2019-08-15T18:54:25-05:00 2018-09-30 990 2017-10-01 541190879 CARILION SERVICES INC CARI 5402245112 PO BOX 12385 ROANOKE VA 240252385 G Robert Vaughan Jr Treasurer 5402245137 2019-08-15 12.168.121.4 2019-08-15 18:54:22 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 5C19F522D5420FF5E836576D684E4322057EF973 2017 2019-02-21 02:37:17Z Nancy Howell Agee PO BOX 12385 ROANOKE VA 240252385 287106642 0 X www.carilionclinic.org X 1982 VA Our mission is to improve the health of the communities we serve. 4 0 2488 0 0 410156 109337 121947 247611531 260084942 5446037 5491038 1370213 2009590 254537118 267707517 0 0 0 0 157646167 158393378 0 0 21481 101159919 107083065 258806086 265476443 -4268968 2231074 733606657 805087779 185777827 173188680 547828830 631899099 X Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost. 0 0 249074937 261352651 See Schedule O.By providing management services and administrative functions with an emphasis on cost effectiveness, compliance, and quality; Carilion Services, Inc. (CSI) supports Carilion Clinic's mission to improve the health of the communities it serves. CSI supports Carilion Clinic's core hospital business and related activities by providing technology, human resources, legal services, patient billing, accounting and finance, internal audit and compliance, materials management, and strategic planning services. This assisted the Clinic's hospitals in admitting 52,717 patients and providing 250,906 days of care during the year, and supporting numerous programs designed to serve the health needs of the area. Honoring its commitment to serving the health care needs of the region regardless of patient ability to pay, Carilion Clinic's hospitals collectively provided extensive uncompensated care. Stated at cost, charity and unreimbursed Medicaid costs for the year exceeded $100.2 million. 249074937 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 849 0 1 2488 1 1 1 0 0 0 0 0 0 0 0 0 X 4 0 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X The Corporation Attn H Kirk 5402245102 213 S Jefferson St Roanoke VA 24011 Jeanne S Armentrout Director/Exec. VP/CAO 46.00 4.00 X 517207 0 151120 Kerri L Thornton Director/Vice President 48.80 1.20 X 257557 0 106265 Nancy Howell Agee Director/President/CEO 29.00 21.00 X X 11987536 0 205141 Donald B Halliwill Director/Asst. Treasurer/EVP 42.50 7.50 X X 537739 0 127331 Nicholas C Conte Secretary/Exec. Vice President 35.00 15.00 X 454577 4359 158490 David S Hagadorn Assistant Treasurer/Dept. Director 47.00 3.00 X 131632 0 26984 Lauren J Schantz Asst.Secretary/Governance Secretary 18.50 31.50 X 72129 0 15236 G Robert Vaughan Jr Treasurer/Senior Vice President 43.50 6.50 X 280967 0 79903 Carolyn H Chrisman Senior Vice President 50.00 X 295801 0 100771 R Keith Perry Senior Vice President/CIO 50.00 X 289860 0 49728 Steven C Arner Executive Vice President/CEO/COO 0.00 50.00 X 497909 0 119052 Stephen A Morgan MD Senior Vice President/CMIO 50.00 X 387293 0 93161 Curtis Mills Senior Vice President 50.00 X 321089 0 61459 Paul Hudgins Senior Vice President/CHRO 50.00 X 325812 0 26516 Patrice M Weiss MD Executive Vice President/CMO 0.00 50.00 X 634135 1469 135987 16991243 5828 1457144 160 0 1 0 Epic Systems Corporation 1979 Milky Way Verona WI 53593 Software Services 4091239 Accenture LLP 161 N Clark St Chicago IL 60601 Consulting Services 3380878 Microsoft Corporation 1950 N Stemmons Fwy Ste 5010 Dallas TX 75207 Software Services 2643398 Huron Consulting Services LLC 3005 Momentum Place Chicago IL 606895330 Professional Services 2393836 AECOM Technical Services Inc 1178 Paysphere Circle Chicago IL 60674 Professional Services 2249248 138 49992 71955 121947 Management Fees 561110 227932665 227932665 Carilion Patient Transportation S 621910 14026332 14026332 Net Patient Revenue 622110 13077903 13077903 Affiliate Insurance Premium Rev. 525100 4992662 4992662 Rent from Exempt Affiliates 531120 55380 55380 260084942 5176698 5176698 19673890 39575 19389109 10016 284781 29559 314340 314340 Purchase Discounts 900099 760377 760377 Life Insurance Proceeds 900099 741881 741881 Medical Records Research 900099 170600 170600 336732 336732 2009590 267707517 261352651 0 6232919 X 5048704 1563388 3485316 69854 69854 115145584 113940411 1205173 12202180 12074466 127714 17914635 16942757 971878 8012421 7710392 302029 1010471 1010471 1010937 1010937 623142 623142 86717 86717 308844 308844 31735520 30435695 1299825 2088497 2088497 12018461 11867285 129695 21481 23118148 22969786 148362 11285141 7185864 4099277 1141698 1032786 108912 13127583 13127583 511404 25245 486159 Bad Debt 2241412 2241412 Dues & Subscriptions 2151369 1266528 884841 Recruitment 1348715 1348715 Education 1346039 1341408 4631 1928967 1756148 172819 265476443 249074937 16380025 21481 2768 3426 204890445 216512468 2120774 2665809 50243 47615 5972218 5858119 12546001 12075202 166727724 132558673 38919536 34169051 47108888 53465638 344954940 396127065 77040844 84163386 733606657 805087779 64987107 71737581 461500 197033 2110984 1721133 118218236 99532933 185777827 173188680 X 547828830 631899099 547828830 631899099 733606657 805087779 X 2231074 1465489 80373706 X 0 1 X 1 1 1 X X 7 Carilion Medical Center 540506332 3 1 0 150720813 Carilion New River Valley Medical Center 540553805 3 1 0 26570296 Carilion Giles Community Hospital 540549603 3 1 0 3923757 Carilion Franklin Memorial Hospital 540480606 3 1 0 5875480 Carilion Stonewall Jackson Hospital 540568001 3 1 0 4515544 Carilion Tazewell Community Hospital 546074580 3 1 0 2329436 Carilion Clinic Foundation 541190773 7 1 107000 0 7 107000 193935326 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Part I, Line 12g Carilion Services, Inc. (CSI) supports Carilion Clinic's mission to improve the health of the communities it serves by providing management services and administrative functions with an emphasis on cost effectiveness, compliance, and quality. CSI supports Carilion Clinic's core hospital business and related activities by providing technology, human resources, legal services, patient billing, accounting and finance, internal audit and compliance, materials management, executive leadership, and strategic planning services. Schedule A: Part IV. Section C. Line 1: The filing organization is supervised or controlled in connection with its supported organizations consistent with the Type II supporting organization requirements because a majority of the officers or directors who control or manage the filing organization also serve as a majority of the officers or directors of its supported organizations. Therefore, the same people who control or manage the filing organization also control or manage its supported organizations. Further, the filing organization's bylaws require that a majority of its directors or officers, as the case may be, must be serving concurrently as directors or officers of at least one of the filing organization's supported organizations. 0 1 0 0 0 0 1 85683 0 1 1034 86717 0 Part II-B, Line 1: A portion of dues paid to various hospital industry associations is attributable to lobbying activities. Carilion employs an individual to monitor and inform management about legislative activity regarding health care. A portion of the individual's time is spent on lobbying. 2788825 2788825 6934608 6044137 890471 115304 101668 13636 153706732 126005530 27701202 3182255 407338 2774917 34169051 Other Non-Publicly Traded Investments 4176118 F Investments in Affiliates 390842773 C Investment Minority Interest 1108174 C 396127065 Interco Loan Receivable 79404035 Excess Umbrella Reinsurance 1225441 Other Long Term Assets 3533910 84163386 Pension Liability 55153919 BRIC Claims Payable 27685935 Deferred Compensation Payable 7695179 Due to Affiliates 8997900 99532933 X Part X, Line 2: Carilion recognizes a tax liability or asset for the estimated taxes payable or refundable on tax returns for current and prior years. Deferred tax assets and liabilities are recognized for the estimated future tax effects attributable to temporary differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. A tax benefit from an uncertain tax position is recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. Uncertain tax positions may include the characterization of income, such as a characterization of income as passive, a decision to exclude reporting taxable income in a tax return, or a decision to classify a transaction, entity, or other position in a tax return as tax exempt. X X 0 1 0 1 0 0 0 0 0 1 0 Jeanne S Armentrout Director/Exec. VP/CAO 462562 0 45797 0 8848 0 147208 0 3912 0 668327 0 0 0 Kerri L Thornton Director/Vice President 234887 0 19793 0 2877 0 99801 0 6464 0 363822 0 0 0 Nancy Howell Agee Director/President/CEO 1218641 0 208987 0 10559908 0 191766 0 13375 0 12192677 0 10545910 0 Donald B Halliwill Director/Asst. Treasurer/EVP 483869 0 49599 0 4271 0 110548 0 16783 0 665070 0 0 0 Nicholas C Conte Secretary/Exec. Vice President 413037 4359 35018 0 6522 0 140407 0 18083 0 613067 4359 0 0 David S Hagadorn Assistant Treasurer/Dept. Director 130617 0 600 0 415 0 26124 0 860 0 158616 0 0 0 G Robert Vaughan Jr Treasurer/Senior Vice President 254802 0 22207 0 3958 0 62034 0 17869 0 360870 0 0 0 Carolyn H Chrisman Senior Vice President 265545 0 22878 0 7378 0 87396 0 13375 0 396572 0 0 0 R Keith Perry Senior Vice President/CIO 262230 0 21824 0 5806 0 41698 0 8030 0 339588 0 0 0 Steven C Arner Executive Vice President/CEO/COO 447471 0 45361 0 5077 0 100969 0 18083 0 616961 0 0 0 Stephen A Morgan MD Senior Vice President/CMIO 349609 0 29679 0 8005 0 78114 0 15047 0 480454 0 0 0 Curtis Mills Senior Vice President 275140 0 23699 0 22250 0 48903 0 12556 0 382548 0 0 0 Paul Hudgins Senior Vice President/CHRO 285106 0 36664 0 4042 0 13156 0 13360 0 352328 0 0 0 Patrice M Weiss MD Executive Vice President/CMO 561668 1469 65276 0 7191 0 0 116421 0 19566 634135 137456 0 0 Part I, Line 1a Employees are occasionally awarded gifts or prizes which are grossed up for taxes at management's discretion and included in taxable compensation. During the reporting period, Ms. Thornton and Mr. Perry received such benefit. The filing organization paid $400 to an independent consultant for tax services provided to the personal tax advisors of Ms. Agee. Part I, Line 1b Management determines tax gross-up decisions based on IRS requirements, amount, and the non-cash status of the benefits. Personal tax services on behalf of Ms. Agee were provided under non-recurring circumstances, communicated to the compensation committee and approved by internal management. Part I, Line 3 The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation, including that of the organization's Chief Executive Officer, is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of Board members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. This review was performed in November 2017 and September 2018. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders, including the CEO. This review included review of a comprehensive report from an outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonuses and other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, the list of which was reviewed by the Compensation Committee. The Compensation Committee maintained detailed minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives. Part I, Line 4b Nancy Howell Agee, President and Chief Executive Officer, participated in a pension restoration plan (Plan). The Plan was established in 1995 and its purpose is to restore the pension benefits that Ms. Agee would otherwise lose as a result of Internal Revenue Code limitations upon contributions to, and payment of benefits from, Carilion Clinic's tax qualified pension plan. In 2017, Ms. Agee became fully vested in the pension restoration benefit, requiring distribution of all benefits earned while participating in the Plan, which totaled $10,310,500 before taxes. The benefits earned under the Plan reflect the value accumulated over Ms. Agee's 45 years of service to the organization through progressive leadership roles, including ten years as Chief Operating Officer and eight years in her current position as President and Chief Executive Officer. As benefits were earned under the Plan, accruals were reported in each of the organization's prior Form 990 filings as "retirement and other deferred compensation." Although the pension restoration benefits were earned over the course of Ms. Agee's career, the Form 990 requires that they be reported again as "other reportable compensation" in total in the current year when vested and paid. The 2017 payment represents Ms. Agee's entire benefit under the Plan. After 2017, Ms. Agee will no longer receive or accrue Plan benefits. Ms. Agee also participated in an executive flexible benefit plan, in which an allowance is provided annually to the participant for use in obtaining certain insurance benefits. The amount of allowance in excess of elected benefits is credited to a capital accumulation account (CAA) with a deferred vesting date of at least two years from the first day of the plan year. The CAA shall be distributed in a lump sum upon vesting while employed by a Carilion Clinic affiliate, disability, or 24 months following certain qualifying separations from service. Upon the death of the participant, the plan shall pay the participant's beneficiary according to terms. In 2017, $235,410 in previously deferred amounts became vested under this plan and were paid. Although CAA contributions were previously reported on the Form 990 as "retirement and other deferred compensation" when allocated, the Form 990 requires that CAA amounts be reported again as "other reportable compensation" in the current year when vested and paid. The two deferred compensation plan payouts for Ms. Agee totaled $10,545,910, as reflected in Schedule J, Part II, column (F). Ms. Agee, Ms. Armentrout, Mr. Arner, Ms. Chrisman, Mr. Conte, Mr. Halliwill, Mr. Hudgins, Dr. Morgan, Mr. Perry, Mr. Vaughan, and Dr. Weiss participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP) in which the employer, at the discretion of Carilion Clinic's Compensation Committee, makes a contribution to an account established on its books for each eligible participant. If a participant ceases to be a participant prior to the vesting date, the account shall be forfeited. A lump sum distribution shall be made upon the participant's vesting date, death, or disability. No distributions were made under this plan in the reporting year. Unvested contributions made to the DC SERP in 2017 are reported on the Form 990 as "retirement and other deferred compensation." Part I, Line 7 The organization pays annual bonus compensation to management based on scorecard performance. While the scorecard contains a formula as a basis for determining overall performance, senior managers have discretion to include additional elements in their assessment of managers reporting to them. In addition, for top management, the actual bonus awarded is in the discretion of the Carilion Clinic Board of Directors Compensation Committee, although it is based on the scorecard measures. Jessica Lemons See Part V 69854 Employee 0 Schedule L, Part IV Family member of Jeanne Armentrout, Director. Form 990, Part VI, Section A, line 2 Nancy Howell Agee, Jeanne S. Armentrout, Carolyn H. Chrisman, Nicholas C. Conte, David S. Hagadorn, Donald B. Halliwill, Lauren J. Schantz, Kerri L. Thornton, and G. Robert Vaughan, Jr. - Business relationships due to each serving as officers, directors and/or employees of the same various related taxable organizations. Form 990, Part VI, Section A, line 6 The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers. Form 990, Part VI, Section A, line 7a The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the board that may occur for any reason. Form 990, Part VI, Section A, line 7b The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO; approval of borrowings, budgets, and strategic plans; and amendments of Articles of Incorporation and Bylaws. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia, certain extraordinary actions require member approval, such as mergers, consolidations, liquidations, and the sale of substantially all of the assets of the organization. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a. Form 990, Part VI, Section A, line 8b The filing organization has no committees. Form 990, Part VI, Section B, line 11b The Form 990 was prepared by Carilion's internal Tax Department with input from various Carilion departments as applicable, and reviewed by internal Accounting management. 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 were encouraged to call with any questions they might have. Form 990, Part VI, Section B, line 12c Our organization monitors and reviews proposed and current transactions for conflicts of interest in a variety of ways. At the governing board level, we have board members complete an initial (upon appointment) and annual conflict of interest questionnaire to disclose actual or potential conflicts. Board members are required to update their disclosure as needed in between questionnaires. All disclosures are reviewed by the Organizational Integrity & Compliance Office and as needed escalated to the appropriate leaders/board members for further discussion/review. If a disclosure is viewed as an actual or potential conflict, an action is recommended to the Compliance Committee of the Carilion Clinic Board and implemented as approved. Actions can include recusal in discussion/voting at board meetings, limitation/termination of the transaction, removal from board appointment or other appropriate controls. In addition, at any time, board members are encouraged to disclose any potential conflicts as they arise at a board meeting and to recuse themselves as deemed appropriate. The same process takes place as described above for key employees (upon hire and annually thereafter), including all Officers, members of the management team, physicians/mid-level practitioners, pharmacists and key supply chain buyers. After review and further discussion as needed, action may be required to manage an actual conflict or to reduce the appearance of such as approved by Organizational Integrity & Compliance Office and other key management team members. As needed, the governing board leaders are notified of any conflicts which may impact board proceedings. Form 990, Part VI, Section B, line 15 The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. With respect to Carilion Clinic, the Compensation Committee reviews the compensation of the Board of Governors annually, which includes the President and Chief Executive Officer, Executive Vice Presidents, Chief Financial Officer, Chief Medical Officer, select Senior Vice Presidents, and physician Chairs of the Clinical Departments. This review was performed in October and November 2017 (President and CEO) and November 2017 and September 2018 (all others). For the fiscal year covered by this return, the Compensation Committee also used the same process to review the compensation of Senior Vice Presidents and other Disqualified Individuals, including the Hospital Vice Presidents, which was performed in November 2017 and September 2018. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders, which includes Vice Presidents, Senior Vice Presidents, Executive Vice Presidents, and the CEO, as well as the compensation philosophy for all employed physicians and physicians in leadership roles. Some officers of the organization who are not compensated in their capacity as an officer but rather in their role as employee in a position not mentioned above are not subject to Committee review. This review included review of a comprehensive report from an outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonuses and other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, which list was reviewed by the Compensation Committee. The Compensation Committee maintained detailed minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest statement, and financial statements are not generally available to the public, but are released from time to time upon request. The Articles of Incorporation are available from the Virginia State Corporation Commission. The consolidated audited financial statements of Carilion Clinic and of the Obligated Group are released to the local newspaper when requested. Limited financial information is available on our website. Form 990, Part IX, Line 11g, Column B: Physician/Professional/Staffing Services: $3,978,640 Billing & Collection Services: $671,530 Other Purchased Services: $1,968,784 Contract Fees/Consulting: $18,839,388 Repairs and Maintenance: $4,977,353 Total Other Service Fees, Column B: $30,435,695 Form 990, Part IX, Line 11g, Column C: Other Purchased Services: $47,940 Contract Fees/Consulting: $1,251,227 Repairs and Maintenance: $658 Total Other Service Fees, Column C: $1,299,825 Form 990, Part XI, line 9: Transfers to/from Affiliates - Net 23,373,751. Pension-related changes other than net periodic pension costs 56,999,955. Blue Ridge Indemnity Company LLC 76 St Paul Street Suite 500 Burlington VT 05401 270927178 Insurance VT 6741277 46309849 Carilion Services Inc Carilion Clinic Patient Transportation LLC PO Box 12385 Roanoke VA 24025 541864693 Transportation VA 12146562 5289749 Carilion Services Inc Carilion Professional Services LLC PO Box 12385 Roanoke VA 24025 542030773 CRNAs VA 12400633 343624 Carilion Services Inc Carilion Clinic PO Box 12385 Roanoke VA 24025 541190771 Supporting organization VA 501(c)(3) Line 12b, II N/A 0 Carilion Clinic Foundation PO Box 12385 Roanoke VA 24025 541190773 Fundraising VA 501(c)(3) Line 7 Carilion Clinic 1 Carilion Franklin Memorial Hospital PO Box 12385 Roanoke VA 24025 540480606 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Giles Community Hospital PO Box 12385 Roanoke VA 24025 540549603 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Medical Center PO Box 12385 Roanoke VA 24025 540506332 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion New River Valley Medical Center PO Box 12385 Roanoke VA 24025 540553805 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Stonewall Jackson Hospital PO Box 12385 Roanoke VA 24025 540568001 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Tazewell Community Hospital PO Box 12385 Roanoke VA 24025 546074580 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Franklin County Ventures LLC PO Box 12385 Roanoke VA 24025 474365316 Real estate VA N/A Community Medical Associates LLP PO Box 12385 Roanoke VA 24025 541517662 Real estate VA N/A Carilion Clinic Medicare Shared Savings Company LLC PO Box 12385 Roanoke VA 24025 455235473 Medicare HMO VA N/A CHS Inc PO Box 12385 Roanoke VA 24025 541725732 Services VA Carilion Services Inc C 214131375 468811712 1.00000 1 Carilion Behavioral Health Inc PO Box 12385 Roanoke VA 24025 203136891 Healthcare VA CHS Inc C 1 Carilion Emergency Services Inc PO Box 12385 Roanoke VA 24025 542033006 Healthcare VA CHS Inc C 1 SCA Credit Services Inc PO Box 12385 Roanoke VA 24025 541180398 Collection Agency VA CHS Inc C 1 Carilion Healthcare Corporation PO Box 12385 Roanoke VA 24025 541586601 Healthcare VA CHS Inc C 1 MedKey Inc PO Box 12385 Roanoke VA 24025 541645357 Financing Services VA CHS Inc C 1 Carilion Clinic Medicare Resources LLC PO Box 12385 Roanoke VA 24025 263729975 Medicare HMO VA Carilion Services Inc C 175786 15641655 1.00000 1 Sprott Private Resource Lending (C-Co-Invest) LP 200 Bay Street Suite 2700 Toronto CA 981378742 Investments CA N/A C 0 1 0 1 1 0 0 0 0 0 1 1 1 1 0 1 0 0 1 1 CHS Inc K 163769 Market Rates CHS Inc L 1543167 Cost Carilion Emergency Services L 1271513 Cost SCA Credit Services Inc L 113990 Cost Carilion Healthcare Corporation L 15742684 Cost MedKey Inc L 103396 Cost CHS Inc M 160322 Cost SCA Credit Services Inc M 93267 Cost Carilion Clinic Medicare Resources LLC A 3360000 Market Rates Carilion Clinic Medicare Resources LLC D 3360000 Cost Carilion Medical Center L 170507147 Cost Carilion New River Valley Medical Center L 31140935 Cost Carilion Giles Community Hospital L 4592200 Cost Carilion Franklin Memorial Hospital L 6484048 Cost Carilion Stonewall Jackson Hospital L 5342368 Cost Carilion Tazewell Community Hospital L 2364186 Cost Carilion Medical Center A 55380 Cost Carilion Medical Center K 1681789 Cost Carilion Medical Center M 2033330 Cost Carilion Clinic Foundation M 606700 Cost Carilion Medical Center S 54906591 Cash Carilion New River Valley Medical Center S 9524137 Cash Carilion Healthcare Corporation M 84853 Cost Carilion Stonewall Jackson Hospital K 75908 Cost Carilion Clinic Foundation R 107000 Cash CHS Inc R 47247150 Cash Carilion Emergency Services Inc S 259031 Cash Carilion Medical Center C 49992 Cash