2025-08-15T18:29:20+00:00 2024-09-30 440160260 FORVIS MAZARS LLP 1201 WALNUT ST SUITE 1700 KANSAS CITY MO 641062246 990 2023-10-01 540506332 Carilion Medical Center CARI 5402245102 PO BOX 12385 Roanoke VA 240252385 G ROBERT VAUGHAN TREASURER 5402245102 2025-08-15 true MIKE ENGLE P00482834 8162216300 2025-08-15 2023 2025-03-06 01:10:19Z STEVE ARNER PO BOX 12385 Roanoke VA 240252385 2166394119 false X WWW.CARILIONCLINIC.ORG X 1899 VA Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost. 12 7 10319 301 20149 0 18680033 10677232 1677450373 1881826902 20993797 65422108 25698737 25536306 1742822940 1983462548 6051197 6123879 0 759154812 840704812 0 279403 1004361607 1071810306 1769567616 1918638997 -26744676 64823551 1989095314 2217235562 1033618621 1198187751 955476693 1019047811 Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost. false false 1646234721 6123879 1898003377 SEE SCHEDULE O. 1646234721 true true false true false false false false true true true false false true false false true false false false false false false false false true true true true true false false false false false false true false false false false false true true true true false false true X 0 0 10319 true true true false false false false false false false false false false false X 12 7 true true false false true true true true true false false true true true true true true true true true true VA X MATTHEW BARR 5402245021 213 S JEFFERSON ST ROANOKE VA 24011 Damon Williams Director/Chair 2.0 4.5 X X 0 10748 0 Steven Arner Director/President/CEO 42.0 8.0 X X 0 1410192 209618 Ann Hoff PhD Director 2.0 0.0 X 0 1123 0 Cathy Jo Swanson MD Director / Chief of Medical Staff 2.0 0 X 90000 0 0 Daniel Tershak MD Director/Chief of Medical Staff 50.0 0 X 530882 0 31520 Isabel Thornton Director 2.0 0 X 0 0 0 Jamie Greenawalt Director 2.0 0 X 0 0 0 Janet Frantz Director 2.0 0.0 X 0 1123 0 Katherin Elam Director 2.0 0 X 0 0 0 Kianna Price Marshall Director 2.0 0.0 X 0 1123 0 Lee Learman MD PhD Director/Physician 4.6 0 X 8655 0 0 Michael Nussbaum MD Director/SVP/Surgical Services Chair 50.0 0 X 976550 0 41513 Paul Haskins MD Director/Physician 50.0 0 X 382001 0 85501 Donald Halliwill Asst. Treasurer 0.5 49.5 X 0 1119248 167911 G Robert Vaughan Jr Treasurer 0.5 49.5 X 0 458008 71002 J Harrison Lapuasa Asst. Treasurer 0.5 39.5 X 0 34109 -1202 Julie Smith-Hamilton Asst. Secretary 0.5 39.5 X 0 60728 18375 Nicholas Conte Secretary 3.0 47.0 X 0 1023717 174893 Daniel Harrington MD Interim Chief Medical Officer/EVP 50.0 2.0 X 0 330239 2444 John Jane MD SVP, Chair Neurosurgery 50.0 0 X 654291 0 72718 Jon Sweet MD SVP/Chair, Dept. of Medicine 50.0 0 X 596807 0 82527 Joseph Moskal MD SVP/Chair, Dept. of Orthopedics 50.0 0 X 1421697 0 24727 Michael Abbott Senior Vice President 50.0 0 X 361790 0 100258 Nancy Howell Agee CEO, Carilion Clinic 2.0 48.0 X 0 3830705 1792 Adeolu Olasunkanmi MD Physician 50.0 0 X 1352897 0 21026 Cara Rogers MD Physician 50.0 0 X 1111647 0 24505 Eric Marvin MD Physician 50.0 0 X 1546060 0 20234 Gregory Howes MD Physician 50.0 0 X 1476712 0 31500 Jonathan Carmouche MD Physician 50.0 0 X 1620383 0 26135 David Hagadorn Former Officer 0.0 0.0 X 0 159104 25072 12130372 8440167 1232069 1373 true true false ROBINS & MORTON BRANCH BUILDS 400 SHADES CREEK PARKWAY BIRMINGHAM AL 35209 CONSTRUCTION SERVICES 124261584 QUALIVIS LLC 1601 ASSEMBLY STREET COLUMBIA SC 29201 TEMPORARY STAFFING 65336017 QUEST DIAGNOSTICS 500 PLAZA DRIVE SECAUCUS NJ 07094 LABORATORY SERVICES 29014877 GE MEDICAL SYSTEMS 5517 COLLECTION CENTER DRIVE CHICAGO IL 60693 EQUIPMENT MAINTENANCE 13040273 MB CONTRACTORS INC 3825 BLUE RIDGE DRIVE ROANOKE VA 24018 CONTRACTOR SERVICES 6982766 116 458222 7705065 2513945 10677232 Net Patient Revenue 622110 1819335512 1819335512 Program Related Investments 621999 690157 690157 Patient Pharmacy Revenue 446110 56630647 56630647 Affiliate Rent Income 531120 914363 914363 Clinical Research 541715 1582042 1582042 2674181 2674181 0 0 1881826902 22620032 20149 22599883 5609 5609 5651344 5651344 0 5651344 5651344 224682688 1045350 181936781 994790 42745907 50560 42796467 42796467 Affiliate Subsidy & Other Income 621111 4707602 4707602 Dining Services 722514 3708487 3708487 Roanoke City Student Health 621400 2470103 2470103 8998770 8998770 0 0 19884962 1983462548 1898003377 20149 74761790 6076280 6076280 47599 47599 5144712 4691952 452760 2829749 2829749 714556134 714007665 493180 55289 16722541 16710999 11542 53994566 53855900 125242 13424 47457110 47398598 58512 237416050 237416050 40362 40362 131261 131261 1654796 1654796 190574570 168444110 22127978 2482 32119 32062 57 27462773 27152724 290582 19467 4650521 4650521 36053464 36032619 20845 3199434 3186695 4832 7907 9396554 9396554 43613345 43613345 15186766 5835147 9351619 Medical Supplies 285166461 285166461 Bad Debt 103100138 103100138 Assessment Fees 99109668 99109668 Affiliate Practice Subsidy 8006490 8006490 7015534 6758184 76573 180777 1918638997 1646234721 272124873 279403 14997 14720 5570330 6029263 939228 0 303785103 364382883 0 0 0 0 3175 93228 11148391 13565513 15661346 24832907 1760195004 1017978560 573445329 742216444 359987021 383201443 703053540 669442369 11002032 11167187 383150 341728 4101672 1947877 1989095314 2217235562 292809367 304535156 472500 176250 3206100 30506778 604039951 593434651 0 0 273000 182000 132817703 269352916 1033618621 1198187751 X 929713842 989520655 25762851 29527156 955476693 1019047811 1989095314 2217235562 X 64823551 103844798 -105097231 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 131261 131261 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY A portion of dues paid to various healthcare industry associations is attributable to lobbying activities. 20046508 190750 3550303 769623 23017938 18491904 238935 2021518 705849 20046508 20613255 190000 -1682218 629133 18491904 16794123 348535 4146435 675838 20613255 16881056 609120 696053 16794123 0.0 0.5159 0.4841 false false 6067755 6067755 557804831 429631596 128173235 1523055 1040445 482610 690536680 580207189 110329491 504262683 7099330 497163353 742216444 8704722 F Alternative Investments 660737647 F 669442369 Due to Affiliates 42306993 Pension Liability 156059106 Deferred Comp Liability 49263477 Interest Rate Swap Liability 10977480 Lease Liability Total 10745860 269352916 Schedule D, Part V, Line 4 Intended uses of endowment funds Income from endowment funds are used for the following. (1) Pediatric programs- both internal and external- and/or pediatric equipment. (2) Patient care assistance. true true X true X 300 true X 500 true true true false true true 12283679 12283679 0.0068 347567599 459073403 0 0.0 0 0.0 0 0 359851278 459073403 12283679 0.0068 5009133 779072 4230061 0.0023 61370646 10074045 51296601 0.0282 21002000 17754066 3247934 0.0018 2690204 2690204 0.0015 1027878 110140 917738 0.0005 0 0 91099861 28717323 62382538 0.0343 0 0 450951139 487790726 74666217 0.0410 4867 4867 0.0000 220662 220662 0.0001 109371 109371 0.0001 0 0.0 0 0.0 16164 16164 0.0000 83184 83184 0.0000 488907 488907 0.0003 0 0.0 0 0 923155 0 923155 0.0005 true 103403345 237803614 262410915 -24607301 X true true ROANOKE AMBULATORY SURGERY CENTER LLC AMBULATORY SURGERY 0.5292 0.0418 0.338 SOUTHWEST VIRGINIA HEALTH PROPERTIES LLC REAL ESTATE 0.5257 0.0365 0.3573 2 1 CARILION MEDICAL CENTER -DBA CRMH 1906 BELLEVIEW AVE ROANOKE VA 24014 HTTPS://CARILIONCLINIC.ORG/LOCATIONS/CARILION-ROANOKE-MEMORIAL-HOSPITAL H 1840 X X X X X X A 2 CARILION MEDICAL CENTER -DBA CRCH 101 ELM AVE ROANOKE VA 24013 HTTPS://CARILIONCLINIC.ORG/LOCATIONS/CARILION-ROANOKE-COMMUNITY-HOSPITAL H 1839 X REHABILITATION UNIT A A 2 false false true X X X X X X X X X 23 true true true true X https://www.carilionclinic.org/cho-community-health-assessments#reports X https://issuu.com/carilionclinic/docs/2024_cmc_cha_final_report X X true 24 true https://www.carilionclinic.org/cho-community-health-assessments#reports false true X 300.0 500.0 X X X X true true X X X true X https://www.carilionclinic.org/billing/financial-assistance X https://www.carilionclinic.org/billing/financial-assistance X https://www.carilionclinic.org/billing/financial-assistance X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E The publicly available Community Health Needs Assessment (CHNA) report details the prioritization process for the community's significant health needs identified through the CHNA. The Community Health Assessment Team (CHAT), comprised of community stakeholders, reviews all data and completes a prioritization survey. Through the survey, each CHAT member selects the most pertinent community needs. Following the survey, CHAT members can further refine the priorities through a consensus-building activity. CHAT members prioritize needs according to the perceived burden, scope, severity or urgency; the importance the community places on addressing the need through survey responses and other interactions; and each member's unique perspective on community health. Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - GROUP A. Carilion Clinic's Community Health Needs Assessments (CHNAs) are community-driven projects. Their success depends highly on engaging citizens, health and human service agencies, businesses and community leaders. Stakeholder collaborations known as Community Health Assessment Teams (CHATs) lead the CHNAs. The CHATs are dynamic and include health and human service agency leaders, people with exceptional knowledge of, or expertise in, public health, and local health department officials. Each CHAT also includes other individuals or organizations serving or representing the community's medically underserved, low-income and minority populations. The following organizations served on the CHAT for the 2024 Roanoke Valley Community Health Needs Assessment (RVCHNA): Adult Care Center of the Roanoke Valley, Black Father Family, Blue Blaze Consulting, Botetourt County Library, Bradley Free Clinic, CHIP of Roanoke Valley, City of Roanoke, Collective Response, Commonwealth Catholic Charities, Council of Community Services, Craig County Public Schools, Craig County, Family Services of Roanoke Valley, Feeding Southwest Virginia, Financial Empowerment Center, FREE Foundation, Freedom First Credit Union, Goodwill, Habitat for Humanity of Roanoke Valley, Harm Reduction Coalition, HCA LewisGale, Healthy Homes Roanoke, LEAP, Leffel Consulting Group, Legal Aid Society of Roanoke Valley, New Horizons Healthcare, Presbyterian Community Center, Rescue Mission, Restoration Housing, Roanoke City & Alleghany Health Districts, Roanoke City Public Schools, Roanoke Fire/EMS, Roanoke Redevelopment and Housing Authority, Roanoke Regional Chamber of Commerce, Roanoke Valley-Alleghany Regional Commission, Radford University Carilion, Salem City Public Schools, and United Way of Roanoke Valley. To obtain input from the community, the RVCHNA conducted a listening session among CHAT stakeholders, held multiple listening sessions with community members, and administered a 27-question community health survey broadly across the service area. These efforts occurred from October 1, 2023, through December 31, 2023. The survey was developed in English and Spanish and asked questions about access to care and other services, health status, community strengths, quality of life, subjective well-being and demographics. The survey included commonly used questions and metrics from previously validated community surveys conducted by organizations such as the National Association of County and City Health Officials and the Centers for Disease Control and Prevention. Community members were invited to participate in Community Listening Sessions to collect qualitative data to understand health-related needs better. Roanoke City and Alleghany Health District staff facilitated sessions with Virginia Harm Reduction Coalition clients and Virginia Western Community College students. Attendees of a Black Father Family Fireside Chat also had the opportunity to provide their input. CHAT members could offer additional perspectives on the needs and barriers to health facing our community during a Healthy Roanoke Valley all-partner meeting that included other community stakeholders. Carilion staff from across the organization facilitated small group discussions. Participants could complete the Stakeholder Survey to quantify focus group data. Community stakeholders, leaders and providers were encouraged to complete the Stakeholder Survey after participating in a listening session. Carilion representatives shared the online survey at the CHAT meetings and via email. The CHAT assisted with survey distribution to reach particular target populations. The survey focused on Roanoke Valley residents 18 years of age and older in the following service area: Bedford, Botetourt, Craig and Roanoke counties, Roanoke City, and Salem City. There were special efforts to include underserved/vulnerable populations disproportionately impacted by social determinants of health such as poverty, race/ethnicity, education and lack of insurance. Specific populations served by CHAT representatives include people who are uninsured or underinsured; people experiencing low income, homelessness, and/or food insecurity; and families with young children. The survey was also available online to all residents living in the Roanoke Valley. Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - Group A. Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital, owned by Carilion Medical Center and serving the same area, jointly conducted their Community Health Needs Assessment. Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - GROUP A. The 2024 (tax year 2023) Roanoke Valley CHNA was conducted with: Adult Care Center of the Roanoke Valley, Black Father Family, Blue Blaze Consulting, Botetourt County Library, Bradley Free Clinic, CHIP of Roanoke Valley, City of Roanoke, Collective Response, Commonwealth Catholic Charities, Council of Community Services, Craig County Public Schools, Craig County, Family Services of Roanoke Valley, Feeding Southwest Virginia, Financial Empowerment Center, FREE Foundation, Freedom First Credit Union, Goodwill, Habitat for Humanity of Roanoke Valley, Harm Reduction Coalition, HCA LewisGale, Healthy Homes Roanoke, LEAP, Leffel Consulting Group, Legal Aid Society of Roanoke Valley, New Horizons Healthcare, Presbyterian Community Center, Rescue Mission, Restoration Housing, Roanoke City & Alleghany Health Districts, Roanoke City Public Schools, Roanoke Fire/EMS, Roanoke Redevelopment and Housing Authority, Roanoke Regional Chamber of Commerce, Roanoke Valley-Alleghany Regional Commission, Radford University Carilion, Salem City Public Schools, and United Way of Roanoke Valley. Schedule H, Part V, Section B, Line 7 Facility A, 1 Facility A, 1 - Group A. The Community Health Assessment Team shared the 2024 Roanoke Valley Community Health Needs Assessment (RVCHNA) on partner websites, social media, and regional news coverage. The RVCHNA was shared through multiple internal presentations for staff and presentations to partner organizations and collaboratives. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - Group A. The following information describes the implementation strategy used by Carilion Medical Center (CMC)-comprised of Carilion Roanoke Memorial Hospital (CRMH) and Carilion Roanoke Community Hospital (CRCH)-to address the community health needs identified in the 2024 Roanoke Valley Community Health Needs Assessment (RVCHNA). The complete implementation strategy is available online at https://issuu.com/carilionclinic/docs/implementation_strategy_final_cmc. The hospital is working to address all significant health needs prioritized through the CHNA . The top prioritized needs for the 2024 RVCHNA were grouped into three overarching categories: chronic disease, mental health and substance use, and injury/violence. We also focus on layered interventions that address multiple priority areas through place-based strategies. We are addressing prioritized needs with the following strategies and committing financial resources, staff time and leadership. Strategies to address mental health and substance use include implementing evidence-based mental health education and well-being programs, expanding Carilion's peer support specialist workforce, and supporting the development and implementation of transitional and/or recovery housing options in the service area. Strategies to address chronic disease include implementing the Healthy Heart Ambassadors program, fruit and vegetable prescription program, and other evidence-based health and nutrition programs. Strategies to address injury/violence include working with the forensic nursing program to support transitioning patients from acute care to the community, sustaining the Violent Injury Recovery and Support program, and participating in the Group Violence Intervention Program and other Roanoke City-led initiatives on violence prevention. Place-based strategies addressing multiple priority areas include expanding Carilion's community health workforce, developing an employee volunteer program to support the capacity of local organizations working to address CHA-identified needs, evaluating a pop-up clinic model supporting safety net partnerships, evaluating additional sites for the LIFT Center model, and implementing health and wellness programming at Melrose Plaza. 33 Carilion Clinic Riverside 1 Medical Office Building 1 Riverside Circle Roanoke VA 24016 Physician and Ancillary Services Carilion Roanoke Community Hospital Medical Office Building 102 Highland Ave Roanoke VA 24013 Physician and Ancillary Services Carilion Clinic Outpatient Therapy 105 Summerfield Court Roanoke VA 24019 Ancillary Services Roanoke Ambulatory Surgery Center LLC 1102 Jefferson St SE Roanoke VA 24016 Outpatient Surgery Center Carilion Clinic Cardiology 1229 Third Street SW Roanoke VA 24016 Physician Services Carilion Clinic Diabetes Management & Prevention 1231 S Jefferson Street Roanoke VA 24016 Ancillary Services Carilion Clinic Cardiology 127 McClanahan Street Roanoke VA 24014 Physician and Ancillary Services Carilion Clinic Family Medicine 1314 Peters Creek Road Roanoke VA 24017 Physician Services Carilion Clinic Medical Office Building 150 Market Ridge Lane Daleville VA 24083 Physician and Ancillary Services Carilion Clinic Pediatric Subspecialty Clinic 1620 Graves Mill Road Lynchburg VA 24502 Physician Services Carilion Clinic Outpatient Therapy 1935 West Main Street Salem VA 24153 Ancillary Services Carilion Clinic OBGYN 1957 West Main Street Salem VA 24153 Physician Services Carilion Clinic Crystal Springs Medical Office Building 2001 Crystal Spring Ave SW Roanoke VA 24014 Physician and Ancillary Services Carilion Mental Health 2017 S Jefferson Street Roanoke VA 24014 Physician and Ancillary Services Carilion Clinic Family Medicine 2145 Mount Pleasant Boulevard Roanoke VA 24014 Physician Services Carilion Clinic Institute for Orthopedics and Neurosciences 2331 Franklin Road Roanoke VA 24014 Physician and Ancillary Services Carilion Clinic Riverside 3 Medical Office Building 3 Riverside Circle Roanoke VA 24016 Physician and Ancillary Services Carilion Clinic Family Medicine 3 Westwood Medical Park Bluefield VA 24605 Physician Services Carilion Clinic Westlake Medical Office Building 35 Medical Court Hardy VA 24101 Physician and Ancillary Services Carilion Clinic Imaging 3707 Brambleton Avenue Roanoke VA 24018 Ancillary Services Carilion Clinic Veterans Administration Clinic 388 Ben Bolt Avenue Tazewell VA 24651 Physician Services Carilion Franklin Memorial Hospital Medical Office Building 390 S Main Street Rocky Mount VA 24151 Physician Services Carilion Clinic Vascular Surgery and Urology 4064 Postal Drive Roanoke VA 24018 Physician Services Carilion Children's -Tanglewood Center 4348 Electric Road Roanoke VA 24018 Physician and Ancillary Services Carilion Dental Care 4348 Electric Rd Entr 3 2nd Fl Roanoke VA 24018 Dental Services Carilion Mental Health and Center for Healthy Aging 4434 Electric Road Roanoke VA 24018 Physician and Ancillary Services Carilion Clinic Vascular Surgery 4437 Starkey Road SW Suite A Roanoke VA 24018 Physician Services Carilion Clinic Outpatient Therapy 4508 Starkey Road Roanoke VA 24018 Ancillary Services Carilion Clinic Pediatric Medicine 490 S Main St Rocky Mount VA 24151 Physician Services Carilion Clinic Urology 5372 Fallowater Lane Roanoke VA 24018 Physician Services Carilion Clinic Breast Care Center 6415 Peters Creek Road Roanoke VA 24019 Ancillary Services Carilion Clinic Obstetrics and Gynecology 902 South Jefferson St Upper Level Roanoke VA 24016 Physician Services Schedule H, Part I, Line 3c Financial Assistance Eligibility Criteria Financial assistance policy in effect for fiscal year 2024: families with family income equal or below 300% of the Federal Poverty Guidelines and countable assets equal or below $25,000 receive 100% adjustment under FAP. Families with family income greater than 300% of the Federal Poverty Guidelines but less than or equal to 500% of the Federal Poverty Guidelines or countable assets above $25,000 and less than or equal to $100,000 receive a partial adjustment under FAP. The partial adjustment matches the highest AGB percentage determined for all facilities. Schedule H, Part I, Line 6a Community Benefit Report Information on community benefit is reported annually through a consolidated report prepared by Carilion Clinic (EIN 54-1190771). Printed copies of this report are distributed throughout communities served by hospitals affiliated with Carilion Clinic. Additionally, the community benefit report is available on Carilion Clinic's website: https://www.carilionclinic.org/cho-community-health-assessments#community-impact-reports Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 103403345 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Line 7a and 7b: For activities reported on the Medicaid Cost Report, a cost-to-charge ratio as determined from the Medicaid Cost Report was used. For all other activities, a cost to charge ratio derived from Worksheet 2 of the 990 instructions was used. Lines 7e and 7f are reported at actual cost. Line 7g: A combination of Cost Accounting and Actual Costs per service line financial statement was used. Lines 7h and 7i are reported at actual cost. Schedule H, Part II Community Building Activities Line 1 - Physical improvements and housing: Carilion acknowledges the impact of housing on health and is involved with housing-focused activities. Carilion has worked with various community partners to discuss collaborations around housing, including convening partners to fill a community gap in substance use treatment/recovery housing for pregnant and parenting women in the Roanoke Valley. Line 2 - Economic development: As the largest employer in Southwest Virginia, Carilion impacts economic development by investing in jobs, higher wages for employees and various capital construction projects. In addition, Carilion had economic development expenses from supporting the GO Virginia Foundation and the Virginia Chamber Foundation. Carilion is also active in many local economic development endeavors, including supporting the Roanoke Regional Partnership and local chambers of commerce, investing in research and technology, and communicating with local businesses about the region's current business climate and prospective companies. These initiatives promote the community's health by improving economic vitality and making the region a vibrant place to live, work and play. Line 3 - Community support: Research demonstrates the strong connection between social determinants of health-such as income, transportation, and education-and communities' overall health and well-being. Carilion supports nonprofit organizations addressing barriers to good health arising from these social determinants in various ways. Carilion also collaborates with local partners to support better education and opportunities for children and families, as well as improved housing and better nutrition for our neighbors in need. These efforts help to remove a range of obstacles to good health for our region's residents. Examples include the Presbyterian Community Center, the West End Center for Youth, and Goodwill Industries of the Valley. Through monetary donations and organizational support, Carilion promotes mental health through local arts and culture, reduces inequity, promotes youth development, and supports events for organizations like the Humble Hustle Company, the Harrison Museum of African American Culture, the Ronald McDonald House Charities, the Taubman Museum of Art, the Grandin Theatre, SWVA Pride, Inc., and the local chapter of the Southern Christian Leadership Conference. Line 6 - Coalition building: Carilion believes in the power of collaboration and understands that we must address our most significant health issues in concert with the community. Carilion participates in coalitions that address health, safety and social determinant needs in the Roanoke Valley to ensure lasting impact from the health assessment and community health improvement process. We also partner with multiple community and business organizations on initiatives to improve health and wellness for everyone in the Roanoke Valley. These coalition-building activities include participation with local substance use prevention coalitions, the Neighborhoods of Opportunity Initiative, the Child Health Investment Partnership of the Roanoke Valley, and Children's Trust of Roanoke Valley. Line 7 - Community health improvement advocacy: Carilion's mission of community health improvement focuses not only on what the organization does directly but also on supporting the advocacy efforts of other organizations. Carilion supported the Virginia Health Care Foundation and the Virginia Public Access Project and started a group of community health stewards to raise awareness on specific community health improvement topics and projects. These efforts promote better health by advocating for particular causes under the larger umbrella of health, safety, and the social determinants of health. Line 8 - Workforce development: With the understanding that employment is directly linked to health and wellness, Carilion partners to provide workforce development and training for community members. These efforts also develop a pipeline for future healthcare workers. Carilion again partnered to offer Project SEARCH, a one-year high school transition program providing employment and educational opportunities for individuals with significant disabilities. This collaborative program includes Goodwill Industries of the Valleys, the Virginia Department of Aging and Rehabilitative Services, and local school systems. Carilion continues to convene the Blue Ridge Partnership for Health Science Careers, a program that will increase awareness of health science careers in elementary, middle and high school children and create pipelines for students to enter specific higher education health science programs. Carilion is involved in the Virginia Business Higher Education Council, promoting reform and reinvestment in the higher education system, and supports Virginia Western Community College and the Virginia Western Community College Education Foundation. Carilion also supported the Virginia Ready Initiative, which works to retrain unemployed community members for in-demand jobs. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Carilion Medical Center estimates bad debt expense by reserving a percentage of all self-pay patient accounts receivable by aging category, based on collection history, adjusted for expected recoveries and, if present, anticipated changes in trends. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Patient accounts receivable are stated at net realizable amounts due from patients, third-party payors, and other insurers for which Carilion Medical Center expects to be entitled in exchange for providing patient care. In accordance with Accounting Standards Update (ASU) No. 2014-09, Revenue from Contracts with Customers (Topic 606) (ASU 2014-09), the estimated uncollectible amounts are generally considered implicit price concessions that are a direct reduction to patient accounts receivable. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Medicare allowable costs are determined from the Medicare cost report using the cost-to-charge ratio. The Hospital believes our Medicare shortfall is a cost we incur as a benefit to the community. IRS Rev. Rul. 69-545 provides that one of the factors demonstrating community benefit is caring for patients who pay their bills through public programs such as Medicare. In order to operate for the benefit of the broad community that we serve we must include our significant Medicare population, even if we are required to subsidize care to our Medicare patients due to being reimbursed at less than cost by Medicare's nonnegotiable rates. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance When accounts receivable efforts are exhausted, the account may be placed with a collection agency and extraordinary collection actions (ECAs) may be considered. Accounts will not be placed with a collection agency prior to 120 days from the date the first post-discharge billing statement is provided except when mailings are returned with no forwarding address and combining multiple accounts of varying age with those already transferred or for legal verification regarding other liabilities. Reasonable efforts will be made to identify appropriate forwarding addresses. When a financial assistance application (FAA) is received during the application period (within 240 days after the date the first post-discharge billing statement is provided), but after initiation of ECAs, all ECAs will be suspended. Best efforts will be made to process completed applications within 30 days of receipt of the application; financial assistance eligibility will be determined and communicated to the individual. Incomplete applications must be completed within 30 days of the initial notification of additional items required; otherwise, the application will be deemed incomplete and closed. If an individual is eligible for financial assistance, ECAs, other than the sale of debt, will be reversed and any payments related to eligible care refunded to the extent no longer owed. ECAs will be reinstated if the individual is not eligible for financial assistance or does not complete the FAA by the deadline. At least 30 days before initiating an ECA, Carilion will send the patient written notice of intended ECA(s), a plain language summary explaining financial assistance available and the process for determining eligibility, and the deadline for applying for assistance. Carilion will also attempt to call individuals at least 30 days before initiating an ECA to make them aware of the financial assistance available and how to obtain assistance with the application process. Carilion shall enter into a written contract with any collection agency to which it refers bad debt. The contract will obligate the collection agency to observe and comply with Carilion's obligations under this policy and the Financial Assistance Policy. A collection agency to which bad debt is referred for collection may not engage in any ECAs without the prior written consent of Carilion. After making reasonable efforts to determine if a patient qualifies for financial assistance and the patient either does not qualify for financial assistance or fails to submit an application as requested, within 240 days from the date the first post-discharge billing statement is provided, Carilion may engage in one or more of the following ECAs: 1. Place a lien on an individual's property; 2. Attach or seize an individual's bank account or any other personal property; 3. Commence a civil action against an individual; 4. Garnish an individual's wages; 5. Sell an individual's debt to another party; or 6. Report the account to credit agencies. Individual account balances greater than $5,000 are not sent to a collection agency. These are handled through the Debt Recovery Department (DRD) for verification of financial assistance status before further collection activity occurs. DRD will also investigate any accounts that require special handling. For example, in cases of a deceased patient, auto accident, or any other unique circumstances requiring special handling, the accounts are placed with the DRD. When all collection efforts have been exhausted, all hospital accounts will be returned and closed as uncollectible. No further collection activity is taken at that time. Accounts with satisfactory payment arrangements, legal activity or accounts with pending payment will be considered active and are not returned. Schedule H, Part V, Section B, Line 16a FAP website A - CARILION MEDICAL CENTER -DBA CRMH: Line 16a URL: https://www.carilionclinic.org/billing/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website A - CARILION MEDICAL CENTER -DBA CRMH: Line 16b URL: https://www.carilionclinic.org/billing/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - CARILION MEDICAL CENTER -DBA CRMH: Line 16c URL: https://www.carilionclinic.org/billing/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment In addition to conducting regular Community Health Needs Assessments (CHNAs), Carilion Clinic closely monitors community health indicators and responds to needs as they arise. Each year, Carilion updates scorecards with refreshed health data from various secondary sources and County Health Rankings indicators provided by the Robert Wood Johnson Foundation. Carilion also responds to needs identified through clinical data and internal departments, including data collected through social determinants of health screenings. A health equity and social determinants of health steering committee exists to provide oversight and guidance related to health equity and screenings, and a resource navigation subcommittee tackles more nuanced topics around current community needs as seen in the patient population. Carilion's call center, Carilion Direct, allows community members to ask questions and connect with community resources. Community Health Workers (CHWs) help address needs, and data is reviewed periodically to identify trends in the healthcare needs of patients served by CHWs. Healthcare needs are also identified through current collaborative relationships and community partnerships, including collaboration with the Virginia Department of Health and local safety net partners. Ongoing collaboration with stakeholders allows for regular communication and gives our partners opportunities to respond cohesively. Carilion has adapted its community health improvement process from Associates in Process Improvement's Model for Improvement and the Plan-Do-Study-Act cycle developed by Walter Shewhart. It consists of five steps: (1) conducting the CHNA, (2) strategic planning, (3) creating the implementation strategy, (4) program implementation and (5) evaluation. This cycle repeats every three years. Continuous quality improvement is a key principle of the process. The Strive Collective Impact Model for the Community Health Assessment Team helps Carilion foster community development in its CHNA and community health improvement processes. This evidence-based model focuses on "the commitment of a group of important players from different sectors to a common agenda for solving a specific social problem(s) can lead to large-scale changes. It focuses on relationship-building between organizations and the progress toward shared strategies. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Information on Financial Assistance is provided to the patient at hospital admission and ambulatory areas in the form of signage, a plain language summary which includes contact information, financial assistance application and documentation in the inpatient handbook. Patient Access staff, Hospital social workers and customer service representatives verbally inform patients on availability of assistance. Each patient billing statement and patient financial responsibility letter includes information on the Financial Assistance policy including who to contact for additional information and location of in-person assisters. The Application, the Policy, and the plain language summary are available free of charge to the patient. They are available by mail and on the web site if the patient did not receive written information at the time of service. Financial Assistance policy and application are also distributed to community partners through electronic mailing groups. Carilion Clinic employs an Eligibility staff that counsel patients on federal and state programs. The staff completes applications for Medicaid and provides information on Social Security, Social Security Disability and Medicare. The staff provides support services ensuring the applications are processed correctly based on federal and state policy. In addition, Eligibility staff are trained as Certified Application Counselors and will assist patients in enrollment in the Marketplace. Eligibility staff will also complete Carilion's financial assistance application and counsel patients on the requirements for financial assistance. Schedule H, Part VI, Line 4 Community information The Roanoke Metropolitan Statistical Area (MSA), home to Carilion Clinic's flagship hospital Carilion Roanoke Memorial Hospital, is commonly known as the Roanoke Valley. It comprises the independent cities of Roanoke and Salem and the counties of Bedford, Botetourt, Craig, Franklin and Roanoke. The Valley is mostly rural, nestled among the Blue Ridge Mountains with the City of Roanoke at its heart. Roanoke is a destination rich in cultural diversity, the arts, shopping, recreational opportunities, natural beauty and services unavailable in the region's more rural areas. The Roanoke Valley comprises distinct communities with significant disparities in size, population and social determinants of health. The 2019-2023 American Community Survey (ACS) found the Roanoke MSA's total population to be 394,915. The cities of Roanoke and Salem had 98,677 and 25,477 residents, respectively. Bedford, Botetourt, Craig, Franklin and Roanoke Counties had 80,254, 33,875, 4,881, 54,958 and 96,793 residents, respectively. The average household income ranges from a low of $76,775 in Roanoke City to a high of $107,156 in Roanoke County. In contrast, the median income ranges from $52,671 to $82,931 in the same localities. Across the Roanoke Valley localities, 11.34% of the population has a household income below the federal poverty guideline. Similarly, 19.79% of the insured population receives Medicaid, and 6.39% of the population have no health insurance. The highest rates of Medicaid patients are in Roanoke City at 29.76% (US Census Bureau, ACS, 2019-2023). Specific to Carilion Medical Center inpatients and outpatients in fiscal year 2024, 22.28% received Medicaid while 4.66% were self-pay (Strata internal data). The median age in the service area ranges from 38.0 in the city of Roanoke to 48.5 in Franklin County, and all other counties are above the state median of 38.8. Most of the population across the service area is White, with rates ranging up to 95.23% in Craig County (US Census Bureau, ACS, 2019-2023). Roanoke City is the most racial and ethnically diverse locality, with 58% of the population identifying as White and 29% Black. The Weldon Cooper Center for Public Service predicts positive population change by 2040 for all communities except Craig County, which may have a slight population loss. Roanoke City is divided into quadrants (Northwest, Northeast, Southwest and Southeast) separated geographically by railroad tracks, the Roanoke River and Interstate 581. These quadrants vary significantly in the demographic and economic make-up of their residents. -The Northwest and Southeast quadrants are designated as federal Medically Underserved Areas (MUAs). These areas are home to a larger proportion of the low-income individuals and families in the city who may be uninsured, underinsured or Medicaid recipients facing additional barriers due to societal and cultural differences. Bedford County, Botetourt County, Craig County and Franklin County also contain MUAs. (https://data.hrsa.gov/tools/shortage-area) In addition to Carilion Medical Center, two other hospitals serve the area: the Salem Veterans Affairs Medical Center and LewisGale Medical Center. Key safety net providers in the region include the Veteran Affairs Medical Center, a federally qualified health center, free clinics, local Virginia Department of Health offices and other service organizations. Schedule H, Part VI, Line 5 Promotion of community health Carilion Medical Center is part of the non-profit Carilion Clinic integrated healthcare system located in the Blue Ridge Mountains. Carilion provides quality care for nearly one million individuals through a comprehensive network of hospitals, primary and specialty physician practices, wellness centers, and other complementary services. Carilion's roots go back 125 years, when a group of dedicated citizens came together and built a hospital to meet the community's healthcare needs. Today, Carilion is a vital anchor institution focused on healthcare and dedicated to our mission of improving the health of the communities we serve. With an enduring commitment to our region's health, care is advanced through clinical services, medical education, research and community health investments. Carilion believes in service, collaboration and caring for all. Carilion invests in discovering and responding to local and regional health needs, understanding that we must involve additional stakeholders to address community health issues and create change effectively. Carilion recognizes the impact the environment has on the health of our communities. Efforts continue to make our hospitals and other facilities more energy-efficient, increase recycling and use of recyclable or bio-degradable materials, reduce waste materials and serve local, sustainable foods to patients and in our cafeterias. Carilion has an office of sustainability that leads these efforts and empowers employees to be involved in environmental health-related projects. Carilion Medical Center (CMC) includes Carilion's flagship facility, Carilion Roanoke Memorial Hospital (CRMH). CRMH includes a Level 1 Trauma Center, a Neonatal Intensive Care Unit, Carilion Children's Hospital and 718 patient beds. Offering a wide range of inpatient and outpatient care, specialty care, medical education, and fellowships, CRMH has gained recognition as Virginia's top six hospital by U.S. News and World Report. CRMH provides access to the region's most experienced providers and specialty services while teaching and developing tomorrow's medical leaders through residencies and fellowships sponsored by the Virginia Tech Carilion School of Medicine. Additionally, Carilion Roanoke Community Hospital houses a highly skilled inpatient rehabilitation unit, a wound healing center, endoscopy services, outpatient surgery, and an occupational medicine practice. Women's services have two practice sites at this facility, including urogynecology and maternal-fetal medicine. CMC serves all patients regardless of their ability to pay. The hospital's governing board members reside in the region and are elected to 3-year terms, with board officers elected annually. The majority of members are neither hospital employees nor contractors. Medical staff privileges are extended to qualified providers. Surplus funds are reinvested in new technology, clinical initiatives, education, staff development, and charitable efforts. Reinvestments include providing free, discounted and subsidized care and critical medical services not otherwise offered in our region. Schedule H, Part VI, Line 6 Affiliated health care system Carilion Medical Center is wholly owned by Carilion Clinic, a not-for-profit healthcare organization based in Roanoke, Virginia. Carilion Clinic includes a comprehensive network of hospitals, primary and specialty physician practices, and complementary services comprising six hospital entities, 86 specialties and 295 practice sites across Southwest Virginia. All are centered on a common mission and shared values. In the mid-2000s, Carilion decided to transform from a collection of hospitals to a physician-led, integrated healthcare system. Advances include developing a multi-specialty physician group, transforming our primary care practices into patient-centered medical homes, implementing electronic health records system-wide creating a robust partnership with Virginia Tech, including developing the Virginia Tech Carilion (VTC) School of Medicine and the Fralin Biomedical Research Institute at VTC, and hosting Radford University Carilion's healthcare professional educational offerings on our Carilion Roanoke Community Hospital campus. Each decision and adaptation have fundamentally changed how Carilion collaborates and provides care (https://www.carilionclinic.org/about-carilion-clinic). Carilion's community and population health infrastructure is the health system's engine for providing collaborative opportunities to improve and promote the community's health. Carilion's Community Health Assessment process helps identify the strengths and barriers impacting health. Our community-based programs reflect the Robert Wood Johnson Foundation's framework of four main influences of health: health behaviors, social and economic factors, clinical care access and quality, and physical environment. Our many partnerships with cross-sector organizations create a collaborative culture of health and wellness. true American Cancer Society 131788491 501(c)(3) 10000 Program support American Heart Association 135613797 501(c)(3) 15050 Event sponsorships Bradley Free Clinic of Roanoke 237380491 501(c)3 28000 Behavioral Health Services Family Service of Roanoke Valley 540505946 501(c)(3) 11000 Mental Health Wellness Grandin Theatre Foundation Inc 010557881 501(c)(3) 25000 Sponsorship Junior Achievement of SW VA 540628293 501(c)(3) 6750 Event sponsorship National Multiple Sclerosis Society 135661935 501(c)(3) 6500 Sponsorship Opera Roanoke 510213334 501(c)(3) 9000 Sponsorship Radford University 546001789 Virginia 243442 Assoc Provost Health Sci Ronald McDonald House Charities SWVA 541244769 501(c)(3) 1500 285327 FMV Donated Rent Donated rent prog support Science Museum of Western Virginia 541023953 501(c)(3) 25000 Program support Taubman Museum of Art 546026841 501(c)(3) 22500 Sponsorship The Virginia Foundation for Community College Education 237004354 501(c)(3) 7500 Event Sponsorship Valleys Innovation Council Verge 462975294 501(c)(3) 100000 Program support Virginia Growth and Opportunity Foundation 811586667 501(c)(3) 100000 Program support Virginia Health Care Foundation 541639924 501(c)(3) 75000 Program support One Valley Inc 274543707 501(c)(3) 10000 Urban farming initiative Blue Ridge Literacy 541377063 501(c)(3) 10000 English and Health literacy classes City of Roanoke 546001569 City of Roanoke 10000 Financial Empowerment Center Commonwealth Catholic Charities 540505877 501(c)(3) 10000 Refugee medical service access Virginia Harm Reduction Coalition 832479145 501(c)(3) 10364 Program support Feeding Southwest Virginia 541939556 501(c)(3) 7500 Nutrition education and resources Planned Parenthood South Atlantic 561282557 501(c)(3) 7500 Informed Health Decision support The Rescue Mission of Roanoke Inc 540573900 501(c)(3) 14000 Recovery coach Roanoke Symphony Orchestra 546019736 501(c)(3) 15000 Sponsorship United Way of Roanoke Valley 540535302 501(c)(3) 50000 Health collaborative Virginia Chamber Foundation 510193842 501(c)(3) 50000 Program support Virginia Business Higher Education Council 541827038 501(c)(3) 25000 Program support Virginia Ready Initiative 851103573 501(c)(3) 62500 Program support Virginia Tech Carilion School of Medicine 264556177 Virginia 4422046 Medical School Support Carilion Clinic Properties LLC 205231645 501(c)(3) 258407 Pediatric Behavioral Health 29 2 Endowment Funded Patient Care 5 47599 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds The hospital donates funds to other charitable organizations in support of health and community improvement. Such organizations also have community boards which oversee the expenditure of such funds. Carilion Clinic is committed to improving the health of the communities that we serve by addressing key health priorities identified through our triennial Community Health Assessments. Carilion fulfills this commitment in many ways, one of which is through targeted grants for community health improvement programs, and those that impact the social determinants of health. For Carilion Clinic's Community Grant Program, each grantee must sign a letter of agreement with Carilion Clinic that delineates the terms and specific objectives of the project. By accepting a Carilion award, grantees are asked to acknowledge the support of Carilion Clinic in all materials and/or related special events or fundraisers throughout the award cycle where other donors are publicly recognized. One mid-cycle progress report and a final program evaluation are required for each funded project. Site visits may be made to grantees. Program evaluation includes alignment with Community Health Assessment priorities, program impact, organizational effectiveness and community benefit through collection of data including clients served, cost effectiveness of the program (cost per client or service), tangible community or client outcomes, collaboration with other organizations, and specific efforts to cultivate diverse funding sources for program sustainability. Each grantee must agree to submit requested data and reports on a timely basis and to complete the evaluation process as requested. X X false true false true false false false false false true false Steven Arner Director/President/CEO 0 1044670 0 164317 0 201205 0 184622 0 24996 0 1619810 0 195888 Paul Haskins MD Director/Physician 349372 0 26661 0 5968 0 59134 0 26367 0 467502 0 0 0 Michael Nussbaum MD Director/SVP/Surgical Services Chair 789374 0 101259 0 85917 0 23702 0 17811 0 1018063 0 0 0 Daniel Tershak MD Director/Chief of Medical Staff 470339 0 41990 0 18553 0 8465 0 23055 0 562402 0 0 0 David Hagadorn Former Officer 0 120679 0 0 0 38425 0 13363 0 11709 0 184176 0 0 Nicholas Conte Secretary 0 731687 0 111366 0 180664 0 156813 0 18080 0 1198610 0 172601 Donald Halliwill Asst. Treasurer 0 767976 0 117511 0 233761 0 142915 0 24996 0 1287159 0 227735 G Robert Vaughan Jr Treasurer 0 353161 0 41359 0 63488 0 46006 0 24996 0 529010 0 57282 Michael Abbott Senior Vice President 318357 0 36299 0 7134 0 90491 0 9767 0 462048 0 0 0 Nancy Howell Agee CEO, Carilion Clinic 0 1718407 0 353685 0 1758613 0 -14700 0 16492 0 3832497 0 1500000 Daniel Harrington MD Interim Chief Medical Officer/EVP 0 320000 0 0 0 10239 0 0 0 2444 0 332683 0 0 John Jane MD SVP, Chair Neurosurgery 541806 0 75000 0 37485 0 62500 0 10218 0 727009 0 0 0 Joseph Moskal MD SVP/Chair, Dept. of Orthopedics 1179271 0 157985 0 84441 0 0 0 24727 0 1446424 0 0 0 Jon Sweet MD SVP/Chair, Dept. of Medicine 512329 0 78578 0 5900 0 69392 0 13135 0 679334 0 0 0 Jonathan Carmouche MD Physician 1471439 0 145830 0 3114 0 3080 0 23055 0 1646518 0 0 0 Gregory Howes MD Physician 1217439 0 256440 0 2833 0 8445 0 23055 0 1508212 0 0 0 Eric Marvin MD Physician 1090939 0 451228 0 3893 0 -2821 0 23055 0 1566294 0 0 0 Adeolu Olasunkanmi MD Physician 847992 0 501380 0 3525 0 11756 0 9270 0 1373923 0 0 0 Cara Rogers MD Physician 746233 0 363121 0 2293 0 15235 0 9270 0 1136152 0 0 0 Schedule J, Part I, Line 1a Tax indemnification and gross-up payments EMPLOYEES ARE OCCASIONALLY PROVIDED SMALL GIFTS, PRIZES OR AWARDS WHICH MAY BE INCLUDED IN TAXABLE COMPENSATION AT AMOUNTS GROSSED UP FOR TAXES. DURING THE REPORTING PERIOD, Dr. NUSSBAUM, DR. LEARMAN, DR. SWEET, AND DR. MOSKAL RECEIVED SUCH BENEFIT. Schedule J, Part I, Line 1a Health or social club dues or initiation fees All Directors are offered a free family or individual membership to a health club owned by a related organization if they choose to accept it. Two reported individuals received this benefit, the value of which is included in reported compensation. Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses Provision of the health club benefit is documented in Board meeting minutes and Carilion internally tracks the memberships and pays the health club directly. MANAGEMENT MAKES TAX GROSS-UP DECISIONS AT ITS DISCRETION FOR NON-ROUTINE SMALL GIFTS, PRIZES OR AWARDS CONSIDERING IRS REQUIREMENTS, AMOUNT, AND NON-CASH STATUS. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The Carilion Clinic Board of Directors Compensation Committee reviews the compensation of the Carilion Clinic Board of Governors annually, which includes Carilion Medical Center's President/CEO. The Compensation Committee is made up of independent Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for certain select positions and the prior year's report on all the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, which list was reviewed by the Compensation Committee. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Mr. Abbott, Mr. Arner, Mr. Conte, Mr. Halliwill, Dr. Moskal, Dr. Nussbaum, Dr. Haskins, Dr. Jane, Dr. Sweet and Mr. Vaughan participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP). Contributions to the plan are at the discretion of Carilion Clinic's Compensation Committee. Amounts vest and become non-forfeitable and payable upon the first of the following (1) attainment of scheduled vesting date (2) attainment of age and years of service requirements (3) disability or death while an eligible employee or (4) entitlement to severance benefits from an involuntary termination without reasonable cause or resignation with good reason. Unvested contributions made to the DC SERP in the reporting period are included in Part II, Column C of this schedule with "retirement and other deferred compensation," while vested contributions paid out during the year are included in Part II, Column B(iii). The following distributions were made to these individuals under this plan in the reporting year. Deferred in prior year and paid out in current year: $227,735 - Donald Halliwill $195,888 - Steven Arner $57,282 - G. Robert Vaughan, Jr. $172,601 - Nicholas Conte Vested and paid in current year: $75,000 - Joseph Moskal $72,352 - Michael Nussbaum Ms. Agee participates in an Executive Flexible Benefit Plan, under which she receives an allowance which can be used to obtain certain benefits, with the excess deferred until the applicable vesting date. Amounts received under this plan now vest immediately and thus are no longer deferred. $245,365 was distributed under this plan in the reporting year. In the current year Ms. Agee also received $1,500,000 per a retention agreement that had been previously reported in Part II Col. C. Schedule J, Part I, Line 7 Non-fixed payments The organization pays annual 'at risk' compensation to certain members of management and physicians based on performance of applicable scorecard metrics. While the scorecard contains a formula as a basis for determining overall performance, in certain cases, senior managers have discretion to include additional elements in their assessment of managers or physicians reporting to them. In addition, for top management, the actual non fixed payment awarded is determined in the discretion of the Carilion Clinic Board of Directors and its compensation committee. Patricia Abbott Family member of Michael Abbott, key employee 181047 Employee false Mary Sweet MD Family member of Jon Sweet, key employee 333129 Employee false Andrew Maslich Family member of Steven Arner, Director 63877 Employee false Form 990, Part I, Line 6 Volunteers The hospital operates a Customer Service-based program for volunteers, going above and beyond to make our patients and their families comfortable in very uncomfortable circumstances. Tasks include delivering mail and flowers, greeting and escorting patients, offering refreshments through our Hospitality cart, conducting pet-assisted therapy visits, and generally supporting the Guest Services Staff. CMC volunteers also support our patient units by performing these tasks in addition to volunteer work that supports the nursing staff, such as organizing supplies and visiting patients who do not have family present. Through Hospice, volunteers provide respite support for caregivers, visits for socialization and comforting presence, check in calls, care for patients' pets, help in the hospice office, plant/harvest/deliver fresh veggies, offer Virtual Reality experiences, sing in the hospice choir to patients, provide honoring ceremonies for military veteran patients, offer pet therapy and Reiki therapy, provide visits from a Santa Claus with a real beard, offer end of life Doula support including Vigil planning, assist with fundraisers, assist with bereavement support activities, make fidget quilts for dementia patients and sew dignity patient gowns, deliver birthday gifts, craft holiday gifts and record patient's life stories. Volunteer licensed cosmetologist provided patients with fresh haircuts. Form 990, Part III, Line 4a Program Service Description Carilion Medical Center (CMC) is an affiliate of Carilion Clinic, a not-for-profit health system headquartered in Roanoke, Virginia. CMC includes Carilion Roanoke Memorial Hospital, Carilion Roanoke Community Hospital and surrounding clinics and practices. Carilion Roanoke Memorial Hospital's commitment to improving the health of its community is recognized through its ranking among the elite 11% of Best Hospitals nationally and among the top three hospitals in Virginia by U.S. News and World Report. CMC also has earned five Magnet designations for nursing excellence, placing it in the top 1% of hospitals globally and the only one in Virginia to earn the honor. Committed to innovation and clinical excellence and supported by education and research, Carilion operates a regional cancer center, the region's only Level I Trauma Center, and the region's only pediatric center of excellence, with an inpatient unit within Carilion Roanoke Memorial Hospital that includes a pediatric intensive care unit, Virginia's third largest neonatal ICU, trauma care and western Virginia's only pediatric Level I Trauma Center. CMC admitted over 35,253 patients, delivered 3,274 babies, and provided 211,891 days of care in fiscal year 2024. With nearly 85,000 visits, CMC's emergency services are a critical component of the health safety net in its service area, acting as a key health provider for a significant number of uninsured patients, who comprise about 7 percent of ED visits. More than a dozen pediatric sub-specialties are housed at Carilion Children's freestanding outpatient clinic. They include physical, occupational and speech therapies, and ENT/audiology, mental health and dentistry services. In addition, CMC physicians provide care in a range of specialties at numerous clinic practice sites on and near its Roanoke hospital campuses as well as throughout the Western Virginia region. To meet the growing need for care in Southwest Virginia, in Summer 2025 Carilion opened a $500 million tower addition to Carilion Roanoke Memorial Hospital. The 12-story, 500,000-square-foot Crystal Spring Tower is home to the Carilion Clinic Cardiovascular Institute and a significantly expanded Emergency Department. In addition to providing medical care, Carilion invests significantly in medical education. The health system's Graduate Medical Education program, based at Carilion Roanoke Memorial Hospital, trains more than 300 residents and fellows in 29 programs with nearly half of program graduates remaining in Southwest Virginia to care for patients in the region. Through partnerships with premier institutions like Virginia Tech and Radford University, Carilion also provides undergraduate medical education and training at CMC for physicians, nurses and a range of allied health professionals. In addition, CMC provides numerous community health screenings and education on chronic disease prevention and management, invests in an internal community health workforce, and partners with community organizations to identify and address health needs. To advance its not-for-profit mission, Carilion cares for all patients regardless of their ability to pay. Stated at cost, in fiscal year 2024, CMC provided nearly $76 million in uncompensated care and other community support . Carilion Medical Center's achievements in patient care, education, and community support demonstrate its steadfast commitment to meeting the needs of the communities it serves. Form 990, Part IV, Line 11f Disclosure of Uncertain Tax Positions Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. Form 990, Part V, Line 1a FORMS 1099 1099s are issued on Carilion Medical Center's behalf by Carilion Services, Inc., a related supporting organization providing management and administrative services, including payment processing. Form 990, Part VI, Line 1a Delegate broad authority to a committee Carilion Medical Center has an Executive Committee authorized to act when the Board is not in session. The Executive Committee has 4 members, made up of the Carilion Medical Center President and Chair of the Board, CAPS Committee, and Nominating Committee. The Executive Committee meets at times that the Board cannot meet and if the need arises to act on behalf of the Board, except to elect directors or Committee members, amend governing documents, approve a plan of merger, or other actions that are required to be approved by Board members. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons Nancy Howell Agee, Steven Arner, Nicholas Conte, Daniel Harrington, Donald Halliwill, G. Robert Vaughan Jr., J. Harrison Lapausa and Julie Smith-Hamilton - Business relationship Form 990, Part VI, Line 3 Delegation of management duties Certain management and related services for the organization are provided by the management and employees of Carilion Services, Inc., a related and supporting organization of the filing organization. Some or all of the compensation of the following individuals listed in Part VII, Section A was provided by Carilion Services Inc.: Nancy Howell Agee, Steven Arner, Nicholas Conte, David Hagadorn, Donald Halliwill, Julie Smith-Hamilton, J. Harrison Lapausa, and G. Robert Vaughan, Jr. Form 990, Part VI, Line 6 Classes of members or stockholders The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the board that may occur for any reason. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO; approval of borrowings, budgets, and strategic plans; and amendments of Articles of Incorporation and Bylaws, among others. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia, certain extraordinary actions require member approval, such as mergers, consolidations, liquidations, and the sale of substantially all of the assets of the organization. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a. Form 990, Part VI, Line 11b Review of form 990 by governing body The Form 990 was prepared by Carilion's internal Tax Department with input from various other Carilion departments as applicable, and reviewed by internal management and an independent CPA firm. Management reviewed a draft of the Form 990 at the August meeting of the Carilion Clinic Board of Directors Audit Committee and was available to answer questions. Several days prior to filing, all Board Members were notified via email that the final Form 990 was available for their access on the organization's Board portal and were provided contact information to reach out to for any questions. Form 990, Part VI, Line 12c Conflict of interest policy Our organization monitors and reviews proposed and current transactions for conflicts of interest in a variety of ways. At the governing board level, we have board members complete an initial (upon appointment) and annual conflict of interest questionnaire to disclose actual or potential conflicts. Board members are required to update their disclosure as needed in between questionnaires. All disclosures are reviewed by the Compliance Office and as needed escalated to the appropriate leaders/board members for further discussion/review. If a disclosure is viewed as an actual or potential conflict, an action is recommended to the Compliance Committee of the Carilion Clinic Board and implemented as approved. Actions can include recusal in discussion/voting at board meetings, limitation/termination of the transaction, removal from board appointment or other appropriate controls. In addition, at any time, board members are encouraged to disclose any potential conflicts as they arise at a board meeting and to recuse themselves as deemed appropriate. The same process takes place as described above for key employees (upon hire and annually thereafter), including all officers, members of the management team, physicians/mid-level practitioners, pharmacists and key supply chain buyers. After review and further discussion as needed, action may be required to manage an actual conflict or to reduce the appearance of such as approved by the Compliance Office and other key management team members. As needed, the governing board leaders are notified of any conflicts which may impact board proceedings. Form 990, Part VI, Line 15a Process to establish compensation of top management official The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The Carilion Clinic Board of Directors Compensation Committee reviews the compensation of the Carilion Clinic Board of Governors annually, which includes the Carilion Clinic President and Chief Executive Officer, Executive Vice Presidents (Chief Financial Officer, Chief Physician Executive, Chief Operating Officer, Chief Administrative Officer and Chief Legal Officer), and select Senior Vice Presidents of Carilion Medical Center who are the physician Chairs of the Clinical Departments. Certain of these same individuals also hold roles as officers and key employees of Carilion Medical Center, including its President/CEO. The Compensation Committee is made up of independent Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. The Compensation Committee also annually reviews the compensation philosophy for all executive leaders in the health system, which includes Vice Presidents, Senior Vice Presidents including Carilion Medical Center's Treasurer, Executive Vice Presidents, and the CEO, as well as the compensation philosophy for employed physicians. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for certain select positions and the prior year's report on all the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, which list was reviewed by the Compensation Committee. The Compensation Committee maintained minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives. For officers who are not directly reviewed by the Compensation Committee, the independent external compensation consultant conducts the same analysis and shares the data/findings with the system EVP/COO. In the case of the interim Chief Medical Officer, compensation was reviewed with the CEO and clinical department Chairs. Certain assistant officers of the organization who are not compensated in their capacity as an officer but rather in their role as employee in a position not mentioned above are not subject to Committee or consultant review but are compared to market benchmarks by the Human Resources department. Form 990, Part VI, Line 15b Process to establish compensation of other employees See response to line 15A. Form 990, Part VI, Line 19 Required documents available to the public The organization's governing documents, conflict of interest statement, and consolidated financial statements are released from time to time during the tax year upon request. The conflict of interest policy is included in our Code of Excellence which is available to the public on our website. The Articles of Incorporation are available from the Virginia State Corporation Commission. Limited consolidated financial information is available on our website. Form 990, Part VIII, Line 2f Other Program Service Revenue Other - Total Revenue: 2674181, Related or Exempt Function Revenue: 2674181, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Revenue - Total Revenue: 8998770, Related or Exempt Function Revenue: 8998770, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part X, Line 20 Tax Exempt Bond Liabilities The amount reported as Tax-Exempt Bonds is the portion of Carilion Clinic Bonds allocated to Carilion Medical Center. Required information for the Bonds, including Schedule K, is reported in the Carilion Clinic (EIN: 54-1190771) IRS Form 990. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfers from/(to) Affiliates - -2938536; Pension-related changes other than net periodic pension costs - -XXX-XX-XXXX; 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) Type II NA false CARILION CLINIC FOUNDATION PO BOX 12385 ROANOKE VA 24025 541190773 FUNDRAISING VA 501(c)(3) 7 CARILION CLINIC true CARILION FRANKLIN MEMORIAL HOSPITAL PO BOX 12385 ROANOKE VA 24025 540480606 HEALTHCARE VA 501(c)(3) 3 CARILION CLINIC true CARILION GILES COMMUNITY HOSPITAL PO BOX 12385 ROANOKE VA 24025 540549603 HEALTHCARE VA 501(c)(3) 3 CARILION CLINIC true CARILION NEW RIVER VALLEY MEDICAL CENTER PO BOX 12385 ROANOKE VA 24025 540553805 HEALTHCARE VA 501(c)(3) 3 CARILION CLINIC true CARILION SERVICES INC PO BOX 12385 ROANOKE VA 24025 541190879 SUPPORTING ORGANIZATION VA 501(c)(3) Type II CARILION CLINIC true CARILION ROCKBRIDGE COMMUNITY HOSPITAL PO BOX 12385 ROANOKE VA 24025 540568001 HEALTHCARE VA 501(c)(3) 3 CARILION CLINIC true CARILION TAZEWELL COMMUNITY HOSPITAL PO BOX 12385 ROANOKE VA 24025 546074580 HEALTHCARE VA 501(c)(3) 3 CARILION CLINIC true CARILION BIOMEDICAL INSTITUTE PO BOX 12385 ROANOKE VA 24025 541965057 SUPPORTING ORGANIZATION VA 501(c)(3) Type I CARILION CLINIC true Franklin County Ventures LLC PO Box 12385 Roanoke VA 24025 474365316 Real estate VA Carilion Clinic Related -17 53814 false false 0.1 Carilion Clinic Medicare Shared Savings Company LLC PO Box 12385 Roanoke VA 24025 455235473 Medicare ACO VA Carilion Clinic Related 643349 9728291 false false 0.5 Roanoke Ambulatory Surgery Center LLC 1102 Jefferson Street SE Roanoke VA 24016 010691564 Surgery VA Carilion Medical Center Related 310909 1353919 false false 0.5292 Southwest Virginia Health Properties LLC 1102 Jefferson Street SE Roanoke VA 24016 010691570 Real estate VA Carilion Medical Center Related 139587 1211565 false false 0.5292 Raven Asset-Based Opportunity Fund IV LP 75 Spring Street 6th Floor New York NY 10012 824119491 Private equity DE NA N/A Starwood VEP II Co-Invest LLC 591 W Putman Ave Greenwich CT 06830 833262407 Investments DE NA N/A TI Platform CC SMA LP 4304 18th Street 14427 San Francisco CA 941149991 842852539 Investments DE NA N/A TI FBV GR LP 4304 18th Street 14427 San Francisco CA 941149991 862597246 Investments DE NA N/A TI Platform DCI SPV LP 4304 18th Street 14427 San Francisco CA 941149991 871897835 Investments DE NA N/A Transpose Platform Zippedi SPV LP 4304 18th Street 14427 San Francisco CA 941149991 873425361 Investments DE NA N/A Transpose Platform Gorgias SPV LP 4304 18th Street 14427 San Francisco CA 941149991 874563291 Investments DE NA N/A Transpose Platform Fintech Fund II LP 4304 18th Street 14427 San Francisco CA 941149991 873126138 Investments DE NA N/A Opera Investment Two SCSP 412F Route dEsch Luxembourg LU 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M 81135 Cost Carilion Services Inc R 2938536 Cash Carilion Clinic B 258407 Cost Carilion Clinic Foundation C 458222 cost Carilion Clinic Foundation R 103171 cash