2017-08-14T19:13:20-05:00 2016-09-30 440160260 BKD LLP 1201 WALNUT ST SUITE 1700 KANSAS CITY MO 641062246 990 2015-10-01 540506332 CARILION MEDICAL CENTER CARI 5402245112 PO BOX 12385 ROANOKE VA 240252385 G Robert Vaughan Jr Treasurer 5402245137 2017-08-14 1 MICHAEL J ENGLE P00482834 8162216300 2015 2021-01-29 14:40:06Z Nancy Howell Agee PO BOX 12385 ROANOKE VA 240252385 2015011377 0 X www.carilionclinic.org X 1899 VA To improve the health of the communities we serve. 15 8 8596 312 19133 0 4444978 5236580 1134789192 1213958161 54291878 11550416 23198283 25472814 1216724331 1256217971 4510033 6838575 0 0 535009191 576424275 0 0 249402 574489716 601695854 1114008940 1184958704 102715391 71259267 1185047389 1292474198 798493941 900982606 386553448 391491592 X Carilion Medical Center's mission is to improve the health of the communities we serve. 0 0 1033507080 6838575 1234215806 See Schedule O.We are committed to a common purpose of better patient care, better community health, and lower cost. Through our comprehensive network of hospitals, primary and specialty physician practices, and other complementary services, we work together to provide quality care close to home for nearly 1 million Virginians. With an enduring commitment to the health of our region, we also seek to advance care through medical education and research, help our community stay healthy, and inspire our region to grow stronger.Carilion Medical Center (CMC) exists to serve the health care needs of its community and region, regardless of patient ability to pay. CMC admitted 37,787 patients and provided 197,839 days of care during the year. Hospital programs include provision of nursing care; an extensive cardiac and vascular program, including cardiac surgery, implants, angioplasty and heart failure programs; neurology, neurosurgery and stroke programs; labor and delivery services (delivering 3,315 babies); the areas only neonatal intensive care unit; inpatient and outpatient psychiatric services; a comprehensive rehabilitation unit; extensive outpatient and inpatient surgical and endoscopic services; oncology services; geriatric services; and diagnostic imaging services including CT, MRI, PET, and mammography. Housing a children's specialty wing, CMC provides specialists in pediatric neurosurgery, cardiology, oncology, gastroenterology, pulmonology, and child development, among others. CMC is a Level I trauma center, providing full trauma services to the region. CMC provides a number of services targeting the specific health needs of the area, including diabetes management; home health and hospice; physical, speech, and occupational therapy programs; and cardiac and respiratory rehab. CMC also provides an emergency department with 24-hour care, emergency transportation, a pediatric department, and chest pain and stroke protocol programs. With 79,563 visits, CMC's emergency services are a critical component of the health safety net in its service area, acting as a key health provider for a significant number of uninsured patients, who comprise 21% percent of ED visits. CMCs urgent care centers also provide access points for cost effective care at an appropriate level. CMC employs a number of specialty physicians to ensure an effective, integrated approach to serving its patients; including pulmonologists, oncologists, obstetricians, orthopedic surgeons, cardiologists, neurosurgeons, general surgeons, and psychiatrists. As a teaching hospital with over 350 full-time faculty members, CMC hosts residency programs in family medicine, internal medicines, obstetrics and gynecology, psychiatry, general surgery, neurosurgery. In addition, the Jefferson College of Health Sciences, a division of CMC, offers nursing, physician assistant, occupational therapy, and other high-need programs. CMC also supports community screenings and education on chronic disease prevention and management, sponsoring 4,549 events touching over 66,244 people. CMC supports a cancer registry program, and participates in a number of other research projects. In furtherance of its mission, CMC provides extensive uncompensated care. Stated at cost, charity and unreimbursed Medicaid costs for the year exceeded $56 million. 1033507080 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 0 0 1 X 3 0 1 8596 1 1 1 0 0 0 0 1 1 0 0 0 0 X 15 8 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 VA X The Corporation Attn J Wright 5402245112 213 S Jefferson St Roanoke VA 24011 John H Burton MD Director 50.00 X 579355 0 63796 George B Cartledge III Director 2.00 X 0 941 0 Elizabeth S Doughty Director 2.00 X 0 941 0 Katherin A Elam Director 2.00 X 0 0 0 Cynda A Johnson MD Director 2.00 48.00 X 0 611179 80228 Stephen A Musselwhite Director 2.00 X 0 0 0 Clifford A Nottingham MD Director 2.00 48.00 X 0 347064 143212 Patrice M Weiss MD Director 46.00 4.00 X 0 679636 132336 Ralph E WhatleyIII MD Director 49.50 0.50 X 557502 0 92922 Damon Williams Director 2.00 X 0 0 0 Nancy Howell Agee Director/CEO 3.00 47.00 X X 0 1621601 2168199 Steve C Arner Director/President/CEO 48.80 1.20 X X 0 483909 123786 R Steve Blanks Director/Vice Chair 3.00 4.50 X X 0 15941 0 Tracy W Criss MD Director/Chief of Medical Staff 50.00 X X 235630 0 78306 Victor Iannello ScD Director/Chair 4.00 2.40 X X 0 13641 0 Hirenkumar Patel MD Director/Chief of Medical Staff 2.00 X X 0 0 0 Lauren J Chen Assistant Secretary 8.00 42.00 X 0 74469 14801 David S Hagadorn Assistant Treasurer 0.10 49.90 X 0 138217 27098 Donald B Halliwill Assistant Treasurer/EVP/CFO 1.50 48.50 X 0 550507 120070 G Robert Vaughan Jr Treasurer 0.30 49.70 X 0 306045 81831 Nicholas C Conte Secretary 1.50 48.50 X 0 0 0 Bruce A Long MD Physician, Dept. Chair 50.00 X 716432 0 56647 Joseph T Moskal MD Physician, Dept. Chair 50.00 X 1305597 0 86734 Jon M Sweet MD Physician, Dept. Chair 50.00 X 312931 0 55385 Jonathan J Carmouche MD Physician 50.00 X 1585313 0 31366 Cay M Mierisch MD Physician 50.00 X 1034300 0 47363 Gary R Simonds MD Physician 50.00 X 1201303 0 70082 Caleb J Behrend MD Physician 50.00 X 985721 0 18018 Gregory A Howes MD Physician 50.00 X 985779 0 11795 Thomas D Denberg MD PhD Former Chief Strategy Officer 0.00 X 0 505339 -10028 Briggs W Andrews Former Secretary 0.00 X 0 479268 64584 Donald E Lorton Former CFO 0.00 X 0 130613 0 Edward Murphy MD Former CEO 0.00 X 0 18155 0 9499863 5977466 3558531 802 1 1 0 Solstas Lab Partners Group LLC PO Box 751337 Charlotte NC 282751337 Laboratory Services 28239128 Siemens Medical Solutions USA Inc 51 Valley Stream Parkway Malvern PA 19355 Equipment Maintenance Contracts 8749679 F&S Building Innovations 2944 Orange Ave NE Roanoke VA 24012 Construction Service 2224754 Food Service Partners of VA LLC 2823 Franklin Road -Building B Roanoke VA 24014 Food Services 2161948 Anesthesiology Consultants of VA PO Box 13306 Roanoke VA 240323306 Anesthesiology Services 1813449 139 89459 137295 4803590 206236 57555 5236580 Net Patient Revenue 622110 1184221158 1184221158 College Tuition/Other 611310 25742349 25742349 Program-related Investments 531120 2867350 2867350 Other Health Education 611710 607541 607541 Clinical Research 541700 519763 519763 1213958161 6436285 19133 6417152 218 218 1884229 0 1884229 1884229 1884229 763772168 21974 758671824 8405 5100344 13569 5113913 5113913 83718 89459 113177 -29459 -29459 Physician & Other Affil. Income 621111 8678887 8678887 Cafeteria & Vending Income 722514 3360399 3360399 EHR Incentive Income 622110 1256352 1256352 10322406 10322406 23618044 1256217971 1234215806 19133 16746452 6692412 6692412 146163 146163 4589931 4589931 1067763 1067763 464240124 463861132 271375 107617 37262637 37262637 39278506 39181058 70376 27072 29985314 29985314 137313176 137313176 31433 31433 23633 23633 62752 62752 539219 539219 97169749 93625211 3524860 19678 428571 418866 249 9456 17087351 16894647 186054 6650 3736757 2960137 776620 26802170 26787025 2000 13145 2799127 2774402 15981 8744 14459085 14459085 40722073 40722073 14705277 11154399 3550878 Medical Supplies 165030660 165030581 79 Bad Debt 70617579 70617579 College Expense 4724372 4724372 Dues & Subscriptions 1952473 1653541 298932 3490397 3425931 7426 57040 1184958704 1033507080 151202222 249402 22649 19570 4327700 3627349 1821705 1456995 179179958 177015218 6684722 5893651 5981889 6242898 4446028 6303745 983070614 710627972 263267160 272442642 658861169 738583705 44343795 62848683 1000 1000 65123 65123 16044491 17973619 1185047389 1292474198 141949193 149801878 500000 6012057 6406627 362087698 352778501 1626435 288444993 389869165 798493941 900982606 X 367010757 372346875 7666782 7268808 11875909 11875909 386553448 391491592 1185047389 1292474198 X 71259267 24440454 -90761577 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 62752 62752 0 Part II-B, Line 1: A portion of dues paid to various hospital industry associations is attributable to lobbying activities. 15705697 904944 809125 15801517 16528095 -57465 764933 15705697 15977886 1448538 898329 16528095 14955835 1798131 776080 15977886 14218995 1514015 777175 14955835 0.75160 0.24840 0 0 5869100 5869100 452477836 298287027 154190809 928236 758690 169546 502494365 405177027 97317338 21301077 6405228 14895849 272442642 Pension Liability 332079593 Interest Rate Swap Liability 40053720 Deferred Compensation Liability 17735602 Due To Affiliate 250 389869165 X Part V, Line 4: Income from endowment funds are used for the following. (1) Pediatric programs- both internal and external- and/or pediatric equipment. (2) Patient indigent care. Part X, Line 2: Carilion recognizes a tax liability or asset for the estimated taxes payable or refundable on tax returns for current and prior years. Deferred tax assets and liabilities are recognized for the estimated future tax effects attributable to temporary differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. A tax benefit from an uncertain tax position is recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. Uncertain tax positions may include the characterization of income, such as a characterization of income as passive, a decision to exclude reporting taxable income in a tax return, or a decision to classify a transaction, entity, or other position in a tax return as tax exempt. Dinner 79561 45986 33575 1030 11868 1000 28325 Luncheon 67637 41973 25664 2000 19303 29119 2 25979 1500 24479 550 4982 15000 173177 89459 83718 2000 1580 36153 1000 72444 113177 -29459 1 1 X 1 X 1 X 0 1 1 0 1 1 51800015 0 51800015 0.04640 112426661 107491897 4934764 0.00440 164226676 107491897 56734779 0.05080 4143 34065 2736319 50593 2685726 0.00240 26 2285 42645825 9990769 32655056 0.02930 0 0 0 0 2 2515 824369 0 824369 0.00070 138 11115 7034829 0 7034829 0.00630 4309 49980 53241342 10041362 43199980 0.03870 4309 49980 217468018 117533259 99934759 0.08950 0 0 0 0 10 9760 65378 0 65378 0.00010 56 1408 73031 0 73031 0.00010 3 0 1996 0 1996 0.00000 0 0 0 0 161 1160 52914 0 52914 0.00000 6 3930 1344 0 1344 0.00000 4 6 180895 0 180895 0.00020 0 0 0 0 240 16264 375558 375558 0.00040 0 70617579 247326476 255050958 -7724482 X 1 1 1 Roanoke Ambulatory Surgery Center LLC Ambulatory surgery 0.43500 0.46080 2 Southwest Virginia Health Properties LLC Real estate 0.45680 0.48040 2 1 Carilion Medical Center- DBA CRMH 1906 Belleview Avenue Roanoke VA 24014 www.carilionclinic.org H 1840 X X X X X X A 2 Carilion Medical Center- DBA CRCH 101 Elm Avenue Roanoke VA 24013 www.carilionclinic.org H1839 X Rehabilitation Unit; Urgent Care A Facility Group A 0 0 1 X X X X X X X X X 14 1 1 1 1 X See Part V, Section C X https://www.carilionclinic.org/about/chna X X 1 15 1 https://www.carilionclinic.org/about/chna 0 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X 1 X 0 X X X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Carilion Medical Center- DBA CRMH, - Facility 2: Carilion Medical Center- DBA CRCH Part V, Section B, line 5: The following explanation applies to both Facility 1 and Facility 2.Carilion Clinic's CHNAs are community-driven projects and success is highly dependent on the involvement of citizens, health and human service agencies, businesses, and community leaders. Community stakeholder collaborations known at "Community Health Assessment Teams" (CHAT) lead the CHNA projects. The CHAT consists of health and human service agency leaders, persons with special knowledge of or expertise in public health, the local health department, and leaders, representatives, or members of medically underserved populations, low-income persons, minority populations, and populations with chronic disease.The following organizations served on the CHAT for the 2015 (tax year 2014) Roanoke Valley CHNA (RVCHNA): Blue Ridge Behavioral Healthcare, Bradley Free Clinic, Carilion Cancer Center, Carilion Clinic, Carilion Clinic Dept. of Family & Community Medicine, CHIP of Roanoke Valley, City of Roanoke, City of Roanoke - Department of Human Services, Council of Community Services, First Citizens Bank, Freedom First Credit Union, Goodwill Industries, Healthy Roanoke Valley, Jefferson College of Health Sciences, LEAP for Local Food, LewisGale Medical Center, Loudon Avenue Christian Church, Mental Health America of Roanoke Valley, Neighborhood Services - City of Roanoke, New Horizons Healthcare - Federally Qualified Health Centers (FQHC), Planned Parenthood South Atlantic, Presbyterian Community Center, Project Access, Roanoke Alleghany Health District- VA Department of Health, Roanoke City Public Schools, Roanoke County Public Schools, Roanoke Redevelopment & Housing Authority, Roanoke Regional Chamber of Commerce, Roanoke Valley- Alleghany Regional Commission, Roanoke Valley Convention & Visitors Bureau, Salem VA Medical Center, Total Action for Progress, United Way of Roanoke Valley, Virginia Tech Fralin Translational Obesity Research Center, and Virginia Tech Carilion School of Medicine. In addition to the CHAT, the RVCHNA conducted stakeholder focus groups, target population focus groups, and a community health survey. Stakeholder focus groups were conducted with the City of Roanoke (Code Enforcement Officers, Fire/EMS Station #5 & #6, & Solid Waste Management), Healthy Roanoke Valley (Coordination of Care Action Team, Medical Action Team, Mental Health Action Team, Oral Health Action Team, & Wellness Action Team), the Neighborhood President's Council and the Roanoke Neighborhood Advocates. Target population focus groups were conducted with a caregiver support group at the Adult Care Center of the Roanoke Valley, a patient focus group at the Bradley Free Clinic, the Residents Council at McCray Court Senior Living, the Pathway's Parents Meeting at the Presbyterian Community Center, the Women's and Children's Center at the Rescue Mission, Roanoke Redevelopment & Housing Authority Melrose Towers and Morningside Manor, Parents Council at Total Action for Progress Head Start and Family Night at the West End Center. The community health survey was made available to all residents living in the Roanoke Valley, and oversampling of the target populations occurred through targeted outreach efforts. In total, 1,990 surveys were collected. Part V, Section B, line 6a: The following explanation applies to both Facility 1 and Facility 2.Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital, both owned by Carilion Medical Center and serving the same area, jointly conducted their CHNA. HCA-LewisGale Medical Center also participated on the Community Health Assessment Team. Part V, Section B, line 6b: The following explanation applies to both Facility 1 and Facility 2.Blue Ridge Behavioral Healthcare, Bradley Free Clinic, Carilion Cancer Center, Carilion Clinic, Carilion Clinic Department of Family & Community Medicine, CHIP of Roanoke Valley, City of Roanoke, City of Roanoke - Department of Human Services, Council of Community Services, First Citizens Bank, Freedom First Credit Union, Goodwill Industries, Healthy Roanoke Valley, Jefferson College of Health Sciences, LEAP for Local Food, LewisGale Medical Center, Loudon Avenue Christian Church, Mental Health America of Roanoke Valley, Neighborhood Services- City of Roanoke, New Horizons Healthcare - (FQHC) , Planned Parenthood South Atlantic, Presbyterian Community Center, Project Access, Roanoke Alleghany Health District- VA Dept. of Health, Roanoke City Public Schools, Roanoke County Public Schools, Roanoke Redevelopment & Housing Authority, Roanoke Regional Chamber of Commerce, Roanoke Valley- Alleghany Regional Commission, Roanoke Valley Convention & Visitors Bureau, Salem VA Medical Center, Total Action for Progress, United Way of Roanoke Valley, Virginia Tech Fralin Translational Obesity Research Center, and Virginia Tech Carilion School of Medicine. Part V, Section B, line 7d: The following explanation applies to both Facility 1 and Facility 2.Line 7a, Facility 1: www.carilionclinic.org/hospitals/carilion-roanoke-memorial-hospital.Line 7a, Facility 2: www.carilionclinic.org/hospitals/carilion-roanoke-community-hospital.Line 7d: The 2015 Roanoke Valley CHNA was also posted to CHAT partner websites and social media. Part V, Section B, line 11: The following explanation applies to both Facility 1 and Facility 2.Carilion Medical Center's two hospital facilities, Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital, partnered with Healthy Roanoke Valley (HRV) to conduct the FY 2015 Roanoke Valley CHNA during the 2014 tax year. Healthy Roanoke Valley (HRV), housed under the United Way of Roanoke Valley, was formed in 2012 as a community response to needs identified in Carilion Medical Center's triennial Roanoke Valley CHNA.In June 2015, the CHAT participated in a prioritization activity to determine the greatest needs in the service area based on the primary and secondary data collected during the assessment period. To quantitatively determine health needs, CHAT members were asked to rank the top ten pertinent community needs, with one being the most pertinent. Next, on a scale of 1-5, CHAT members were asked to assign a feasibility and potential impact score for each of the ranked needs. This information was used for the CHAT strategic planning retreat held in August 2015.The top ten priority areas that emerged from these findings include:1. Poor eating habits / lack of nutrient dense foods in diet 2. Access to mental health counseling / substance abuse 3. Access to adult dental care 4. Access to dental care for children 5. Lack of exercise / physical activity 6. Value not placed on preventive care and chronic disease management 7. Access to primary care 8. High prevalence of obesity / overweight individuals 9. Lack of knowledge of community resources 10. Improved coordination of care across the health and human sectorThe CHAT participated in strategic planning on August 31, 2015. It reviewed and accepted the priority areas of access to services (primary care, mental health & substance abuse, and oral health), coordination of care, and wellness. Expected outcomes were approved by the CHAT and will be used by Carilion Medical Center (CMC) to measure impact around the priority areas. Significant Health Needs to be AddressedCMC plans to address key community health needs identified in the 2015 assessment by focusing its efforts on a particular community, one that emerged with the greatest need. Through greater access to clinical care, enhanced community outreach programs, creative community partnerships and focused financial and in-kind support of initiatives, CMC plans to improve community health in the South East neighborhood of Roanoke City. Key focus areas of this health improvement project over the next three years include access to services, coordination of care and wellness.A. Access to Services:CMC will explore the development of a community health center in South East with the goal of increasing access to primary care, urgent care and dental services in the neighborhood. The center may also include a mix of services to address social determinants of health, such as job training, health education and wellness services. This offering will be planned with and provided by community partners, including the City of Roanoke, safety net providers and private businesses.B. Coordination of Care:Carilion's family practices have adopted the medical home model and have added care coordinators to proactively work with its high risk, chronic care patients. Carilion will take a focused approach on the South East patients, integrating medical home approaches with a planned community coordination hub being developed by Healthy Roanoke Valley. C. Wellness:Carilion's Community Outreach staff will provide education, flu shots, and community health screenings to the target population in the South East community. Education includes free interactive presentations on the topics of cancer prevention, diabetes prevention, fitness/exercise, food safety, health/stroke, healthy lifestyles, nutrition, smoking cessation, and stress. Poor eating habits were identified as a key concern in the 2015 RVCHNA. The Carilion Clinic Healthy Food Program (formed to respond to the 2012 RVCHNA) is designed to address this need by promoting healthy, local (when possible), and nutrient-dense food to patients and employees and to encourage healthy eating in the community. Fresh Foods RX, is a partnership with HRV, a program which includes a physician's prescription for healthy food, and a waiver for free local fruits and vegetables was successfully piloted in 2015 with a second pilot expanding the program to three sites in 2016. The Healthier Hospital Healthy Food Initiative, the Carilion Farm Share program, and funding of community programs that address increased access to healthy food will continue.Exercise and fitness opportunities will be a key focus for South East, particularly in relation to childhood obesity. Through a partnership with a local soccer club, Carilion will help build fields in the South East neighborhood and provide scholarships to local children. Carilion also helped to build a community kayak launch on the Roanoke River with access in that neighborhood. Funding of community programs that address increased access to physical activity opportunities will continue.D. Focused Community Grants and Partnerships:Carilion Clinic funds health safety-net providers and causes identified through the RVCHNA and will focus on providing financial support to community health improvement initiatives in the South East neighborhood through community grants and sponsorships.In-kind assistance is also provided through community partnerships that align with the RVCHNA. Carilion actively looks for opportunities to support by providing outreach and educational support. Partnerships include HRV, Anchor of Hope's Community Health Promoter Program, West End Freedom First, Roanoke Regional Housing Authority, Kohl's Cares, the PATH Coalition, Safe Kids, Leap for Local Foods, the Feeding America of SWVA Veggie Mobile, as well as many others. E. Implementation and Measurement:HRV is serving as a key partner in the implementation of health improvement initiatives emerging from the CHNA. The findings of this assessment are key in measuring the progress of HRV initiatives and their impact in the community. The HRV Strategic Action Framework to better meet the needs of our target population includes data driven, evidence-based goals and strategies which address access to care (mental health, oral health, primary care); coordination of care; and wellness. As a result of the 2015 RVCHNA, HRV underwent strategic planning with both its Steering Committee and Action Team members to update the Governance Guidelines, Operations Structure, and Strategic Action Framework to ensure HRV continues to align with the priorities identified in the needs assessment. HRV completed this process in 2016 and began implementation of the 2016-2019 Strategic Action Framework in the summer of 2016.Priority Areas Not being Addressed and the ReasonsA community approach to determine and address priority needs as described above was used in determining which needs cannot be addressed immediately. The needs not identified as "priority" are those that will not be actively addressed in this time period. Part V, Section B, line 16i: Line 16a: https://www.carilionclinic.org/billing/financial-assistance.Line 16b: https://www.carilionclinic.org/billing/financial-assistance.Line 16c: https://www.carilionclinic.org/billing/financial-assistance. Part V, Section B, line 20e: Presumptive eligibility based upon specific free clinic or indigent health access programs, other state or local assistance programs, and/or third party evaluation to determine ability to pay prior to transfer to bad debt. Part V, Section B, line 22d: Maximum amounts that can be charged are determined based on average allowed amounts from Medicare and private insurance payers, calculated using the look-back method per 26 CFR section 1.501(r). 85 1 - DBA - Carilion Roanoke Memorial Rehab 2017 South Jefferson Street Roanoke VA 24153 Psych Unit, Outpatient Rehabilitation 2 - Carilion Breast Care Center 102 Highland Ave Ste 202 Roanoke VA 24014 Breast Care Center 3 - Carilion Clinic Cardiology 2001 Crystal Spring Avenue Suite 203 Roanoke VA 24014 Cardiology 4 - Carilion Clinic Cardiology 127 McClanahan Street SW Suite 300 Roanoke VA 24014 Cardiology 5 - Carilion Clinic Cardiology 2001 Crystal Spring Ave Suite 300 Roanoke VA 24014 Cardiology Services 6 - Carilion Sleep Center 1030 Jefferson Plaza Ste G100 Roanoke VA 24016 Sleep Disorder 7 - Carilion Clinic Orthopaedics - ION 2331 Franklin Road SW Roanoke VA 24014 Orthopaedics 8 - Carilion Clinic Internal Medicine 3 Riverside Circle Roanoke VA 24016 Internal Medicine 9 - CSC - Roanoke 213 McClanahan Suite 404 Roanoke VA 24014 Surgical Services 10 - Carilion Clinic Neurosurgery - ION 2331 Franklin Road Roanoke VA 24014 Neurosurgery 11 - Carilion Pulmonary Clinic 2001 Crystal Spring Avenue Suite 205 Roanoke VA 24014 Pulmonary Services 12 - Carilion Clinic Gastroenterology 3 Riverside Circle Roanoke VA 24016 Gastroenterology 13 - Carilion Dental Care 2017 S Jefferson Street Roanoke VA 24014 Dental Service 14 - Carilion Clinic Neurology 3 Riverside Circle Roanoke VA 24016 Neurosciences 15 - Daleville Imaging 46 Wesley Road Daleville VA 24014 Imaging Services 16 - CNRV Emergency Services 2900 Lamb Circle Christiansburg VA 24073 Emergency Physicians 17 - Botetourt Athletic Center 105 Summerfield Court Roanoke VA 24019 Outpatient Therapy Services 18 - Carilion Clinic Dermatology 1 Riverside Circle Suite 300 Roanoke VA 24016 Dermatology 19 - Roanoke Athletic Club 4508 Starkey Road Roanoke VA 24018 Physical Therapy Services 20 - Carilion Imaging Professionals 1 Taylor Avenue Pearisburg VA 24134 Imaging Services 21 - CNRVMC - Radiology 2900 Lamb Circle Christiansburg VA 24073 Radiology 22 - Carilion GYN Clinic 102 Highland Avenue Suite 303 Roanoke VA 24013 Gynecolgical services 23 - Carilion ObstetricsGynecology Clinic 902 South Jefferson Street Upper Level Roanoke VA 24016 Obstetrics and Gynecology 24 - Carilion Clinic Dept of Psychiatry 2900 Lamb Circle Christiansburg VA 24073 Psych and Behavioral Medicine 25 - Carilion Clinic Orthopaedics Trauma ION 2331 Franklin Road Roanoke VA 24014 Ortho Trauma 26 - Carilion Cardiothoracic Surgery 2001 Crystal Spring Avenue Suite 201 Roanoke VA 24014 Cardiac Surgery Office 27 - Carilion ENTPlastic Surgery 1 Riversde Circle Suite 300 Roanoke VA 24016 Plastic Surgery 28 - Carilion General Pediatric Clinic 1030 S Jefferson Street Suite 106 Roanoke VA 24016 General Pediatrics 29 - Carilion Clinic Orthopaedics 3 Riverside Circle Roanoke VA 24016 Orthopaedic Services 30 - CES - Tazewell 141 Ben Bolt Ave Tazewell VA 24651 Emergency Physicians 31 - Carilion Clinic Pediatric Surgery 102 Highland Avenue Suite 404 Roanoke VA 24013 Surgical Services 32 - CES - Giles 1611 Wenonah Avenue Pearisburg VA 24134 Emergency Physicians 33 - Carilion Center for Healthy Aging 2001 Crystal Spring Avenue Suite 302 Roanoke VA 24014 Geriatrics 34 - CES - Franklin 180 Floyd Avenue Rocky Mount VA 24017 Emergency Physicians 35 - CFM - Salem 2102 West Main Street Salem VA 24153 Family Practice 36 - CSJH Emergency Department 1 Health Circle Lexington VA 24450 Emergency Physicians 37 - CFM Southeast 2145 Mount Pleasant Boulevard Roanoke VA 24014 Family Practice 38 - CFM Roanoke Salem 1314 Peters Creek Road Roanoke VA 24017 Family Practice 39 - Carilion Anticoagulation Clinic 1030 S Jefferson St Ste G101 Roanoke VA 24014 Anticoagulation Clinic 40 - CRMH Rheumatology Clinic 3 Riverside Circle Roanoke VA 24016 Rheumatology 41 - Carilion Infectious Disease Clinic 2001 Crystal Spring Avenue Suite 301 Roanoke VA 24014 Infectious Disease 42 - Breast Mammography - North 6415 Peters Creek Road Roanoke VA 24014 Breast Mammography 43 - Carilion Clinic Physiatry 3 Riverside Circle Roanoke VA 24016 Physical Medicine and Rehab 44 - Community Psychiatry 611 McDowell Avenue Roanoke VA 24016 Behavioral Health 45 - Carilion Plastic and Reconstructive 3 Riverside Circle Roanoke VA 24016 Plastic Surgery 46 - Pediatric Developmental Clinic 1030 S Jefferson Street Suite 201 Roanoke VA 24016 Pediatrics 47 - Community Care 101 Elm Avenue SE Roanoke VA 24013 Family Medicine 48 - Carilion Dept of Psychiatry Roanoke 2017 S Jefferson Street Roanoke VA 24014 Behavioral Health 49 - Carilion Sleep Center Westlake 35 Medical Court Hardy VA 24101 Sleep Disorder 50 - Carilion Clinic Urogynecology 101 Elm Avenue Suite 400 Roanoke VA 24013 Urogynecology Services 51 - Carilion Cardiac Rehab 127 McClanahan Street Roanoke VA 24016 Cardiac Rehab 52 - Pediatric Gastroenterology 102 Highland Avenue Suite 305 Roanoke VA 24013 Gastroenterology 53 - Carilion Pediatric Neurology 102 Highland Avenue Suite 104 Roanoke VA 24013 Neurosciences 54 - Carilion Child & Adolescent Psychiatry 213 McClanahan Street Suite 310 Roanoke VA 24014 Child and Adolescent Psychiatry Services 55 - Carilion Prenatal Diagnostic Center 102 Highland Ave Ste 455 Roanoke VA 24014 Prenatal Testing 56 - Pediatric Pulmonology and Allergy 102 Highland Avenue Suite 203 Roanoke VA 24013 Pulmonology 57 - Carilion Clinic Family Med Tazewell 141 Ben Bolt Avenue Tazewell VA 24651 Family Practice 58 - CRCH Occupational Medicine PO Box 12946 Roanoke VA 24029 Occupational Medicine 59 - Carilion Clinic Pulmonary and Sleep 2001 Crystal Spring Avenue Suite 300 Roanoke VA 24014 Pulmonary and Sleep Services 60 - Carilion Roanoke IP Psychiatry 2017 S Jefferson Street 1st Floor Roanoke VA 24014 Psychiatry Services 61 - Carilion Clinic OBGYN Spartan Drive 150 Spartan Drive Salem VA 24153 Obstetrics and Gynecology 62 - Carilion Pediatric Endocrinology 102 Highland Avenue MOB Suite 203 Roanoke VA 24013 Endocrinology 63 - Department of Psychiatry & Behavioral 213 McClanahan Street Suite 310 Roanoke VA 24014 Behavioral Health 64 - Pediatric Cardiology Clinic 102 Highland Avenue Suite 101 Roanoke VA 24013 Cardiology 65 - Carilion Clinic OBGYN Botetourt 150 Market Ridge Lane Daleville VA 24083 Obstetrics and Gynecology 66 - Carilion Reproductive Endocrinology 102 Highland Avenue Suite 304 Roanoke VA 24013 Reproductive Endocrinology 67 - Carilion Wound Care Center 101 Elm Ave SE Roanoke VA 24019 Wound Care 68 - Carilion Clinic TraumaCritical Care 3 Riverside Circle Roanoke VA 24016 Surgical Services 69 - Carilion Dentistry Pediatric Surgery 101 Elm Avenue Roanoke VA 24017 Dental Service 70 - Carilion Diabetic Education 1030 S Jefferson Suite G101 Roanoke VA 24016 Diabetic Eduation 71 - CNRVMC - Neurosciences 2900 Lamb Circle Christiansburg VA 24073 Neurology 72 - Carilion Clinic Pain Management - ION 2331 Franklin Road Roanoke VA 24014 Pain Management 73 - Carilion Clinic Gastroenterology 1201 Franklin Rd Roanoke VA 24016 Gastroenterology 74 - Carilion Genetics 102 Highland Avenue Suite 104 Roanoke VA 24013 Genetic Counseling 75 - General Surgery Clinic 180 Floyd Avenue Rocky Mount VA 24151 General Surgery 76 - Carilion Clinic Internal Medicine 3 Riverside Circle Roanoke VA 24016 Internal Medicine 77 - Carilion GYN Oncology 1 Riverside Circle Suite 300 Roanoke VA 24016 Gynecolgical Oncology 78 - Carilion Clinic Urology Christiansburg 120 Akers Farm Road NE Christiansburg VA 24073 Urology 79 - Carilion Pediatric OtolaryngologyENT 3 Riverside Circle 4th Floor Roanoke VA 24016 ENT Services 80 - Carilion Surgery Westlake 35 Medical Court Hardy VA 24101 Surgical Services 81 - Carilion Clinic AllergyImmunology 46 Wesley Road Daleville VA 24083 Allergy Services 82 - Carilion OBGYN - Riverside 3 Riverside Circle Roanoke VA 24016 Obstetrics and Gynecology 83 - Tazewell Veterans Affairs Community 141 Ben Bolt Avenue Tazewell VA 24651 VA Clinic 84 - Carilion Heart Failure Clinic 127 McClanahan Street Roanoke VA 24016 Heart Failure Services 85 - Carilion Cardiology Westlake 35 Medical Court Hardy VA 24101 Cardiology Services Part I, Line 3c: Asset test is used. Money in checking/savings, trust, retirement accounts, equity in real property. Part I, Line 6a: Information on community benefit is reported annually through a consolidated report prepared by Carilion Clinic (EIN 54-1190771). Printed copies of this report are distributed throughout communities served by hospitals affiliated with Carilion Clinic. Additionally, the community benefit report is available on Carilion Clinic's website: www.carilionclinic.org/community-outreach. Part I, Line 7: Part I, Line 7 a-b: The ratio of cost-to-charges was used to calculate the expense.Part I, Line 7:Column f calculation-The organization's bad debt expense of $70,617,579 is subtracted from total expenses for the calculation.Part I Line 7e: Community Health Improvement:This line is reported at actual cost. Carilion Medical Center provides education to the public about health risks and steps that can be taken to improve health. Events include regularly scheduled health screenings such as blood pressure, blood glucose and cholesterol as well as seasonal stroke, vascular, prostate and facial sun damage detection screenings. Carilion Medical Center's community health education department serves as host of the local chapter of the National Safe Kids Coalition and provides education on childhood injury prevention to the community and other providers. In addition, Carilion Medical Center's Safe Kids Coalition coordinator provided training and national certification on proper car seat installation for other health and safety providers free of charge. Children learn about healthcare careers through Caring Careers, an educational program for school aged children provided onsite at local schools and community centers. Additional health improvement services include physician coverage at the Bradley Free Clinic and the Roanoke Rescue Mission. Additional services include blood drives, assistance with enrollment in public medical programs such as Medicaid, and interpreter services for non-English speaking patients. Community benefit operations includes expenses related to support of Healthy Roanoke Valley, a collaboration of health and human service agencies developing initiatives to address prioritized community health needs, the cost associated with tracking community health improvement activities, and the cost associated with conducting a Community Health Needs Assessment.Part I, Line 7f:Health Professions:This line is reported at actual cost. Carilion Medical Center provides a full time staff member to Radford University's Bachelor of Science Nursing Program and mentors nursing students within Carilion Roanoke Memorial Hospital. Education is provided to non-employed health professionals such as school nurses, and staff who provide labor, delivery and emergency services. Financial support was provided for Virginia Foundation for Independent Colleges for 10 science research fellowships for undergraduate students. In addition, financial as well as in-kind support was provided for Virginia Tech Carilion School of Medicine in the form of paid physician hours dedicated to education of students. Part I, Line 7g:Subsidized Health Services: N/A.Part I, Line 7h:Research:This line is reported at actual cost. Carilion Medical Center participates in clinical research projects which includes internal review board oversight. Additionally, community research is provided through a cancer registry to assist public health professionals in understanding and addressing the cancer burden more effectively. Information obtained is used in development of programs on cancer prevention, early detection, and successful treatment and care. Part I, Line 7i: Cash and In-Kind Contributions: At Cost.Carilion has long been committed to improving the health of the communities we serve. We know that significant change doesn't happen alone, but takes a community of partners working together towards common goals. Our dedication to this mission is evidenced by the support we provide to various nonprofit partners, furthering their efforts to positively impact health. Contributions of various amounts, both financial and in-kind, are made each year to dozens of organizations directly impacting the issues identified in our triennial Community Health Needs Assessment as well as to organizations addressing a variety of social determinants that impact people's health. Support provided helps with access to nutrient dense foods, promotion of exercise and healthy activity, chronic disease management, access to mental health services and coordination of care in addition to a multitude of other community health improvement goals. Part II, Lines 1-8 Part II, Line 1:Physical Improvements and Housing- N/A.Part II, Line 2: Economic Development- Support was provided to the Vinton Chamber of Commerce, Roanoke Blacksburg Innovation Partnership, Roanoke Blacksburg Technology Council, Salem Roanoke County Chamber of Commerce, Roanoke Regional Chamber of Commerce, and Virginia Chamber of Commerce to strengthen the social and economic environment of the community. Funding was provided to the Greater Roanoke Transit Company for the Star Line Trolley.Part II, Line 3: Community Support- Research demonstrates the strong connection between social determinants of health such as transportation, housing, and education and the overall health and well-being of communities. Support is provided in a variety of ways for non-profit organizations that address barriers to good health that arise from these social determinants. Through support of local partners, Carilion is able to help provide better education and opportunities for children and families as well as housing, nutrition and resources for our neighbors in need, removing obstacles to good health. Part II, Line 4: Environmental Improvements- Financial support was provided to Pathfinders for Greenways and in-kinds support was provided for Clean Valley Day in southeast Roanoke City. Part II, Line 5: Leadership Development and Training for Community Members-N/A. Part II, Line 6: Coalition Building- In-kind support was provided through representation on Roanoke Area Youth Substance Abuse Coalition and Roanoke Prevention Alliance, a group of concerned citizens, parents, youth, teachers, police officers, business people, judges, and other caring individuals that strive to keep the youth of the Roanoke Valley and southwest Virginia alcohol, tobacco and drug-free; Safe Kids Coalition, a multidisciplinary team, working to eliminate infant injury and deaths due to abusive head trauma and sudden infant death syndrome (SIDS); Positive Action Toward Health, promoting healthy behaviors in children; Salem Prevention Planning Team; Virginia Highway Safety Board representation; Roanoke City Health Advisory Board; and YOVASO, a statewide youth leadership program dedicated to saving the lives of teenage drivers through educating, encouraging and empowering teenagers to be traffic safety advocates in their schools and communities. In-kind support was also provided through representation on Boards or committees for the following organizations: Children's Trust, CHIP, Family Service of Roanoke Valley, New Horizons Healthcare, Presbyterian Community Center, United Way of Roanoke Valley, Virginia Tech Carilion School of Medicine, and the YMCA.Part II, Line 7: Community Health Improvement Advocacy-In-kind support was provided for distribution of a newsletter on behalf of adolescent and student health services.Part II, Line 8: Workforce Development- Carilion Medical Center partnered with Goodwill Industries of the Roanoke Valley, the Department of Rehabilitative Services, Blue Ridge Behavioral Health, Blue Ridge Independent Living Center and local parent representatives to offer Project SEARCH, a one year high school transition program that provides employment and educational opportunities for individuals with significant disabilities and assists with finding long term employment in skilled positions for its participants. Additional expenses include recruitment of providers to meet the needs of underserved individuals in the Roanoke Valley. Support was also provided for Virginia Business Higher Education Council's Grow By Degrees campaign. Part III, Line 2: Carilion Medical Center estimates bad debt expense by reserving a percentage of all self-pay accounts receivable by aging category, based on collection history, adjusted for expected recoveries and, if present, anticipated changes in trends. Part III, Line 4: Accounts receivable are reduced by an allowance for amounts that could become uncollectible in the future. Carilion Medical Center estimates the allowance for doubtful accounts by reserving a percentage of all self-pay accounts receivable by aging category, based on collection history, adjusted for expected recoveries and, if present, anticipated changes in trends. Carilion Medical Center collects substantially all of its third-party insured receivables, which include receivables from governmental agencies and commercial insurers. Part III, Line 8: Medicare allowable costs are determined from the Medicare cost report using the cost-to-charges ratio. The Hospital does not consider a Medicare shortfall as a community benefit. Part III, Line 9b: When accounts receivable efforts are exhausted, the account may be placed with a collection agency and Extraordinary Collection Actions (ECA) may be considered. Accounts will not be placed with a collection agency prior to 120 days from the date the first billing statement is provided except when mailings are returned with no forwarding address and combining multiple accounts of varying age with those already transferred or for legal verification regarding other liabilities.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 if no positive patient response is received within 120 days from the date the first billing statement is provided, Carilion may engage in one or more of the following ECAs: 1. Place a lien on an individual's property; 2. Attach or seize an individual's bank account or any other personal property; 3. Commence a civil action against an individual; 4. Garnish an individual's wages; 5. Sell an individual's debt to another party; or 6. Report the account to credit agencies.Individual account balances greater than $5,000 are not sent to a collection agency. These are handled through the Debt Recovery Department (DRD) for verification of Financial Assistance status before further collection activity occurs. DRD will also investigate any accounts that require special handling. For example, when the billing office becomes aware that a patient is deceased, auto accident or any other unique circumstances requiring special handling, the accounts are placed with the Debt Recovery Department.When all collection efforts have been exhausted, all hospital accounts will be returned and closed as uncollectible. No further collection activity is taken at that time. Accounts with satisfactory payment arrangements, legal activity or accounts with pending payment will be considered active and are not returned. Part VI, Line 2: Needs Assessment:Carilion Clinic's community health improvement process was adapted from Associates in Process Improvement's the Model for Improvement and the Plan-Do-Study-Act (PDSA) cycle developed by Walter Shewhart. It consists of five distinct steps: (1) conducting the CHNA, (2) strategic planning, (3) creating the implementation strategy, (4) program implementation, and (5) evaluation. This cycle is repeated every three years to comply with IRS requirements. Carilion Clinic fosters community development in its CHNA process and community health improvement process by using the Strive Collective Impact Model for the CHAT. This evidence-based model focuses on "the commitment of a group of important players from different sectors to a common agenda for solving a specific social problem(s) and has been proven to lead to large-scale changes. It focuses on relationship building between organizations and the progress towards shared strategies. Carilion Clinic and Healthy Roanoke Valley (HRV) partnered to conduct the 2015 Roanoke Valley CHNA. This process was community-driven and focused on high levels of community engagement involving health and human services leaders, stakeholders, providers, the target population, and the community as a whole. HRV, housed under the United Way of Roanoke Valley, was formed in 2012 as a community response to needs identified in Carilion Clinic's triennial Roanoke Valley CHNA. HRV's mission is to mobilize community resources to improve access to care, coordination of services, and promote a culture of wellness. Using the collective impact model, the partnership boasts more than 160 individuals representing cross-sector stakeholders and leaders who are working to implement cost-effective programs resulting in improved health outcomes. Part VI, Line 3: Education of the Financial Assistance Policy is provided to patients at all hospital admission and ambulatory areas in the form of signage, in a summary of the policy which includes contact information, in available financial assistance applications and is included in the inpatient handbook. Hospital social workers and customer service representatives provide patients with verbal and/or written information regarding availability of assistance. Each patient billing statement and letters regarding patient financial responsibility include information on the Financial Assistance Policy and who to contact for additional information. Applications, the policy and Plain Language Summary are available free of charge to the patient. These items will be mailed to the patient if the patient failed to keep the documents at the time of service and they are also available on the Carilion Clinic web site. Carilion Clinic also employs an Eligibility Assistance Team that counsels patients regarding federal and state programs. This department completes applications for Medicaid, Social Security, Social Security Disability, and Medicare and provides support services for ensuring the applications are processed correctly based on federal and state policy. In addition, the Eligibility Team members are all Certified Application Counselors and will assist patients with enrollment in insurance exchange marketplace products provided through the Affordable Care Act. Eligibility Team members will also complete Carilion's financial assistance application and explain the requirements for financial assistance eligibility. Part VI, Line 4: Community Information:Carilion Medical Center (CMC), comprised of two hospitals, Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital, is located in Roanoke, Virginia. Roanoke is a 1,186 square mile valley located in southwest Virginia near the Blue Ridge and Allegheny Mountains. In fiscal year 2014, CMC served 121,168 unique patients. Patient origin data revealed that in fiscal year 2014, 72.77% of patients served by CMC lived in the following localities: Roanoke City (30.80%), Roanoke County (19.97%), Franklin County (8.78%), Botetourt County (6.94%), Salem City (5.61%), and Craig County (0.68%). The Roanoke Metropolitan Statistical Area (MSA), commonly known as the Roanoke Valley, is composed of the independent cities of Roanoke and Salem and the counties of Botetourt, Craig, Franklin and Roanoke.According to the 2010 Census, the total population of the Roanoke MSA is 308,707. 78.5% of residents are 18 years old or over and 16.3% are 65 years old or over. The MSA is 82.2% white and 12.8% black. According to the 2011-2015 American Community Survey 5-Year Estimates, 38.01% of MSA residents are not in the labor force, the median household income is $50,340, 10.8% of residents have no health insurance coverage, 13.9% of all people and 20.5% of people under 18 years old live below the federal poverty level, 87.9% of residents have graduated high school, and 26.7% of residents have a bachelor's degree or higher. Craig County and Franklin County are designated Medically Underserved Areas (MUA) as are portions of northern Botetourt County. In the city of Roanoke, nine census tracts are designated MUA's - seven are located in the northwest (NW) quadrant (Census Tracts 1, 9-11, 23-25) and two in the southeast (SE) quadrant (Census Tracts 26 and 27). Health Professional Shortage Areas (HPSA) are present in the portions of the Roanoke MSA for Primary Care, Dental, and Mental Health providers. Part VI, Line 5: Community Health Promotion:Carilion Medical Center includes Carilion Roanoke Memorial Hospital, one of the largest hospitals in the state of Virginia with 703 beds and an additional 60-bed neonatal intensive care unit and pediatric emergency department. With a Level One Trauma Center and children's hospital, complete with pediatric emergency room, Carilion Roanoke Memorial Hospital treats residents throughout southwest Virginia. In addition to offering high-tech services, the Hospital is also home to eight residency programs and two fellowship programs. Carilion Medical Center serves all patients regardless of their ability to pay. The Hospital's governing Board is elected annually and the majority are members of the local community who are neither employees nor contractors of the Hospital. Medical staff privileges are extended to qualified providers. In addition to clinical care, the Hospital works to achieve its mission through the education of health professionals and the community. Any surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. This includes providing free, discounted and subsidized care as well as critical medical services that operate at a loss. Part VI, Line 6: Affiliated System:Carilion Medical Center is wholly owned by Carilion Clinic, a not-for-profit healthcare organization based in Roanoke, Virginia. Through a comprehensive network of hospitals, primary and specialty physician practices and other complementary services, quality care is provided close to home for more than one million Virginians. With an enduring commitment to the health of the region, care is advanced through medical education and research and assistance is provided to help the community to stay healthy. Carilion Clinic employees 685 physicians representing more than 70 specialties who provide care at 241 practice sites. To advance education of health professionals, Jefferson College of Health Sciences, within Carilion Medical Center, is a professional health sciences college offering Associate's, Bachelor's, and Master's degree programs. During fiscal year 2016, 800 undergraduate and 262 graduate students were enrolled. Carilion Clinic, through Carilion Medical Center, works in cooperation with Virginia Tech Carilion School of Medicine to provide medical education opportunities to the community. There are 13 accredited residency programs (Carilion/OMNEE Emergency Medicine, Dermatology, General Hospital Dentistry, Emergency Medicine, Family Medicine, Internal Medicine, Neurosurgery, Obstetrics/Gynecology, Pediatrics, Plastic Surgery, Podiatry, Psychiatry and Surgery) and 11 accredited fellowship programs (Addiction Psychology, Adult Joint Reconstruction, Cardiovascular Disease, Child and Adolescent Psychiatry, Gastroenterology, Geriatric Medicine, Geriatric Psychiatry, Hospice and Palliative Care, Infectious Disease, Interventional Cardiology, and Pulmonary Critical Care). Advanced clinical technology and programs include Cyberknife Stereotactic Radiourgery, DaVinci Robotic Surgical System, 60 bed neonatal intensive care unit, hybrid operating room, Carilion Clinic Children's Hospital, Cancer Center, Spine Center, and comprehensive cardiothoracic, vascular and orthopedic surgery programs. Carilion Roanoke Memorial Hospital serves as a Level One Trauma Center with EMS services that include three EMS helicopters, six first-response vehicles and 38 Advanced Life Support Ambulances. An additional benefit to the community is Carilion Clinic's economic contribution to the region. As the area's largest employer, jobs are provided for more than 12,800 residents of the region. 1 Ronald McDonald House 2224 S Jefferson St Roanoke VA 24014 541244769 501(c)(3) 246800 FMV Donated Rent General Support Virginia Tech Carilion School of Medicine Inc Two Riverside Circle Roanoke VA 24016 264556177 501(c)(3) 4497406 0 0 0 General Support Taubman Museum of Art 110 Salem Ave Roanoke VA 24011 546026841 501(c)(3) 508000 0 0 0 General Support Valley AFC Inc PO Box 20045 Roanoke VA 24018 541608581 501(c)(3) 75000 0 0 0 General Support The Rescue Mission of Roanoke Inc PO Box 11525 Roanoke VA 24022 540573900 501(c)(3) 113100 0 0 0 Food Access Program/Homelessness Support Virginia Business Higher Education Council 1108 E Main St 1100 Richmond VA 23219 541827038 501(c)(3) 110000 0 0 0 General Support Virginia Healthcare Foundation 707 East Main Street Suite 1350 Richmond VA 23219 541639924 501(c)(3) 100000 0 0 0 General Support Virginia Tech Foundation Inc 902 Prices Fork Rd University Gateway Center STE 400 Blacksburg VA 24061 540721690 501(c)(3) 90000 0 0 0 Scholarship City of Roanoke 215 Church Ave Room 254 Roanoke VA 24011 546001569 Roanoke, VA 70250 0 0 0 Playground United Way of Roanoke Valley 325 Campbell Avenue Roanoke VA 24016 540535302 501(c)(3) 67688 0 0 0 Fresh Foods RX Pilot Program/ Healthy Roanoke Valley Collab./General Support Children's Trust of Roanoke Valley Inc 541 Luck Ave Suite 308 Roanoke VA 24016 510235891 501(c)(3) 61800 0 0 0 Operational Support The Virginia Foundation for Community College Education Inc 300 Arboretum Parkway No 200 Richmond VA 23236 237004354 501(c)(3) 60000 0 0 0 Sponsorship CHIP of Roanoke Valley 1201 3rd Street Roanoke VA 24016 541566451 501(c)(3) 51500 0 0 0 Operational Support Carilion Clinic Patient Transportation 431 McClanahan St SW Roanoke VA 24014 541864693 501(c)(3) 50000 0 0 0 General Support Roanoke Symphony Orchestra 128 East Campbell Ave SE Roanoke VA 24011 546019736 501(c)(3) 37309 0 0 0 General Support Local Environmental Agriculture Project PO Box 3249 Roanoke VA 24015 271050909 501(c)(3) 35000 0 0 0 Community Kitchen/SNAP Double Value Mental Health of America Rke Valley PO Box 592 Roanoke VA 24004 540703132 501(c)(3) 32500 0 0 0 Mental Health Collaboration/Operational support American Cancer Society 2840 Electric Road 106A Roanoke VA 24018 131788491 501(c)(3) 25000 0 0 0 General Support Depaul Community Resources 5650 Hollins Road Roanoke VA 24019 541108079 501(c)(3) 25000 0 0 0 General Support Grandin Theatre Foundation Inc 1310 Grandin Road Roanoke VA 24015 010557881 501(c)(3) 25000 0 0 0 Community Engagement Feeding America Southwest Virginia 1025 Electirc Rd Salem VA 24153 541939556 501(c)(3) 22000 0 0 0 VeggieMobile-Nutrition VA Blue Ridge Affiliate of Susan G Komen for the Cure 4910 Valley View Blvd Ste212 Roanoke VA 24012 562619425 501(c)(3) 20000 0 0 0 General Support Virginia Foundation for Independent Colleges 8010 Ridge Road Richmond VA 23229 540554396 501(c)(3) 20000 0 0 0 Educational Attainment Happy Healthy Cooks 1914 Belleview Rd Roanoke VA 24013 464937238 501(c)(3) 19000 0 0 0 School Nutrition Program American Heart Association PO Box 4002906 Des Moines IA 503402906 135613797 501(c)(3) 17500 0 0 0 General Support Total Action for Progress PO Box 2868 Roanoke VA 24001 546057095 501(c)(3) 16000 0 0 0 Dental Health Initiative/General Support Foundation for Rehabilitation Equipment & Endowment PO Box 8873 Roanoke VA 24014 541934695 501(c)(3) 15800 0 0 0 Operational Support Junior Achievement of Southwest Virginia 3433 Brambleton Ave Suite 202B Roanoke VA 24018 540628293 501(c)(3) 15094 0 0 0 General Support Family Services of Roanoke Valley 360 Campbell Ave SW Roanoke VA 24016 540505946 501(c)(3) 15000 0 0 0 Counselling Mill Mountain Theatre One Market Square SE - 2nd Floor Roanoke VA 24011 540792067 501(c)(3) 15000 0 0 0 General Support Young Audiences Arts for Learning Virginia 420 North Center Drive Ste 239 Norfolk VA 23502 546063377 501(c)(3) 12200 0 0 0 Youth Dance/Math Program Opera Roanoke 20 East Church Avenue 3rd Floor Roanoke VA 24011 510213334 501(c)(3) 10000 0 0 0 General Support Roanoke Community Garden Association 655 Highland AveSE Roanoke VA 24013 262082150 501(c)(3) 10000 0 0 0 Community Gardens Roanoke Outside 111 Franklin Plaza Roanoke VA 24011 451648056 501(c)(3) 10000 0 0 0 Marathon Scott Robertson Memorial Junior Golf Academy 3707 Densmore Road NW Roanoke VA 24017 201237999 501(c)(3) 10000 0 0 0 Parent-Child Tournament The Medical Society of Virginia 2924 Emerywood Parkway Suite 300 Richmond VA 23294 540299956 501(c)(3) 10000 0 0 0 Sponsorship RX Partnership 2924 Emerywood Pky Ste 300 Richmond VA 23294 571186937 501(c)(3) 9310 0 0 0 Rx Access Program National Multiple Sclerosis Society Central & Eastern Virginia Chapter 4200 Innslake Drive Glen Allen VA 23060 540633474 501(c)(3) 7500 0 0 0 General Support Roanoke Academy of Medicine Alliance Foundation 2911 Crystal Spring Ave Roanoke VA 24014 510218435 501(c)(3) 7500 0 0 0 General Support Western Virginia Foundation For The Arts And Sciences One Market Square Roanoke VA 24011 510238900 501(c)(3) 7500 0 0 0 General Support Juvenile Diabetes 3959 Electric Rd Ste222 Roanoke VA 24012 231907729 501(c)(3) 6500 0 0 0 General Support Arthritis Foundation Inc 1355 Peachtree Street NE Sutie 600 Atlanta GA 30309 581341679 501(c)(3) 5000 0 0 0 General Support Boys & Girls Clubs of Southwest Virginia Inc 1714 9th Street SE Roanoke VA 24013 541867366 501(c)(3) 5000 0 0 0 Wellness Program Hollins University Corporation PO Box 9658 Roanoke VA 24020 540506314 501(c)(3) 5000 0 0 0 Scholarship March of Dimes Greater Roanoke 2840 Electric Road - Suite 102A Roanoke VA 24018 131846366 501(c)(3) 5000 0 0 0 General Support Greater Roanoke Transit 1108 Campbell Ave SE Roanoke VA 24013 540982022 501(c)(3) 38754 Trolley Service 46 Endowment-funded indigent patient medical bills 36 86063 Transportation Assistance 1733 60100 Schedule I, Part I, Line 2 The hospital donates funds to other 501(c)3 charitable organizations with a similar mission. Such organizations also have community boards which oversee the expenditure of such funds. Carilion Medical Center also has a program under which funds are granted to community organizations with a focus on chidren's health and well-being. A committee of Carilion Medical Center employees and an independent physician reviews the applications and selects the recipients. Recipients sign a letter of agreement that delineates the terms and objectives of the project. One mid-year project report, a site visit and a final program evaluation reports on the program's services, outcomes and budget. For Carilion Clinic's Community Grant Program, each grantee must sign a letter of agreement with Carilion Clinic that delineates the terms and specific objectives of the project. By accepting a Carilion award, grantees are asked to acknowledge the support of Carilion Clinic in all materials and/or related special events or fundraisers throughout the award cycle where other donors are publicly recognized. One mid-cycle progress report and a final program evaluation are required for each funded project. Site visits may be made to new grantees. Program evaluation includes organizational effectiveness, program impact, and community benefit through collection of data including clients served, cost effectiveness of the program (cost per client of service), tangible community or client outcomes, and specific efforts to cultivate diverse funding sources for program sustainability. Each grantee must agree to submit requested data and reports on a timely basis and to complete the evaluation process as requested. Schedule I, Part III, Line 1 Grant requests for indigent patients are evaluated for eligibility based on the restriction criteria placed by the grantor of the endowment, account payment status and funds available under the grant. 0 1 0 0 0 0 0 1 0 John H Burton MD Director 479335 0 96918 0 3102 0 52261 0 11535 0 643151 0 0 0 Cynda A Johnson MD Director 0 593756 0 10000 0 7423 0 71531 0 8697 0 691407 0 0 Clifford A Nottingham MD Director 0 303423 0 36944 0 6697 0 134784 0 8428 0 490276 0 0 Patrice M Weiss MD Director 0 560900 0 112459 0 6277 0 118149 0 14187 0 811972 0 0 Ralph E WhatleyIII MD Director 461603 0 85555 0 10344 0 81573 0 11349 0 650424 0 0 0 Nancy Howell Agee Director/CEO 0 1137025 0 332354 0 152222 0 2158081 0 10118 0 3789800 0 141071 Steve C Arner Director/President/CEO 0 404698 0 75226 0 3985 0 111082 0 12704 0 607695 0 0 Tracy W Criss MD Director/Chief of Medical Staff 183093 0 50076 0 2461 0 67611 0 10695 0 313936 0 0 0 David S Hagadorn Assistant Treasurer 0 128218 0 2500 0 7499 0 26279 0 819 0 165315 0 0 Donald B Halliwill Assistant Treasurer/EVP/CFO 0 460065 0 86171 0 4271 0 108666 0 11404 0 670577 0 0 G Robert Vaughan Jr Treasurer 0 248071 0 47425 0 10549 0 70577 0 11254 0 387876 0 0 Bruce A Long MD Physician, Dept. Chair 489572 0 223307 0 3553 0 45112 0 11535 0 773079 0 0 0 Joseph T Moskal MD Physician, Dept. Chair 1080145 0 218109 0 7343 0 75199 0 11535 0 1392331 0 0 0 Jon M Sweet MD Physician, Dept. Chair 238669 0 71884 0 2378 0 47745 0 7640 0 368316 0 0 0 Jonathan J Carmouche MD Physician 1036482 0 546282 0 2549 0 19831 0 11535 0 1616679 0 0 0 Cay M Mierisch MD Physician 823078 0 208389 0 2833 0 35568 0 11795 0 1081663 0 0 0 Gary R Simonds MD Physician 869842 0 326108 0 5353 0 58547 0 11535 0 1271385 0 0 0 Caleb J Behrend MD Physician 652920 0 330239 0 2562 0 6483 0 11535 0 1003739 0 0 0 Gregory A Howes MD Physician 736978 0 228597 0 20204 0 0 0 11795 0 997574 0 0 0 Thomas D Denberg MD PhD Former Chief Strategy Officer 0 395252 0 88182 0 21905 0 -21708 0 11680 0 495311 0 0 Briggs W Andrews Former Secretary 0 294741 0 71120 0 113407 0 61932 0 2652 0 543852 0 109782 Donald E Lorton Former CFO 0 0 0 0 0 130613 0 0 0 0 0 130613 0 130613 Edward Murphy MD Former CEO 0 0 0 0 0 18155 0 0 0 0 0 18155 0 0 Part I, Line 3 The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation, including that of the organization's Chief Executive Officer, is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of Board members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. This review was performed in November 2015 and September 2016. 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 Select members of management participate in a Pension Restoration Plan. This plan provides a benefit equal to the normal retirement benefit that would be payable to the participant were it not for the Qualified Plan's legislative restrictions on compensation and payable benefits, less the actual benefits under the Qualified Plan. Entitlement to benefits and consequent lump sum payment occurs upon attaining age 65 while employed by Carilion Clinic, disability, or 24 months after certain qualifying separations from service. Upon the death of the participant, the plan shall pay the participant's beneficiary according to plan terms. Select members of management participate in an Executive Flexible Benefit Plan, in which an allowance is provided to the participant for use in obtaining certain insurance benefits. The allowance is determined annually as a percentage of salary at Carilion Clinic's discretion. The amount of allowance in excess of elected benefits is credited to a capital accumulation account (CAA) with a deferred vesting date of at least two years from the first day of the plan year. The CAA shall be distributed in a lump sum upon vesting while employed by Carilion, disability, or 24 months following certain qualifying separations from service. Upon the death of the participant, the plan shall pay the participant's beneficiary according to plan terms. Select members of management participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP) in which the employer at the discretion of Carilion Clinic's Board of Directors 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. Payments during the calendar year under these plans included the following: Nancy Howell Agee $141,071 Briggs Andrews $109,782 Donald Lorton $130,613 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 Industrial Development Authority of the City of Roanoke VA 541106038 770084EQ0 2014-04-09 125000000 Reissuance of Series 2005A originally issued on 12/14/05 0 0 0 B VA Small Business Financing Authority Hospital Revenue Bonds 541300845 928101AE4 2014-03-25 11950000 Reissuance of Series 2008A and 2008B originally issued on 07/16/08 0 0 0 C Industrial Development Authority of the City of Roanoke VA 541106038 770082AB1 2010-10-13 96404094 Refunding of Series 2003A-C Bonds (08/03), Issuance Costs 0 0 0 D Economic Development Authority of the City of Roanoke VA 541106038 770082AW5 2012-02-09 69968434 Refunding of Series 2000 and 2002A Bonds, Issuance Costs, Capital Projects 0 0 0 A 1890000 125000000 797940 1940086 122261974 2007 1 0 1 1 B 11950000 107259 11842741 2009 0 0 1 1 C 96404094 1229094 95175000 1 0 1 1 D 21045000 69968434 771282 5189198 64007954 2011 0 1 1 1 A 0 1 1 1 0 0.00120 0.00000 0.00120 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 0 0 1 1 0 1 AIG 0.300000000000 1 0 1 B 0 0 0 1 1 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: Industrial Development Authority of the City of Roanoke, VA, Date the Rebate Computation was Performed: 04/30/2009 Issuer Name: VA Small Business Financing Authority, Hospital Revenue Bonds Date the Rebate Computation was Performed: 06/22/2011 Issuer Name: Industrial Development Authority of the City of Roanoke, VA Date the Rebate Computation was Performed: 04/29/2011 Issuer Name: Economic Development Authority of the City of Roanoke, VA Date the Rebate Computation was Performed: 04/04/2013 Issuer Name: Industrial Development Authority of the City of Roanoke, VA Date the Rebate Computation was Performed: 05/04/2011 Schedule K, Bond Issues (a) Issuer Name: Part I, Line A Industrial Development Authority of the City of Roanoke, VA, Hospital Revenue Bonds, Carilion Health System Obligated Group, Series 2005A (a) Issuer Name: Part I, Line B VA Small Business Financing Authority, Hospital Revenue Bonds, Carilion Clinic Obligated Group, Series 2008A & 2008B (a) Issuer Name: Part I, Line C Industrial Development Authority of the City of Roanoke, VA, Hospital Revenue Bonds, Carilion Health System Obligated Group, Series 2010 (a) Issuer Name: Part I, Line D Economic Development Authority of the City of Roanoke, VA, Hospital Revenue Bonds, Carilion Clinic Obligated Group, Series 2012 (a) Issuer Name: Part I, Line E Industrial Development Authority of the City of Roanoke, VA, Hospital Revenue Refunding Bonds, Carilion Clinic Obligated Group, Series 2005B & 2005C Schedule K, Part II All bond issues- multiple entities across multiple jurisdictions; therefore, proceeds allocated to multiple hospitals. A Industrial Development Authority of the City of Roanoke VA 541106038 770084FU0 2010-10-13 98852291 Reoffering Circular and interest rate conversion to fixed, Issuance Costs 0 0 0 A 16957000 98852291 1068912 41693 97741687 2007 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 1 0 1 AIG 0.300000000000 1 0 1 A 1 1 Eric Chen MD See Part V 313814 Employee 0 2 Bruce Johnson MD See Part V 331982 Employee 0 3 Mary Sweet MD See Part V 360516 Employee 0 Sched. L Part IV (1) Family member of Lauren Chen, Officer.(2) Family member of Cynda Johnson, Director.(3) Family member of Jon Sweet, Key Employee. X 5334 FMV X 23 11516 FMV X 37 10052 FMV X Gift Cards 66 28653 FMV X Event Prizes 1 2000 FMV 0 0 1 0 Part I, Column (b): Number of contributions represents the number of items contributed. Form 990, Part I, Line 6 The hospital operates a Customer Service-based program for volunteers and we do anything to make our patients and patient families comfortable in very uncomfortable circumstances. Tasks include delivering mail, delivering flowers, greeting and escorting patients and providing snacks in the hospital waiting rooms. Through Hospice, volunteers provide respite support for caregivers, visits for socialization and comforting presence, checking calls, take care of patients' pets, sing to patients, pet therapy, yoga therapy, help in the hospice office, assist with fundraisers, assist with bereavement support activities, deliver birthday gifts, make holiday gifts and memory quilts and record patient's life stories. Form 990, Part V, Line 1a 1099s are issued on Carilion Medical Center's behalf by Carilion Services, Inc., a related supporting organization providing management and administrative services, including payment processing. Form 990, Part VI, Section A, line 2 1. Nancy Howell Agee, Steve Arner, Lauren J. Chen, David S. Hagadorn, Nicholas C. Conte, Donald B. Halliwill, Cynda A. Johnson, M.D., G. Robert Vaughan, Jr., Clifford A. Nottingham, M.D., Patrice M. Weiss, M.D., and Ralph E. Whatley, M.D. - Business relationship due to each serving as officers, directors, and/or employees of the same related organizations. Form 990, Part VI, Section A, line 3 Certain management and related services for the organization are provided by the management and employees of Carilion Services, Inc., a related organization and supporting organization of the filing organization. Compensation of the following individuals listed in Part VII, Section A was provided by Carilion Services Inc.: Nancy Howell Agee, Briggs Andrews, Steven Arner, Lauren Chen, Thomas Denberg, David Hagadorn, Donald Halliwill, Donald Lorton, Edward Murphy, G. Robert Vaughan, Patrice Weiss. Form 990, Part VI, Section A, line 6 The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers. Form 990, Part VI, Section A, line 7a The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the board that may occur for any reason. Form 990, Part VI, Section A, line 7b The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO; approval of borrowings, budgets, and strategic plans; and amendments of Articles of Incorporation and Bylaws. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia, certain extraordinary actions require member approval, such as mergers, consolidations, liquidations, and the sale of substantially all of the assets of the organization. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a. Form 990, Part VI, Section B, line 11 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 outside CPA firm. Several days prior to filing, all Board Members were notified by email of its availability on Carilion's Board portal, which is the mechanism used to disseminate meeting materials to the directors, and were encouraged to call with any questions they might have. Form 990, Part VI, Section B, line 12c Our organization monitors and reviews proposed and current transactions for conflicts of interest in a variety of ways. At the governing board level, we have board members complete an initial (upon appointment) and annual conflict of interest questionnaire to disclose actual or potential conflicts. Board members are required to update their disclosure as needed in between questionnaires. All disclosures are reviewed by the Organizational Integrity & Compliance Office and as needed escalated to the appropriate leaders/board members for further discussion/review. If a disclosure is viewed as an actual or potential conflict, an action is recommended to the Audit & Compliance Committee of the Carilion Clinic Board and implemented as approved. Actions can include recusal in discussion/voting at board meetings, limitation/termination of the transaction, removal from board appointment or other appropriate controls. In addition, at any time, board members are encouraged to disclose any potential conflicts as they arise at a board meeting and to recuse themselves as deemed appropriate. The same process takes place as described above for key employees (upon hire and annually thereafter), including all Officers, members of the management team, physicians/mid-level practitioners, pharmacists and key supply chain buyers. After review and further discussion as needed, action may be required to manage an actual conflict or to reduce the appearance of such as approved by Organizational Integrity & Compliance Office and other key management team members. As needed, the governing board leaders are notified of any conflicts which may impact board proceedings. Form 990, Part VI, Section B, line 15 The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. With respect to Carilion Clinic, the Compensation Committee reviews the compensation of the Board of Governors annually, which includes the President and Chief Executive Officer, Executive Vice Presidents, Chief Financial Officer, Chief Medical Officer, select Senior Vice Presidents, and physician Chairs of the Clinical Departments. This review was performed in November 2015 and September 2016. For the fiscal year covered by this return, the Compensation Committee also used the same process to review the compensation of all Senior Vice Presidents and other Disqualified Individuals, including the Hospital Vice Presidents. These reviews were performed in September and November 2015, and September 2016, respectively. 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 an 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 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 annually to the local newspaper. Limited financial information is available on our website. Form 990, Part XI, line 9: Transfers to/from Affiliates 1,086,059. Pension-related changes other than net periodic pension costs -91,847,636. RMH Emergency Services LLC PO Box 12385 Roanoke VA 24025 541686589 Physician billing VA 0 0 Carilion Medical Center Carilion Clinic PO Box 12385 Roanoke VA 24025 541190771 Supporting organization VA 501(c)(3) Line 11b, II N/A 0 Carilion Clinic Foundation PO Box 12385 Roanoke VA 24025 541190773 Fundraising VA 501(c)(3) Line 7 Carilion Clinic 1 Carilion Franklin Memorial Hospital PO Box 12385 Roanoke VA 24025 540480606 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Giles Community Hospital PO Box 12385 Roanoke VA 24025 540549603 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion New River Valley Medical Center PO Box 12385 Roanoke VA 24025 540553805 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Services Inc PO Box 12385 Roanoke VA 24025 541190879 Supporting organization VA 501(c)(3) Line 11b, II Carilion Clinic 1 Carilion Stonewall Jackson Hospital PO Box 12385 Roanoke VA 24025 540568001 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Tazewell Community Hospital PO Box 12385 Roanoke VA 24025 546074580 Healthcare VA 501(c)(3) Line 3 Carilion Clinic 1 Carilion Biomedical Institute PO Box 12385 Roanoke VA 24025 541965057 Supporting organization VA 501(c)(3) Line 11a, I Carilion Clinic 1 Franklin County Ventures LLC PO Box 12385 Roanoke VA 24025 474365316 Real estate VA Carilion Clinic Related -609 41942 0 0 0.10000 Carilion Clinic Medicare Shared Savings Company LLC PO Box 12385 Roanoke VA 24025 455235473 Medicare HMO VA Carilion Clinic Related -801314 1 0 0 0.50000 Community Medical Associates LLP PO Box 12385 Roanoke VA 24025 541517662 Real estate VA Carilion Medical Center Related 87525 865030 0 0 0.47300 CHS Inc PO Box 12385 Roanoke VA 24025 541725732 Services VA N/A C 1 Carilion Clinic Medicare Resources LLC PO Box 12385 Roanoke VA 24025 263729975 Medicare HMO VA N/A C 1 Carilion Behavioral Health Inc PO Box 12385 Roanoke VA 24025 203136891 Healthcare VA N/A C 1 Carilion Emergency Services Inc PO Box 12385 Roanoke VA 24025 542033006 Healthcare VA N/A C 1 SCA Credit Services Inc PO Box 12385 Roanoke VA 24025 541180398 Collection agency VA N/A C 1 Carilion Healthcare Corporation PO Box 12385 Roanoke VA 24025 541586601 Healthcare VA N/A C 1 MedKey Inc PO Box 12385 Roanoke VA 24025 541645357 Financing services VA N/A C 1 1 0 0 1 1 0 0 0 0 1 1 1 1 0 0 0 0 1 0 Carilion Services Inc A 2270001 Cost Carilion Clinic Foundation A 37560 Cost CHS Inc A 74033 Cost Carilion Emergency Services A 93132 Cost Carilion Healthcare Corporation A 26208 Cost Carilion New River Valley Medical Center L 3823720 Cost Carilion Giles Community Hospital L 1341578 Cost Carilion Franklin Memorial Hospital L 1804068 Cost Carilion Stonewall Jackson Hospital L 1499238 Cost Carilion Tazewell Community Hospital L 1441788 Cost Carilion Services Inc L 1197701 Cost Carilion Behavioral Health L 126567 Cost Carilion Emergency Services L 117401 Cost Carilion Healthcare Corporation L 313039 Cost MedKey Inc L -352161 Cost Carilion New River Valley Medical Center K 84653 Cost Carilion Tazewell Community Hospital M 84160 Cost Carilion Services Inc K 52805 Cost Carilion Services Inc M 157519721 Cost CHS Inc K 3126285 Cost CHS Inc M 5505302 Cost Carilion Behavioral Health M 121778 Cost SCA Credit Services Inc M 680547 Cost Carilion Services Inc R 3425699 Cash