CARILION TAZEWELL COMMUNITY HOSPITAL: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: CARILION TAZEWELL COMMUNITY HOSPITAL (EIN 54-6074580)
Tax period: 2019-10-01 to 2020-09-30
Filed: 2021-08-16
IRS object ID: 202132289349303183
Schema version: 2019v5.0
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-08-16T15:30:50-05:00	ReturnTs
Tax Period End	2020-09-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	546074580	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Carilion Tazewell Community Hospital	BusinessNameLine1Txt

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

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

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

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

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

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$16,506,221	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CARILIONCLINIC.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1968	FormationYr
Legal Domicile State	VA	LegalDomicileStateCd
Activity Or Mission	Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	183	TotalEmployeeCnt
Total Volunteers	21	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$110,560	PYContributionsGrantsAmt
CY Contributions Grants	$1,208,402	CYContributionsGrantsAmt
PY Program Service Revenue	$15,591,569	PYProgramServiceRevenueAmt
CY Program Service Revenue	$15,293,546	CYProgramServiceRevenueAmt
PY Investment Income	$6,842	PYInvestmentIncomeAmt
CY Investment Income	$7,700	CYInvestmentIncomeAmt
PY Other Revenue	$59,871	PYOtherRevenueAmt
CY Other Revenue	-$3,427	CYOtherRevenueAmt
PY Total Revenue	$15,768,842	PYTotalRevenueAmt
CY Total Revenue	$16,506,221	CYTotalRevenueAmt
PY Grants And Similar Paid	$22,384	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$10,586	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$6,936,393	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$7,484,751	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$11,724,940	PYOtherExpensesAmt
CY Other Expenses	$11,406,625	CYOtherExpensesAmt
PY Total Expenses	$18,683,717	PYTotalExpensesAmt
CY Total Expenses	$18,901,962	CYTotalExpensesAmt
PY Revenues Less Expenses	-$2,914,875	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$2,395,741	CYRevenuesLessExpensesAmt
Total Assets BOY	$6,897,849	TotalAssetsBOYAmt
Total Assets EOY	$6,326,544	TotalAssetsEOYAmt
Total Liabilities BOY	$28,752,779	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$30,577,490	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$21,854,930	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$24,250,946	NetAssetsOrFundBalancesEOYAmt
Mission	Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$16,216,439	ExpenseAmt
Grant	$10,586	GrantAmt
Revenue	$15,203,085	RevenueAmt
Desc	See Schedule O.	Desc
Total Program Service Expenses	$16,216,439	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	183	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (true)	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	false	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

Field	Value	IRS element (for citing)
Phone	5402245102	PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Alicia Bales
Director/CEO	36.0	14.0	Yes (X)	Yes (X)	$68,674	$27,569	$34,772
D Michael HYMES
Director/Vice Chair	1.2	0	Yes (X)	Yes (X)	$0	$0	$0
James Thompson
Director/Chair	2.5	2.4	Yes (X)	Yes (X)	$0	$7,200	$0
Kristie Williams
Director/Hospital VP	2.5	47.5	Yes (X)	Yes (X)	$0	$195,595	$152,584
Mandy French
Director/Secretary/Treasurer	1.2	0	Yes (X)	Yes (X)	$0	$0	$0
Peggy RILEY
Director/Secretary/Treasurer	1.2	0	Yes (X)	Yes (X)	$0	$0	$0
Anthony Grills
Director	1.2	0	Yes (X)		$0	$0	$0
Antony Roop
Director	1.2	0	Yes (X)		$0	$0	$0
Kevin Combs DO
Director	1.2	48.8	Yes (X)		$0	$228,384	$48,117
Michael Rorrer MD
Director	1.2	48.8	Yes (X)		$0	$286,828	$2,941
Nellie Stillwell
Director	1.2	0	Yes (X)		$0	$0	$0
William Flattery
Director	1.2	48.8	Yes (X)		$0	$326,678	$154,080
David Hagadorn
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$149,339	$99,463
Donald Halliwill
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$774,298	$360,873
G Robert Vaughan Jr
Asst. Treasurer	0.5	49.5		Yes (X)	$0	$353,112	$316,295
Nicholas Conte
Asst. Secretary	1.0	49.0		Yes (X)	$0	$709,682	$182,512
Nancy Howell Agee
CEO, Carilion Clinic	2.0	48.0			$0	$2,254,723	$341,866	Yes (X)
Steven Arner
Executive Vice President	2.0	48.0			$0	$877,942	$363,619	Yes (X)
DAVID VANCE
Pharmacy Manager	42.1	7.9			$108,534	$20,513	$40,205		Yes (X)
Kathren Dowdy
Former Director/Officer	50.0	0			$104,624	$0	$123			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$281,832	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$6,211,863	TotReportableCompRltdOrgAmt
Total Other Compensation	$2,097,450	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
QUEST DIAGNOSTICS
500 PLAZA DRIVE	SECAUCUS	NJ	07094	LABORATORY SERVICES	$815,156
MR RAMAKRISHNAN MD PC
1745 VALLEY VIEW DRIVE	BIG STONE GAP	VA	24219	PHYSICIAN SERVICES	$288,000
DIRECT RADIOLOGY PLLC
1839 NORTH GOVERNMENT WAY	COEUR DALENE	ID	838143454	PROFESSIONAL SERVICES	$109,396

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	3	CntrctRcvdGreaterThan100KCnt
Government Grants	$1,179,477	GovernmentGrantsAmt
All Other Contributions	$28,925	AllOtherContributionsAmt
Total Contributions	$1,208,402	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue	622110	$15,141,537	$15,141,537
Rent From Affiliates	531120	$152,009	$152,009

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

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

Field	Value	IRS element (for citing)
Total Program Service Revenue	$15,293,546	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,233	TotalRevenueColumnAmt
Exclusion	$4,233	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$49,807	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$49,807	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$49,807	TotalRevenueColumnAmt
Exclusion	$49,807	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$3,467	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$3,467	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,467	TotalRevenueColumnAmt
Exclusion	$3,467	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
Affiliate Contract Revenue	900099	$6,720	$6,720
Prior Year Grant adjustment	900099	-$100,000	-$100,000
Cafeteria	722514	$37,227		$37,227

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,819	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,819	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	-$53,234	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$16,506,221	TotalRevenueColumnAmt
Related Or Exempt Func Income	$15,203,085	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$94,734	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$10,586	TotalAmt
Program Services	$10,586	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$118,438	TotalAmt
Management And General	$118,438	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$105,403	TotalAmt
Program Services	$105,403	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$5,815,691	TotalAmt
Program Services	$5,768,975	ProgramServicesAmt
Management And General	$46,716	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$469,676	TotalAmt
Program Services	$465,903	ProgramServicesAmt
Management And General	$3,773	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$548,863	TotalAmt
Program Services	$536,250	ProgramServicesAmt
Management And General	$12,613	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$426,680	TotalAmt
Program Services	$416,106	ProgramServicesAmt
Management And General	$10,574	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$2,346,492	TotalAmt
Management And General	$2,346,492	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$1,289	TotalAmt
Program Services	$1,289	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,288,103	TotalAmt
Program Services	$2,226,076	ProgramServicesAmt
Management And General	$62,027	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$900	TotalAmt
Management And General	$900	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$334,449	TotalAmt
Program Services	$323,251	ProgramServicesAmt
Management And General	$11,198	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$26,472	TotalAmt
Program Services	$26,472	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$214,291	TotalAmt
Program Services	$214,291	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$148,120	TotalAmt
Program Services	$147,381	ProgramServicesAmt
Management And General	$739	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$565,728	TotalAmt
Program Services	$565,728	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$716,770	TotalAmt
Program Services	$716,770	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$135,177	TotalAmt
Program Services	$76,312	ProgramServicesAmt
Management And General	$58,865	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$700,691	$700,666	$25
Bad Debt	$1,631,918	$1,631,918
Intercompany Practice Subsidy	$1,863,744	$1,863,744
Assessment Fees	$399,060	$399,060

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$33,421	TotalAmt
Program Services	$20,258	ProgramServicesAmt
Management And General	$13,163	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$18,901,962	TotalAmt
Program Services	$16,216,439	ProgramServicesAmt
Management And General	$2,685,523	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,175	BOYAmt
EOY	$1,175	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$23,825	BOYAmt
EOY	$3,825	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$2,092,794	BOYAmt
EOY	$1,997,147	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

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

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$131,978	BOYAmt
EOY	$25,601	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$18,022,561	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$13,723,765	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$4,648,077	BOYAmt
EOY	$4,298,796	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Other Assets Total OtherAssetsTotalGrp

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

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$6,897,849	BOYAmt
EOY	$6,326,544	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,514,857	BOYAmt
EOY	$1,570,971	EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$36,813	BOYAmt
EOY	$4,205,957	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$27,201,109	BOYAmt
EOY	$24,800,562	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$28,752,779	BOYAmt
EOY	$30,577,490	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$21,854,930	BOYAmt
EOY	-$24,250,946	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	-$21,854,930	BOYAmt
EOY	-$24,250,946	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$6,897,849	BOYAmt
EOY	$6,326,544	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$2,395,741	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$275	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$1,289	OtherActivitiesAmt
Total Lobbying Expenditures	$1,289	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

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

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$48,753	OtherCostOrOtherBasisAmt
Book Value	$48,753	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,108,124	OtherCostOrOtherBasisAmt
Depreciation	$5,957,268	DepreciationAmt
Book Value	$3,150,856	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$0	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$8,359,588	OtherCostOrOtherBasisAmt
Depreciation	$7,421,224	DepreciationAmt
Book Value	$938,364	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$506,096	OtherCostOrOtherBasisAmt
Depreciation	$345,273	DepreciationAmt
Book Value	$160,823	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$4,298,796	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
Due to Affiliate	$24,749,361
Pension Liability	$51,201

Field	Value	IRS element (for citing)
Total Liability	$24,800,562	TotalLiabilityAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	false	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$282,473	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$282,473	NetCommunityBenefitExpnsAmt
Total Expense	0.0164	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,473,659	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,834,549	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

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

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$1,756,132	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,834,549	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$282,473	NetCommunityBenefitExpnsAmt
Total Expense	0.0164	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	35	ActivitiesOrProgramsCnt
Persons Served	747	PersonsServedCnt
Total Community Benefit Expns	$136,487	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,828	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$129,659	NetCommunityBenefitExpnsAmt
Total Expense	0.0075	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

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

Subsidized Health Services SubsidizedHealthServicesGrp

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

Research ResearchGrp

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

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	2600	PersonsServedCnt
Total Community Benefit Expns	$5,607	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$152	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,455	NetCommunityBenefitExpnsAmt
Total Expense	0.0003	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	38	ActivitiesOrProgramsCnt
Persons Served	3347	PersonsServedCnt
Total Community Benefit Expns	$142,094	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,980	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$135,114	NetCommunityBenefitExpnsAmt
Total Expense	0.0078	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	38	ActivitiesOrProgramsCnt
Persons Served	3347	PersonsServedCnt
Total Community Benefit Expns	$1,898,226	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,841,529	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$417,587	NetCommunityBenefitExpnsAmt
Total Expense	0.0242	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

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

Economic Development EconomicDevelopmentGrp

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

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$3,064	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,064	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

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

Leadership Development LeadershipDevelopmentGrp

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

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$856	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$856	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

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

Workforce Development WorkforceDevelopmentGrp

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

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

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

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	11	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$3,920	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,920	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,631,918	BadDebtExpenseAmt
Reimbursed By Medicare	$3,798,272	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$4,212,113	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$413,841	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CARILION TAZEWELL COMMUNITY HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	388 BEN BOLT AVENUE	AddressLine1Txt
City	TAZEWELL	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24651	ZIPCd

Field	Value	IRS element (for citing)
Website Address	https://carilionclinic.org/locations/carilion-tazewell-community-hospital	WebsiteAddressTxt
State License	H 1907	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	CARILION TAZEWELL COMMUNITY HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	17	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	https://carilionclinic.org/locations/carilion-tazewell-community-hospital	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	https://www.carilionclinic.org/community-health-assessments#tazewell-county	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	17	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	https://www.carilionclinic.org/community-health-assessments#tazewell-county	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	https://carilionclinic.org/billing/financial-assistance	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	https://carilionclinic.org/billing/financial-assistance	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	https://carilionclinic.org/billing/financial-assistance	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	The Community Health Needs Assessment report prioritizes the community's significant health needs that were identified by the assessment, and explains how the health needs were prioritized.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Carilion Tazewell Community Hospital. Carilion Clinic's Community Health Needs Assessments (CHNA) are community-driven projects. Their success is highly dependent 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 a dynamic group that includes health and human service agency leaders, persons with exceptional knowledge of, or expertise in, public health, and local health department officials. The CHATs obtain input from leaders, representatives or members among medically underserved populations who report as low-income, are minorities and suffer from chronic diseases. The following organizations served on the CHAT for the 2018 (tax year 2017) Tazewell County Community Health Needs Assessment (TCCHNA)-Appalachian Agency for Senior Citizens, Tazewell Area Chamber of Commerce, Clinch Valley Community Action, Cumberland Plateau Health District, Cumberland Plateau Regional Housing Authority, Southwest Virginia Community Health Systems, Southwest Virginia Legal Aid Society, Inc. To further obtain input from the community, the TCCHNA conducted focus groups among stakeholders and target populations and administered a community health survey. During the CHNA process, community stakeholders, leaders and providers are encouraged to complete a stakeholder survey (print and electronic versions were available) to provide additional perspectives about our community's health needs and barriers. CHATs conducted stakeholder focus groups with the CHAT. CHATs conducted focus groups with target populations to capture the story of health needs and barriers for the uninsured, underinsured, low-income, minority, senior and chronically ill populations. Four focus groups were held, located closely and conveniently to target populations. Participants discussed health needs and barriers and access to primary, oral and mental health care. The groups included Head Start parents, Labor of Love clients, the Tazewell Lions Club, and a veterans group at the Cumberland Mountain Community Services Board. A 39-question survey was developed (in English and Spanish) with questions about socioeconomic factors, access to medical, dental and mental health care, health behaviors, physical environment, health outcomes, and demographics. The survey included commonly used questions and metrics from previously validated community surveys conducted by organizations such as the National Association of County and City Health Officials and Centers for Disease Control and Prevention. The CHAT identified target populations, collection sites and survey distribution methods. The survey focused on Tazewell County residents 18 years of age and older. There were special efforts to include underserved/vulnerable populations disproportionately impacted by social determinants of health such as income, race/ethnicity, education and insurance status. The survey was also made available to all residents living in Tazewell County. The oversampling of the target populations occurred through targeted outreach efforts. In total, 388 surveys were collected.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - Carilion Tazewell Community Hospital. Appalachian Agency for Senior Citizens, Tazewell Area Chamber of Commerce, Clinch Valley Community Action, Cumberland Plateau Health District, Cumberland Plateau Regional Housing Authority, Southwest Virginia Community Health Systems, Southwest Virginia Legal Aid Society, Inc.
Schedule H, Part V, Section B, Line 7 Facility , 1	Facility , 1 - Carilion Tazewell Community Hospital. The Community Health Assessment Team shared the 2018 Tazewell County Community Health Needs Assessment (TCCHNA) on partner websites and social media. The TCCHNA was also shared through community forums, community presentations and media interviews.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Carilion Tazewell Community Hospital. The following information describes the implementation strategies used by Carilion Tazewell Community Hospital (CTCH) to address the community health needs identified in the 2018 Tazewell County Community Health Needs Assessment (TCCHNA). The complete implementation strategies are available online at https://www.carilionclinic.org/community-health-assessments#tazewell-county According to the Robert Wood Johnson Foundation's (RWJF) County Health Rankings, where an individual lives, works and plays is a strong predictor of their health outcomes. (http://www.countyhealthrankings.org) In the United States, a person's zip code can help predict their life expectancy due to its direct link to the social determinants of health such as poverty, race/ethnicity, education and employment status in these areas (https://www.rwjf.org/en/library/interactives/whereyouliveaffectshowlongyoulive.html). These factors, part of the 10-year national Healthy People 2030 objectives, are crucial to our overall health because they "create social and physical environments that promote good health for all" (https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health). Carilion responds to community health needs in innovative ways- making sure our region has access to state-of-the-art health care close to home, providing community grants and sponsorships to extend our mission and support other organizations addressing health needs, creating and implementing community-wide strategies to reduce barriers, coordinating resources and enhancing community strengths, and providing community-based health and wellness programs. Commitment to community health is evident at all levels of the organization. Carilion's infrastructure includes a Planning and Community Development division dedicated to assessing and addressing community needs. The division is responsible for leading and facilitating the Community Health Improvement Plan, CHNAs, Carilion's community grant process, community health education, community benefit collection and neighborhood health initiatives. There are Community Health and Outreach (CHO) staff at the system level and each community hospital. They work with hospital Boards of Directors and Carilion Clinic's Board of Governors to create health improvement strategies. A Community Benefit Council provides oversight and strategic guidance for Carilion's community health improvement work and community benefit strategy, collection and submission. Carilion's response strategies follow the RWJF framework for what influences health-health behaviors, social and economic factors, clinical care access and quality, and physical environment. With the onset of COVID-19, Carilion immediately recognized the prominent role we would play in both prevention and treatment for our region. The pandemic demanded a shift in operations and priorities. While some of our implementation strategies were delayed or altered, Carilion quickly responded to the new and unique health-related social needs arising from COVID-19. An addendum to the CTCH implementation strategies was approved in July 2020 to reflect the organization's planning and response to the pandemic. The complete addendum is available online at https://www.carilionclinic.org/sites/default/files/2020-10/CTCH%20IS%20COVID%20Addendum__0.pdf - COVID-19 Community Response - Carilion worked with local media partners to provide expert advice and guidance to the community for COVID-19 prevention, detection and recovery. In a historic collaborative effort, competing hospitals and broadcasting organizations publicized a community town hall. We coordinated efforts to ensure the public received the most accurate and up-to-date information about the pandemic. We developed the COVID-19 Community Hotline as a dedicated phone line to answer community member questions about COVID-19 signs and symptoms, Carilion guidelines, and resources. We also established a recovery support phone line to ensure employees, patients, and community members have access to mental health and recovery support. Peer Recovery Specialists created five virtual peer support community groups. These provided options for individuals in recovery to maintain recovery-oriented support during stay-at-home orders. Carilion is actively providing counsel to community partners, businesses, universities and colleges regarding COVID-19 through consultation with our infectious disease physicians and our management team. This service, offered free of charge, aims to promote safety and reduces hospitalizations and deaths. - Home Alone and Patient Outreach - Because older adults are especially vulnerable to COVID-19, accessing essential resources presented another serious challenge for them during the pandemic. Amid stay-at-home orders, business closures and medical appointment cancellations, we made it our mission to check on seniors in need who were living alone. Carilion's Planning and Community Development, Geriatric Medicine, Home Care and Hospice and Accountable Care Organization departments coordinated efforts to establish Home Alone. Through this initiative, Carilion made more than 1,200 phone calls to provide up-to-date information and connect seniors with local governments and community resources. From delivering masks to offering support over the phone, the program helped meet a wide range of needs head-on. Seniors were able to stay home safely, reduce their exposure to COVID-19 and avoid the hospital. Community Partnerships Carilion Clinic believes in the power of collaboration. Carilion also understands the most significant health issues are addressed through cooperation with the community. Carilion participates in and provides financial and in-kind support to community health coalitions addressing Tazewell County's health needs. We also partner with multiple community and business organizations to improve health and wellness and impact the social determinants of health for everyone we serve. Tazewell County Coordinated Community Response Team The Tazewell County Coordinated Community Response Team (TCCCRT) consists of a multidisciplinary team of professionals and citizens who gather regularly to examine the response of our community systems to victims and offenders of the crimes of domestic violence, sexual assault, dating violence and stalking. The team consists of representatives from local agencies, including law enforcement, social services, housing health care, higher education and the judicial system. TCCCRT plans to merge with the Tazewell County Domestic Violence Task Force to serve the community's needs further. Community Grants Carilion fulfills our commitment to addressing key health priorities through targeted grants for community health improvement programs and those that affect the social determinants of health. Carilion provides many community grants and health sponsorships to help local charitable organizations fulfill their missions related to our communities' health and well-being. Community grant dollars are allocated across the Carilion Clinic service area based on requests received. During the fall cycle of fiscal year 2020 (2019 tax year), $5,388 was awarded as a grant to provide local emergency medical services (EMS) to purchase a transport ventilator to improve continuity of care provided for potential COVID-19 patients and prevent possible transmission of COVID-19 to EMS personnel. (Continued in Part VI)
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - Carilion Tazewell Community Hospital. An individual with Out of Network insurance is not eligible for Financial Assistance unless the plan does not meet minimum essential coverage as defined in the PPACA or it is a governmental plan.

Field	Value	IRS element (for citing)
Facility	0	FacilityNum

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 11 Addressing Needs Identified in CHNA (Continued)	(Continued from Part V, Section C) -Significant Health Priorities to be Addressed- Health Behaviors needs include alcohol and drug use, high prevalence of chronic disease, poor diet, lack of knowledge of healthy behaviors. Carilion Clinic continues to address health behavior-related priorities from the 2018 TCCHNA. To improve overall health culture and promote healthy diets, Carilion provides various free health education classes, screenings and flu immunizations in community settings. In fiscal year 2020, Carilion provided 18 health education, screening and immunization opportunities/events in Tazewell County, serving more than 484 people. Community health education is provided by the Community and Health Outreach (CHO) department and Trauma Outreach, dieticians, Carilion Wellness, homecare, hospice and other select departments. Health and wellness education topics include general wellness, healthy eating and exercise, stress management, and infant and child safety. During the COVID-19 pandemic, CHO transitioned to "Take a Break" virtual education sessions providing timely, relevant tips focused on improving well-being and maintaining a healthy lifestyle during an uncertain time. As the year progressed, we added well-being support groups, cooking videos, online gardening classes, guided walks and hikes, and limited in-person outdoor education. Resources committed to these programs include staff time, volunteer hours, and food and giveaway items that encourage healthy behaviors. Carilion remains committed to addressing poor diets through the Healthier Hospital Initiative pledge and continues working to improve the amount of healthy, local, sustainable foods purchased and served through its cafeterias. In addition to community events, Carilion fosters healthy behaviors by offering classes to employees and partnering with other Tazewell area employers. As the largest employer in the region, efforts to engage our employees and their families in healthy lifestyles impact community health overall. Carilion offers Virgin Pulse at no charge to employees and their spouses. The program enables employees to connect personal activity trackers and a platform to encourage daily healthy behaviors such as exercise, climbing stairs and planning healthy meals. -Alcohol and drug use- Carilion's Addiction Task Force brings together expertise from throughout the Carilion system to better understand and address the opioid epidemic in Southwest Virginia. Efforts include-developing system-wide guidelines and a system dashboard for opioid prescriptions; creating treatment pathways for opioid addiction in specific high-risk groups, developing best practices for risk assessment, treatment and standard orders in Carilion's electronic medical record system, growing an inventory of community resources related to prevention, treatment and recovery services for patients and community members, and providing locations for free, safe, prescription drug returns or deactivation bags. CTCH participates in the Virginia Rural Health Association's High Risk Patient Education Program, which focuses on addressing the opioid abuse crisis at a local level. The program involves identifying high-risk patients, provision of patient and family education on opioid risks and disposal sites for unused medications, assistance acquiring Narcan, referrals to pain management support, and REVIVE education for the public. CTCH also participates as a partner on the Substance Abuse Taskforce in Rural Appalachia (SATIRA). (SATIRA) promotes healthy, safe and drug-free lifestyles in Tazewell County by educating and empowering youth and caregivers about drug, alcohol and tobacco use, partnering with media, improving coordination among community sectors and maintaining resources on alcohol and drug prevention. -Clinical Care- Needs include access to mental health and substance use services, high uninsured / underinsured population, access to substance use services, access to primary care. Issues with access to care are essential to CTCH when addressing community health needs. In addition to providing financial support to qualifying patients who cannot afford care, Carilion works to improve affordable access to care and resources. -Mental health and substance use services- CTCH partners with Cumberland Mountain Community Services Board (CSB) to provide peer support services through the emergency department. The program links patients who come to the emergency department with an opioid overdose with recovery resources. During the pandemic, Cumberland Mountain CSB conducted remote screenings using a telemedicine cart. In an ongoing effort to increase access to psychiatry and mental health services, the technological infrastructure to provide telepsych services has been put in place at Carilion Family Medicine Tazewell and for the Veterans Affairs Clinic. A U.S. Department of Agriculture grant helped CTCH receive two telemedicine carts, which allowed patients to stay connected to providers during the pandemic and will offer expanded care in the future. -High uninsured / underinsured population and high cost of care- Carilion is committed to helping improve access to affordable medical care in our communities. Since the expansion of Medicaid in the Commonwealth of Virginia, in 2019, Carilion has worked diligently on outreach and enrollment for newly eligible beneficiaries. By the end of fiscal year 2020 (tax year 2019), more than 4,439 people were newly enrolled in Medicaid in Tazewell County. -Social and Economic Factors- Needs include transportation, poverty. In its commitment to reducing inequities in care, Carilion provides financial support for people who cannot afford insurance or health care. Each year, Carilion coordinates a system-wide United Way campaign through which employees can offer additional financial support to these causes. Carilion also recognizes the impact that a lack of reliable transportation can have on health. In response to the community need for transportation, the Town of Tazewell has begun providing rides home, when needed from CTCH and select other local transports to address demand. CTCH has worked to educate staff that this resource is available for patients. -Physical Environment- While physical environment did not necessarily arise as a top priority in the 2018 TCCHNA, Carilion still recognizes the impact the environment has on the health of our communities. Efforts continue to make our hospitals and other facilities more energy-efficient, increase recycling and use of recyclable or bio-degradable materials, reduce waste materials and serve local, sustainable foods to patients and in our cafeterias. -Implementation and Measurement- Carilion has invested in systems to help manage data and track outcomes of our community. We assessed program-level outcomes for community health education classes and screening events. We tracked these outcomes using pre- and post-tests for education and screening results such as blood pressure, cholesterol, diabetes risk assessments and glucose readings. Community programs supported by Carilion grants were responsible for regularly reporting program outcomes. Scorecards developed contain key secondary data points. They are updated annually to track the community health initiatives' impact. Specifically, Carilion tracked and measured impact on specific aligned indicators contributing to the the Robert Wood Johnson Foundation County Health Factors Ranking and County Health Outcomes Ranking. Our goal is to improve County Health Rankings for the entire Tazewell area. Still, we understand that improvements are relative to progress in other communities in the Commonwealth of Virginia by these rankings' nature.
Schedule H, Part I, Line 3c Other Financial Assistance Eligibility Criteria	Patients' eligibility is determined by family size, family income, real property equity and liquid assets. Families with family income equal or below 200% of the Federal Poverty Guidelines (FPG) and assets equal or below $15,000 receive 100% adjustment under the Financial Assistance Policy (FAP). Families with family income greater than 200% of the FPG but less than or equal to 400% of the FPG or assets above $15,000 and less than or equal to $100,000 receive a partial adjustment under FAP. The partial adjustment matches the Amounts Generally Billed (AGB) percentage for each service area.
Schedule H, Part I, Line 6a Public Availability of 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: www.carilionclinic.org/about-carilion-clinic#our-values
Schedule H, Part V, Section B, Line 11 Addressing Needs Identified in CHNA (Continued)	-Priority Areas Not being Addressed and the Reasons Why- Earlier, we described using a community approach to determine and address priority needs. We used a similar approach to determine which needs cannot be immediately addressed. We considered several needs during the prioritization process. However, we did not actively address these needs during this period due to low feasibility or low potential impact. These needs are culture: healthy behaviors not a priority, lack of exercise, lack of knowledge of community resources, risky sexual activity, tobacco use, access to dental care, access to specialty care (general), communication barriers with providers, coordination of care, high cost of care, quality of care, child abuse/neglect, community safety/violence, domestic violence, educational attainment, lack of family/social support systems, unemployment, air quality, affordable/safe housing, injury prevention/safety of the environment, outdoor recreation, and water quality. Of the top 10 priorities determined by the TCCHNA, access to primary care is the only need not currently being addressed. In the past few years, Carilion has addressed the need for primary care through additional provider recruitment. Carilion will continue to explore ways to improve access to primary care in Tazewell County.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	Line 7, Column (f) - Bad debt expense of $1,631,918 as included in Part IX, Statement of Expenses on line 25 was excluded from the calculation of Part I Line 7 Column (f) Percent of total expense. 7e - Community Health Improvement and Community Benefit Operations - At Cost. Carilion's commitment to community health is evident at all levels of the organization. Our infrastructure includes a Planning and Community Health division dedicated to assessing and addressing community needs. The division leads and facilitates the Community Health Improvement Plan, Community Health Needs Assessments, community grants, community health education, collection of community benefit data, and neighborhood health initiatives. Some Community Health and Outreach staff work with the hospital's Board of Directors and Carilion Clinic's Board of Governors to create health improvement strategies to address community health needs. The hospital also has a Community Benefit Council providing oversight for Carilion's community health improvement work and community benefit strategy, data collection and submission. Carilion Tazewell Community Hospital (CTCH) educates the public about health risks and steps to improve health. Health and wellness education topics include general wellness, healthy eating and activity, and tips on keeping kids safe. Other events include regularly scheduled community health screenings for blood pressure, blood glucose and cholesterol. Due to COVID-19, work shifted from the typical health education and improvement programming to education and outreach aimed at lessening the impact of the pandemic. For many months, representatives across the organization were involved in the Home Alone program-an outreach effort to connect vulnerable patients to community resources and help them overcome any barriers caused by supply shortages, business closures, and cancellation of medical appointments. Carilion received federal relief funding that will offset the Community Benefit expenses generated by this and other similar work. Carilion also connects patients to resources for enrollment in public health care programs such as Medicaid. Following the rollout of Medicaid expansion in Virginia, Carilion began contracting with MedAssist for Medicaid enrollment outreach, ensuring access to a wide range of health services across the community. MedAssist screens uninsured patients to identify eligibility and helps them with the application process, including documentation and substantiation of eligibility. Greater coverage increases access to benefits not only for general health, but for dental and mental health services as well. The increase in scope for Medicaid eligibility and enrollment led to an increase in Community Benefit dollars invested in this category. Community benefit operations include the expenses to track community health improvement activities and the cost associated with coordinating responses to community health needs identified through the most recent Tazewell County Community Health Needs Assessment. This coordination includes participation in community partnerships such as Tazewell County Coordinated Community Response Team and the Community Health Assessment Team for the local health department. Line 7f - Health professions education - n/a Line 7g - Subsidized Health Services - n/a Line 7h - Research -n/a Line 7i - Cash and In-Kind Contributions - At cost. Carilion's dedication to our mission of improving the health of the communities we serve is evidenced by the annual financial and in-kind contributions we provide to dozens of nonprofit partners. Our support directly impacts the issues identified in our triennial Community Health Needs Assessment and various social determinants that impact health. In fiscal year 2020 (tax year 2019), CTCH supported the United Way. We provided in-kind support to local nursing home staff to provide N95 mask fit-testing, an imperative need for health care providers to limit the spread of COVID-19.
Schedule H, Part II Community Building Activities	Line 1 - Physical improvements and housing - n/a Line 2 - Economic development - n/a Line 3 - Community support - Research demonstrates the strong connection between social determinants of health such as transportation, housing and education, and communities' overall health and well-being. Carilion supports nonprofit organizations addressing barriers to good health arising from these social determinants in various ways. Carilion also collaborates with local partners to support better education and opportunities for children and families and improved housing, better nutrition and additional resources for its neighbors in need. These efforts make progress in removing a range of obstacles to good health for residents of our region. Through monetary donations and organizational support, Carilion Tazewell Community Hospital participates in various health and social determinant-related programs. For example, Carilion leaders dedicate their time to impact the need for nutrition for kids by coordinating the collection and donation of backpacks for the United Way Backpack program. Financial contributions and staff support impact health through Clinch Valley Community Action programs, the Labor of Love Mission, Tazewell Town Today and Legacy Hospice. Line 4 - Environmental improvements - n/a Line 5 - Leadership development and training for community members - n/a Line 6 - Coalition building - Carilion believes in the power of collaboration and understands that we must address our most significant health issues in concert with the community. To ensure lasting impact from the health assessment and community health improvement process, Carilion participates in community health coalitions that address health, safety and social determinant needs in Tazewell County. Also, we partner with multiple community and business organizations around initiatives to improve health and wellness for everyone living in Tazewell County. An example is Carilion-led community wellness walks that bring different community groups and members together to increase physical activity while enjoying the region's natural beauty. Carilion also participates on the Tazewell County Domestic Violence Task Force and the Four Seasons YMCA Board. Line 7 - Community health improvement advocacy - n/a Line 8 - Workforce development - n/a
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Carilion Tazewell Community Hospital estimates bad debt expense by reserving a percentage of all self-pay patient accounts receivable by aging category, based on collection history, adjusted for expected recoveries and, if present, anticipated changes in trends.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Accounts receivable are stated at net realizable amounts due from patients, third-party payors, and other insurers for which Carilion Tazewell Community Hospital 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	The Hospital believes our Medicare shortfall is a cost we incur as a benefit to the community. IRS Rev. Rul. 69-545, provides that one of the factors demonstrating community benefit is operating an emergency room open to all persons regardless of ability to pay and providing hospital care for all patients able to pay, including those who pay their bills through public programs such as Medicare. In order to operate for the benefit of the broad community that we serve we must include our significant Medicare population, even if we are required to subsidize care to our Medicare patients due to being reimbursed at less than cost by Medicare's nonnegotiable rates. Medicare allowable costs are determined from the Medicare cost report using the cost-to-charge ratio.
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 billing statement is provided except when mailings are returned with no forwarding address and combining multiple accounts of varying age with those already transferred or for legal verification regarding other liabilities. Reasonable efforts will be made to identify appropriate forwarding addresses. When a Financial assistance application (FAA) is received during the application period (within 240 days after the date the first billing statement is provided), but after initiation of ECAs, all ECAs will be suspended. Best efforts will be made to process completed applications within 30 days of receipt of the application, financial assistance eligibility will be determined and communicated to the individual. Incomplete applications must be completed within 30 days of the initial notification of additional items required, otherwise, the application will be deemed incomplete and closed. If an individual is eligible for financial assistance, ECAs, other than the sale of debt, will be reversed and any payments related to eligible care refunded to the extent no longer owed. ECAs will be reinstated if the individual is not eligible for financial assistance or does not complete the FAA by the deadline. At least 30 days before initiating an ECA, Carilion will send the patient written notice of intended ECA(s), a plain language summary explaining financial assistance available and the process for determining eligibility, and the deadline for applying for assistance. Carilion will also attempt to call individuals at least 30 days before initiating an ECA to make them aware of the financial assistance available and how to obtain assistance with the application process. Carilion shall enter into a written contract with any collection agency to which it refers bad debt. The contract will obligate the collection agency to observe and comply with Carilion's obligations under this Policy and the Financial Assistance Policy. A collection agency to which bad debt is referred for collection may not engage in any ECAs without the prior written consent of Carilion. After making reasonable efforts to determine if a patient qualifies for Financial Assistance and the patient either does not qualify for Financial Assistance or fails to submit an application as requested, within 240 days from the date the first billing statement is provided, Carilion may engage in one or more of the following ECAs- (1) Place a lien on an individual's property, (2) Attach or seize an individual's bank account or any other personal property, (3) Commence a civil action against an individual, (4) Garnish an individual's wages, (5) Sell an individual's debt to another party, or (6) Report the account to credit agencies. Individual account balances greater than $5,000 are not sent to a collection agency. These are handled through the Debt Recovery Department (DRD) for verification of Financial Assistance status before further collection activity occurs. DRD will also investigate any accounts that require special handling. For example, in cases of a deceased patient, auto accident, or any other unique circumstances requiring special handling, the accounts are placed with the DRD. When all collection efforts have been exhausted, all hospital accounts will be returned and closed as uncollectible. No further collection activity is taken at that time. Accounts with satisfactory payment arrangements, legal activity or accounts with pending payment will be considered active and are not returned.
Schedule H, Part V, Section B, Line 16a FAP website	- CARILION TAZEWELL COMMUNITY HOSPITAL: Line 16a URL: https://carilionclinic.org/billing/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	- CARILION TAZEWELL COMMUNITY HOSPITAL: Line 16b URL: https://carilionclinic.org/billing/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- CARILION TAZEWELL COMMUNITY HOSPITAL: Line 16c URL: https://carilionclinic.org/billing/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessment	In addition to conducting regular Community Health Needs Assessments (CHNAs), Carilion closely monitors community health indicators and responds to needs as they arise. Each year, Carilion updates scorecards with refreshed County Health Rankings indicators provided by the Robert Wood Johnson Foundation. Carilion is also responsive to needs identified through clinical data and internal departments. Carilion's call center, Carilion Direct, is available for community members to ask questions and connect with community resources. The Planning and Community Development department studies chronic disease incidence and prevalence rates, monitors health status indicators and assesses health disparities. Carilion 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 is repeated every three years. Needs are also identified through advisory boards and focus groups conducted in key neighborhoods or aligned with community initiatives. Ongoing collaboration with community stakeholders allows for regular communication of community needs and gives our partners opportunities to respond cohesively. Carilion fosters community development in its CHNA and community health improvement processes through the Strive Collective Impact Model for the Community Health Assessment Team. This evidence-based model focuses on "the commitment of a group of important players from different sectors to a common agenda for solving a specific social problem(s)" and has been proven to lead to large-scale changes. It focuses on relationship-building between organizations and the progress toward shared strategies.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Information on Financial Assistance is provided to the patient at hospital admission and ambulatory areas in the form of signage, a plain language summary which includes contact information, financial assistance application and documentation in the inpatient handbook. Patient Access staff, Hospital social workers and customer service representatives verbally inform patients on availability of assistance. Each patient statement and patient financial responsibility letter includes information on the Financial Assistance policy including who to contact for additional information and location of in-person assisters. The Application, the Policy, and the plain language summary are available free of charge to the patient. They are available by mail and on the web site if the patient did not receive written information at the time of service. Financial Assistance policy and application are also distributed to community partners through electronic mailing groups. Carilion Clinic employs an Eligibility staff that counsel patients on federal and state programs. The staff completes applications for Medicaid, Social Security, Social Security Disability and Medicare. The staff provides support services ensuring the applications are processed correctly based on federal and state policy. In addition, 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	Tazewell County is nestled among the Appalachian Mountains in Southwest Virginia and borders West Virginia to its north. Tazewell County has a land area of 518.85 square miles and about 86.9 persons per square mile (U.S. Census Bureau Quick Facts, 2019 https://www.census.gov/quickfacts/tazewellcountyvirginia). Historically, what is now Tazewell County was a hunting ground for Native American tribes. Tazewell County was chartered on December 19, 1799, and included five towns: Bluefield, Richlands, Tazewell, Cedar Bluff and Pocahontas. The land for the county came from portions of the bordering Wythe and Russell counties. Today, Tazewell County is home to an outstanding array of hiking, biking and ATV trails, scenic drives, including "Back of the Dragon," outdoor parks and venues for experiencing culture, art and history (https://visittazewellcounty.org/history/). In addition to Carilion, key safety net providers in the region include the Cumberland Plateau Health District; Tazewell Community Health, a federally qualified health center, and other service organizations. Despite these entities' presence, however, thousands of low-income, uninsured and underinsured residents do not have access to affordable health care services. The 2018 Tazewell County Community Health Needs Assessment revealed significant disparities in health and social determinants compared to the Commonwealth of Virginia. The 2015-2019 U.S. Census Bureau's American Community Survey (ACS) found the total population of Tazewell County to be 41,603. The Weldon Cooper Center for Public Service predicts a negative population change for Tazewell County by 2040 (https://demographics.coopercenter.org/virginia-population-projections). According to the ACS, the median age is 45.2 in Tazewell County compared to 38.2 in Virginia. The ACS also finds that a more significant percentage of the population is White in Tazewell County than in the Commonwealth of Virginia as a whole. In Tazewell County, 94.4% of the population is White and 3.2% of the population is Black. All of Tazewell County is a designated Medically Underserved Area and a Health Professional Shortage Area (HPSA) for the low-income population regarding primary care and dental health. It is also considered a high-needs geographical HPSA for mental health by the Department of Health and Human Services.
Schedule H, Part VI, Line 5 Promotion of community health	Carilion Clinic is a not-for-profit, integrated health care system located among the Blue Ridge Mountains. Our flagship hospital in the heart of the City of Roanoke, which is the largest urban hub in western Virginia. Carilion provides quality care for nearly one million individuals through a comprehensive network of hospitals, primary and specialty physician practices, wellness centers, and other complementary services. Carilion's roots go back more than a century when a group of dedicated citizens came together and built a hospital to meet the community's health care needs. Today, Carilion is a vital anchor institution focused on health care and dedicated to our mission of improving the health of the communities we serve. With an enduring commitment to our region's health, care is advanced through clinical services, medical education, research and community health investments. Carilion believes in service, collaboration and caring for all. Carilion invests in discovering and responding to local and regional health needs, understanding that we must involve additional stakeholders to address community health issues and create change effectively. Carilion Tazewell Community Hospital (CTCH) is located in the beautiful mountains of Southwest Virginia and primarily serves Tazewell County and the southern West Virginia counties of Mercer and McDowell. CTCH has private rooms and is equipped to treat patients needing medical care. It also supports an extended care recovery program (Swing Bed) that allows eligible patients an opportunity to grow stronger before going home. CTCH hosts diagnostic services such as imaging, including screening mammography, and therapy services including physical therapy and respiratory therapy. CTCH offers 24/7 emergency services and can arrange access to higher levels of care if needed. Carilion Clinic Family Medicine and the Tazewell Veteran's Outpatient Clinic provide primary care on site at entrance 2. CTCH officially became part of Carilion Clinic in 2008 but has been under Carilion's management since 1981. CTCH is dedicated to community, history and family, as exemplified through memorials and tributes throughout the hospital.
Schedule H, Part VI, Line 6 Affiliated health care system	Carilion Tazewell Community Hospital is wholly owned by Carilion Clinic, a not-for-profit health care organization based in Roanoke, Virginia. Through a comprehensive network of hospitals, primary and specialty physician practices, and complementary services, Carilion provides exceptional care for nearly one million Virginians. With an enduring commitment to the region's health, Carilion advances care through medical education and research, helps its community stay healthy and inspires the region to grow stronger. In the mid-2000s, Carilion made the strategic decision to transform from a collection of hospitals to a physician-led, integrated health care system. Advances include-developing a multi-specialty physician group, transforming our primary care practices into patient-centered medical homes, implementing electronic health records system-wide and creating a robust partnership with Virginia Tech, including developing the Virginia Tech Carilion (VTC) School of Medicine and the Fralin Biomedical Research Institute at VTC. In addition, Carilion continues its long relationship with what is now Radford University Carilion to assist with educating students in various health professions. Each decision and adaptation have fundamentally changed the way Carilion collaborates and provides care (https://www.carilionclinic.org/about-carilion-clinic). Carilion's community and population health infrastructure is the health system's engine for providing collaborative opportunities to improve and promote the community's health. Carilion's Community Health Assessments process helps identify the strengths and barriers impacting health. Its community-based programs reflect the Robert Wood Johnson Foundation's framework of four main influences of health: health behaviors, social and economic factors, clinical care access and quality, and physical environment. The health system's many partnerships with cross-sector organizations create a collaborative culture of community health and wellness.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Town of Tazewell EMS	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	211 Central Avenue	AddressLine1Txt
City	Tazewell	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24651	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	546001647	RecipientEIN
IRC Section	Local Government	IRCSectionDesc
Cash Grant	$5,388	CashGrantAmt
Purpose Of Grant	DETAIL INCLUDED ON PART IV	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule I, Part II, Line 1(h) Purpose of grant or assistance- Town of Tazewell EMS

The grant provided for the purchase of a transport ventilator and required accessories.

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 we serve by addressing key health priorities identified through our triennial Community Health Assessments. Carilion fulfills this commitment in many ways, one of which is through targeted grants for community health improvement programs and those that impact the social determinants of health. For Carilion Clinic's Community Grant Program, each grantee must sign a letter of agreement with Carilion Clinic that delineates the terms and specific objectives of the project. By accepting a Carilion award, grantees are asked to acknowledge the support of Carilion Clinic in all materials and/or related special events or fundraisers throughout the award cycle where other donors are publicly recognized. One mid-cycle progress report and a final program evaluation are required for each funded project. Site visits may be made to grantees. A grant cycle specifically addressing the need resulting from the impacts of COVID-19 was held in fiscal year 2020 (tax year 2019) and due to the nature of the funding, awardees were required to submit only one, final report. Program evaluation includes alignment with Community Health Assessment priorities, program impact, organizational effectiveness and community benefit through collection of data including clients served, cost effectiveness of the program (cost per client or service), tangible community or client outcomes, and specific efforts to cultivate diverse funding sources for program sustainability. Each grantee must agree to submit requested data and reports on a timely basis and to complete the evaluation process as requested.

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Kristie Williams
Director/Hospital VP	$0	$158,987	$0	$36,365	$0	$243	$0	$141,324	$0	$11,260	$0	$348,179	$0	$0
Kevin Combs DO
Director	$0	$221,274	$0	$5,000	$0	$2,110	$0	$37,297	$0	$10,820	$0	$276,501	$0	$0
William Flattery
Director	$0	$256,357	$0	$52,998	$0	$17,323	$0	$152,051	$0	$2,029	$0	$480,758	$0	$0
Michael Rorrer MD
Director	$0	$261,353	$0	$19,492	$0	$5,983	$0	$0	$0	$2,941	$0	$289,769	$0	$0
Kathren Dowdy
Former Director/Officer	$43,431	$0	$0	$0	$61,193	$0	$0	$0	$123	$0	$104,747	$0	$0	$0
Nicholas Conte
Asst. Secretary	$0	$501,457	$0	$201,967	$0	$6,258	$0	$163,964	$0	$18,548	$0	$892,194	$0	$0
David Hagadorn
Asst. Treasurer	$0	$138,561	$0	$2,000	$0	$8,778	$0	$98,598	$0	$865	$0	$248,802	$0	$0
Donald Halliwill
Asst. Treasurer	$0	$568,290	$0	$201,281	$0	$4,727	$0	$343,625	$0	$17,248	$0	$1,135,171	$0	$0
G Robert Vaughan Jr
Asst. Treasurer	$0	$270,749	$0	$78,415	$0	$3,948	$0	$297,970	$0	$18,325	$0	$669,407	$0	$0
Nancy Howell Agee
CEO, Carilion Clinic	$0	$1,292,284	$0	$555,922	$0	$406,517	$0	$329,565	$0	$12,301	$0	$2,596,589	$0	$195,503
Steven Arner
Executive Vice President	$0	$647,421	$0	$225,708	$0	$4,813	$0	$345,071	$0	$18,548	$0	$1,241,561	$0	$0
DAVID VANCE
Pharmacy Manager	$106,882	$20,513	$1,500	$0	$152	$0	$20,283	$3,834	$13,531	$2,557	$142,348	$26,904	$0	$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments	Employees are occasionally provided small gifts, prizes or awards which may be included in taxable compensation at amounts grossed up for taxes. During the reporting period, Ms. Bales received such benefit.
Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses	Management makes tax gross-up decisions at its discretion 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. Executive compensation, including that of the organization's Chief Executive Officer, is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee.This Committee is made up of Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk' and other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, the list of which was reviewed by the Compensation Committee.The Compensation Committee maintained detailed minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives.
Schedule J, Part I, Line 4a Severance or change-of-control payment	Kathren Dowdy received $60,954 upon separation of employment.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	Mr. Arner, Mr. Conte, Mr. Halliwill, and Mr. Vaughan participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP) in which the employer, at the discretion of Carilion Clinic's Compensation Committee, makes a contribution to an account established on its books for each eligible participant. If a participant ceases to be a participant prior to the vesting date, the account shall be forfeited. A lump sum distribution shall be made upon the participant's vesting date, death, or disability. Unvested contributions made to the DC SERP are included on the Form 990 as "retirement and other deferred compensation." No distributions from the plan were made to these individuals during the reporting year. Ms. Agee participated in an executive flexible benefit plan, in which an allowance is provided annually to the participant for use in obtaining certain insurance benefits. In prior years, the amount of allowance in excess of elected benefits was credited to a capital accumulation account (CAA) with various deferred vesting dates of at least two years from the first day of the plan year, distributable upon vesting while employed by a Carilion Clinic affiliate, death, disability, or 24 months following certain qualifying separations from service. Deferrals no longer occur under this plan. $195,503 was distributed under this plan in the reporting year.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

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

Field	Value	IRS element (for citing)
Relationship Description	Family member of Alicia Bales, CEO	RelationshipDescriptionTxt
Transaction	$105,403	TransactionAmt
Transaction	Employee	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part I, Line 6 Volunteers	Volunteers greet and assist patients and visitors with way finding, provide clerical assistance when called upon, and assist in various departments to help facilitate good customer service. Volunteers staff the gift shop and support the Look Good/Feel Better Wig Program, and support community events. Volunteer hours worked are 1,603. NOTE: THE VOLUNTEER PROGRAM WAS SUSPENDED ON MARCH 16, 2020 DUE TO COVID.
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS	Carilion Tazewell Community Hospital, part of Carilion Clinic, is a not-for-profit healthcare organization committed to improving health outcomes for every patient while advancing the quality of care in the community it serves. This hospital primarily serves the counties of Tazewell and Russell in Virginia and Mercer and McDowell in West Virginia. Carilion Tazewell Community Hospital exists to serve its community's health care needs, regardless of a patient's ability to pay. Tazewell's acute hospital admitted 500 patients and provided 1,926 days of care during the year. Hospital programs include an active primary care practice for the community, the provision of nursing care, and diagnostic imaging services including CT, MRI, mammography, x-ray and ultrasound. Tazewell provides several services targeting the specific health needs of its population, including physical, speech, and occupational therapy programs, home health services and bone density testing. Tazewell also provides an emergency department with 24-hour care and emergency transportation. With 8,425 visits, Tazewell's emergency services are a critical component of the health safety net in its service area. It acts as a vital health provider for a significant number of uninsured patients who comprise 5 percent of ED visits. Tazewell supports community screenings and education on chronic disease management, sponsoring 49 events touching more than 3,347 people. In furtherance of its mission, Tazewell provides extensive uncompensated care. Stated at cost, financial assistance for the year exceeded $282,000.
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 Tazewell Community Hospital's behalf by Carilion Services, Inc., a related organization providing management and administrative services, including payment processing.
Form 990, Part VI, Line 8b Committees With Authority To Act on Behalf of Governing Body	Carilion Tazewell Community Hospital has no committees.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	NANCY HOWELL AGEE, STEVE ARNER, KEVIN COMBS, ALICIA BALES, NICHOLAS CONTE, WILLIAM FLATTERY, DAVID HAGADORN, DONALD HALLIWILL, MICHAEL RORRER, G. ROBERT VAUGHAN, JR., AND KRISTIE WILLIAMS - Business relationship, JAMES THOMPSON, NELLIE STILLWELL - 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, Steve Arner, Nicholas C. Conte, David S. Hagadorn, Donald B. Halliwill, 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. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia, certain extraordinary actions require member approval, such as mergers, consolidations, liquidations, and the sale of substantially all of the assets of the organization. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a.
Form 990, Part VI, Line 11b Review of form 990 by governing body	The Form 990 was prepared by Carilion's internal Tax Department with input from various Carilion departments, as applicable, and reviewed by internal Accounting management. Several days prior to filing, all Board Members were notified via email of its availability on Carilion's Board portal, which is the mechanism used to disseminate meeting materials to the directors, and directors were encouraged to call with any questions they might have.
Form 990, Part VI, Line 12c Conflict of interest policy	Our organization monitors and reviews proposed and current transactions for conflicts of interest in a variety of ways. At the governing board level, we have board members complete an initial (upon appointment) and annual conflict of interest questionnaire to disclose actual or potential conflicts. Board members are required to update their disclosure as needed in between questionnaires. All disclosures are reviewed by the Organizational Integrity & Compliance Office and as needed escalated to the appropriate leaders/board members for further discussion/review. If a disclosure is viewed as an actual or potential conflict, an action is recommended to the Compliance Committee of the Carilion Clinic Board and implemented as approved. Actions can include recusal in discussion/voting at board meetings, limitation/termination of the transaction, removal from board appointment or other appropriate controls. In addition, at any time, board members are encouraged to disclose any potential conflicts as they arise at a board meeting and to recuse themselves as deemed appropriate. The same process takes place as described above for key employees (upon hire and annually thereafter), including all Officers, members of the management team, physicians/mid-level practitioners, pharmacists and key supply chain buyers. After review and further discussion as needed, action may be required to manage an actual conflict or to reduce the appearance of such as approved by Organizational Integrity & Compliance Office and other key management team members. As needed, the governing board leaders are notified of any conflicts which may impact board proceedings.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. With respect to Carilion Clinic, the Compensation Committee reviews the compensation of the Board of Governors annually, which includes the President and Chief Executive Officer, the Executive Vice Presidents (Chief Financial Officer, Chief Medical Officer, Chief Operating Officer, Chief Administrative Officer and Chief Legal Officer), and select Senior Vice Presidents who are the physician Chairs of the Clinical Departments. For the fiscal year covered by this return, the Compensation Committee also used the same process to review the compensation of other Disqualified Individuals, including the Hospital Vice Presidents. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders, which includes Vice Presidents, Senior Vice Presidents, Executive Vice Presidents, and the CEO, as well as the compensation philosophy for employed physicians. Some officers of the organization who are not compensated in their capacity as an officer but rather in their role as employee in a position not mentioned above are not subject to Committee review. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk' and other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, which list was reviewed by the Compensation Committee. The Compensation Committee maintained detailed minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	See response to line 15A
Form 990, Part VI, Line 19 Required documents available to the public	The organization's governing documents, conflict of interest statement, and financial statements are released from time to time during the tax year upon request. The conflict of interest policy is included in our Code of Excellence which is available to the public on our website. The Articles of Incorporation are available from the Virginia State Corporation Commission. Limited financial information is available on our website.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Sale Medical Records - Total Revenue: 15, Related or Exempt Function Revenue: 15, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Miscellaneous - Total Revenue: 2123, Related or Exempt Function Revenue: 2123, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Court Cost Recovery - Total Revenue: 1710, Related or Exempt Function Revenue: 1710, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Other Revenue adjustment - Total Revenue: -1029, Related or Exempt Function Revenue: -1029, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	Physician/Professional Services - Total Expense: 387738, Program Service Expense: 387738, Management and General Expenses: , Fundraising Expenses: ; Other Purchased Services - Total Expense: 806756, Program Service Expense: 787376, Management and General Expenses: 19380, Fundraising Expenses: ; Repairs and Maintenance - Total Expense: 306760, Program Service Expense: 306760, Management and General Expenses: , Fundraising Expenses: ; Reference Labs - Total Expense: 744202, Program Service Expense: 744202, Management and General Expenses: , Fundraising Expenses: ; Billing and Collection Services - Total Expense: 42647, Program Service Expense: , Management and General Expenses: 42647, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Pension-related changes other than net periodic pension costs - -275;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
CARILION CLINIC
PO BOX 12385	ROANOKE	VA	24025	541190771	SUPPORTING ORGANIZATION	VA	501(c)(3)	Type II	NA	false
CARILION CLINIC FOUNDATION
PO BOX 12385	ROANOKE	VA	24025	541190773	FUNDRAISING	VA	501(c)(3)	7	CARILION CLINIC	Yes (true)
CARILION FRANKLIN MEMORIAL HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	540480606	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION GILES COMMUNITY HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	540549603	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION MEDICAL CENTER
PO BOX 12385	ROANOKE	VA	24025	540506332	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION NEW RIVER VALLEY MEDICAL CENTER
PO BOX 12385	ROANOKE	VA	24025	540553805	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)
CARILION SERVICES INC
PO BOX 12385	ROANOKE	VA	24025	541190879	SUPPORTING ORGANIZATION	VA	501(c)(3)	Type II	CARILION CLINIC	Yes (true)
CARILION STONEWALL JACKSON HOSPITAL
PO BOX 12385	ROANOKE	VA	24025	540568001	HEALTHCARE	VA	501(c)(3)	3	CARILION CLINIC	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt
CARILION CLINIC MEDICARE SHARED SAVINGS COMPANY LLC
PO BOX 12385	ROANOKE	VA	24025	455235473	MEDICARE HMO	VA	NA	N/A
FRANKLIN COUNTY VENTURES LLC
PO BOX 12385	ROANOKE	VA	24025	474365316	REAL ESTATE	VA	NA	N/A
RAVEN ASSET-BASED OPPORTUNITY FUND IV LP
110 Greene Street Suite 9G	New York	NY	10012	824119491	PRIVATE EQUITY	DE	NA	N/A
SOUTHWEST VIRGINIA HEALTH PROPERTIES LLC
1102 Jefferson Street SE	Roanoke	VA	24016	010691570	REAL ESTATE	VA	NA	N/A
STARWOOD VEP II CO-INVEST LLC
591 W Putnam Avenue	Greenwich	CT	06830	833262407	INVESTMENTS	DE	NA	N/A
TI PLATFORM CC SMA LP
1160 Battery St East	San Francisco	CA	94111	842852539	INVESTMENTS	DE	NA	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)

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

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

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
CHS INC
E	-$2,314,244	CASH
CARILION MEDICAL CENTER
A	$152,009	COST
CARILION MEDICAL CENTER
M	$1,996,945	COST
CARILION SERVICES INC
M	$2,373,171	COST
CHS INC
M	$633,210	COST