponsorships American Heart Association Mid-Atlantic Affliliate PO Box 50045 Prescott AZ 86304 135613797 501(c)(3) 18500 Event Sponsorships Anchor of Hope Community Foundation 118 Centre Avenue NW Roanoke VA 24017 474222612 501(c)(3) 8500 Community Health Promoter program in SE Roanoke. Big Brothers Big Sisters of Southwest Virginia 124 Wells Avenue NW Roanoke VA 24016 540837136 501(c)(3) 33000 Mentoring program Boys and Girls Clubs of Southwest Virginia 1714 9th Street SE Roanoke VA 24013 541867366 501(c)(3) 9500 Triple Play program Bradley Free Clinic Inc 1240 Third Street SW Roanoke VA 24016 237380491 501(c)(3) 10000 Open a specialty Women's Health Program. Carilion Clinic Patient Transportation 431 McClanahan St SW Roanoke VA 24014 541864693 501(c)(3) 50013 General Support Children's Trusts of Roanoke 541 Luck Ave Suite 308 Roanoke VA 24016 510235891 501(c)(3) 91500 Operational Support CHIP of Roanoke Valley 1201 3rd Street Roanoke VA 24016 541566451 501(c)(3) 52403 Operational Support City of Roanoke 215 Church Ave Room 254 Roanoke VA 24011 546001569 City of Roanoke 49750 General Support DePaul Community Resources 5650 Hollins Road Roanoke VA 24019 541108079 501(c)(3) 6680 Event sponsorships Down by Downtown Music Inc 22 Kirk Ave SW Roanoke VA 24011 812334271 501(c)(3) 5000 General support Family Service of Roanoke Valley 360 Campbell Ave SW Roanoke VA 24016 540505946 501(c)(3) 15000 Therapy Subsidies and Play Therapy Institue Feeding America Southwest Virginia 1025 Electric Rd Salem VA 24153 541939556 501(c)(3) 25000 Community Solutions Center/ General Support Foundation for Rehabilitation Equipment and Endowment PO Box 8873 Roanoke VA 24014 541934695 501(c)(3) 8500 General Support Greater Roanoke Transit Company 1108 Campbell Avenue SE Roanoke VA 24013 540982022 City of Roanoke 55889 General support Happy Healthy Cooks 1914 Belleville Rd SW Roanoke VA 24015 464937238 501(c)(3) 20000 Healthy Eating Program Jefferson Center Foundation 541 Luck Avenue SW Suite 221 Roanoke VA 24016 621392982 501(c)(3) 60000 General Support Junior Achievement of Southwest Virginia Inc 3433 Brambleton Avenue SW Suite 202B Roanoke VA 24018 540628293 501(c)(3) 5500 General Support March of Dimes Greater Roanoke 4191 Innslake Drive Suite 201 Glenn Allen VA 23060 131846366 501(c)(3) 5000 Event sponsorship Mental Health of America Rke Valley PO Box 592 Roanoke VA 24004 540703132 501(c)(3) 31000 General Support Mill Mountain Theatre One Market Square SE Roanoke VA 24011 540792067 501(c)(3) 10000 Corporate Sponsorship National Multiple Sclerosis Society 4200 Innslake Dr Ste 301 Glen Allen VA 23060 540633474 501(c)(3) 8700 Event sponsorship Northern Virginia Technology Council Inc 2214 Rock Hill Road Suite 300 Herndon VA 20170 621471948 501(c )(6) 5000 Corporate Sponsorship Opera Roanoke 20 E Church Ave 3rd Floor Roanoke VA 24011 510213334 501(c)(3) 10000 Corporate Sponsorship Presbyterian Community Center Inc 1228 Jamison Ave SE Roanoke VA 24013 541610899 501(c)(3) 5000 Event sponsorship Roanoke Academy of Medicine Alliance Foundation PO BOX 8602 Roanoke VA 24014 510218435 501(c)(3) 9100 Event Sponsorship Roanoke Branch NAACP PO Box 12362 Roanoke VA 24025 546070115 501(c)(4) 5200 Event Sponsorship Roanoke Community Garden Association 655 Highland AveSE Roanoke VA 24012 262082150 501(c)(3) 19000 Nutrition Program Roanoke Symphony Orchestra 128 East Campbell Avenue Roanoke VA 24011 546019736 501(c)(3) 22500 Corporate Sponsorship Roanoke Valley - Alleghany Regional Commission PO Box 2569 Roanoke VA 24010 540722734 City of Roanoke 18000 Bike Share Sponsorship Roanoke Valley End of Life Care Partnership PO Box 18238 Roanoke VA 24014 113683571 501(c)(3) 7795 General Support Ronald McDonald House Charities of SW VA 2224 S Jefferson St Roanoke VA 24014 541244769 501(c)(3) 600 249690 FMV Donated Rent General Support RX Drug Access Partnership 2924 Emerywood Parkway Suite 30 Rickmond VA 23294 571186937 501(c)(3) 5405 General Support Scott Robertson Memorial Junior Golf Academy 3707 Densmore Rd NW Roanoke VA 24017 201237999 501(c)(3) 10000 Event sponsorship Southwest Virginia Ballet Company PO Box 3275 Roanoke VA 24015 541563448 501(c)(3) 5000 Event Sponsorship Total Action Against Poverty in Roanoke Valley 302 2nd Street SW Roanoke VA 24001 546057095 501(c)(3) 10000 General Support United Way of Roanoke Valley 325 Campbell Ave SW Roanoke VA 24016 540535302 501(c)(3) 36441 Fresh Foods RX program/Healthy Roanoke Valley collaborative Virginia Blue Ridge Affiliate of Susan G Komen 4910 Valley View Blvd Ste 212 Roanoke VA 24012 562619425 501(c)(3) 20000 Event sponsorships Virginia Business Higher Education Council 1108 E Main St 1100 Richmond VA 23219 541827038 501(c)(3) 50000 General Support Virginia Foundation for Independent Colleges 901 East Byrd Street No 1625 Richmond VA 23219 540554396 501(c)(3) 10000 Science Research Fellowships Virginia Polytechnic Institute and State University 2 Riverside Circle Roanoke VA 24016 546001805 State of Virginia 32500 General Support Virginia Tech Carilion School of Medicine Inc Two Riverside Circle Roanoke VA 24016 264556177 501(c)(3) 90029 General Support Visit Virginia's Blue Ridge Foundation 101 Shenandoah Ave NE Roanoke VA 24016 814589910 501(c)(3) 11200 Community Bike Repair stations West End Center PO Box 4562 Roanoke VA 24015 541150320 501(c)(3) 5000 Healthy Living Western Virginia Foundation For The Arts And Sciences 1 Market Square Roanoke VA 24011 510238900 501(c)(3) 270000 Children's Museum WSLC-FM 3934 Electric Rd SW Roanoke VA 24018 952913603 - 5000 Charity Fundraiser Sponsorship YMCA of Roanoke Valley Inc PO Box 2130 Roanoke VA 24009 540515736 501(c)(3) 55000 General Support 46 3 Endowment-funded indigent patient medical bills 48 228425 Scholarships 5 9000 Schedule I, Part I, Line 2 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. 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 new grantees. Program evaluation includes organizational effectiveness, program impact, and community benefit through collection of data including clients served, cost effectiveness of the program (cost per client of 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 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. 0 1 0 0 0 0 0 1 0 Nancy Howell Agee Director 0 1189180 0 358500 0 245942 0 2363574 0 12316 0 4169512 0 235766 Nathaniel L Bishop D Min Director, SVP, President-JCOHS 339978 0 52178 0 5838 0 180525 0 3442 0 581961 0 0 0 John H Burton MD Director, SVP, Medical Chair 486735 0 93654 0 6464 0 75880 0 15812 0 678545 0 0 0 Cynda A Johnson MD Director 0 587496 0 0 0 11014 0 91656 0 10542 0 700708 0 0 Clifford A Nottingham MD Director 0 285867 0 47640 0 6567 0 196725 0 10335 0 547134 0 0 Patrice M Weiss MD Director, EVP 0 551506 0 134942 0 7280 0 161196 0 15812 0 870736 0 0 Ralph E WhatleyIII MD Director, SVP 451154 0 86254 0 11150 0 117215 0 13547 0 679320 0 0 0 Steve C Arner Director/President/CEO/COO 0 426986 0 98146 0 4840 0 192610 0 14330 0 736912 0 0 Nicholas C Conte Secretary 0 332117 0 117252 0 3542 0 54850 0 14330 0 522091 0 0 David S Hagadorn Assistant Treasurer 0 128352 0 3000 0 7717 0 61157 0 843 0 201069 0 0 Donald B Halliwill Assistant Treasurer/CFO 0 464019 0 107317 0 4271 0 196448 0 13030 0 785085 0 0 G Robert Vaughan Jr Treasurer 0 300771 0 48281 0 7946 0 168199 0 14090 0 539287 0 0 Bruce A Long MD Physician, Interim Medical Chair 477695 0 250894 0 13453 0 100042 0 13160 0 855244 0 0 0 Joseph T Moskal MD SVP, Medical Chair 1040512 0 243057 0 9259 0 101207 0 15812 0 1409847 0 0 0 Paul R Skolnik MD SVP, Medical Chair 229052 0 0 0 8476 0 9231 0 8567 0 255326 0 0 0 Jonathan J Carmouche MD Physician 1184900 0 449358 0 2549 0 44322 0 13160 0 1694289 0 0 0 Caleb J Behrend MD Physician 737035 0 497566 0 2562 0 15825 0 13160 0 1266148 0 0 0 Eric A Marvin MD Physician 697131 0 429977 0 2293 0 24868 0 13160 0 1167429 0 0 0 Gregory A Howes MD Physician 742331 0 286191 0 20204 0 44820 0 13160 0 1106706 0 0 0 Cay M Mierisch MD Physician 790188 0 228874 0 3553 0 81933 0 13420 0 1117968 0 0 0 Tracy W Criss MD Physician, Former Officer 197749 0 66743 0 2647 0 148862 0 12493 0 428494 0 0 0 Thomas D Denberg MD PhD Former Officer 0 299868 0 0 0 0 0 0 0 0 0 299868 0 0 Part I, Line 3 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. This review was performed in September 2017. 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, bonuses 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. Part I, Line 4b Select members of management participate in a Pension Restoration Plan. This plan provides a benefit equal to the normal retirement benefit that would be payable to the participant were it not for the Qualified Plan's legislative restrictions on compensation and payable benefits, less the actual benefits under the Qualified Plan. Entitlement to benefits and consequent lump sum payment occurs upon attaining age 65 while employed by Carilion Clinic, disability, or 24 months after certain qualifying separations from service. Upon the death of the participant, the plan shall pay the participant's beneficiary according to Plan terms. Select members of management participate in an Executive Flexible Benefit Plan, in which an allowance is provided to the participant for use in obtaining certain insurance benefits. The allowance is determined annually as a percentage of salary at Carilion Clinic's discretion. The amount of allowance in excess of elected benefits is 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. The CAA shall be distributed in a lump sum upon vesting while employed by Carilion, disability, or 24 months following certain qualifying separations from service. Upon the death of the participant, the plan shall pay the participant's beneficiary according to plan terms. Beginning in the year in which the participant attains age 67, a pro-rated portion of the award is paid monthly. Select members of management 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. THe following reported individual was paid amounts under these plans during the calendar year: Nancy Howell Agee -$235,766 Part I, Line 7 The organization pays annual bonus compensation to management based on scorecard performance. While the scorecard contains a formula as a basis for determining overall performance, senior managers have discretion to include additional elements in their assessment of managers reporting to them. In addition, for top management, the actual bonus awarded is in the discretion of the Carilion Clinic Board of Directors Compensation Committee, although it is based on the scorecard measures. A Economic Development Authority of the City of Roanoke VA 541106038 770084EQ0 2017-03-01 125000000 Reissuance of Series 2005A originally issued on 12/14/05 0 0 0 B VA Small Business Financing Authority Hospital Revenue Bonds 541300845 928101AE4 2017-04-03 11950000 Reissuance of Series 2008A and 2008B originally issued on 07/16/08 0 0 0 C Economic Development Authority of the City of Roanoke VA 541106038 770082AB1 2010-10-13 96404094 Refunding of Series 2003A-C Bonds (08/03), Costs of Issuance 0 0 0 D Economic Development Authority of the City of Roanoke VA 541106038 770082AW5 2012-02-09 69968434 Refunding of Series 2000 and 2002A Bonds, Costs of Issuance Capital Projects 0 0 0 A 1890000 125000000 797940 1940086 122261974 2007 1 0 1 1 B 11950000 107259 11842741 2009 0 0 1 1 C 96404094 1229094 95175000 1 0 1 1 D 25583000 69968434 771282 5189198 64007954 2011 0 1 1 1 A 0 1 1 1 0 0.00120 0.00120 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 0 0 1 1 0 1 AIG 0.300000000000 1 0 1 B 0 0 0 1 1 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: Economic Development Authority of the City of Roanoke, VA Date the Rebate Computation was Performed: 04/30/2009 Issuer Name: VA Small Business Financing Authority, Hospital Revenue Bonds Date the Rebate Computation was Performed: 06/22/2011 Issuer Name: Economic Development Authority of the City of Roanoke, VA Date the Rebate Computation was Performed: 04/29/2011 Issuer Name: Economic Development Authority of the City of Roanoke, VA Date the Rebate Computation was Performed: 04/04/2013 Issuer Name: Industrial Development Authority of the City of Roanoke, VA Date the Rebate Computation was Performed: 05/04/2011 Schedule K, Part II All bond issues- multiple entities across multiple jurisdictions; therefore, proceeds allocated to multiple hospitals. A Industrial Development Authority of the City of Roanoke VA 541106038 770084FU0 2010-10-13 98852291 Reoffering Circular and interest rate conversion to fixed, Costs of Issuance 0 0 0 A 20634000 98852291 1068911 41693 97741687 2007 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 1 0 1 AIG 0.300000000000 1 0 1 A 1 1 Eric Chen MD See Part V 329412 Employee 0 2 Bruce Johnson MD See Part V 312541 Employee 0 Sched. L Part IV (1) Family member of Lauren Schantz, Officer.(2) Family member of Cynda Johnson, Director Form 990, Part 1, Line 6, Total number of volunteers: The hospital operates a Customer Service-based program for volunteers and we do anything 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 V, Line 1a 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, Section A, line 1 As of the first day of the new fiscal year, a majority of the filing organization's Directors were independent. Form 990, Part VI, Section A, line 2 Nancy Howell Agee, Steve Arner, John H. Burton, M.D., Nicholas C. Conte, David S. Hagadorn, Donald B. Halliwill, Cynda A. Johnson, M.D., Clifford A. Nottingham, M.D., Lauren J. Schantz, G. Robert Vaughan, Jr., Patrice M. Weiss, M.D., and Ralph E. Whatley, III, M.D. - Business relationship due to each serving as officers, directors, and/or employees of the same related organizations. Form 990, Part VI, Section A, line 3 Certain management and related services for the organization are provided by the management and employees of Carilion Services, Inc., a related organization and supporting organization of the filing organization. Compensation of the following individuals listed in Part VII, Section A was provided by Carilion Services Inc.: Nancy Howell Agee, Steven C. Arner, Nicholas C. Conte, David S. Hagadorn, Donald B. Halliwill, Lauren J. Schantz, G. Robert Vaughan, Jr., and Patrice M. Weiss, M.D. Form 990, Part VI, Section A, line 4 The filing organization's Articles of Incorporation and Bylaws were revised to update the filing organization's ex officio directors. Form 990, Part VI, Section A, line 6 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, Section A, line 7a 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, Section A, line 7b 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, Section B, line 11b The Form 990 was prepared by Carilion's internal Tax Department with input from various Carilion departments as applicable, and reviewed by internal Accounting management and an independent CPA firm. Several days prior to filing, all Board Members were notified by email of its availability on Carilion's Board portal, which is the mechanism used to disseminate meeting materials to the directors, and were encouraged to call with any questions they might have. Form 990, Part VI, Section B, line 12c 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 Audit & 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, Section B, line 15 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, Executive Vice Presidents, Chief Financial Officer, Chief Medical Officer, select Senior Vice Presidents, and physician Chairs of the Clinical Departments. This review was performed in November 2016 (President and CEO) and September 2017 (all others). For the fiscal year covered by this return, the Compensation Committee also used the same process to review the compensation of Senior Vice Presidents and other Disqualified Individuals, including the Hospital Vice Presidents, which was performed in September and November 2017. 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 all employed physicians and physicians in leadership roles. 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 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, bonuses 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, Section C, line 19 The organization's governing documents, conflict of interest statement, and financial statements are not generally available to the public, but are released from time to time upon request. The Articles of Incorporation are available from the Virginia State Corporation Commission. The consolidated audited financial statements of Carilion Clinic and of the Obligated Group are released to the local newspaper when requested. Limited financial information is available on our website. Form 990, Part XI, line 9: Transfers to Affiliates -38,975,000. Pension-related changes other than net periodic pension costs 32,556,227. Share of Investment Loss of Related Organization 40,465. Form 990, Schedule H, Part V, Section A, Line 1: https://carilionclinic.org/locations/carilion-roanoke-memorial-hospital Form 990, Schedule H, Part V, Section A, Line 2: https://carilionclinic.org/locations/carilion-roanoke-community-hospital RMH Emergency Services LLC PO Box 12385 Roanoke VA 24025 541686589 Physician billing VA 0 0 Carilion Medical Center Carilion Clinic PO Box 12385 Roanoke VA 24025 541190771 Supporting organization VA 501(c)(3) Line 12b, II N/A 0 Carilion Clinic Foundation PO Box 12385 Roanoke VA 24025 541190773 Fundraising VA 501(c)(3) Line 7 Carilion Clinic 1 Carilion Franklin Memorial Hospital PO Box 12385 Roanoke VA 24025 540480606 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Giles Community Hospital PO Box 12385 Roanoke VA 24025 540549603 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion New River Valley Medical Center PO Box 12385 Roanoke VA 24025 540553805 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Services Inc PO Box 12385 Roanoke VA 24025 541190879 Supporting organization VA 501(c)(3) Line 12b, II Carilion Clinic 1 Carilion Stonewall Jackson Hospital PO Box 12385 Roanoke VA 24025 540568001 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Tazewell Community Hospital PO Box 12385 Roanoke VA 24025 546074580 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Biomedical Institute PO Box 12385 Roanoke VA 24025 541965057 Supporting organization VA 501(c)(3) Line 12a, I Carilion Clinic 1 Franklin County Ventures LLC PO Box 12385 Roanoke VA 24025 474365316 Real estate VA Carilion Clinic Related -481 40704 0 0 0.10000 Carilion Clinic Medicare Shared Savings Company LLC PO Box 12385 Roanoke VA 24025 455235473 Medicare HMO VA Carilion Clinic Related -2533465 0 0 0.50000 Community Medical Associates LLP PO Box 12385 Roanoke VA 24025 541517662 Real estate VA Carilion Clinic Related 101121 732060 0 0 0.47300 CHS Inc PO Box 12385 Roanoke VA 24025 541725732 Services VA N/A C 1 Carilion Clinic Medicare Resources LLC PO Box 12385 Roanoke VA 24025 263729975 Medicare HMO VA N/A C 1 Carilion Behavioral Health Inc PO Box 12385 Roanoke VA 24025 203136891 Healthcare VA N/A C 1 Carilion Emergency Services Inc PO Box 12385 Roanoke VA 24025 542033006 Healthcare VA N/A C 1 SCA Credit Services Inc PO Box 12385 Roanoke VA 24025 541180398 Collection Agency VA N/A C 1 Carilion Healthcare Corporation PO Box 12385 Roanoke VA 24025 541586601 Healthcare VA N/A C 1 MedKey Inc PO Box 12385 Roanoke VA 24025 541645357 Financing Services VA N/A C 1 1 0 0 1 1 0 0 0 0 1 1 1 1 0 0 0 0 1 0 Carilion Clinic Foundation A 31992 Cost Carilion Emergency Services A 94524 Cost Carilion Healthcare Corporation A 26560 Cost Carilion Services Inc A 2005071 Cost CHS Inc A 74873 Cost Carilion Behavioral Health L 93410 Cost Carilion Emergency Services L 137892 Cost Carilion Franklin Memorial Hospital L 1989363 Cost Carilion Giles Community Hospital L 1269782 Cost Carilion Healthcare Corporation L 414436 Cost Carilion New River Valley Medical Center L 3502871 Cost Carilion Services Inc L 1735942 Cost Carilion Stonewall Jackson Hospital L 1566923 Cost Carilion Tazewell Community Hospital L 1712424 Cost MedKey Inc L 406136 Cost Carilion Behavioral Health M 129636 Cost Carilion Giles Community Hospital M 77140 Cost Carilion New River Valley Medical Center K 82332 Cost Carilion Services Inc K 53240 Cost Carilion Services Inc M 164138025 Cost Carilion Stonewall Jackson Hospital M 67702 Cost Carilion Tazewell Community Hospital K 137283 Cost Carilion Tazewell Community Hospital M 59840 Cost CHS Inc K 2727239 Cost CHS Inc M 5806804 Cost SCA Credit Services Inc M 839451 Cost Carilion Services Inc R 38975000 Cash