2019-08-15T18:56:35-05:00 2018-09-30 440160260 BKD LLP 1201 WALNUT ST SUITE 1700 KANSAS CITY MO 641062246 990 2017-10-01 541190771 CARILION CLINIC CARI 5402245112 PO BOX 12385 ROANOKE VA 240252385 G Robert Vaughan Jr Treasurer 5402245137 2019-08-15 1 Mike Engle P00482834 8162216300 12.168.121.4 2019-08-15 18:56:32 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 5C19F522D5420FF5E836576D684E4322057EF973 2017 2019-02-21 02:37:17Z Nancy Howell Agee PO BOX 12385 ROANOKE VA 240252385 37323120 0 X www.carilionclinic.org X 1981 VA Our mission is to improve the health of the communities we serve. 15 12 0 0 -315892 -315892 0 0 24819907 25610272 1182341 22326 8877297 11690522 34879545 37323120 0 0 0 0 241825 127175 0 0 0 27417575 28596341 27659400 28723516 7220145 8599604 217082759 226809347 143619069 130113327 73463690 96696020 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 27275220 28583171 See Schedule O.Carilion Clinic is a tax-exempt healthcare organization headquartered in Roanoke, Virginia. Through our comprehensive network of hospitals, primary and specialty physician practices, and other complementary services, we work together to provide quality care close to home for nearly 1 million Virginians. With an enduring commitment to the health of our region, we also seek to advance care through medical education and research, help our community stay healthy, and inspire our region to grow stronger.As the parent company for all Carilion affiliates, Carilion Clinic drives fulfillment of Carilion's mission to improve the health of the communities it serves. Providing leadership and vision, Carilion Clinic oversees a core hospital business that admitted 52,717 patients and provided 250,906 days of care. Carilion's hospitals delivered 4,195 babies, and provided neonatal intensive care support to the region. Carilion's hospitals administered a comprehensive heart program; stroke and chest pain protocols; oncology programs; extensive outpatient and inpatient surgical and endoscopic services; psychiatric and rehabilitation units; a network of specialty and primary care physicians to ensure patient access; and diagnostic imaging services including PET, CT, MRI, and mammography. Targeting specific needs of its population, Carilion provided home health services; speech, occupational, and physical therapy; diabetes management; geriatric services; and cardiac and pulmonary rehab programs. Carilion Clinic maintains both a Level I designated trauma center (Carilion Medical Center) serving the western Virginia area and a Level III trauma center (Carilion New River Valley Medical Center) serving its surrounding area. As part of its commitment to trauma response, Carilion sponsors medical air transport helicopters flying 1,385 patients and a ground service providing 23,022 transports during the year. With 172,310 visits, Carilion's emergency departments are a critical component of the health safety net in its service area, acting as a key health provider for a significant number of uninsured patients, who comprise 18% of emergency visits. Carilion Clinic's hospitals supported community screenings and education on chronic disease prevention and management, sponsoring more than 14,661 events touching more than 95,183 people. In furtherance of its mission to improve health, 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. 27275220 1 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 X 16 0 1 0 1 1 0 0 0 0 0 0 0 0 0 X 15 12 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X The Corporation Attn H Kirk 5402245102 213 S Jefferson St Roanoke VA 24011 R Steve Blanks Director 2.40 4.00 X 14750 0 0 H Laurent Boetsch Jr DML Director 2.40 1.20 X 11200 0 0 John A Bond Director 4.50 X 15750 0 0 J Alexander Boone Director 4.50 X 18287 0 0 Abney S Boxley III Director 4.50 0.50 X 11825 0 0 Daniel R Jones MD Director 2.40 2.10 X 0 56003 0 William R Kingery Jr Director 2.40 3.00 X 10575 0 0 Joseph P Scartelli PhD Director 2.40 1.20 X 13075 0 0 Raymond D Smoot Jr PhD Director 4.50 X 18875 0 0 James C Thompson Director 2.40 2.50 X 8325 0 0 James M Turner Jr Director 4.50 X 14325 0 0 William White Sr Director 2.40 X 12450 0 0 Danielle H Yarber Director 4.50 X 15600 0 0 James A Hartley Director/Chair 7.00 1.70 X X 24875 0 0 Nancy Howell Agee Director/President/CEO 8.00 42.00 X X 0 11987536 205141 Jeanne S Armentrout Chief Administrative Officer/EVP 4.00 46.00 X 0 517207 151120 Steven C Arner Chief Operating Officer/EVP 4.00 46.00 X 0 497909 119052 Nicholas C Conte Secretary/EVP/General Counsel 6.00 44.00 X 0 458936 158490 David S Hagadorn Assistant Treasurer 0.50 49.50 X 0 131632 26984 Donald B Halliwill Asst. Treasurer/CFO/EVP 4.00 46.00 X 0 537739 127331 Lauren J Schantz Assistant Secretary 15.00 35.00 X 0 72129 15236 G Robert Vaughan Jr Treasurer/SVP 2.00 48.00 X 0 280967 79903 Patrice M Weiss MD Chief Medical Officer/EVP 4.00 46.00 X 0 635604 135987 189912 15175662 1019244 0 0 1 0 F&S Building Innovations Inc 2944 Orange Ave NE Roanoke VA 24012 Contractor Services 542231 Skanska USA Building Inc 4309 Emperor Blvd Suite 200 Durham NC 27703 Contractor Services 345988 Servicemaster Commercial Cleaning 6580 Valley Center Dr Radford VA 24141 Janitorial Services 343829 McNeil Roofing 1921 Salem Ave Roanoke VA 24016 Contractor Services 316793 Thyssenkrupp Elevator Corp 7724 Garland Circle Roanoke VA 24019 Maintenance Services 296789 20 Rent from Exempt Affiliates 531120 25486603 25486603 Program Related Investment Income 523000 312386 312386 Interco Mgmt Fee 551112 127175 127175 Unrelated Investment Income 523000 -315892 -315892 25610272 8717623 0 8717623 8717623 8717623 22326 0 22326 22326 22326 Pledge Cancellation 900099 2927547 2927547 Parking Fees 531120 45352 45352 2972899 37323120 28899063 -315892 8739949 X 127175 127175 1137078 1137078 44389 44389 673 673 3678335 3678335 466535 457693 8842 4117 3136 981 9006268 9006268 2508 2508 3492800 3492800 10549857 10549857 128499 9283 119216 Wellness Fees 77175 77175 8107 8107 28723516 27275220 1448296 0 2967407 1580880 312704093 123837802 187965851 188866291 12980557 3508775 11384189 14777754 200767 6263500 1583988 11812147 217082759 226809347 10328457 11410731 7661785 231012 36500 14696 96190725 96081667 29401602 22375221 143619069 130113327 X 73463690 96696020 73463690 96696020 217082759 226809347 X 8599604 6886059 7746667 X 0 1 X 1 1 1 X X 6 Carilion Medical Center 540506332 3 1 0 92908 Carilion New River Valley Medical Center 540553805 3 1 0 16379 Carilion Giles Community Hospital 540549603 3 1 0 2419 Carilion Franklin Memorial Hospital 540480606 3 1 0 3622 Carilion Stonewall Jackson Hospital 540568001 3 1 0 2783 Carilion Tazewell Community Hospital 546074580 3 1 0 1436 6 0 119547 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Part I, Line 12 Although the filing organization has an IRS letter determining that it is a Type 1 supporting organization under Section 509(a)(3), the organization's status is more appropriately described under the Type 2 test as an organization supervised or controlled in connection with its supported organizations by having control or management of the supporting organization vested in the same persons that control or manage the supported organizations. Part I, Line 12g Carilion Clinic provides leadership, governance, and strategic direction to its supported organizations. 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 0 0 0 0 0 0 0 1 673 673 0 Part II-B, Line 1: A portion of dues paid to various hospital industry associations is attributable to lobbying activities. 17212502 17212502 275192519 115517045 159675474 5893988 529003 5364985 9426459 5357581 4068878 4978625 2434173 2544452 188866291 Comingled funds 2979723 F Hedge funds 6484761 F Real Estate limited partnerships 1288446 F Private equity 2971370 F Fixed income alternative investments 1053454 F 14777754 Due from Carilion Services, Inc. 10226900 Other Long-Term Assets 1585247 11812147 Interest Rate Swap Liability 14309699 Qualified Pension Liability 8065522 22375221 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. Central America and the Caribbean - Cayman Islands 0 0 Investments 433385824 North America - Canada and Mexico, but not the United States 0 0 Investments 21724833 0 0 0 0 0 0 455110657 0 455110657 1 0 1 0 1 0 Part I, Line 3: Investment assets are held in custody under the name of Carilion Clinic and allocated to related entities based on their ownership interest in the investment pool. X 0 1 X X X X X X 0 1 0 0 0 0 0 1 0 Nancy Howell Agee Director/President/CEO 0 1218641 0 208987 0 10559908 0 191766 0 13375 0 12192677 0 10545910 Jeanne S Armentrout Chief Administrative Officer/EVP 0 462562 0 45797 0 8848 0 147208 0 3912 0 668327 0 0 Steven C Arner Chief Operating Officer/EVP 0 447471 0 45361 0 5077 0 100969 0 18083 0 616961 0 0 Nicholas C Conte Secretary/EVP/General Counsel 0 417396 0 35018 0 6522 0 140407 0 18083 0 617426 0 0 David S Hagadorn Assistant Treasurer 0 130617 0 600 0 415 0 26124 0 860 0 158616 0 0 Donald B Halliwill Asst. Treasurer/CFO/EVP 0 483869 0 49599 0 4271 0 110548 0 16783 0 665070 0 0 G Robert Vaughan Jr Treasurer/SVP 0 254802 0 22207 0 3958 0 62034 0 17869 0 360870 0 0 Patrice M Weiss MD Chief Medical Officer/EVP 0 563137 0 65276 0 7191 0 116421 0 19566 0 771591 0 0 Part I, Line 1a All Directors are offered a free family or individual membership to a health club owned by a related organization if they choose to accept it. The organization provided this benefit to eight reported individuals and included the value in taxable compensation. Part I, Line 1b Provision of the benefit is documented in Board meeting minutes and Carilion internally tracks the memberships and pays the health club directly. 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, Mr. Conte, Mr. Halliwill, 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. A VA Small Business Financing Authority Hospital Revenue Bonds 541300845 928101AH7 2017-04-03 160000000 Reissuance of Series 2008A and 2008B originally issued on 07/16/2008 0 0 0 A 160000000 160000000 1 0 1 1 A 0 1 1 1 0 0.02300 0.02300 0 0 1 A 0 0 0 1 1 0 0 0 1 A 1 Date Rebate Computation Performed Issuer Name: VA Small Business Financing Authority, Hospital Revenue Bonds, Date the Rebate Computation was Performed: 06/22/2011 Schedule K Part VI Bond issuance total proceeds allocated to each entity. Schedule K Part II Multiple entities across multiple jurisdictions; therefore, proceeds allocated to multiple hospitals. Form 990 Part V, Line 1a 1099s are issued on Carilion Clinic's behalf by Carilion Services, Inc., a related organization providing management and administrative services, including payment processing. Form 990, Part VI, Section A, line 1 Carilion Clinic has an Executive Committee authorized to act when the Board is not in session. The Executive Committee has 9 members, made up of the Chair of the Board, the CEO, the Chairs of each of the 6 standing committees, and the Chair of the Board of Carilion Medical Center, which is the organization that holds the flagship hospital. The Executive Committee typically meets in months the full Board does not meet and can act on behalf of the Board, except it cannot elect directors or take certain extraordinary actions, such as a sale, merger, or dissolution of the corporation. Form 990, Part VI, Section A, line 2 1. Nancy Howell Agee, Abney S. Boxley, III, and Raymond D. Smoot, Jr., Ph.D. Business relationship 2. Nancy Howell Agee, James M. Turner, Jr., and Danielle H. Yarber Business relationship 3. Nancy Howell Agee, Jeanne S. Armentrout, Steven C. Arner, John A. Bond, Nicholas C. Conte, David S. Hagadorn, Donald B. Halliwill, Daniel R. Jones, M.D., Lauren J. Schantz, G. Robert Vaughan, Jr., and Patrice M. Weiss, M.D. Business relationship due to each serving as officers, directors, and/or employees of the same related organizations. Form 990, Part VI, Section A, line 3 Certain management and related services for the organization are provided by the management and employees of Carilion Services, Inc., a related organization to 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, Jeanne S. Armentrout, Steven C. Arner, Nicholas C. Conte, David S. Hagadorn, Donald B. Halliwill, Lauren J. Schantz, G. Robert Vaughan, Jr., and Patrice M. Weiss, M.D. Form 990, Part VI, Section B, line 11b The Form 990 was prepared by Carilion's internal tax department with input from various Carilion departments as applicable, and reviewed by internal Accounting management and an independent CPA firm. The return was also reviewed with the Carilion Clinic Board of Directors Audit Committee. All Board Members were notified via email that the final Form 990 was posted on our Board portal prior to filing 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 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 employed physicians and physicians in leadership roles. 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: Other Purchased Services: $272,231 Housekeeping Service: $1,451,524 Contract Fees/Consulting: $14,075 Repairs and Maintenance: $1,940,505 Total Other Service Fees, Line 11g, Column B: $3,678,335 Form 990, Part XI, line 9: Transfer from Affiliates - Net 7,430,775. Unrelated Investment Income 315,892. Carilion Clinic Properties LLC PO Box 12385 Roanoke VA 24025 205231645 Real estate VA 41431348 202667487 Carilion Clinic 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 Services Inc PO Box 12385 Roanoke VA 24025 541190879 Supporting organization VA 501(c)(3) Line 12b, II Carilion Clinic 1 Carilion Stonewall Jackson Hospital PO Box 12385 Roanoke VA 24025 540568001 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Tazewell Community Hospital PO Box 12385 Roanoke VA 24025 546074580 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Franklin County Ventures LLC PO Box 12385 Roanoke VA 24025 474365316 Real estate VA Carilion Clinic Related 22771 355195 0 0 0.90000 Carilion Clinic Medicare Shared Savings Company LLC PO Box 12385 Roanoke VA 24025 455235473 Medicare HMO VA N/A Community Medical Associates LLP PO Box 12385 Roanoke VA 24025 541517662 Real estate VA N/A Carilion Clinic Medicare Resources LLC PO Box 12385 Roanoke VA 24025 263729975 Medicare HMO VA N/A C 1 CHS Inc PO Box 12385 Roanoke VA 24025 541725732 Services VA N/A C 1 Carilion Behavioral Health Inc PO Box 12385 Roanoke VA 24025 203136891 Healthcare VA N/A C 1 Carilion Emergency Services Inc PO Box 12385 Roanoke VA 24025 542033006 Healhcare VA N/A C 1 SCA Credit Services Inc PO Box 12385 Roanoke VA 24025 541180398 Collection Agency VA N/A C 1 Carilion Healthcare Corporation PO Box 12385 Roanoke VA 24025 541586601 Healthcare VA N/A C 1 MedKey Inc PO Box 12385 Roanoke VA 24025 541645357 Financing Services VA N/A C 1 Sprott Private Resource Lending (C-Co-Invest) LP 200 Bay Street Suite 2700 Toronto Ontario CA MSJ2J1 981378742 Investments CA Carilion Clinic C 657403 15929957 1.00000 1 1 0 0 1 1 0 0 0 0 1 0 1 1 0 0 0 0 0 1 Carilion Medical Center A 14670180 Cost Carilion New River Valley Medical Center A 284720 Cost Carilion Franklin Memorial Hospital A 57681 Cost Carilion Giles Community Hospital A 244104 Cost Carilion Services Inc A 10274871 Cost CHS Inc A 483275 Cost Carilion Behavioral Health Inc A 38328 Cost Carilion Healthcare Corporation A 6285151 Cost Carilion Emergency Services Inc A 56100 Cost CHS Inc M 1479891 Cost Carilion Services Inc L 127175 Cost Carilion Services Inc M 1134528 Cost Carilion Services Inc S 7430773 Cash