2026-08-18T13:25:48+00:00 2025-09-30 440160260 FORVIS MAZARS LLP 1201 WALNUT ST SUITE 1700 KANSAS CITY MO 641062246 990 2024-10-01 540506332 CARILION MEDICAL CENTER CARI 5402245102 PO BOX 12385 ROANOKE VA 240252385 G ROBERT VAUGHAN TREASURER 5402245102 2026-08-18 true true MICHAEL ENGLE P00482834 8162216300 2026-08-18 2024 2025-03-06 01:10:19Z MICHAEL ABBOTT PO BOX 12385 ROANOKE VA 240252385 2338975837 false X WWW.CARILIONCLINIC.ORG X 1899 VA OUR MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH OUR COMMITMENT TO A COMMON PURPOSE OF BETTER PATIENT CARE, BETTER COMMUNITY HEALTH, AND LOWER COST. 11 6 10579 495 19530 0 10677232 9292252 1881826902 2209361982 65422108 80339091 25536306 25272806 1983462548 2324266131 6123879 7507297 0 840704812 905182790 0 285788 1071810306 1247296994 1918638997 2159987081 64823551 164279050 2217235562 2380203801 1198187751 1114913127 1019047811 1265290674 OUR MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH OUR COMMITMENT TO A COMMON PURPOSE OF BETTER PATIENT CARE, BETTER COMMUNITY HEALTH, AND LOWER COST. false false 1820436126 7507297 2225122325 SEE SCHEDULE O. 1820436126 true true false true false false false false false true true true false false true false false true false false false false false false false false true true true true true false false false false false false false false true false false false false false true true true true false false true X 0 0 10579 true true true false false false false false false false false false false false X 11 6 true true false false true true true true true false false false true true true true true true true true true true VA X MATTHEW BARR 5402245021 213 S JEFFERSON ST ROANOKE VA 24011 DAMON WILLIAMS DIRECTOR 2.0 4.5 X X 0 8400 0 JANET FRANTZ DIRECTOR/CHAIR 2.0 2.4 X X 0 2673 0 MICHAEL ABBOTT PHARMD PRESIDENT 50.0 0 X X 463183 0 160443 ANN HOFF PHD DIRECTOR 2.0 0.0 X 0 1123 0 DANIEL TERSHAK MD DIRECTOR/CHIEF OF MEDICAL STAFF 50.0 0 X 597139 0 199144 ISABEL THORNTON DIRECTOR 2.0 0 X 0 0 0 JAMIE GREENAWALT DIRECTOR 2.0 0 X 0 0 0 KATHERIN ELAM DIRECTOR 2.0 0 X 0 0 0 KIANNA PRICE MARSHALL DIRECTOR 2.0 0.0 X 0 1123 0 LEE LEARMAN MD PHD DIRECTOR 2.0 0 X 3250 0 0 MICHAEL NUSSBAUM MD DIRECTOR/SVP/DEPT. CHAIR 50.0 0 X 1086957 0 94097 PAUL HASKINS MD DIRECTOR/PHYSICIAN 50.0 0 X 498315 0 311229 DONALD HALLIWILL ASST. TREASURER/EVP/CFO 0.5 49.5 X 0 1309012 407205 G ROBERT VAUGHAN JR TREASURER 0.5 49.5 X 0 543489 326337 J HARRISON LAPUASA ASST. TREASURER 0.5 39.5 X 0 117661 9745 JULIE SMITH-HAMILTON ASST. SECRETARY 0.5 39.5 X 0 63772 26601 MICHELLE FRANKLIN SVP, CHIEF NURSING OFFICER 50.0 0 X 329052 0 316334 NICHOLAS CONTE SECRETARY/EVP/CLO 3.0 47.0 X 0 1218022 268294 STEVEN ARNER CEO 2.5 47.5 X 0 1715344 489922 TAMARA FROST SVP, CHIEF NURSING OFFICER 50.0 0 X 380304 0 96934 JON SWEET MD SVP/DEPARTMENT CHAIR 50.0 0 X 642653 0 278866 JOSEPH MOSKAL MD SVP/DEPARTMENT CHAIR 50.0 0 X 1505418 0 26867 R TONY SEUPAUL MD CHIEF PHYSICIAN EXECUTIVE/EVP 49.5 0.5 X 22924 926859 161937 SHYAM ODETI MD VP/CHIEF MEDICAL OFFICER 25.0 25.0 X 464043 0 50072 ADEOLU OLASUNKANMI MD PHYSICIAN 50.0 0 X 1625000 0 65121 ERIC MARVIN MD PHYSICIAN 50.0 0 X 1730753 0 122729 GREGORY HOWES MD PHYSICIAN 50.0 0 X 1540924 0 104964 JAMES DROUGAS MD PHYSICIAN 50.0 0 X 1374026 0 43188 JONATHAN CARMOUCHE MD PHYSICIAN 50.0 0 X 1706703 0 136236 JOHN JANE MD SVP, DEPARTMENT CHAIR 50.0 0 X 1356823 0 135128 NANCY HOWELL AGEE CEO EMERITUS, CARILION CLINIC 0.0 50.0 X 0 2565963 17888 15327467 8473441 3849281 1687 true true false ROBINS & MORTON BRANCH BUILDS 400 SHADES CREEK PARKWAY BIRMINGHAM AL 35209 CONSTRUCTION SERVICES 116871283 QUALIVIS LLC 1601 ASSEMBLY STREET COLUMBIA SC 29201 TEMPORARY STAFFING 48100680 QUEST DIAGNOSTICS 500 PLAZA DRIVE SECAUCUS NJ 07094 LABORATORY SERVICES 29766336 ACV INC 5115 BERNARD DR SW 201 ROANOKE VA 24018 ANESTHESIOLOGIST SERVICES 14874473 GE MEDICAL SYSTEMS 5517 COLLECTION CENTER DRIVE CHICAGO IL 60693 EQUIPMENT MAINTENANCE 14218238 147 538132 6736702 2017418 9292252 NET PATIENT REVENUE 622110 2093045593 2093045593 PROGRAM RELATED INVESTMENTS 621999 8310623 8310623 PATIENT PHARMACY REVENUE 456110 102298939 102298939 AFFILIATE RENT INCOME 531120 522850 522850 CLINICAL RESEARCH 541715 2588306 2588306 2595671 2595671 0 0 2209361982 10807669 19530 10788139 4768 4768 5393103 5393103 0 5393103 5393103 84166221 70139 14659972 49734 69506249 20405 69526654 69526654 AFFILIATE SUBSIDY & OTHER INCOME 621111 5355311 5355311 DINING SERVICES 722514 4119360 4119360 ROANOKE CITY STUDENT HEALTH 621400 2373898 2373898 8031134 8031134 0 0 19879703 2324266131 2225122325 19530 89832024 X 7176461 7176461 330836 330836 6335355 5732007 603348 3332828 3332828 760338818 759843467 435660 59691 31710021 31691852 18169 53212070 53106708 90439 14923 50253698 50187921 61877 3900 318435177 318435177 173386 173386 7744 7744 1231500 1231500 219575871 207348053 12224511 3307 23763 23731 32 35416950 34615738 791793 9419 4617807 4612093 5673 41 39871681 39850315 21366 3818779 3810430 1507 6842 8014449 8014449 52600230 52600230 15746602 10601488 5145114 MEDICAL SUPPLIES 315517323 315517323 ASSESSMENT FEES 120122206 120122206 BAD DEBT 95294644 95294644 AFFILIATE PRACTICE SUBSIDY 7916919 7916919 8911963 8698683 25647 187633 2159987081 1820436126 339265167 285788 14720 15560 6029263 3241112 0 364382883 470859659 0 0 0 0 93228 57877 13565513 17452282 24832907 20873145 1923450410 1069865767 742216444 853584643 383201443 282911365 669442369 711361336 11167187 18838090 341728 300307 1947877 708425 2217235562 2380203801 304535156 253169156 176250 290000 30506778 14821274 593434651 582474689 0 0 182000 91000 269352916 264067008 1198187751 1114913127 X 989520655 1233440015 29527156 31850659 1019047811 1265290674 2217235562 2380203801 X 164279050 62679226 19284587 X false true true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 7744 7744 false SCHEDULE C, PART II-B, LINE 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY A PORTION OF DUES PAID TO VARIOUS HEALTHCARE INDUSTRY ASSOCIATIONS IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. 23017938 296075 2579982 645155 25248840 20046508 190750 3550303 769623 23017938 18491904 238935 2021518 705849 20046508 20613255 190000 -1682218 629133 18491904 16794123 348535 4146435 675838 20613255 0.0 0.4704 0.5296 false false 6067755 6067755 1062260332 450836145 611424187 1598462 1129922 468540 789659976 610779853 178880123 63863885 7119847 56744038 853584643 4672601 F CLOSELY-HELD EQUITY INTERESTS FINANCIAL DERIVATIVES 4672601 F ALTERNATIVE INVESTMENTS 706688735 F 711361336 FEDERAL INCOME TAXES DUE TO AFFILIATES 54800993 PENSION LIABILITY 136969481 DEFERRED COMPENSATION LIABILITY 55293134 INTEREST RATE SWAP LIABILITY 9014731 LEASE LIABILITY TOTAL 7988669 264067008 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE D, PART V, LINE 4 INTENDED USES OF ENDOWMENT FUNDS INCOME FROM ENDOWMENT FUNDS ARE USED FOR THE FOLLOWING. (1) PEDIATRIC PROGRAMS- BOTH INTERNAL AND EXTERNAL- AND/OR PEDIATRIC EQUIPMENT. (2) PATIENT CARE ASSISTANCE. true true X true X 300 true X 500 true true true false true true 20528574 20528574 0.00992 383802649 591430829 0 0.0 0 0.0 0 0 404331223 591430829 20528574 0.00992 5898076 679856 5218220 0.00252 63919071 10071049 53848022 0.02602 25316893 21119716 4197177 0.00203 2721781 2721781 0.00132 8189329 110000 8079329 0.00390 0 0 106045150 31980621 74064529 0.03579 0 0 510376373 623411450 94593103 0.04571 85 85 0.00000 115576 115576 0.00006 90471 90471 0.00004 4587 4587 0.00000 0 0.0 62857 62857 0.00003 3604 3604 0.00000 635477 635477 0.00031 0 0.0 0 0 912657 0 912657 0.00044 true 95300753 254966260 284062662 -29096402 X true true ROANOKE AMBULATORY SURGERY CENTER LLC AMBULATORY SURGERY 0.5 0.0465 0.3036 SOUTHWEST VIRGINIA HEALTH PROPERTIES LLC REAL ESTATE 0.527 0.0369 0.3145 2 1 CARILION MEDICAL CENTER -DBA CRMH 1906 BELLEVIEW AVE ROANOKE VA 24014 HTTPS://CARILIONCLINIC.ORG/LOCATIONS/CARILION-ROANOKE-MEMORIAL-HOSPITAL H 1840 X X X X X X A 2 CARILION MEDICAL CENTER -DBA CRCH 101 ELM AVE ROANOKE VA 24013 HTTPS://CARILIONCLINIC.ORG/LOCATIONS/CARILION-ROANOKE-COMMUNITY-HOSPITAL H 1839 X REHABILITATION UNIT A A 2 false false true X X X X X X X X X 23 true true true true X https://www.carilionclinic.org/cho-community-health-assessments#reports https://issuu.com/carilionclinic/docs/2024_cmc_cha_final_report X X true 24 true https://issuu.com/carilionclinic/docs/implementation_strategy_final_cmc false true X 300.0 500.0 X X X X true true X X X true X https://www.carilionclinic.org/billing/financial-assistance X https://www.carilionclinic.org/billing/financial-assistance X https://www.carilionclinic.org/billing/financial-assistance X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 3E THE PUBLICLY AVAILABLE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT DETAILS THE PRIORITIZATION PROCESS FOR THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS. THE COMMUNITY HEALTH ASSESSMENT TEAM (CHAT), COMPRISED OF COMMUNITY STAKEHOLDERS, REVIEWS ALL DATA AND COMPLETES A PRIORITIZATION SURVEY. THROUGH THE SURVEY, EACH CHAT MEMBER SELECTS THE MOST PERTINENT COMMUNITY NEEDS. FOLLOWING THE SURVEY, CHAT MEMBERS FURTHER REFINE THE PRIORITIES THROUGH A CONSENSUS-BUILDING ACTIVITY. CHAT MEMBERS PRIORITIZE NEEDS ACCORDING TO THE PERCEIVED BURDEN, SCOPE, SEVERITY, OR URGENCY; THE IMPORTANCE THE COMMUNITY PLACES ON ADDRESSING THE NEED THROUGH SURVEY RESPONSES AND OTHER INTERACTIONS; AND EACH MEMBER'S UNIQUE PERSPECTIVE ON COMMUNITY HEALTH. THE RESULTING LIST OF PRIORITY HEALTH OUTCOMES REFLECTS THE TOP SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS DETERMINED BY THE CHNA PROCESS AND PARTNERS. SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY A, 1 FACILITY A, 1 - GROUP A. CARILION CLINIC'S COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) ARE COMMUNITY-DRIVEN PROJECTS. THEIR SUCCESS DEPENDS HIGHLY ON ENGAGING CITIZENS, HEALTH AND HUMAN SERVICE AGENCIES, BUSINESSES, AND COMMUNITY LEADERS. STAKEHOLDER COLLABORATIONS KNOWN AS COMMUNITY HEALTH ASSESSMENT TEAMS (CHATS) LEAD THE CHNAS. THE CHATS INCLUDE HEALTH AND HUMAN SERVICE AGENCY LEADERS, PEOPLE WITH EXCEPTIONAL KNOWLEDGE OF, OR EXPERTISE IN, PUBLIC HEALTH, AND LOCAL HEALTH DEPARTMENT OFFICIALS. EACH CHAT ALSO INCLUDES INDIVIDUALS OR ORGANIZATIONS SERVING OR REPRESENTING THE COMMUNITY'S MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. THE FOLLOWING ORGANIZATIONS SERVED ON THE CHAT FOR THE 2024 ROANOKE VALLEY COMMUNITY HEALTH NEEDS ASSESSMENT (RVCHNA): ADULT CARE CENTER OF THE ROANOKE VALLEY, BLACK FATHER FAMILY, BLUE BLAZE CONSULTING, BOTETOURT COUNTY LIBRARY, BRADLEY FREE CLINIC, CHIP OF ROANOKE VALLEY, CITY OF ROANOKE, COLLECTIVE RESPONSE, COMMONWEALTH CATHOLIC CHARITIES, COUNCIL OF COMMUNITY SERVICES, CRAIG COUNTY PUBLIC SCHOOLS, CRAIG COUNTY, FAMILY SERVICES OF ROANOKE VALLEY, FEEDING SOUTHWEST VIRGINIA, FINANCIAL EMPOWERMENT CENTER, FREE FOUNDATION, FREEDOM FIRST CREDIT UNION, GOODWILL, HABITAT FOR HUMANITY OF ROANOKE VALLEY, HARM REDUCTION COALITION, HCA LEWISGALE, HEALTHY HOMES ROANOKE, LEAP, LEFFEL CONSULTING GROUP, LEGAL AID SOCIETY OF ROANOKE VALLEY, NEW HORIZONS HEALTHCARE, PRESBYTERIAN COMMUNITY CENTER, RESCUE MISSION, RESTORATION HOUSING, ROANOKE CITY AND ALLEGHANY HEALTH DISTRICTS, ROANOKE CITY PUBLIC SCHOOLS, ROANOKE FIRE/EMS, ROANOKE REDEVELOPMENT AND HOUSING AUTHORITY, ROANOKE REGIONAL CHAMBER OF COMMERCE, ROANOKE VALLEY-ALLEGHANY REGIONAL COMMISSION, RADFORD UNIVERSITY CARILION, SALEM CITY PUBLIC SCHOOLS, AND UNITED WAY OF ROANOKE VALLEY. TO OBTAIN INPUT FROM THE COMMUNITY, THE RVCHNA CONDUCTED A LISTENING SESSION AMONG CHAT STAKEHOLDERS, HELD MULTIPLE LISTENING SESSIONS WITH COMMUNITY MEMBERS, AND ADMINISTERED A 27-QUESTION COMMUNITY HEALTH SURVEY BROADLY ACROSS THE SERVICE AREA. THESE EFFORTS OCCURRED FROM OCTOBER 1, 2023, THROUGH DECEMBER 31, 2023. THE SURVEY WAS DEVELOPED IN ENGLISH AND SPANISH AND ASKED QUESTIONS ABOUT ACCESS TO CARE, HEALTH STATUS, COMMUNITY STRENGTHS, QUALITY OF LIFE, SUBJECTIVE WELL-BEING, AND DEMOGRAPHICS. THE SURVEY INCLUDED COMMONLY USED QUESTIONS AND METRICS FROM PREVIOUSLY VALIDATED COMMUNITY SURVEYS CONDUCTED BY ORGANIZATIONS SUCH AS THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. COMMUNITY MEMBERS WERE INVITED TO PARTICIPATE IN COMMUNITY LISTENING SESSIONS TO COLLECT QUALITATIVE DATA TO UNDERSTAND HEALTH-RELATED NEEDS BETTER. ROANOKE CITY AND ALLEGHANY HEALTH DISTRICT STAFF FACILITATED SESSIONS WITH VIRGINIA HARM REDUCTION COALITION CLIENTS AND VIRGINIA WESTERN COMMUNITY COLLEGE STUDENTS. ATTENDEES OF A BLACK FATHER FAMILY FIRESIDE CHAT ALSO PROVIDED INPUT. CHAT MEMBERS OFFERED ADDITIONAL PERSPECTIVES ON THE NEEDS AND BARRIERS TO HEALTH FACING OUR COMMUNITY DURING A HEALTHY ROANOKE VALLEY ALL-PARTNER MEETING THAT INCLUDED OTHER COMMUNITY STAKEHOLDERS. CARILION STAFF FROM ACROSS THE ORGANIZATION FACILITATED SMALL GROUP DISCUSSIONS. PARTICIPANTS COMPLETED THE STAKEHOLDER SURVEY TO QUANTIFY FOCUS GROUP DATA. COMMUNITY STAKEHOLDERS, LEADERS, AND HEALTHCARE PRACTITIONERS WERE ENCOURAGED TO COMPLETE THE STAKEHOLDER SURVEY AFTER PARTICIPATING IN A LISTENING SESSION. CARILION REPRESENTATIVES SHARED THE ONLINE SURVEY AT THE CHAT MEETINGS AND VIA EMAIL. THE CHAT ASSISTED WITH SURVEY DISTRIBUTION TO REACH TARGET POPULATIONS. THE SURVEY FOCUSED ON ROANOKE VALLEY RESIDENTS 18 YEARS OF AGE AND OLDER IN THE FOLLOWING SERVICE AREAS: BEDFORD, BOTETOURT, CRAIG AND ROANOKE COUNTIES, ROANOKE CITY, AND SALEM CITY. THERE WERE SPECIAL EFFORTS TO INCLUDE UNDERSERVED/VULNERABLE POPULATIONS DISPROPORTIONATELY IMPACTED BY SOCIAL DETERMINANTS OF HEALTH SUCH AS POVERTY, RACE/ETHNICITY, EDUCATION, AND LACK OF INSURANCE. SPECIFIC POPULATIONS SERVED BY CHAT REPRESENTATIVES INCLUDE PEOPLE WHO ARE UNINSURED OR UNDERINSURED; PEOPLE EXPERIENCING LOW INCOME, HOMELESSNESS, AND/OR FOOD INSECURITY; AND FAMILIES WITH YOUNG CHILDREN. THE SURVEY WAS ALSO AVAILABLE ONLINE TO ALL RESIDENTS LIVING IN THE ROANOKE VALLEY. SCHEDULE H, PART V, SECTION B, LINE 6A FACILITY A, 1 FACILITY A, 1 - GROUP A. CARILION ROANOKE MEMORIAL HOSPITAL AND CARILION ROANOKE COMMUNITY HOSPITAL, OWNED BY CARILION MEDICAL CENTER AND SERVING THE SAME AREA, JOINTLY CONDUCTED THEIR COMMUNITY HEALTH NEEDS ASSESSMENT. SCHEDULE H, PART V, SECTION B, LINE 6B FACILITY A, 1 FACILITY A, 1 - GROUP A. THE 2024 (TAX YEAR 2023) ROANOKE VALLEY CHNA WAS CONDUCTED WITH: ADULT CARE CENTER OF THE ROANOKE VALLEY, BLACK FATHER FAMILY, BLUE BLAZE CONSULTING, BOTETOURT COUNTY LIBRARY, BRADLEY FREE CLINIC, CHIP OF ROANOKE VALLEY, CITY OF ROANOKE, COLLECTIVE RESPONSE, COMMONWEALTH CATHOLIC CHARITIES, COUNCIL OF COMMUNITY SERVICES, CRAIG COUNTY PUBLIC SCHOOLS, CRAIG COUNTY, FAMILY SERVICES OF ROANOKE VALLEY, FEEDING SOUTHWEST VIRGINIA, FINANCIAL EMPOWERMENT CENTER, FREE FOUNDATION, FREEDOM FIRST CREDIT UNION, GOODWILL, HABITAT FOR HUMANITY OF ROANOKE VALLEY, HARM REDUCTION COALITION, HCA LEWISGALE, HEALTHY HOMES ROANOKE, LEAP, LEFFEL CONSULTING GROUP, LEGAL AID SOCIETY OF ROANOKE VALLEY, NEW HORIZONS HEALTHCARE, PRESBYTERIAN COMMUNITY CENTER, RESCUE MISSION, RESTORATION HOUSING, ROANOKE CITY & ALLEGHANY HEALTH DISTRICTS, ROANOKE CITY PUBLIC SCHOOLS, ROANOKE FIRE/EMS, ROANOKE REDEVELOPMENT AND HOUSING AUTHORITY, ROANOKE REGIONAL CHAMBER OF COMMERCE, ROANOKE VALLEY-ALLEGHANY REGIONAL COMMISSION, RADFORD UNIVERSITY CARILION, SALEM CITY PUBLIC SCHOOLS, AND UNITED WAY OF ROANOKE VALLEY. SCHEDULE H, PART V, SECTION B, LINE 7 FACILITY A, 1 FACILITY A, 1 - GROUP A. THE COMMUNITY HEALTH ASSESSMENT TEAM SHARED THE 2024 ROANOKE VALLEY COMMUNITY HEALTH NEEDS ASSESSMENT (RVCHNA) ON PARTNER WEBSITES, SOCIAL MEDIA, AND REGIONAL NEWS COVERAGE. THE RVCHNA WAS SHARED THROUGH MULTIPLE INTERNAL PRESENTATIONS FOR STAFF AND EXTERNAL PRESENTATIONS TO PARTNER ORGANIZATIONS, ACADEMIC INSTITUTIONS AND COALITIONS. SCHEDULE H, PART V, SECTION B, LINE 11 FACILITY A, 1 FACILITY A, 1 - GROUP A. THE FOLLOWING INFORMATION DESCRIBES THE IMPLEMENTATION STRATEGY USED BY CARILION MEDICAL CENTER (CMC)-COMPRISED OF CARILION ROANOKE MEMORIAL HOSPITAL (CRMH) AND CARILION ROANOKE COMMUNITY HOSPITAL (CRCH)-TO ADDRESS THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2024 ROANOKE VALLEY COMMUNITY HEALTH NEEDS ASSESSMENT (RVCHNA). THE COMPLETE IMPLEMENTATION STRATEGY IS AVAILABLE ONLINE AT HTTPS://ISSUU.COM/CARILIONCLINIC/DOCS/IMPLEMENTATION_STRATEGY_FINAL_CMC. THE HOSPITAL IS WORKING TO ADDRESS ALL SIGNIFICANT HEALTH NEEDS PRIORITIZED THROUGH THE CHNA . THE TOP PRIORITIZED NEEDS FOR THE 2024 RVCHNA WERE GROUPED INTO THREE OVERARCHING CATEGORIES: CHRONIC DISEASE, MENTAL HEALTH AND SUBSTANCE USE, AND INJURY/VIOLENCE. WE ALSO FOCUS ON LAYERED INTERVENTIONS THAT ADDRESS MULTIPLE PRIORITY AREAS THROUGH PLACE-BASED STRATEGIES. WE ARE ADDRESSING PRIORITIZED NEEDS WITH THE FOLLOWING STRATEGIES AND COMMITTING FINANCIAL RESOURCES, STAFF TIME AND LEADERSHIP. STRATEGIES TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE INCLUDE IMPLEMENTING EVIDENCE-BASED MENTAL HEALTH EDUCATION AND WELL-BEING PROGRAMS, EXPANDING CARILION'S PEER SUPPORT SPECIALIST WORKFORCE, AND SUPPORTING THE DEVELOPMENT AND IMPLEMENTATION OF TRANSITIONAL AND/OR RECOVERY HOUSING OPTIONS IN THE SERVICE AREA. STRATEGIES TO ADDRESS CHRONIC DISEASE INCLUDE IMPLEMENTING THE HEALTHY HEART AMBASSADORS PROGRAM, FRUIT AND VEGETABLE PRESCRIPTION PROGRAM, AND OTHER EVIDENCE-BASED HEALTH AND NUTRITION PROGRAMS. STRATEGIES TO ADDRESS INJURY/VIOLENCE INCLUDE WORKING WITH THE FORENSIC NURSING PROGRAM TO SUPPORT TRANSITIONING PATIENTS FROM ACUTE CARE TO THE COMMUNITY, SUSTAINING THE VIOLENT INJURY RECOVERY AND SUPPORT PROGRAM, AND PARTICIPATING IN THE GROUP VIOLENCE INTERVENTION PROGRAM AND OTHER ROANOKE CITY-LED INITIATIVES ON VIOLENCE PREVENTION. PLACE-BASED STRATEGIES ADDRESSING MULTIPLE PRIORITY AREAS INCLUDE EXPANDING CARILION'S COMMUNITY HEALTH WORKFORCE, DEVELOPING AN EMPLOYEE VOLUNTEER PROGRAM TO SUPPORT THE CAPACITY OF LOCAL ORGANIZATIONS WORKING TO ADDRESS CHA-IDENTIFIED NEEDS, EVALUATING A POP-UP CLINIC MODEL SUPPORTING SAFETY NET PARTNERSHIPS, EVALUATING ADDITIONAL SITES FOR THE LIFT CENTER MODEL, AND IMPLEMENTING HEALTH AND WELLNESS PROGRAMMING AT MELROSE PLAZA. EXAMPLES OF KEY ACHIEVEMENTS DURING FY25 FOR THESE PROGRAMS INCLUDE: A SUCCESSFUL YEAR 1 OF SWPRX, POSITIVELY IMPACTING BIOMETRIC READINGS AND ACCESS TO FRESH PRODUCE FOR PROGRAM PARTICIPANTS; THE OPENING OF MELROSE PLAZA AND ITS ESTABLISHMENT AS A SITE FOR HEALTH, WELLNESS, AND HEALING ARTS PROGRAMMING IN NW ROANOKE CITY; AND OVER 440 HOURS OF DIRECT PATIENT CONTACT THROUGH THE VIOLENT INJURY RECOVERY AND SUPPORT PROGRAM, REACHING 174 INDIVIDUALS. 33 CARILION CLINIC RIVERSIDE 1 MEDICAL OFFICE BUILDING 1 RIVERSIDE CIRCLE ROANOKE VA 24016 PHYSICIAN AND ANCILLARY SERVICES CARILION ROANOKE COMMUNITY HOSPITAL MEDICAL OFFICE BUILDING 102 HIGHLAND AVE ROANOKE VA 24013 PHYSICIAN AND ANCILLARY SERVICES CARILION CLINIC OUTPATIENT THERAPY 105 SUMMERFIELD COURT ROANOKE VA 24019 ANCILLARY SERVICES ROANOKE AMBULATORY SURGERY CENTER LLC 1102 JEFFERSON ST SE ROANOKE VA 24016 OUTPATIENT SURGERY CENTER CARILION CLINIC NEUROPSYCHOLOGY 1118 FIRST STREET SW ROANOKE VA 24016 PHYSICIAN SERVICES CARILION CLINIC CARDIOLOGY 1229 THIRD STREET SW ROANOKE VA 24016 PHYSICIAN SERVICES CARILION CLINIC DIABETES MANAGEMENT & PREVENTION 1231 S JEFFERSON STREET ROANOKE VA 24016 ANCILLARY SERVICES CARILION CLINIC INTERVENTIONAL RADIOLOGY AND CARILION CLINIC CARDIOPULMONAR Y REHAB 127 MCCLANAHAN STREET ROANOKE VA 24014 PHYSICIAN AND ANCILLARY SERVICES CARILION CLINIC FAMILY MEDICINE 1314 PETERS CREEK ROAD ROANOKE VA 24019 PHYSICIAN SERVICES CARILION CLINIC MEDICAL OFFICE BUILDING 150 MARKET RIDGE LANE DALEVILLE VA 24083 PHYSICIAN AND ANCILLARY SERVICES CARILION CLINIC PEDIATRIC SUBSPECIALTY CLINIC 1620 GRAVES MILL ROAD LYNCHBURG VA 24502 PHYSICIAN SERVICES CARILION CLINIC OUTPATIENT THERAPY 1935 WEST MAIN STREET SALEM VA 24153 ANCILLARY SERVICES CARILION CLINIC OBGYN 1957 WEST MAIN STREET SALEM VA 24153 PHYSICIAN SERVICES CARILION CLINIC CRYSTAL SPRINGS MEDICAL OFFICE BUILDING 2001 CRYSTAL SPRING AVE SW ROANOKE VA 24014 PHYSICIAN AND ANCILLARY SERVICES CARILION MENTAL HEALTH 2017 S JEFFERSON STREET ROANOKE VA 24014 PHYSICIAN AND ANCILLARY SERVICES CARILION CLINIC FAMILY MEDICINE 2145 MOUNT PLEASANT BOULEVARD ROANOKE VA 24014 PHYSICIAN SERVICES CARILION CLINIC INSTITUTE FOR ORTHOPEDICS AND NEUROSCIENCES 2331 FRANKLIN ROAD ROANOKE VA 24014 PHYSICIAN AND ANCILLARY SERVICES CARILION CLINIC PEDIATRIC SPECIALTY CLINIC 2900 LAMB CIRCLE SUITE 210 CHRISTIANSBURG VA 24073 PHYSICIAN SERVICES CARILION CLINIC RIVERSIDE 3 MEDICAL OFFICE BUILDING 3 RIVERSIDE CIRCLE ROANOKE VA 24016 PHYSICIAN AND ANCILLARY SERVICES CARILION CLINIC FAMILY MEDICINE 3 WESTWOOD MEDICAL PARK BLUEFIELD VA 24605 PHYSICIAN SERVICES CARILION CLINIC WESTLAKE MEDICAL OFFICE BUILDING 35 MEDICAL COURT HARDY VA 24101 PHYSICIAN AND ANCILLARY SERVICES CARILION CLINIC IMAGING 3707 BRAMBLETON AVENUE ROANOKE VA 24018 ANCILLARY SERVICES CARILION CLINIC VETERANS ADMINISTRATION CLINIC 388 BEN BOLT AVENUE TAZEWELL VA 24651 PHYSICIAN SERVICES CARILION FRANKLIN MEMORIAL HOSPITAL MEDICAL OFFICE BUILDING 390 S MAIN STREET ROCKY MOUNT VA 24151 PHYSICIAN SERVICES CARILION CLINIC VASCULAR SURGERY AND UROLOGY 4064 POSTAL DRIVE ROANOKE VA 24018 PHYSICIAN SERVICES CARILION CHILDREN'S -TANGLEWOOD CENTER 4348 ELECTRIC ROAD ROANOKE VA 24018 PHYSICIAN AND ANCILLARY SERVICES CARILION DENTAL CARE 4348 ELECTRIC RD ENTR 3 2ND FL ROANOKE VA 24018 DENTAL SERVICES CARILION MENTAL HEALTH AND CENTER FOR HEALTHY AGING 4434 ELECTRIC ROAD ROANOKE VA 24018 PHYSICIAN AND ANCILLARY SERVICES CARILION CLINIC VASCULAR SURGERY 4437 STARKEY ROAD SW SUITE A ROANOKE VA 24018 PHYSICIAN SERVICES CARILION CLINIC OUTPATIENT THERAPY 4508 STARKEY ROAD ROANOKE VA 24018 ANCILLARY SERVICES CARILION CLINIC UROLOGY 5372 FALLOWATER LANE ROANOKE VA 24018 PHYSICIAN SERVICES CARILION CLINIC BREAST CARE CENTER 6415 PETERS CREEK ROAD ROANOKE VA 24019 ANCILLARY SERVICES CARILION CLINIC OBSTETRICS AND GYNECOLOGY 902 SOUTH JEFFERSON ST UPPER LEVEL ROANOKE VA 24016 PHYSICIAN SERVICES SCHEDULE H, PART I, LINE 3C FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA FINANCIAL ASSISTANCE POLICY IN EFFECT FOR FISCAL YEAR 2025: FAMILIES WITH FAMILY INCOME EQUAL OR BELOW 300% OF THE FEDERAL POVERTY GUIDELINES AND COUNTABLE ASSETS EQUAL OR BELOW $25,000 RECEIVE 100% ADJUSTMENT UNDER FAP. FAMILIES WITH FAMILY INCOME GREATER THAN 300% OF THE FEDERAL POVERTY GUIDELINES BUT LESS THAN OR EQUAL TO 500% OF THE FEDERAL POVERTY GUIDELINES OR COUNTABLE ASSETS ABOVE $25,000 AND LESS THAN OR EQUAL TO $100,000 RECEIVE A PARTIAL ADJUSTMENT UNDER FAP. THE PARTIAL ADJUSTMENT MATCHES THE HIGHEST AGB PERCENTAGE DETERMINED FOR ALL FACILITIES. SCHEDULE H, PART I, LINE 6A COMMUNITY BENEFIT REPORT INFORMATION ON COMMUNITY BENEFIT IS REPORTED ANNUALLY THROUGH A CONSOLIDATED REPORT PREPARED BY CARILION CLINIC (EIN 54-1190771). PRINTED COPIES OF THIS REPORT ARE DISTRIBUTED THROUGHOUT COMMUNITIES SERVED BY HOSPITALS AFFILIATED WITH CARILION CLINIC. ADDITIONALLY, THE COMMUNITY BENEFIT REPORT IS AVAILABLE ON CARILION CLINIC'S WEBSITE: HTTPS://WWW.CARILIONCLINIC.ORG/CHO-COMMUNITY-HEALTH-ASSESSMENTS#COMMUNITY-IMPACT-REPORTS SCHEDULE H, PART I, LINE 7 BAD DEBT EXPENSE EXCLUDED FROM FINANCIAL ASSISTANCE CALCULATION 95300754 SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED TO CALCULATE FINANCIAL ASSISTANCE LINE 7A AND 7B: FOR ACTIVITIES REPORTED ON THE MEDICAID COST REPORT, A COST-TO-CHARGE RATIO AS DETERMINED FROM THE MEDICAID COST REPORT WAS USED. FOR ALL OTHER ACTIVITIES, A COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 OF THE 990 INSTRUCTIONS WAS USED. LINES 7E AND 7F ARE REPORTED AT ACTUAL COST. LINE 7G: A COMBINATION OF COST ACCOUNTING AND ACTUAL COSTS PER SERVICE LINE FINANCIAL STATEMENT WAS USED. LINES 7H AND 7I ARE REPORTED AT ACTUAL COST. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES LINE 1 - PHYSICAL IMPROVEMENTS AND HOUSING: CARILION ACKNOWLEDGES THE IMPACT OF HOUSING ON HEALTH AND IS INVOLVED WITH HOUSING-FOCUSED ACTIVITIES. CARILION HAS WORKED WITH VARIOUS COMMUNITY PARTNERS INCLUDING THE ROANOKE REDEVELOPMENT AND HOUSING AUTHORITY, WHO SERVES AS A KEY CONVENER OF EFFORTS AND RESOURCES AROUND AFFORDABLE HOUSING AND HOMELESSNESS IN THE VALLEY. LINE 2 - ECONOMIC DEVELOPMENT: AS THE LARGEST EMPLOYER IN SOUTHWEST VIRGINIA, CARILION IMPACTS ECONOMIC DEVELOPMENT BY INVESTING IN JOBS, HIGHER WAGES FOR EMPLOYEES, AND VARIOUS CAPITAL CONSTRUCTION PROJECTS. WE ALSO HAD ECONOMIC DEVELOPMENT EXPENSES FROM SUPPORTING THE GO VIRGINIA FOUNDATION AND THE BLUE RIDGE INNOVATION CORRIDOR. CARILION IS ALSO ACTIVE IN MANY LOCAL ECONOMIC DEVELOPMENT ENDEAVORS, INCLUDING SUPPORTING THE ROANOKE REGIONAL PARTNERSHIP AND LOCAL CHAMBERS OF COMMERCE, INVESTING IN RESEARCH AND TECHNOLOGY, AND COMMUNICATING WITH LOCAL BUSINESSES ABOUT THE REGION'S CURRENT BUSINESS CLIMATE AND PROSPECTIVE COMPANIES. THESE INITIATIVES PROMOTE THE COMMUNITY'S HEALTH BY IMPROVING ECONOMIC VITALITY AND MAKING THE REGION A VIBRANT PLACE TO LIVE, WORK, AND PLAY. LINE 3 - COMMUNITY SUPPORT: RESEARCH DEMONSTRATES THE STRONG CONNECTION BETWEEN SOCIAL DETERMINANTS OF HEALTH-SUCH AS INCOME, TRANSPORTATION, AND EDUCATION-AND COMMUNITIES' OVERALL HEALTH AND WELL-BEING. ADDITIONALLY, BELONGING AND CIVIC MUSCLE ARE RECOGNIZED AS A KEY COMPONENT TO THRIVING COMMUNITIES THROUGH THE VITAL CONDITIONS OF WELLBEING FRAMEWORK. CARILION SUPPORTS NONPROFIT ORGANIZATIONS ADDRESSING BARRIERS TO GOOD HEALTH ARISING FROM THESE FACTORS IN VARIOUS WAYS AND DIRECTLY SUPPORTS ORGANIZATIONS BUILDING A SENSE OF BELONGING AND CIVIC ENGAGEMENT. WE COLLABORATE WITH LOCAL PARTNERS TO SUPPORT BETTER EDUCATION AND OPPORTUNITIES FOR CHILDREN AND FAMILIES, IMPROVED HOUSING, AND BETTER NUTRITION FOR OUR NEIGHBORS IN NEED. THESE EFFORTS HELP TO REMOVE A RANGE OF OBSTACLES TO GOOD HEALTH FOR OUR REGION'S RESIDENTS. EXAMPLES INCLUDE THE PRESBYTERIAN COMMUNITY CENTER, THE WEST END CENTER FOR YOUTH, JUNIOR ACHIEVEMENT OF SWVA, AND FIRST TEE OF ROANOKE VALLEY. THROUGH MONETARY DONATIONS AND ORGANIZATIONAL SUPPORT, CARILION ALSO PROMOTES A SENSE OF COMMUNITY AND PARTNERS ON HEALTH-RELATED PROGRAMMING AND MESSAGING THROUGH ORGANIZATIONS INCLUDING THE TAUBMAN MUSEUM OF ART, MILL MOUNTAIN THEATRE, OPERA ROANOKE, SWVA PRIDE, INC., AND THE LOCAL CHAPTER OF THE SOUTHERN CHRISTIAN LEADERSHIP CONFERENCE. LINE 4 - ENVIRONMENTAL IMPROVEMENTS: RECOGNIZING THE IMPORTANCE OF THE PHYSICAL ENVIRONMENT ON HEALTH, CARILION SUPPORTS ENVIRONMENT-FOCUSED EFFORTS ACROSS THE REGION, INCLUDING REPRESENTATION ON THE BOARD OF DIRECTORS FOR THE WESTERN VIRGINIA WATER AUTHORITY. THROUGH THIS ENDEAVOR, CARILION SUPPORTS THE AUTHORITY'S VISION OF ENHANCING THE REGION'S WELL-BEING AND QUALITY OF LIFE AND THE PROTECTION OF NATURAL RESOURCES THROUGH EDUCATION AND CONSERVATION. LINE 6 - COALITION BUILDING: CARILION BELIEVES IN THE POWER OF COLLABORATION AND UNDERSTANDS THAT WE MUST ADDRESS OUR MOST SIGNIFICANT HEALTH ISSUES IN CONCERT WITH THE COMMUNITY. CARILION PARTICIPATES IN COALITIONS THAT ADDRESS HEALTH, SAFETY, AND SOCIAL DETERMINANT NEEDS IN THE ROANOKE VALLEY TO ENSURE LASTING IMPACT FROM THE CHNA AND COMMUNITY HEALTH IMPROVEMENT PROCESS. WE ALSO PARTNER WITH MULTIPLE NONPROFITS AND BUSINESSES ON INITIATIVES TO IMPROVE HEALTH AND WELLNESS FOR EVERYONE IN THE ROANOKE VALLEY. THESE COALITION-BUILDING ACTIVITIES INCLUDE PARTICIPATION WITH LOCAL SUBSTANCE USE PREVENTION COALITIONS, SCHOOL HEALTH ADVISORY BOARDS, TRAUMA-INFORMED CARE NETWORKS, THE CHILD HEALTH INVESTMENT PARTNERSHIP OF THE ROANOKE VALLEY, THE DISASTER NETWORKING COLLABORATIVE, AND THE PARTNERSHIP FOR COMMUNITY WELLNESS. LINE 7 - COMMUNITY HEALTH IMPROVEMENT ADVOCACY: CARILION'S MISSION OF COMMUNITY HEALTH IMPROVEMENT FOCUSES NOT ONLY ON WHAT WE IMPACT DIRECTLY BUT ALSO ON SUPPORTING THE ADVOCACY EFFORTS OF OTHER ORGANIZATIONS. CARILION SUPPORTED THE VIRGINIA HEALTH CARE FOUNDATION AND PARTICIPATED IN EVENTS CONNECTING GOVERNMENT OFFICIALS WITH COMMUNITY HEALTH IMPROVEMENT-FOCUSED WORK, INCLUDING THE GRAND OPENING OF MELROSE PLAZA AND THE EXCEL CENTER. BOTH EXAMPLES HIGHLIGHTED ADVOCACY AND GOVERNMENT FUNDING AS CRITICAL ASPECTS OF PROJECT FEASIBILITY AND PROMOTE BETTER HEALTH BY CONNECTING RESOURCES ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH IN ONE CENTRAL SITE. LINE 8 - WORKFORCE DEVELOPMENT: WITH THE UNDERSTANDING THAT EMPLOYMENT IS DIRECTLY LINKED TO HEALTH AND WELLNESS, CARILION PARTNERS TO PROVIDE WORKFORCE DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS. THESE EFFORTS ALSO DEVELOP A PIPELINE FOR FUTURE HEALTHCARE WORKERS. CARILION AGAIN PARTNERED TO OFFER PROJECT SEARCH, A ONE-YEAR HIGH SCHOOL TRANSITION PROGRAM PROVIDING EMPLOYMENT AND EDUCATIONAL OPPORTUNITIES FOR INDIVIDUALS WITH SIGNIFICANT DISABILITIES. THIS COLLABORATIVE PROGRAM INCLUDES GOODWILL INDUSTRIES OF THE VALLEYS, THE VIRGINIA DEPARTMENT OF AGING AND REHABILITATIVE SERVICES, AND LOCAL SCHOOL SYSTEMS. CARILION CONTINUES TO CONVENE THE BLUE RIDGE PARTNERSHIP FOR HEALTH SCIENCE CAREERS, A PROGRAM THAT WILL INCREASE AWARENESS OF HEALTH SCIENCE CAREERS IN ELEMENTARY, MIDDLE, AND HIGH SCHOOL CHILDREN AND CREATE PIPELINES FOR STUDENTS TO ENTER SPECIFIC HIGHER EDUCATION HEALTH SCIENCE PROGRAMS. THROUGH STAFF EFFORTS AND LEADERSHIP, CARILION SUPPORTED THE VIRGINIA WESTERN COMMUNITY COLLEGE EDUCATIONAL FOUNDATION BOARD AND THE VIRGINIA TECH FOUNDATION. SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT CARILION MEDICAL CENTER ESTIMATES BAD DEBT EXPENSE BY RESERVING A PERCENTAGE OF ALL SELF-PAY PATIENT ACCOUNTS RECEIVABLE BY AGING CATEGORY, BASED ON COLLECTION HISTORY, ADJUSTED FOR EXPECTED RECOVERIES AND, IF PRESENT, ANTICIPATED CHANGES IN TRENDS. SCHEDULE H, PART III, LINE 3 BAD DEBT EXPENSE METHODOLOGY THE HOSPITAL USES A COMPREHENSIVE PROCESS TO IDENTIFY PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE, INCLUDING PRESUMPTIVE ELIGIBILITY SCREENING OF ALL PATIENTS USING AVAILABLE THIRD-PARTY AND EXTERNAL INFORMATION. PRESUMPTIVE ELIGIBILITY CRITERIA MAY INCLUDE A PROPENSITY-TO-PAY INDICATOR, INCOME AT OR BELOW 300% OF THE FEDERAL POVERTY GUIDELINES, AND A CREDIT SCORE OF 625 OR LESS. ACCOUNTS MEETING APPLICABLE PRESUMPTIVE ELIGIBILITY CRITERIA ARE PROCESSED AS FINANCIAL ASSISTANCE. AFTER CONSIDERING INFORMATION OBTAINED THROUGH PRESUMPTIVE ELIGIBILITY SCREENING AND OTHER AVAILABLE PATIENT-ACCOUNT INFORMATION, THE HOSPITAL DETERMINED THAT THE REMAINING BAD DEBT POPULATION DOES NOT CONTAIN SUFFICIENT INFORMATION TO RELIABLY IDENTIFY PATIENTS WHO WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE HAD THEY PROVIDED ADDITIONAL INFORMATION. ACCORDINGLY, THE HOSPITAL DID NOT IDENTIFY A REASONABLE METHODOLOGY TO RELIABLY ESTIMATE THE PORTION OF REMAINING BAD DEBT ATTRIBUTABLE TO PATIENTS POTENTIALLY ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY, AND NO AMOUNT IS REPORTED ON SCHEDULE H, PART III, LINE 3. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE PATIENT ACCOUNTS RECEIVABLE ARE STATED AT NET REALIZABLE AMOUNTS DUE FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHER INSURERS FOR WHICH CARILION MEDICAL CENTER EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. IN ACCORDANCE WITH ACCOUNTING STANDARDS UPDATE (ASU) NO. 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) (ASU 2014-09), THE ESTIMATED UNCOLLECTIBLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT ACCOUNTS RECEIVABLE. SCHEDULE H, PART III, LINE 8 COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTS MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE MEDICARE COST REPORT USING THE COST-TO-CHARGE RATIO. THE HOSPITAL BELIEVES OUR MEDICARE SHORTFALL IS A COST WE INCUR AS A BENEFIT TO THE COMMUNITY. IRS REV. RUL. 69-545 PROVIDES THAT ONE OF THE FACTORS DEMONSTRATING COMMUNITY BENEFIT IS CARING FOR PATIENTS WHO PAY THEIR BILLS THROUGH PUBLIC PROGRAMS SUCH AS MEDICARE. IN ORDER TO OPERATE FOR THE BENEFIT OF THE BROAD COMMUNITY THAT WE SERVE WE MUST INCLUDE OUR SIGNIFICANT MEDICARE POPULATION, EVEN IF WE ARE REQUIRED TO SUBSIDIZE CARE TO OUR MEDICARE PATIENTS DUE TO BEING REIMBURSED AT LESS THAN COST BY MEDICARE'S NONNEGOTIABLE RATES. SCHEDULE H, PART III, LINE 9B COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WHEN ACCOUNTS RECEIVABLE EFFORTS ARE EXHAUSTED, THE ACCOUNT MAY BE PLACED WITH A COLLECTION AGENCY AND EXTRAORDINARY COLLECTION ACTIONS (ECAS) MAY BE CONSIDERED. ACCOUNTS WILL NOT BE PLACED WITH A COLLECTION AGENCY PRIOR TO 120 DAYS FROM THE DATE THE FIRST POST-DISCHARGE BILLING STATEMENT IS PROVIDED EXCEPT WHEN MAILINGS ARE RETURNED WITH NO FORWARDING ADDRESS AND COMBINING MULTIPLE ACCOUNTS OF VARYING AGE WITH THOSE ALREADY TRANSFERRED OR FOR LEGAL VERIFICATION REGARDING OTHER LIABILITIES. REASONABLE EFFORTS WILL BE MADE TO IDENTIFY APPROPRIATE FORWARDING ADDRESSES. WHEN A FINANCIAL ASSISTANCE APPLICATION (FAA) IS RECEIVED DURING THE APPLICATION PERIOD (WITHIN 240 DAYS AFTER THE DATE THE FIRST POST-DISCHARGE BILLING STATEMENT IS PROVIDED), BUT AFTER INITIATION OF ECAS, ALL ECAS WILL BE SUSPENDED. BEST EFFORTS WILL BE MADE TO PROCESS COMPLETED APPLICATIONS WITHIN 30 DAYS OF RECEIPT OF THE APPLICATION; FINANCIAL ASSISTANCE ELIGIBILITY WILL BE DETERMINED AND COMMUNICATED TO THE INDIVIDUAL. INCOMPLETE APPLICATIONS MUST BE COMPLETED WITHIN 30 DAYS OF THE INITIAL NOTIFICATION OF ADDITIONAL ITEMS REQUIRED; OTHERWISE, THE APPLICATION WILL BE DEEMED INCOMPLETE AND CLOSED. IF AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE, ECAS, OTHER THAN THE SALE OF DEBT, WILL BE REVERSED AND ANY PAYMENTS RELATED TO ELIGIBLE CARE REFUNDED TO THE EXTENT NO LONGER OWED. ECAS WILL BE REINSTATED IF THE INDIVIDUAL IS NOT ELIGIBLE FOR FINANCIAL ASSISTANCE OR DOES NOT COMPLETE THE FAA BY THE DEADLINE. AT LEAST 30 DAYS BEFORE INITIATING AN ECA, CARILION WILL SEND THE PATIENT WRITTEN NOTICE OF INTENDED ECA(S), A PLAIN LANGUAGE SUMMARY EXPLAINING FINANCIAL ASSISTANCE AVAILABLE AND THE PROCESS FOR DETERMINING ELIGIBILITY, AND THE DEADLINE FOR APPLYING FOR ASSISTANCE. CARILION WILL ALSO ATTEMPT TO CALL INDIVIDUALS AT LEAST 30 DAYS BEFORE INITIATING AN ECA TO MAKE THEM AWARE OF THE FINANCIAL ASSISTANCE AVAILABLE AND HOW TO OBTAIN ASSISTANCE WITH THE APPLICATION PROCESS. CARILION SHALL ENTER INTO A WRITTEN CONTRACT WITH ANY COLLECTION AGENCY TO WHICH IT REFERS BAD DEBT. THE CONTRACT WILL OBLIGATE THE COLLECTION AGENCY TO OBSERVE AND COMPLY WITH CARILION'S OBLIGATIONS UNDER THIS POLICY AND THE FINANCIAL ASSISTANCE POLICY. A COLLECTION AGENCY TO WHICH BAD DEBT IS REFERRED FOR COLLECTION MAY NOT ENGAGE IN ANY ECAS WITHOUT THE PRIOR WRITTEN CONSENT OF CARILION. AFTER MAKING REASONABLE EFFORTS TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE AND THE PATIENT EITHER DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE OR FAILS TO SUBMIT AN APPLICATION AS REQUESTED, WITHIN 240 DAYS FROM THE DATE THE FIRST POST-DISCHARGE BILLING STATEMENT IS PROVIDED, CARILION MAY ENGAGE IN ONE OR MORE OF THE FOLLOWING ECAS: 1. PLACE A LIEN ON AN INDIVIDUAL'S PROPERTY; 2. ATTACH OR SEIZE AN INDIVIDUAL'S BANK ACCOUNT OR ANY OTHER PERSONAL PROPERTY; 3. COMMENCE A CIVIL ACTION AGAINST AN INDIVIDUAL; 4. GARNISH AN INDIVIDUAL'S WAGES; 5. SELL AN INDIVIDUAL'S DEBT TO ANOTHER PARTY; OR 6. REPORT THE ACCOUNT TO CREDIT AGENCIES. CARILION RECOVERY DEPARTMENT WILL INVESTIGATE ANY ACCOUNTS THAT REQUIRE SPECIAL HANDLING. FOR EXAMPLE, IN CASES OF A DECEASED PATIENT, AUTO ACCIDENT, OR ANY OTHER UNIQUE CIRCUMSTANCES REQUIRING SPECIAL HANDLING, THE ACCOUNTS ARE PLACED WITH THE CARILION 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. SCHEDULE H, PART V, SECTION B, LINE 16A FAP WEBSITE A - CARILION MEDICAL CENTER -DBA CRMH: LINE 16A URL: HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE; SCHEDULE H, PART V, SECTION B, LINE 16B FAP APPLICATION WEBSITE A - CARILION MEDICAL CENTER -DBA CRMH: LINE 16B URL: HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE; SCHEDULE H, PART V, SECTION B, LINE 16C FAP PLAIN LANGUAGE SUMMARY WEBSITE A - CARILION MEDICAL CENTER -DBA CRMH: LINE 16C URL: HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE; SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT IN ADDITION TO CONDUCTING REGULAR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS), CARILION CLINIC CLOSELY MONITORS COMMUNITY HEALTH INDICATORS AND RESPONDS TO NEEDS AS THEY ARISE. EACH YEAR, CARILION REVIEWS UPDATED COMMUNITY HEALTH DATA SNAPSHOTS. WE ALSO RESPOND TO NEEDS IDENTIFIED THROUGH CLINICAL DATA AND INTERNAL DEPARTMENTS, INCLUDING DATA COLLECTED THROUGH SOCIAL DETERMINANTS OF HEALTH SCREENINGS. A HEALTH EQUITY AND SOCIAL DETERMINANTS OF HEALTH STEERING COMMITTEE PROVIDES OVERSIGHT AND GUIDANCE RELATED TO THESE EFFORTS, AND A RESOURCE NAVIGATION SUBCOMMITTEE TACKLES MORE NUANCED TOPICS AROUND CURRENT COMMUNITY NEEDS AS SEEN IN THE PATIENT POPULATION. CARILION'S CALL CENTER, CARILION DIRECT, ALLOWS COMMUNITY MEMBERS TO ASK QUESTIONS AND CONNECT WITH AVAILABLE RESOURCES. COMMUNITY HEALTH WORKERS HELP ADDRESS NEEDS AND DATA IS REVIEWED PERIODICALLY TO IDENTIFY PATIENT HEALTH TRENDS. HEALTHCARE NEEDS ARE ALSO IDENTIFIED THROUGH COLLABORATIVE RELATIONSHIPS AND COMMUNITY PARTNERSHIPS, INCLUDING WORKING WITH THE VIRGINIA DEPARTMENT OF HEALTH AND LOCAL SAFETY NET PARTNERS. ONGOING COLLABORATION WITH STAKEHOLDERS ALLOWS FOR REGULAR COMMUNICATION AND GIVES OUR PARTNERS OPPORTUNITIES TO RESPOND COHESIVELY. CARILION HAS ADAPTED ITS COMMUNITY HEALTH IMPROVEMENT PROCESS FROM ASSOCIATES IN PROCESS IMPROVEMENT'S MODEL FOR IMPROVEMENT AND THE PLAN-DO-STUDY-ACT CYCLE DEVELOPED BY WALTER SHEWHART. IT CONSISTS OF 5 STEPS: (1) CONDUCTING THE CHNA, (2) STRATEGIC PLANNING, (3) CREATING THE IMPLEMENTATION STRATEGY, (4) PROGRAM IMPLEMENTATION, AND (5) EVALUATION. THIS CYCLE REPEATS EVERY 3 YEARS. CONTINUOUS QUALITY IMPROVEMENT IS A KEY PRINCIPLE OF THE PROCESS. THE STRIVE COLLECTIVE IMPACT MODEL FOR THE COMMUNITY HEALTH ASSESSMENT TEAM HELPS CARILION FOSTER COMMUNITY DEVELOPMENT IN ITS CHNA AND COMMUNITY HEALTH IMPROVEMENT PROCESSES. THIS EVIDENCE-BASED MODEL FOCUSES ON "THE COMMITMENT OF A GROUP OF IMPORTANT PLAYERS FROM DIFFERENT SECTORS TO A COMMON AGENDA FOR SOLVING A SPECIFIC SOCIAL PROBLEM(S) CAN LEAD TO LARGE-SCALE CHANGES. IT FOCUSES ON RELATIONSHIP-BUILDING BETWEEN ORGANIZATIONS AND THE PROGRESS TOWARD SHARED STRATEGIES. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE INFORMATION ON FINANCIAL ASSISTANCE IS PROVIDED TO THE PATIENT AT HOSPITAL ADMISSION AND AMBULATORY AREAS IN THE FORM OF SIGNAGE, A PLAIN LANGUAGE SUMMARY WHICH INCLUDES CONTACT INFORMATION, FINANCIAL ASSISTANCE APPLICATION AND DOCUMENTATION IN THE INPATIENT HANDBOOK. PATIENT ACCESS STAFF, HOSPITAL SOCIAL WORKERS AND CUSTOMER SERVICE REPRESENTATIVES VERBALLY INFORM PATIENTS ON AVAILABILITY OF ASSISTANCE. EACH PATIENT STATEMENT AND PATIENT FINANCIAL RESPONSIBILITY LETTER INCLUDES INFORMATION ON THE FINANCIAL ASSISTANCE POLICY INCLUDING WHO TO CONTACT FOR ADDITIONAL INFORMATION AND LOCATION OF IN-PERSON ASSISTERS. THE APPLICATION, THE POLICY, AND THE PLAIN LANGUAGE SUMMARY ARE AVAILABLE FREE OF CHARGE TO THE PATIENT. THEY ARE AVAILABLE BY MAIL AND ON THE WEB SITE IF THE PATIENT DID NOT RECEIVE WRITTEN INFORMATION AT THE TIME OF SERVICE. FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE ALSO DISTRIBUTED TO COMMUNITY PARTNERS THROUGH ELECTRONIC MAILING GROUPS. CARILION CLINIC PARTNERS WITH AN ELIGIBILITY STAFF THAT COUNSEL PATIENTS ON FEDERAL AND STATE PROGRAMS. THE STAFF COMPLETES APPLICATIONS FOR MEDICAID AND PROVIDES INFORMATION ON SOCIAL SECURITY, SOCIAL SECURITY DISABILITY AND MEDICARE. THE STAFF PROVIDES SUPPORT SERVICES ENSURING THE APPLICATIONS ARE PROCESSED CORRECTLY BASED ON FEDERAL AND STATE POLICY. IN ADDITION, ELIGIBILITY STAFF ARE TRAINED AS CERTIFIED APPLICATION COUNSELORS AND WILL ASSIST PATIENTS IN ENROLLMENT IN THE MARKETPLACE. ELIGIBILITY STAFF WILL ALSO COMPLETE CARILION'S FINANCIAL ASSISTANCE APPLICATION AND COUNSEL PATIENTS ON THE REQUIREMENTS FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION THE ROANOKE METROPOLITAN STATISTICAL AREA (MSA), HOME TO CARILION CLINIC'S FLAGSHIP HOSPITAL CARILION ROANOKE MEMORIAL HOSPITAL, IS COMMONLY KNOWN AS THE ROANOKE VALLEY. IT IS COMPRISED OF THE INDEPENDENT CITIES OF ROANOKE AND SALEM AND THE COUNTIES OF BEDFORD, BOTETOURT, CRAIG, FRANKLIN, AND ROANOKE. THE VALLEY IS MOSTLY RURAL, NESTLED AMONG THE BLUE RIDGE MOUNTAINS, WITH THE CITY OF ROANOKE AT ITS HEART. ROANOKE IS A DESTINATION RICH IN CULTURAL DIVERSITY, THE ARTS, SHOPPING, RECREATIONAL OPPORTUNITIES, NATURAL BEAUTY, AND SERVICES UNAVAILABLE IN THE REGION'S MORE RURAL AREAS. THE ROANOKE VALLEY COMPRISES DISTINCT COMMUNITIES WITH SIGNIFICANT DISPARITIES IN SIZE, POPULATION, AND SOCIAL DETERMINANTS OF HEALTH. THE 2020-2024 AMERICAN COMMUNITY SURVEY (ACS) FOUND THE ROANOKE MSA'S TOTAL POPULATION TO BE 395,880. THE CITIES OF ROANOKE AND SALEM HAD 98,355 AND 25,618 RESIDENTS, RESPECTIVELY. BEDFORD, BOTETOURT, CRAIG, FRANKLIN, AND ROANOKE COUNTIES HAD 80,894, 34,004, 4,856, 55,130, AND 97,023 RESIDENTS, RESPECTIVELY. THE AVERAGE HOUSEHOLD INCOME RANGES FROM A LOW OF $80,578 IN ROANOKE CITY TO A HIGH OF $108,750 IN ROANOKE COUNTY. IN CONTRAST, THE MEDIAN INCOME RANGES FROM $55,378 TO $83,709 IN THE SAME LOCALITIES. ACROSS ROANOKE VALLEY LOCALITIES, 11% OF THE POPULATION HAS A HOUSEHOLD INCOME BELOW THE FEDERAL POVERTY GUIDELINE. SIMILARLY, 21% OF THE INSURED POPULATION RECEIVES MEDICAID, AND 6% OF THE POPULATION HAVE NO HEALTH INSURANCE. THE HIGHEST RATES OF MEDICAID PATIENTS ARE IN ROANOKE CITY AT 33% (US CENSUS BUREAU, ACS, 2020-2024). SPECIFIC TO CARILION MEDICAL CENTER INPATIENTS AND OUTPATIENTS IN FISCAL YEAR 2025, 21% RECEIVED MEDICAID WHILE 5% WERE SELF-PAY (STRATA INTERNAL DATA). THE MEDIAN AGE IN THE SERVICE AREA RANGES FROM 38.3 IN THE CITY OF ROANOKE TO 48.4 IN FRANKLIN COUNTY, AND ALL OTHER COUNTIES ARE ABOVE THE STATE MEDIAN OF 39. MOST OF THE POPULATION ACROSS THE SERVICE AREA IS WHITE, WITH RATES RANGING UP TO 95.8% IN CRAIG COUNTY (US CENSUS BUREAU, ACS, 2020-2024). ROANOKE CITY IS THE MOST RACIALLY AND ETHNICALLY DIVERSE LOCALITY, WITH 57% OF THE POPULATION IDENTIFYING AS WHITE AND 28% BLACK. THE WELDON COOPER CENTER FOR PUBLIC SERVICE PREDICTS POSITIVE POPULATION CHANGE BY 2040 FOR ALL COMMUNITIES EXCEPT FRANKLIN AND CRAIG COUNTIES, WHICH MAY HAVE A SLIGHT POPULATION LOSS. ROANOKE CITY IS DIVIDED INTO QUADRANTS (NORTHWEST, NORTHEAST, SOUTHWEST AND SOUTHEAST) SEPARATED GEOGRAPHICALLY BY RAILROAD TRACKS, THE ROANOKE RIVER, AND INTERSTATE 581. THESE QUADRANTS VARY SIGNIFICANTLY IN THE DEMOGRAPHIC AND ECONOMIC MAKE-UP OF THEIR RESIDENTS. THE NORTHWEST AND SOUTHEAST QUADRANTS ARE DESIGNATED AS FEDERAL MEDICALLY UNDERSERVED AREAS (MUAS). THESE AREAS ARE HOME TO A LARGER PROPORTION OF THE LOW-INCOME INDIVIDUALS AND FAMILIES IN THE CITY WHO MAY BE UNINSURED, UNDERINSURED, OR MEDICAID RECIPIENTS FACING ADDITIONAL BARRIERS DUE TO SOCIETAL AND CULTURAL DIFFERENCES. BEDFORD COUNTY, BOTETOURT COUNTY, CRAIG COUNTY, AND FRANKLIN COUNTY ALSO CONTAIN MUAS. (HTTPS://DATA.HRSA.GOV/TOOLS/SHORTAGE-AREA) IN ADDITION TO CARILION MEDICAL CENTER, 2 OTHER HOSPITALS SERVE THE AREA: SALEM VETERANS AFFAIRS MEDICAL CENTER AND LEWISGALE MEDICAL CENTER. KEY SAFETY NET PROVIDERS IN THE REGION INCLUDE THE VETERAN AFFAIRS MEDICAL CENTER, A FEDERALLY QUALIFIED HEALTH CENTER, FREE CLINICS, LOCAL VIRGINIA DEPARTMENT OF HEALTH OFFICES, AND OTHER SERVICE ORGANIZATIONS. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH CARILION MEDICAL CENTER IS PART OF THE NON-PROFIT CARILION CLINIC INTEGRATED HEALTHCARE SYSTEM LOCATED IN THE BLUE RIDGE MOUNTAINS. WE PROVIDE QUALITY CARE FOR NEARLY ONE MILLION INDIVIDUALS THROUGH A COMPREHENSIVE NETWORK OF HOSPITALS, PRIMARY AND SPECIALTY PHYSICIAN PRACTICES, WELLNESS CENTERS, AND OTHER COMPLEMENTARY SERVICES. CARILION'S ROOTS GO BACK 125 YEARS, WHEN A GROUP OF DEDICATED CITIZENS CAME TOGETHER AND BUILT A HOSPITAL TO MEET THE COMMUNITY'S HEALTHCARE NEEDS. TODAY, CARILION IS A VITAL ANCHOR INSTITUTION FOCUSED ON HEALTHCARE AND DEDICATED TO OUR MISSION OF IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. CARE IS ADVANCED THROUGH CLINICAL SERVICES, MEDICAL EDUCATION, RESEARCH, AND COMMUNITY HEALTH INVESTMENTS. CARILION BELIEVES IN SERVICE, COLLABORATION, AND CARING FOR ALL. CARILION INVESTS IN DISCOVERING AND RESPONDING TO LOCAL AND REGIONAL HEALTH NEEDS, UNDERSTANDING THAT WE MUST INVOLVE ADDITIONAL STAKEHOLDERS TO ADDRESS COMMUNITY HEALTH ISSUES AND CREATE CHANGE EFFECTIVELY. CARILION RECOGNIZES THE IMPACT THE ENVIRONMENT HAS ON THE HEALTH OF OUR COMMUNITIES. EFFORTS CONTINUE TO MAKE OUR HOSPITALS AND OTHER FACILITIES MORE ENERGY-EFFICIENT, INCREASE RECYCLING AND USE OF RECYCLABLE OR BIO-DEGRADABLE MATERIALS, REDUCE WASTE MATERIALS, AND SERVE LOCAL, SUSTAINABLE FOODS TO PATIENTS. CARILION HAS AN OFFICE OF SUSTAINABILITY THAT LEADS THESE EFFORTS AND EMPOWERS EMPLOYEES TO BE INVOLVED IN ENVIRONMENTAL HEALTH-RELATED PROJECTS. CARILION MEDICAL CENTER (CMC) INCLUDES CARILION'S FLAGSHIP FACILITY, CARILION ROANOKE MEMORIAL HOSPITAL (CRMH). CRMH INCLUDES A LEVEL 1 TRAUMA CENTER, A NEONATAL INTENSIVE CARE UNIT, CARILION CHILDREN'S HOSPITAL, AND 718 PATIENT BEDS. OFFERING A WIDE RANGE OF INPATIENT AND OUTPATIENT CARE, SPECIALTY CARE, MEDICAL EDUCATION, AND FELLOWSHIPS, CRMH HAS GAINED RECOGNITION AS VIRGINIA'S SIXTH TOP HOSPITAL BY U.S. NEWS AND WORLD REPORT. CRMH PROVIDES ACCESS TO THE REGION'S MOST EXPERIENCED HEALTHCARE PROFESSIONALS AND SPECIALTY SERVICES WHILE TEACHING AND DEVELOPING TOMORROW'S MEDICAL LEADERS THROUGH RESIDENCIES AND FELLOWSHIPS SPONSORED BY THE VIRGINIA TECH CARILION SCHOOL OF MEDICINE. ADDITIONALLY, CARILION ROANOKE COMMUNITY HOSPITAL HOUSES A HIGHLY SKILLED INPATIENT REHABILITATION UNIT, A WOUND HEALING CENTER, ENDOSCOPY SERVICES, OUTPATIENT SURGERY, AND AN OCCUPATIONAL MEDICINE PRACTICE. WOMEN'S SERVICES HAVE 2 PRACTICE SITES AT THIS FACILITY, INCLUDING UROGYNECOLOGY AND MATERNAL-FETAL MEDICINE. CMC SERVES ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL'S GOVERNING BOARD MEMBERS RESIDE IN THE REGION AND ARE ELECTED TO 3-YEAR TERMS, WITH BOARD OFFICERS ELECTED ANNUALLY. THE MAJORITY OF MEMBERS ARE NEITHER HOSPITAL EMPLOYEES NOR CONTRACTORS. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO QUALIFIED HEALTHCARE PROFESSIONALS. SURPLUS FUNDS ARE REINVESTED IN NEW TECHNOLOGY, CLINICAL INITIATIVES, EDUCATION, STAFF DEVELOPMENT, AND CHARITABLE EFFORTS. REINVESTMENTS INCLUDE PROVIDING FREE, DISCOUNTED, AND SUBSIDIZED CARE AND CRITICAL MEDICAL SERVICES NOT OTHERWISE OFFERED IN OUR REGION. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM CARILION MEDICAL CENTER IS WHOLLY OWNED BY CARILION CLINIC, A NONPROFIT HEALTHCARE ORGANIZATION BASED IN ROANOKE, VIRGINIA. CARILION INCLUDES A COMPREHENSIVE NETWORK OF HOSPITALS, PRIMARY AND SPECIALTY PHYSICIAN PRACTICES, AND COMPLEMENTARY SERVICES COMPRISING 6 HOSPITAL ENTITIES, 86 SPECIALTIES, AND 295 PRACTICE SITES ACROSS SOUTHWEST VIRGINIA. ALL ARE CENTERED ON A COMMON MISSION AND SHARED VALUES. IN THE MID-2000S, CARILION TRANSFORMED FROM A COLLECTION OF HOSPITALS TO A PHYSICIAN-LED, INTEGRATED HEALTHCARE SYSTEM. ADVANCES INCLUDE DEVELOPING A MULTI-SPECIALTY PHYSICIAN GROUP, TRANSFORMING OUR PRIMARY CARE PRACTICES INTO PATIENT-CENTERED MEDICAL HOMES, IMPLEMENTING ELECTRONIC HEALTH RECORDS SYSTEM-WIDE, CREATING A ROBUST PARTNERSHIP WITH VIRGINIA TECH, INCLUDING DEVELOPING THE VIRGINIA TECH CARILION (VTC) SCHOOL OF MEDICINE AND THE FRALIN BIOMEDICAL RESEARCH INSTITUTE AT VTC AND HOSTING RADFORD UNIVERSITY CARILION'S HEALTHCARE PROFESSIONAL EDUCATIONAL OFFERINGS ON OUR CARILION ROANOKE COMMUNITY HOSPITAL CAMPUS. EACH DECISION AND ADAPTATION HAS FUNDAMENTALLY CHANGED HOW CARILION COLLABORATES AND PROVIDES CARE (HTTPS://WWW.CARILIONCLINIC.ORG/ABOUT-CARILION-CLINIC). CARILION'S COMMUNITY AND POPULATION HEALTH INFRASTRUCTURE IS THE HEALTH SYSTEM'S ENGINE FOR PROVIDING COLLABORATIVE OPPORTUNITIES TO IMPROVE THE COMMUNITY'S HEALTH. CARILION'S COMMUNITY HEALTH ASSESSMENT PROCESS HELPS IDENTIFY THE STRENGTHS AND BARRIERS IMPACTING HEALTH. OUR COMMUNITY-BASED PROGRAMS REFLECT THE ROBERT WOOD JOHNSON FOUNDATION'S FRAMEWORK OF 4 MAIN INFLUENCES OF HEALTH: HEALTH BEHAVIORS, SOCIAL AND ECONOMIC FACTORS, CLINICAL CARE ACCESS AND QUALITY, AND PHYSICAL ENVIRONMENT. OUR MANY PARTNERSHIPS WITH CROSS-SECTOR ORGANIZATIONS CREATE A COLLABORATIVE CULTURE OF HEALTH AND WELLNESS. true TAUBMAN MUSEUM OF ART 110 SALEM AVE SE ROANOKE VA 24011 546026841 501(C)(3) 22500 SPONSORSHIP JUNIOR ACHIEVEMENT OF SW VA 110 CAMPBELL AVE SE 001 ROANOKE VA 24011 540628293 501(C)(3) 10350 EVENT SPONSORSHIP NATIONAL MS SOCIETY 733 3RD AVE 3RD FL NEW YORK NY 10017 135661935 501(C)(3) 10000 SPONSORSHIP RADFORD UNIVERSITY PO BOX 6923 RADFORD VA 24142 546001789 VIRGINIA 225877 ASSOC PROVOST HEALTH SCI ROANOKE SYMPHONY ORCHESTRA 1125 1ST ST SW ROANOKE VA 24016 546019736 501(C)(3) 16000 SPONSORSHIP VIRGINIA WESTERN EDUCATIONAL FDN 3093 COLONIAL AVENUE ROANOKE VA 24015 511200913 501(C)(3) 10000 SPONSORSHIP WEST END CENTER FOR YOUTH 1223 PATTERSON AVE ROANOKE VA 24016 541150320 501(C)(3) 7000 EVENT SPONSORSHIP THE SCOTT ROBERTSON MEM JR GOLF ACAD 3707 DENSMORE ROAD ROANOKE VA 24017 201237999 501(C)(3) 10000 EVENT SPONSORSHIP AMERICAN HEART ASSOCIATION 4217 PARK PLACE COURT GLEN ALLEN VA 23060 135613797 501(C)(3) 15000 EVENT SPONSORSHIPS LOCAL ENVIRO AGRICULTURAL PROJ (LEAP) 1027 PATTERSON AVE SW ROANOKE VA 24016 271050909 501(C)(3) 25000 ACCESS TO HEALTHY FOOD VALLEYS INNOVATION COUNCIL VERGE 2200 KRAFT DRIVE BLACKSBURG VA 24060 462975294 501(C)(3) 300000 PROGRAM SUPPORT COMPRESSION & SHOCK FOUNDATION 2128 CHESTNUT OAK CT SW ROANOKE VA 24018 814994130 501(C)(3) 15000 PROGRAM SUPPORT AMERICAN CANCER SOCIETY PO BOX 4110 GLEN ALLEN VA 23058 131788491 501(C)(3) 10000 EVENT SPONSORSHIPS VIRGINIA BREAST CANCER FOUNDATION 2821 EMERYWOOD PARKWAY SUITE 203 RICHMOND VA 23294 541633519 501(C)(3) 5250 EVENT SPONSORSHIP GOODWILL INDUSTRIES OF THE VALLEYS 310 1ST STREET SW SUITE 1200 ROANOKE VA 24011 540884014 501(C)(3) 250000 RESTORING GREATNESS/MELROSE PLAZA THE TWELVE FOUNDATION 2149 DEYERLE ROAD SW ROANOKE VA 24018 993702152 501(C)(3) 50000 SUBSTANCE USE DISORDER TREATMENT FACILITY BLUE RIDGE INNOVATION CORRIDOR 2601 FLOYD AVENUE RICHMOND VA 23220 994309531 501(C)(3) 50000 GENERAL SUPPORT BOY SCOUTS OF AMERICA BLUE RIDGE MOUNTAINS COUNCIL 6342 PETERS CREEK RD ROANOKE VA 24019 540912706 501(C)(3) 5300 SPONSORSHIP A TREE PLANTED COLLECTIVE 2107 WESTOVER AVE SW ROANOKE VA 24015 832535127 501(C)(3) 20000 SCHOOL ECOSYSTEM THERAPY BLUE RIDGE LITERACY 706 S JEFFERSON ST ROANOKE VA 24016 541377063 501(C)(3) 10000 ENGLISH AND HEALTH LITERACY COMMONWEALTH CATHOLIC CHARITIES 1601 ROLLING HILLS DR RICHMOND VA 23229 540505877 501(C)(3) 15000 HEALTH CASE MANAGEMENT SUPPORT FAMILY SERVICE OF ROANOKE VALLEY 360 CAMPBELL AVE SW ROANOKE VA 24016 540505946 501(C)(3) 20000 MENTAL HEALTH COUNSELING FEEDING SOUTHWEST VIRGINIA 1025 ELECTRIC RD SALEM VA 24153 541939556 501(C)(3) 18575 FOOD FARMACY INITIATIVE RONALD MCDONALD HOUSE CHARITIES OF SW VA 2224 S JEFFERSON ST ROANOKE VA 24014 541244769 501(C)(3) 626975 FMV BUILDING, DONATED RENT BUILDING IMPACT LIVING SERVICES 1454 MEXICO WAY ROANOKE VA 24012 454769701 501(C)(3) 10000 YOUTH INDEPENDENT LIVING PROGRAM PLANNED PARENTHOOD SOUTH ATLANTIC 100 S BOYLAN AVE RALEIGH NC 27603 561282557 501(C)(3) 7500 EDUCATIONAL PROGRAM SUPPORT VIRGINIA TECH CARILION SCHOOL OF MEDICINE 2 RIVERSIDE CIRCLE ROANOKE VA 24016 264556177 501(C)(3) 4250200 MEDICAL SCHOOL SUPPORT CARDINAL PRODUCTIONS INC PO BOX 4455 ROANOKE VA 24015 871532828 501(C)(3) 25000 HEALTH REPORTER GREATER ROANOKE TRANSIT COMPANY 1108 CAMPBELL AVE SE ROANOKE VA 24013 540982022 CITY OF ROANOKE 131195 TRANSPORTATION SUPPORT CHILDREN'S ASSISTIVE TECHNOLOGY SERVICES 12801 MONETA ROAD MONETA VA 24121 464866068 501(C)(3) 11424 FMV DONATED RENT DONATED RENT COALITION TO STRENGTHEN AMERICA'S HEALTHCARE PO BOX 30211 BETHESDA MD 20824 522253225 501(C)(4) 56250 PROGRAM SUPPORT BLUFORD HEALTHCARE LEADERSHIP INSTITUTE 7900 LEES SUMMIT ROAD KANSAS CITY MO 64139 463328194 501(C)(3) 15000 PROGRAM SUPPORT VIRGINIA COMMEMORATIONS INC 1001 E BROAD ST SUITE 240 RICHMOND VA 23219 810703911 501(C)(3) 50000 SPONSORSHIP CHILDREN'S TRUST ROANOKE VALLEY 541 LUCK AVENUE SUITE 308 ROANOKE VA 24016 510235891 501(C)(3) 121000 OPERATING SUPPORT CHIP OF ROANOKE VALLEY 1201 THIRD STREET ROANOKE VA 24016 541566451 501(C)(3) 101000 OPERATING SUPPORT CARILION FRANKLIN MEMORIAL HOSPITAL PO BOX 12385 ROANOKE VA 23285 540480606 501(C)(3) 543398 PEDIATRIC CLINIC CAPITAL PROJECT CARILION SERVICES INC PO BOX 12385 ROANOKE VA 240252385 541190879 501(C)(3) 18732 SUPPORT 36 1 ENDOWMENT FUNDED PATIENT CARE 7 83518 MEDICATION ASSISTANCE 73 247318 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS THE HOSPITAL DONATES FUNDS TO OTHER CHARITABLE ORGANIZATIONS IN SUPPORT OF HEALTH AND COMMUNITY IMPROVEMENT. SUCH ORGANIZATIONS ALSO HAVE COMMUNITY BOARDS WHICH OVERSEE THE EXPENDITURE OF SUCH FUNDS. CARILION CLINIC IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES THAT WE SERVE BY ADDRESSING KEY HEALTH PRIORITIES IDENTIFIED THROUGH OUR TRIENNIAL COMMUNITY HEALTH ASSESSMENTS. CARILION FULFILLS THIS COMMITMENT IN MANY WAYS, ONE OF WHICH IS THROUGH TARGETED GRANTS FOR COMMUNITY HEALTH IMPROVEMENT PROGRAMS, AND THOSE THAT IMPACT THE SOCIAL DETERMINANTS OF HEALTH. FOR CARILION CLINIC'S COMMUNITY GRANT PROGRAM, EACH GRANTEE MUST SIGN A LETTER OF AGREEMENT WITH CARILION CLINIC THAT DELINEATES THE TERMS AND SPECIFIC OBJECTIVES OF THE PROJECT. BY ACCEPTING A CARILION AWARD, GRANTEES ARE ASKED TO ACKNOWLEDGE THE SUPPORT OF CARILION CLINIC IN ALL MATERIALS AND/OR RELATED SPECIAL EVENTS OR FUNDRAISERS THROUGHOUT THE AWARD CYCLE WHERE OTHER DONORS ARE PUBLICLY RECOGNIZED. ONE MID-CYCLE PROGRESS REPORT AND A FINAL PROGRAM EVALUATION ARE REQUIRED FOR EACH FUNDED PROJECT. SITE VISITS MAY BE MADE TO GRANTEES. PROGRAM EVALUATION INCLUDES ALIGNMENT WITH COMMUNITY HEALTH ASSESSMENT PRIORITIES, PROGRAM IMPACT, ORGANIZATIONAL EFFECTIVENESS AND COMMUNITY BENEFIT THROUGH COLLECTION OF DATA INCLUDING CLIENTS SERVED, COST EFFECTIVENESS OF THE PROGRAM (COST PER CLIENT OR SERVICE), TANGIBLE COMMUNITY OR CLIENT OUTCOMES, COLLABORATION WITH OTHER ORGANIZATIONS, AND SPECIFIC EFFORTS TO CULTIVATE DIVERSE FUNDING SOURCES FOR PROGRAM SUSTAINABILITY. EACH GRANTEE MUST AGREE TO SUBMIT REQUESTED DATA AND REPORTS ON A TIMELY BASIS AND TO COMPLETE THE EVALUATION PROCESS AS REQUESTED. X X false true false true false false false false false true false MICHAEL ABBOTT PHARMD PRESIDENT 358110 0 67326 0 37747 0 141046 0 19397 0 623626 0 30339 0 PAUL HASKINS MD DIRECTOR/PHYSICIAN 409893 0 82666 0 5756 0 284215 0 27014 0 809544 0 0 0 MICHAEL NUSSBAUM MD DIRECTOR/SVP/DEPT. CHAIR 829296 0 169464 0 88197 0 74891 0 19206 0 1181054 0 0 0 DANIEL TERSHAK MD DIRECTOR/CHIEF OF MEDICAL STAFF 496601 0 45227 0 55311 0 173753 0 25391 0 796283 0 0 0 STEVEN ARNER CEO 0 1184280 0 281741 0 249323 0 462803 0 27119 0 2205266 0 244219 NICHOLAS CONTE SECRETARY/EVP/CLO 0 786488 0 196275 0 235259 0 248836 0 19458 0 1486316 0 227408 MICHELLE FRANKLIN SVP, CHIEF NURSING OFFICER 279244 0 47985 0 1823 0 299073 0 17261 0 645386 0 0 0 TAMARA FROST SVP, CHIEF NURSING OFFICER 325877 0 52158 0 2269 0 70263 0 26671 0 477238 0 0 0 DONALD HALLIWILL ASST. TREASURER/EVP/CFO 0 825952 0 207880 0 275180 0 380086 0 27119 0 1716217 0 269399 G ROBERT VAUGHAN JR TREASURER 0 382897 0 73983 0 86609 0 299218 0 27119 0 869826 0 80547 NANCY HOWELL AGEE CEO EMERITUS, CARILION CLINIC 0 1794446 0 555971 0 215546 0 0 0 17888 0 2583851 0 0 JOHN JANE MD SVP, DEPARTMENT CHAIR 1131649 0 219531 0 5643 0 115670 0 19458 0 1491951 0 0 0 JOSEPH MOSKAL MD SVP/DEPARTMENT CHAIR 1181949 0 239395 0 84074 0 0 0 26867 0 1532285 0 0 0 SHYAM ODETI MD VP/CHIEF MEDICAL OFFICER 349944 0 110958 0 3141 0 24879 0 25193 0 514115 0 0 0 R TONY SEUPAUL MD CHIEF PHYSICIAN EXECUTIVE/EVP 22924 713029 0 171864 0 41966 3254 131564 655 26464 26833 1084887 0 0 JON SWEET MD SVP/DEPARTMENT CHAIR 533069 0 103778 0 5806 0 264874 0 13992 0 921519 0 0 0 JONATHAN CARMOUCHE MD PHYSICIAN 1483689 0 216236 0 6778 0 110845 0 25391 0 1842939 0 0 0 JAMES DROUGAS MD PHYSICIAN 856981 0 509622 0 7423 0 24158 0 19030 0 1417214 0 0 0 GREGORY HOWES MD PHYSICIAN 1217439 0 319988 0 3497 0 79573 0 25391 0 1645888 0 0 0 ERIC MARVIN MD PHYSICIAN 1090940 0 633875 0 5938 0 97338 0 25391 0 1853482 0 0 0 ADEOLU OLASUNKANMI MD PHYSICIAN 847992 0 773455 0 3553 0 55154 0 9967 0 1690121 0 0 0 SCHEDULE J, PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS EMPLOYEES ARE OCCASIONALLY PROVIDED SMALL GIFTS, PRIZES OR AWARDS WHICH ARE INCLUDED IN TAXABLE COMPENSATION AT GROSSED UP AMOUNTS TO COVER TAXES. DURING THE REPORTING PERIOD, DR. HASKINS AND DR. TERSHAK RECEIVED SUCH BENEFIT. SCHEDULE J, PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES ALL DIRECTORS ARE OFFERED A FREE FAMILY OR INDIVIDUAL MEMBERSHIP TO A HEALTH CLUB OWNED BY A RELATED ORGANIZATION IF THEY CHOOSE TO ACCEPT IT. THREE REPORTED INDIVIDUALS RECEIVED THIS BENEFIT, THE VALUE OF WHICH IS INCLUDED IN REPORTED COMPENSATION. SCHEDULE J, PART I, LINE 1B WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF EXPENSES PROVISION OF THE HEALTH CLUB BENEFIT IS DOCUMENTED IN BOARD MEETING MINUTES AND CARILION INTERNALLY TRACKS THE MEMBERSHIPS AND PAYS THE HEALTH CLUB DIRECTLY. MANAGEMENT MAKES TAX GROSS-UP DECISIONS AT ITS DISCRETION FOR NON-ROUTINE SMALL GIFTS, PRIZES OR AWARDS CONSIDERING IRS REQUIREMENTS, AMOUNT, AND NON-CASH STATUS. SCHEDULE J, PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION THE ORGANIZATION HAS A SINGLE MEMBER, CARILION CLINIC, A CHARITABLE TAX-EXEMPT ORGANIZATION WHICH SERVES AS THE PARENT COMPANY OF THE CARILION CLINIC INTEGRATED HEALTH CARE DELIVERY SYSTEM. EXECUTIVE COMPENSATION, INCLUDING THAT OF THE ORGANIZATION'S PRESIDENT, IS REVIEWED ANNUALLY BY THE CARILION CLINIC BOARD OF DIRECTORS COMPENSATION COMMITTEE. THIS COMMITTEE IS MADE UP OF BOARD MEMBERS OF CARILION CLINIC WHO DO NOT HAVE A CONFLICT OF INTEREST WITH ANY OF THE EXECUTIVES BEING REVIEWED. IN ADDITION, THE COMPENSATION COMMITTEE ANNUALLY REVIEWS THE COMPENSATION PHILOSOPHY FOR ALL EXECUTIVE LEADERS. THIS REVIEW INCLUDED REVIEW OF A COMPREHENSIVE REPORT FROM AN INDEPENDENT, OUTSIDE COMPENSATION CONSULTANT SPECIALIZING IN HEALTHCARE ORGANIZATIONS FOR SELECT POSITIONS AND THE PRIOR YEAR'S REPORT ON ALL OF THE REVIEWED POSITIONS. THE REPORTS REVIEWED BY THE COMMITTEE INCLUDED A COMPARISON OF TOTAL COMPENSATION AND EACH ELEMENT THEREOF, INCLUDING BASE SALARY, BONUS, 'AT-RISK OTHER CASH COMPENSATION, AND BENEFITS, INCLUDING DEFERRED AND RETIREMENT BENEFITS. COMPENSATION WAS COMPARED TO BOTH A NATIONAL AND REGIONAL PEER GROUP OF ORGANIZATIONS SIMILAR IN SIZE AND STRUCTURE TO THE ORGANIZATION, WHICH LIST WAS REVIEWED BY THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE MAINTAINED MINUTES OF ITS MEETINGS, SETTING FORTH THE DELIBERATIONS AND DECISIONS OF THE COMMITTEE REGARDING THE COMPENSATION OF THESE EXECUTIVES. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN MR. ABBOTT, MR. ARNER, MR. CONTE, MR. HALLIWILL, DR. MOSKAL, DR. NUSSBAUM, DR. HASKINS, DR. JANE, DR. SWEET, DR. SEUPAUL AND MR. VAUGHAN PARTICIPATE IN A DEFINED CONTRIBUTION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (DC SERP). CONTRIBUTIONS TO THE PLAN ARE AT THE DISCRETION OF CARILION CLINIC'S COMPENSATION COMMITTEE. AMOUNTS VEST AND BECOME NON-FORFEITABLE AND PAYABLE UPON THE FIRST OF THE FOLLOWING (1) ATTAINMENT OF SCHEDULED VESTING DATE (2) ATTAINMENT OF AGE AND YEARS OF SERVICE REQUIREMENTS (3) DISABILITY OR DEATH WHILE AN ELIGIBLE EMPLOYEE OR (4) ENTITLEMENT TO SEVERANCE BENEFITS FROM AN INVOLUNTARY TERMINATION WITHOUT REASONABLE CAUSE OR RESIGNATION WITH GOOD REASON. UNVESTED CONTRIBUTIONS MADE TO THE DC SERP IN THE REPORTING PERIOD ARE INCLUDED IN PART II, COLUMN C OF THIS SCHEDULE WITH "RETIREMENT AND OTHER DEFERRED COMPENSATION," WHILE VESTED CONTRIBUTIONS PAID OUT DURING THE YEAR ARE INCLUDED IN PART II, COLUMN B(III). THE FOLLOWING DISTRIBUTIONS WERE MADE TO THESE INDIVIDUALS UNDER THIS PLAN IN THE REPORTING YEAR. DEFERRED IN PRIOR YEAR AND PAID OUT IN CURRENT YEAR: $269,399 - DONALD HALLIWILL $244,219 - STEVEN ARNER $80,547 - G. ROBERT VAUGHAN, JR. $227,408 - NICHOLAS CONTE $30,339-MICHAEL ABBOTT VESTED AND PAID IN CURRENT YEAR: $75,000 - JOSEPH MOSKAL $75,000 - MICHAEL NUSSBAUM MS. AGEE PARTICIPATES IN AN EXECUTIVE FLEXIBLE BENEFIT PLAN, UNDER WHICH SHE RECEIVES AN ALLOWANCE WHICH CAN BE USED TO OBTAIN CERTAIN BENEFITS, WITH THE EXCESS DEFERRED UNTIL THE APPLICABLE VESTING DATE. AMOUNTS RECEIVED UNDER THIS PLAN NOW VEST IMMEDIATELY AND THUS ARE NO LONGER DEFERRED. $202,495 WAS DISTRIBUTED UNDER THIS PLAN IN THE REPORTING YEAR. SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS THE ORGANIZATION PAYS ANNUAL 'AT RISK' COMPENSATION TO CERTAIN MEMBERS OF MANAGEMENT AND PHYSICIANS BASED ON PERFORMANCE OF APPLICABLE SCORECARD METRICS. WHILE THE SCORECARD CONTAINS A FORMULA AS A BASIS FOR DETERMINING OVERALL PERFORMANCE, IN CERTAIN CASES, SENIOR MANAGERS HAVE DISCRETION TO INCLUDE ADDITIONAL ELEMENTS IN THEIR ASSESSMENT OF MANAGERS OR PHYSICIANS REPORTING TO THEM. IN ADDITION, FOR TOP MANAGEMENT, THE ACTUAL NON FIXED PAYMENT AWARDED IS DETERMINED IN THE DISCRETION OF THE CARILION CLINIC BOARD OF DIRECTORS AND ITS COMPENSATION COMMITTEE. PATRICIA ABBOTT FAMILY MEMBER OF MICHAEL ABBOTT, DIRECTOR 22885 EMPLOYEE false MARY SWEET MD FAMILY MEMBER OF JON SWEET, KEY EMPLOYEE 340762 EMPLOYEE false ANDREW MASLICH FAMILY MEMBER OF STEVEN ARNER, OFFICER 72057 EMPLOYEE false ALISON BEGAY FAMILY MEMBER OF STEVEN ARNER, OFFICER 126728 EMPLOYEE false GARY FRANKLIN FAMILY MEMBER OF MICHELLE FRANKLIN, OFFICER 56508 EMPLOYEE false AMANDA FRANKLIN FAMILY MEMBER OF MICHELLE FRANKLIN, OFFICER 58732 EMPLOYEE false FORM 990, PART I, LINE 6 VOLUNTEERS THE HOSPITAL OPERATES A CUSTOMER SERVICE-BASED PROGRAM FOR VOLUNTEERS, GOING ABOVE AND BEYOND TO MAKE OUR PATIENTS AND THEIR FAMILIES COMFORTABLE IN VERY UNCOMFORTABLE CIRCUMSTANCES. TASKS INCLUDE DELIVERING MAIL AND FLOWERS, GREETING AND ESCORTING PATIENTS, OFFERING REFRESHMENTS THROUGH OUR HOSPITALITY CART, CONDUCTING PET-ASSISTED THERAPY VISITS, AND GENERALLY SUPPORTING THE GUEST SERVICES STAFF. CMC VOLUNTEERS ALSO SUPPORT OUR PATIENT-UNITS BY PERFORMING THESE TASKS IN ADDITION TO VOLUNTEER WORK THAT SUPPORTS THE NURSING STAFF, SUCH AS ORGANIZING SUPPLIES AND VISITING PATIENTS WHO DO NOT HAVE FAMILY PRESENT. THE ROANOKE VOLUNTEER PROGRAM EXPANDED THIS YEAR TO INCLUDE VOLUNTEERS FOR THE EXPANDED EMERGENCY DEPARTMENT AND NEW CRYSTAL SPRING TOWER. VOLUNTEERS IN THESE LOCATIONS SERVE ALONGSIDE GUEST SERVICES STAFF TO ESCORT PATIENTS AND FAMILIES, ASSIST WITH WAYFINDING, AND ENHANCE PATIENT EXPERIENCE. THROUGH HOSPICE, VOLUNTEERS PROVIDE RESPITE SUPPORT FOR CAREGIVERS, VISITS FOR SOCIALIZATION AND COMFORTING PRESENCE, WEEKLY CHECK-IN CALLS, CARE FOR PATIENTS' PETS, ADMINISTRATIVE SUPPORT IN THE HOSPICE OFFICE, PLANT/HARVEST/DELIVER FRESH VEGGIES, OFFER VIRTUAL REALITY EXPERIENCES, SING IN THE HOSPICE CHOIR TO PATIENTS, PROVIDE HONORING CEREMONIES FOR MILITARY VETERAN PATIENTS, OFFER PET THERAPY AND REIKI THERAPY, OFFER END OF LIFE DOULA SUPPORT INCLUDING VIGIL PLANNING, ASSIST WITH FUNDRAISERS, ASSIST WITH BEREAVEMENT SUPPORT ACTIVITIES, MAKE FIDGET QUILTS FOR DEMENTIA PATIENTS AND SEW DIGNITY PATIENT GOWNS, DELIVER BIRTHDAY GIFTS, CRAFT HOLIDAY GIFTS, AND RECORD PATIENT'S LIFE STORIES. A VOLUNTEER LICENSED COSMETOLOGIST PROVIDED PATIENTS WITH FRESH HAIRCUTS. FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION CARILION MEDICAL CENTER (CMC) IS AN AFFILIATE OF CARILION CLINIC, A NOT-FOR-PROFIT HEALTH SYSTEM HEADQUARTERED IN ROANOKE, VIRGINIA. CMC INCLUDES CARILION ROANOKE MEMORIAL HOSPITAL, CARILION ROANOKE COMMUNITY HOSPITAL AND SURROUNDING CLINICS AND PRACTICES. CARILION ROANOKE MEMORIAL HOSPITAL'S COMMITMENT TO IMPROVING THE HEALTH OF ITS COMMUNITY IS RECOGNIZED THROUGH ITS RANKING AMONG THE ELITE 11% OF BEST HOSPITALS NATIONALLY AND AMONG THE TOP THREE HOSPITALS IN VIRGINIA BY U.S. NEWS AND WORLD REPORT. CMC ALSO HAS EARNED FIVE MAGNET DESIGNATIONS FOR NURSING EXCELLENCE, PLACING IT IN THE TOP 1% OF HOSPITALS GLOBALLY AND THE ONLY ONE IN VIRGINIA TO EARN THE HONOR. COMMITTED TO INNOVATION AND CLINICAL EXCELLENCE AND SUPPORTED BY EDUCATION AND RESEARCH, CARILION OPERATES A REGIONAL CANCER CENTER, THE REGION'S ONLY LEVEL I TRAUMA CENTER, AND THE REGION'S ONLY PEDIATRIC CENTER OF EXCELLENCE, WITH AN INPATIENT UNIT WITHIN CARILION ROANOKE MEMORIAL HOSPITAL THAT INCLUDES A PEDIATRIC INTENSIVE CARE UNIT, VIRGINIA'S THIRD LARGEST NEONATAL ICU, TRAUMA CARE AND WESTERN VIRGINIA'S ONLY PEDIATRIC LEVEL I TRAUMA CENTER. CMC ADMITTED OVER 40,615 PATIENTS, DELIVERED 3,366 BABIES, AND PROVIDED 231,419 DAYS OF CARE IN FISCAL YEAR 2025. WITH NEARLY 87,000 VISITS, CMC'S EMERGENCY SERVICES ARE A CRITICAL COMPONENT OF THE HEALTH SAFETY NET IN ITS SERVICE AREA, ACTING AS A KEY HEALTH PROVIDER FOR A SIGNIFICANT NUMBER OF UNINSURED PATIENTS, WHO COMPRISE ABOUT 7 PERCENT OF ED VISITS. MORE THAN A DOZEN PEDIATRIC SUB-SPECIALTIES ARE HOUSED AT CARILION CHILDREN'S FREESTANDING OUTPATIENT CLINIC. THEY INCLUDE PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES, AND ENT/AUDIOLOGY, MENTAL HEALTH AND DENTISTRY SERVICES. IN ADDITION, CMC PHYSICIANS PROVIDE CARE IN A RANGE OF SPECIALTIES AT NUMEROUS CLINIC PRACTICE SITES ON AND NEAR ITS ROANOKE HOSPITAL CAMPUSES AS WELL AS THROUGHOUT THE WESTERN VIRGINIA REGION. TO MEET THE GROWING NEED FOR CARE IN SOUTHWEST VIRGINIA, IN SUMMER 2025 CARILION OPENED A $500 MILLION TOWER ADDITION TO CARILION ROANOKE MEMORIAL HOSPITAL. THE 12-STORY, 500,000-SQUARE-FOOT CRYSTAL SPRING TOWER IS HOME TO THE CARILION CLINIC CARDIOVASCULAR INSTITUTE AND A SIGNIFICANTLY EXPANDED EMERGENCY DEPARTMENT. IN ADDITION TO PROVIDING MEDICAL CARE, CARILION INVESTS SIGNIFICANTLY IN MEDICAL EDUCATION. THE HEALTH SYSTEM'S GRADUATE MEDICAL EDUCATION PROGRAM, BASED AT CARILION ROANOKE MEMORIAL HOSPITAL, TRAINS MORE THAN 300 RESIDENTS AND FELLOWS IN 29 PROGRAMS WITH NEARLY HALF OF PROGRAM GRADUATES REMAINING IN SOUTHWEST VIRGINIA TO CARE FOR PATIENTS IN THE REGION. THROUGH PARTNERSHIPS WITH PREMIER INSTITUTIONS LIKE VIRGINIA TECH AND RADFORD UNIVERSITY, CARILION ALSO PROVIDES UNDERGRADUATE MEDICAL EDUCATION AND TRAINING AT CMC FOR PHYSICIANS, NURSES AND A RANGE OF ALLIED HEALTH PROFESSIONALS. IN ADDITION, CMC PROVIDES NUMEROUS COMMUNITY HEALTH SCREENINGS AND EDUCATION ON CHRONIC DISEASE PREVENTION AND MANAGEMENT, INVESTS IN AN INTERNAL COMMUNITY HEALTH WORKFORCE, AND PARTNERS WITH COMMUNITY ORGANIZATIONS TO IDENTIFY AND ADDRESS HEALTH NEEDS. TO ADVANCE ITS NOT-FOR-PROFIT MISSION, CARILION CARES FOR ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. STATED AT COST, IN FISCAL YEAR 2025, CMC PROVIDED NEARLY $95 MILLION IN UNCOMPENSATED CARE AND OTHER COMMUNITY SUPPORT. CARILION MEDICAL CENTER'S ACHIEVEMENTS IN PATIENT CARE, EDUCATION, AND COMMUNITY SUPPORT DEMONSTRATE ITS STEADFAST COMMITMENT TO MEETING THE NEEDS OF THE COMMUNITIES IT SERVES. FORM 990, PART IV, LINE 11F DISCLOSURE OF UNCERTAIN TAX POSITIONS MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. FORM 990, PART V, LINE 1A FORMS 1099 1099S ARE ISSUED ON CARILION MEDICAL CENTER'S BEHALF BY CARILION SERVICES, INC., A RELATED SUPPORTING ORGANIZATION PROVIDING MANAGEMENT AND ADMINISTRATIVE SERVICES, INCLUDING PAYMENT PROCESSING. FORM 990, PART VI, LINE 1A DELEGATE BROAD AUTHORITY TO A COMMITTEE CARILION MEDICAL CENTER HAS AN EXECUTIVE COMMITTEE AUTHORIZED TO ACT IN THE PLACE OF THE BOARD WHEN THE BOARD IS NOT IN SESSION. THE EXECUTIVE COMMITTEE HAS 4 MEMBERS, MADE UP OF THE CARILION MEDICAL CENTER PRESIDENT AND CHAIR OF THE BOARD, CLINICAL ADVANCEMENT AND PATIENT SAFETY (CAPS) COMMITTEE, AND NOMINATING COMMITTEE. THE EXECUTIVE COMMITTEE MEETS AT TIMES THAT THE BOARD CANNOT MEET AND IF THE NEED ARISES TO ACT ON BEHALF OF THE BOARD, EXCEPT TO ELECT DIRECTORS OR COMMITTEE MEMBERS, AMEND GOVERNING DOCUMENTS, APPROVE A PLAN OF MERGER, OR OTHER ACTIONS THAT ARE REQUIRED TO BE APPROVED BY BOARD MEMBERS. FORM 990, PART VI, LINE 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS STEVEN ARNER, NICHOLAS CONTE, DONALD HALLIWILL, G. ROBERT VAUGHAN JR., J. HARRISON LAPAUSA, R. TONY SEUPAUL AND JULIE SMITH-HAMILTON - BUSINESS RELATIONSHIP FORM 990, PART VI, LINE 3 DELEGATION OF MANAGEMENT DUTIES CERTAIN MANAGEMENT AND RELATED SERVICES FOR THE ORGANIZATION ARE PROVIDED BY THE MANAGEMENT AND EMPLOYEES OF CARILION SERVICES, INC., A RELATED AND SUPPORTING ORGANIZATION OF THE FILING ORGANIZATION. SOME OR ALL OF THE COMPENSATION OF THE FOLLOWING INDIVIDUALS LISTED IN PART VII, SECTION A WAS PROVIDED BY CARILION SERVICES INC.: NANCY HOWELL AGEE, STEVEN ARNER, NICHOLAS CONTE, DONALD HALLIWILL, JULIE SMITH-HAMILTON, J. HARRISON LAPAUSA, R TONY SEUPAUL, AND G. ROBERT VAUGHAN, JR. FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS THE ORGANIZATION HAS A SINGLE MEMBER. THE SOLE MEMBER IS CARILION CLINIC, A CHARITABLE TAX-EXEMPT ORGANIZATION WHICH SERVES AS THE PARENT COMPANY OF THE CARILION CLINIC INTEGRATED HEALTH CARE DELIVERY SYSTEM. THE SOLE MEMBER ELECTS THE DIRECTORS OF THE ORGANIZATION AND HAS CERTAIN OTHER RESERVED POWERS. FORM 990, PART VI, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY THE SOLE MEMBER OF THE ORGANIZATION, CARILION CLINIC, ELECTS THE MEMBERS OF THE GOVERNING BODY OF THE ORGANIZATION PERIODICALLY AS TERMS EXPIRE. THE SOLE MEMBER ALSO HAS THE RIGHT TO REMOVE DIRECTORS AND FILL ANY VACANCIES ON THE BOARD THAT MAY OCCUR FOR ANY REASON. FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS THE SOLE MEMBER OF THE ORGANIZATION, CARILION CLINIC, HOLDS RESERVED POWERS WITH RESPECT TO CERTAIN ENUMERATED ACTIONS, INCLUDING APPOINTMENT OF CEO; APPROVAL OF BORROWINGS, BUDGETS, AND STRATEGIC PLANS; AND AMENDMENTS OF ARTICLES OF INCORPORATION AND BYLAWS, AMONG OTHERS. APPROVAL BY THE BOARD OF DIRECTORS OF CARILION CLINIC IS REQUIRED FOR SUCH ACTIONS. IN ADDITION TO THE RESERVED POWERS, UNDER THE LAWS OF THE COMMONWEALTH OF VIRGINIA, CERTAIN EXTRAORDINARY ACTIONS REQUIRE MEMBER APPROVAL, SUCH AS MERGERS, CONSOLIDATIONS, LIQUIDATIONS, AND THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION. SEE ALSO SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION A, LINE 7A. FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY THE FORM 990 WAS PREPARED BY CARILION'S INTERNAL TAX DEPARTMENT WITH INPUT FROM VARIOUS OTHER CARILION DEPARTMENTS AS APPLICABLE, AND REVIEWED BY INTERNAL MANAGEMENT AND AN INDEPENDENT CPA FIRM. MANAGEMENT REVIEWED A DRAFT OF THE FORM 990 AT THE AUGUST MEETING OF THE CARILION CLINIC BOARD OF DIRECTORS AUDIT COMMITTEE AND WAS AVAILABLE TO ANSWER QUESTIONS. SEVERAL DAYS PRIOR TO FILING, ALL BOARD MEMBERS WERE NOTIFIED VIA EMAIL THAT THE FINAL FORM 990 WAS AVAILABLE FOR THEIR ACCESS ON THE ORGANIZATION'S BOARD PORTAL AND WERE PROVIDED CONTACT INFORMATION TO REACH OUT TO FOR QUESTIONS. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY OUR ORGANIZATION MONITORS AND REVIEWS PROPOSED AND CURRENT TRANSACTIONS FOR CONFLICTS OF INTEREST IN A VARIETY OF WAYS. AT THE GOVERNING BOARD LEVEL, WE HAVE BOARD MEMBERS COMPLETE AN INITIAL (UPON APPOINTMENT) AND ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS. BOARD MEMBERS ARE REQUIRED TO UPDATE THEIR DISCLOSURE AS NEEDED IN BETWEEN QUESTIONNAIRES. ALL DISCLOSURES ARE REVIEWED BY THE COMPLIANCE OFFICE AND AS NEEDED ESCALATED TO THE APPROPRIATE LEADERS/BOARD MEMBERS FOR FURTHER DISCUSSION/REVIEW. IF A DISCLOSURE IS VIEWED AS AN ACTUAL OR POTENTIAL CONFLICT, AN ACTION IS RECOMMENDED TO THE COMPLIANCE COMMITTEE OF THE CARILION CLINIC BOARD AND IMPLEMENTED AS APPROVED. ACTIONS CAN INCLUDE RECUSAL IN DISCUSSION/VOTING AT BOARD MEETINGS, LIMITATION/TERMINATION OF THE TRANSACTION, REMOVAL FROM BOARD APPOINTMENT OR OTHER APPROPRIATE CONTROLS. IN ADDITION, AT ANY TIME, BOARD MEMBERS ARE ENCOURAGED TO DISCLOSE ANY POTENTIAL CONFLICTS AS THEY ARISE AT A BOARD MEETING AND TO RECUSE THEMSELVES AS DEEMED APPROPRIATE. THE SAME PROCESS TAKES PLACE AS DESCRIBED ABOVE FOR KEY EMPLOYEES (UPON HIRE AND ANNUALLY THEREAFTER), INCLUDING ALL OFFICERS, MEMBERS OF THE MANAGEMENT TEAM, PHYSICIANS/MID-LEVEL PRACTITIONERS, PHARMACISTS AND KEY SUPPLY CHAIN BUYERS. AFTER REVIEW AND FURTHER DISCUSSION AS NEEDED, ACTION MAY BE REQUIRED TO MANAGE AN ACTUAL CONFLICT OR TO REDUCE THE APPEARANCE OF SUCH AS APPROVED BY THE COMPLIANCE OFFICE AND OTHER KEY MANAGEMENT TEAM MEMBERS. AS NEEDED, THE GOVERNING BOARD LEADERS ARE NOTIFIED OF ANY CONFLICTS WHICH MAY IMPACT BOARD PROCEEDINGS. FORM 990, PART VI, LINE 15A PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL THE ORGANIZATION HAS A SINGLE MEMBER, CARILION CLINIC, A CHARITABLE TAX-EXEMPT ORGANIZATION WHICH SERVES AS THE PARENT COMPANY OF THE CARILION CLINIC INTEGRATED HEALTH CARE DELIVERY SYSTEM. THE COMPENSATION OF SYSTEM EXECUTIVES IS REVIEWED ANNUALLY BY THE CARILION CLINIC BOARD OF DIRECTORS COMPENSATION COMMITTEE, WHICH IS MADE UP OF INDEPENDENT BOARD MEMBERS OF CARILION CLINIC WHO DO NOT HAVE A CONFLICT OF INTEREST WITH ANY OF THE EXECUTIVES BEING REVIEWED. THE COMPENSATION COMMITTEE REVIEWS THE COMPENSATION OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, SYSTEM EXECUTIVE VICE PRESIDENTS (CHIEF FINANCIAL OFFICER, CHIEF PHYSICIAN EXECUTIVE, CHIEF OPERATING OFFICER, CHIEF ADMINISTRATIVE OFFICER AND CHIEF LEGAL AND GOVERNANCE OFFICER), AND SELECT SYSTEM SENIOR VICE PRESIDENT PHYSICIAN CLINICAL DEPARTMENT CHAIRS. CERTAIN OF THESE SAME INDIVIDUALS ALSO HOLD ROLES AS OFFICERS AND KEY EMPLOYEES OF CARILION MEDICAL CENTER, INCLUDING ITS PRESIDENT AND CEO. THIS REVIEW INCLUDED REVIEW OF A COMPREHENSIVE REPORT FROM AN INDEPENDENT, OUTSIDE COMPENSATION CONSULTANT SPECIALIZING IN HEALTHCARE ORGANIZATIONS FOR CERTAIN SELECT POSITIONS AND THE PRIOR YEAR'S REPORT ON ALL THE REVIEWED POSITIONS. THE REPORTS REVIEWED BY THE COMMITTEE INCLUDED A DETAILED COMPARISON OF TOTAL COMPENSATION AND EACH ELEMENT THEREOF, INCLUDING BASE SALARY, BONUS, 'AT-RISK OTHER CASH COMPENSATION, AND BENEFITS, INCLUDING DEFERRED AND RETIREMENT BENEFITS. COMPENSATION WAS COMPARED TO BOTH A NATIONAL AND REGIONAL PEER GROUP OF ORGANIZATIONS SIMILAR IN SIZE AND STRUCTURE TO THE ORGANIZATION, WHICH LIST WAS REVIEWED BY THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE MAINTAINED MINUTES OF ITS MEETINGS, SETTING FORTH THE DELIBERATIONS AND DECISIONS OF THE COMMITTEE REGARDING THE COMPENSATION OF THESE EXECUTIVES. THE COMPENSATION COMMITTEE ALSO ANNUALLY REVIEWS THE COMPENSATION PHILOSOPHY FOR ALL EXECUTIVE LEADERS IN THE HEALTH SYSTEM, WHICH INCLUDES VICE PRESIDENTS, SENIOR VICE PRESIDENTS INCLUDING CARILION MEDICAL CENTER'S TREASURER, EXECUTIVE VICE PRESIDENTS, AND THE CEO, AS WELL AS THE COMPENSATION PHILOSOPHY FOR EMPLOYED PHYSICIANS. FOR CERTAIN OFFICERS WHO ARE NOT DIRECTLY REVIEWED BY THE COMPENSATION COMMITTEE, INCLUDING FOR THE ORGANIZATION'S TREASURER, THE INDEPENDENT EXTERNAL COMPENSATION CONSULTANT CONDUCTS THE SAME ANALYSIS AND SHARES THE DATA/FINDINGS WITH THE RELEVANT SYSTEM EVP. CERTAIN ASSISTANT OFFICERS OF THE ORGANIZATION WHO ARE NOT COMPENSATED IN THEIR CAPACITY AS AN OFFICER BUT RATHER IN THEIR ROLE AS EMPLOYEE IN A POSITION NOT MENTIONED ABOVE ARE NOT SUBJECT TO COMMITTEE OR CONSULTANT REVIEW BUT ARE COMPARED TO MARKET BENCHMARKS BY THE HUMAN RESOURCES DEPARTMENT. FORM 990, PART VI, LINE 15B PROCESS TO ESTABLISH COMPENSATION OF OTHER EMPLOYEES SEE RESPONSE TO LINE 15A. FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENT, AND CONSOLIDATED FINANCIAL STATEMENTS ARE RELEASED FROM TIME TO TIME DURING THE TAX YEAR UPON REQUEST. THE CONFLICT OF INTEREST POLICY IS INCLUDED IN OUR CODE OF EXCELLENCE WHICH IS AVAILABLE TO THE PUBLIC ON OUR WEBSITE. THE ARTICLES OF INCORPORATION ARE AVAILABLE FROM THE VIRGINIA STATE CORPORATION COMMISSION. LIMITED CONSOLIDATED FINANCIAL INFORMATION IS AVAILABLE ON OUR WEBSITE. FORM 990, PART VIII, LINE 2F OTHER PROGRAM SERVICE REVENUE OTHER PROGRAM SERVICE REVENUE - TOTAL REVENUE: 2595671, RELATED OR EXEMPT FUNCTION REVENUE: 2595671, UNRELATED BUSINESS REVENUE: , REVENUE EXCLUDED FROM TAX UNDER SECTIONS 512, 513, OR 514: ; FORM 990, PART VIII, LINE 11D OTHER MISCELLANEOUS REVENUE OTHER REVENUE - TOTAL REVENUE: 8031134, RELATED OR EXEMPT FUNCTION REVENUE: 8031134, UNRELATED BUSINESS REVENUE: , REVENUE EXCLUDED FROM TAX UNDER SECTIONS 512, 513, OR 514: ; FORM 990, PART IX, LINE 11G OTHER FEES PHYSICIAN/PROFESSIONAL SERVICES - TOTAL EXPENSE: 37026439, PROGRAM SERVICE EXPENSE: 37026439, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; BILLING & COLLECTION SERVICES - TOTAL EXPENSE: 11182292, PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: 11182292, FUNDRAISING EXPENSES: ; LAUNDRY/HOUSEKEEPING SERVICES - TOTAL EXPENSE: 10058284, PROGRAM SERVICE EXPENSE: 10058284, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; OTHER PURCHASED SERVICES - TOTAL EXPENSE: 7185845, PROGRAM SERVICE EXPENSE: 6770353, MANAGEMENT AND GENERAL EXPENSES: 412185, FUNDRAISING EXPENSES: 3307; CONTRACT FEES/CONSULTING - TOTAL EXPENSE: 38477526, PROGRAM SERVICE EXPENSE: 37848045, MANAGEMENT AND GENERAL EXPENSES: 629481, FUNDRAISING EXPENSES: ; REPAIRS AND MAINTENANCE - TOTAL EXPENSE: 20356129, PROGRAM SERVICE EXPENSE: 20355576, MANAGEMENT AND GENERAL EXPENSES: 553, FUNDRAISING EXPENSES: ; REFERENCE LABS - TOTAL EXPENSE: 33339157, PROGRAM SERVICE EXPENSE: 33339157, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; TEMPORARY STAFFING - TOTAL EXPENSE: 61950199, PROGRAM SERVICE EXPENSE: 61950199, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; FORM 990, PART X, LINE 20 TAX EXEMPT BOND LIABILITIES THE AMOUNT REPORTED AS TAX-EXEMPT BONDS IS THE PORTION OF CARILION CLINIC BONDS ALLOCATED TO CARILION MEDICAL CENTER. REQUIRED INFORMATION FOR THE BONDS, INCLUDING SCHEDULE K, IS REPORTED IN THE CARILION CLINIC (EIN: 54-1190771) IRS FORM 990. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS - 19284587; TOTAL - 19284587; RMH EMERGENCY SERVICES LLC PO BOX 12385 ROANOKE VA 24025 541686589 PHYSICIAN BILLING VA 0 0 CARILION MEDICAL CENTER CARILION CLINIC PO BOX 12385 ROANOKE VA 24025 541190771 SUPPORTING ORGANIZATION VA 501(C)(3) TYPE II NA false CARILION CLINIC FOUNDATION PO BOX 12385 ROANOKE VA 24025 541190773 FUNDRAISING VA 501(C)(3) 7 CARILION CLINIC true CARILION FRANKLIN MEMORIAL HOSPITAL PO BOX 12385 ROANOKE VA 24025 540480606 HEALTHCARE VA 501(C)(3) 3 CARILION CLINIC true CARILION GILES COMMUNITY HOSPITAL PO BOX 12385 ROANOKE VA 24025 540549603 HEALTHCARE VA 501(C)(3) 3 CARILION CLINIC true CARILION NEW RIVER VALLEY MEDICAL CENTER PO BOX 12385 ROANOKE VA 24025 540553805 HEALTHCARE VA 501(C)(3) 3 CARILION CLINIC true CARILION SERVICES INC PO BOX 12385 ROANOKE VA 24025 541190879 SUPPORTING ORGANIZATION VA 501(C)(3) TYPE II CARILION CLINIC true CARILION ROCKBRIDGE COMMUNITY HOSPITAL PO BOX 12385 ROANOKE VA 24025 540568001 HEALTHCARE VA 501(C)(3) 3 CARILION CLINIC true CARILION TAZEWELL COMMUNITY HOSPITAL PO BOX 12385 ROANOKE VA 24025 546074580 HEALTHCARE VA 501(C)(3) 3 CARILION CLINIC true CARILION BIOMEDICAL INSTITUTE PO BOX 12385 ROANOKE VA 24025 541965057 SUPPORTING ORGANIZATION VA 501(C)(3) TYPE I CARILION CLINIC true FRANKLIN COUNTY VENTURES LLC PO BOX 12385 ROANOKE VA 24025 474365316 REAL ESTATE VA CARILION CLINIC RELATED -94 0 false false 0.1 CARILION CLINIC MEDICARE SHARED SAVINGS COMPANY LLC PO BOX 12385 ROANOKE VA 24025 455235473 MEDICARE ACO VA CARILION CLINIC RELATED 8082878 17811169 false false 0.5 ROANOKE AMBULATORY SURGERY CENTER LLC 1102 JEFFERSON STREET SE ROANOKE VA 24016 010691564 SURGERY VA CARILION MEDICAL CENTER RELATED 641572 1601374 false false 0.5 SOUTHWEST VIRGINIA HEALTH PROPERTIES LLC 1102 JEFFERSON STREET SE ROANOKE VA 24016 010691570 REAL ESTATE VA CARILION MEDICAL CENTER RELATED 128341 1190250 false false 0.53 RAVEN ASSET-BASED OPPORTUNITY FUND IV LP 75 SPRING STREET 6TH FLOOR NEW YORK NY 10012 824119491 PRIVATE EQUITY DE NA N/A STARWOOD VEP II CO-INVEST LLC 591 W PUTMAN AVE GREENWICH CT 06830 833262407 INVESTMENTS DE NA N/A TI PLATFORM CC SMA LP 27 SOUTH PARK SUITE 100 SAN FRANCISCO CA 94107 842852539 INVESTMENTS DE NA N/A TI FBV GR LP 27 SOUTH PARK SUITE 100 SAN FRANCISCO CA 94107 862597246 INVESTMENTS DE NA N/A TI PLATFORM DCI SPV LP 27 SOUTH PARK SUITE 100 SAN FRANCISCO CA 94107 871897835 INVESTMENTS DE NA N/A TRANSPOSE PLATFORM ZIPPEDI SPV LP 27 SOUTH PARK SUITE 100 SAN FRANCISCO CA 94107 873425361 INVESTMENTS DE NA N/A TRANSPOSE PLATFORM GORGIAS SPV LP 27 SOUTH PARK SUITE 100 SAN FRANCISCO CA 94107 874563291 INVESTMENTS DE NA N/A TRANSPOSE PLATFORM FINTECH FUND II LP 27 SOUTH PARK SUITE 100 SAN FRANCISCO CA 94107 873126138 INVESTMENTS DE NA N/A OPERA INVESTMENT TWO SCSP 412F ROUTE DESCH LUXEMBOURG LU INVESTMENTS LU NA N/A VTC INNOVATION FUND III LP C/O MIDDLEAND CAPITAL 709 S JEFFERS ROANOKE VA 24016 921362795 INVESTMENTS DE NA N/A L2 VENTURES GP LLC 333 EAST 91ST STREET UNIT 24B NEW YORK NY 10128 834149763 INVESTMENTS DE NA N/A SAGE RESIDENTIAL MSROF IV LP 192 HEADQUARTERS PLAZA EAST TOWER 6 MORRISTOWN NJ 07960 993046859 INVESTMENTS DE NA N/A CHS INC PO BOX 12385 ROANOKE VA 24025 541725732 SERVICES VA NA C CORPORATION true CARILION BEHAVIORAL HEALTH INC PO BOX 12385 ROANOKE VA 24025 203136891 HEALTHCARE VA NA C CORPORATION true CARILION EMERGENCY SERVICES INC PO BOX 12385 ROANOKE VA 24025 542033006 HEALTHCARE VA NA C CORPORATION true SCA CREDIT SERVICES INC PO BOX 12385 ROANOKE VA 24025 541180398 COLLECTION AGENCY VA NA C CORPORATION true CARILION HEALTHCARE CORPORATION PO BOX 12385 ROANOKE VA 24025 541586601 HEALTHCARE VA NA C CORPORATION true MEDKEY INC PO BOX 12385 ROANOKE VA 24025 541645357 FINANCING SERVICES VA NA C CORPORATION true CARILION DTC SERVICES INC PO BOX 12385 ROANOKE VA 24025 872635239 HEALTHCARE VA NA C CORPORATION true true true true false false false false false false false true true true false true false false true true CARILION SERVICES INC A 261382 MARKET CHS INC A 75204 MARKET CARILION EMERGENCY SERVICES INC A 112344 MARKET CARILION FRANKLIN MEMORIAL HOSPITAL B 543398 COST CARILION CLINIC FOUNDATION C 489435 COST CARILION NEW RIVER VALLEY MEDICAL CENTER L 3073399 COST CARILION GILES COMMUNITY HOSPITAL L 566920 COST CARILION FRANKLIN MEMORIAL HOSPITAL L 772433 COST CARILION ROCKBRIDGE COMMUNITY HOSPITAL L 901377 COST CARILION TAZEWELL COMMUNITY HOSPITAL L 2533528 COST CARILION EMERGENCY SERVICES INC L 436612 COST CARILION HEALTHCARE CORPORATION L 348326 COST CARILION NEW RIVER VALLEY MEDICAL CENTER K 228662 MARKET RATE CARILION FRANKLIN MEMORIAL HOSPITAL K 74546 MARKET RATE CARILION TAZEWELL COMMUNITY HOSPITAL K 113909 MARKET RATE CHS INC K 2501138 MARKET RATE CARILION GILES COMMUNITY HOSPITAL M 467468 COST CARILION ROCKBRIDGE COMMUNITY HOSPITAL M 505595 COST CARILION TAZEWELL COMMUNITY HOSPITAL M 366440 COST CARILION SERVICES INC M 329178966 COST CARILION BEHAVIORAL HEALTH INC M 224112 COST CHS INC M 4497457 COST SCA CREDIT SERVICES INC M 107639 COST MEDKEY INC M 51984 COST CARILION CLINIC FOUNDATION R 80978 COST FRANKLIN COUNTY VENTURES LLC S 53720 CASH CARILION FRANKLIN MEMORIAL HOSPITAL M 435204 COST CARILION CLINIC M 147786 COST CARILION CLINIC FOUNDATION A 43584 COST CARILION HEALTHCARE CORPORATION A 30336 COST