TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) John H Burton MD...................................................................... Director	50.00 .................	X		579,355	0	63,796
(2) George B Cartledge III...................................................................... Director	2.00 .................	X		0	941	0
(3) Elizabeth S Doughty...................................................................... Director	2.00 .................	X		0	941	0
(4) Katherin A Elam...................................................................... Director	2.00 .................	X		0	0	0
(5) Cynda A Johnson MD...................................................................... Director	2.00 ................. 48.00	X		0	611,179	80,228
(6) Stephen A Musselwhite...................................................................... Director	2.00 .................	X		0	0	0
(7) Clifford A Nottingham MD...................................................................... Director	2.00 ................. 48.00	X		0	347,064	143,212
(8) Patrice M Weiss MD...................................................................... Director	46.00 ................. 4.00	X		0	679,636	132,336
(9) Ralph E WhatleyIII MD...................................................................... Director	49.50 ................. 0.50	X		557,502	0	92,922
(10) Damon Williams...................................................................... Director	2.00 .................	X		0	0	0
(11) Nancy Howell Agee...................................................................... Director/CEO	3.00 ................. 47.00	X	X	0	1,621,601	2,168,199
(12) Steve C Arner...................................................................... Director/President/CEO	48.80 ................. 1.20	X	X	0	483,909	123,786
(13) R Steve Blanks...................................................................... Director/Vice Chair	3.00 ................. 4.50	X	X	0	15,941	0
(14) Tracy W Criss MD...................................................................... Director/Chief of Medical Staff	50.00 .................	X	X	235,630	0	78,306
(15) Victor Iannello ScD...................................................................... Director/Chair	4.00 ................. 2.40	X	X	0	13,641	0
(16) Hirenkumar Patel MD...................................................................... Director/Chief of Medical Staff	2.00 .................	X	X	0	0	0
(17) Lauren J Chen...................................................................... Assistant Secretary	8.00 ................. 42.00		X	0	74,469	14,801

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) David S Hagadorn........................................................................ Assistant Treasurer	0.10 .......................49.90	X				0	138,217	27,098
(19) Donald B Halliwill........................................................................ Assistant Treasurer/EVP/CFO	1.50 .......................48.50	X				0	550,507	120,070
(20) G Robert Vaughan Jr........................................................................ Treasurer	0.30 .......................49.70	X				0	306,045	81,831
(21) Nicholas C Conte........................................................................ Secretary	1.50 .......................48.50	X				0	0	0
(22) Bruce A Long MD........................................................................ Physician, Dept. Chair	50.00 .......................		X			716,432	0	56,647
(23) Joseph T Moskal MD........................................................................ Physician, Dept. Chair	50.00 .......................		X			1,305,597	0	86,734
(24) Jon M Sweet MD........................................................................ Physician, Dept. Chair	50.00 .......................		X			312,931	0	55,385
(25) Jonathan J Carmouche MD........................................................................ Physician	50.00 .......................			X		1,585,313	0	31,366
(26) Cay M Mierisch MD........................................................................ Physician	50.00 .......................			X		1,034,300	0	47,363
(27) Gary R Simonds MD........................................................................ Physician	50.00 .......................			X		1,201,303	0	70,082
(28) Caleb J Behrend MD........................................................................ Physician	50.00 .......................			X		985,721	0	18,018
(29) Gregory A Howes MD........................................................................ Physician	50.00 .......................			X		985,779	0	11,795
(30) Thomas D Denberg MD PhD........................................................................ Former Chief Strategy Officer	0.00 .......................				X	0	505,339	-10,028
(31) Briggs W Andrews........................................................................ Former Secretary	0.00 .......................				X	0	479,268	64,584
(32) Donald E Lorton........................................................................ Former CFO	0.00 .......................				X	0	130,613	0
(33) Edward Murphy MD........................................................................ Former CEO	0.00 .......................				X	0	18,155	0

(A) Name and business address	(B) Description of services	(C) Compensation
Solstas Lab Partners Group LLC PO Box 751337 Charlotte,NC282751337	Laboratory Services	28,239,128
Siemens Medical Solutions USA Inc 51 Valley Stream Parkway Malvern,PA19355	Equipment Maintenance Contracts	8,749,679
F&S Building Innovations 2944 Orange Ave NE Roanoke,VA24012	Construction Service	2,224,754
Food Service Partners of VA LLC 2823 Franklin Road -Building B Roanoke,VA24014	Food Services	2,161,948
Anesthesiology Consultants of VA PO Box 13306 Roanoke,VA240323306	Anesthesiology Services	1,813,449
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 139

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

CARILION MEDICAL CENTER

Employer identification number

54-0506332

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Name of the organization

CARILION MEDICAL CENTER

Employer identification number

54-0506332

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization CARILION MEDICAL CENTER

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization CARILION MEDICAL CENTER		Employer identification number 54-0506332

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization CARILION MEDICAL CENTER			Employer identification number 54-0506332
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

CARILION MEDICAL CENTER

Employer identification number

54-0506332

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................
c	Total lobbying expenditures (add lines 1a and 1b) .......................................................................
d	Other exempt purpose expenditures .........................................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ..............................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

62,752

Total. Add lines 1c through 1i ....................................................................................................

62,752

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Part II-B, Line 1:	A portion of dues paid to various hospital industry associations is attributable to lobbying activities.

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CARILION MEDICAL CENTER

Employer identification number

54-0506332

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	15,705,697	16,528,095	15,977,886	14,955,835	14,218,995
b	Contributions ...
c	Net investment earnings, gains, and losses	904,944	-57,465	1,448,538	1,798,131	1,514,015
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	809,125	764,933	898,329	776,080	777,175
f	Administrative expenses ....
g	End of year balance ......	15,801,517	15,705,697	16,528,095	15,977,886	14,955,835

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

75.160 %

Temporarily restricted endowment SchDMd Bullet

24.840 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	5,869,100		5,869,100
b	Buildings	452,477,836	298,287,027	154,190,809
c	Leasehold improvements	928,236	758,690	169,546
d	Equipment ...	502,494,365	405,177,027	97,317,338
e	Other ...	21,301,077	6,405,228	14,895,849
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				272,442,642

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Pension Liability	332,079,593
Interest Rate Swap Liability	40,053,720
Deferred Compensation Liability	17,735,602
Due To Affiliate	250
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	389,869,165
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

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.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Information about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
CARILION MEDICAL CENTER

Employer identification number

54-0506332

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2015

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 Dinner (event type)	(b) Event #2 Luncheon (event type)	(c) Other events 2 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	79,561	67,637	25,979	173,177
2	Less: Contributions . . . .	45,986	41,973	1,500	89,459
3	Gross income (line 1 minus line 2) . . . . . .	33,575	25,664	24,479	83,718

4	Cash prizes . . . . .
5	Noncash prizes . . . .		2,000		2,000
6	Rent/facility costs . . . .	1,030		550	1,580
7	Food and beverages . . .	11,868	19,303	4,982	36,153
8	Entertainment . . . .	1,000			1,000
9	Other direct expenses . . .	28,325	29,119	15,000	72,444
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				113,177
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-29,459

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .	28,325	29,119	15,000	72,444

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2015

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CARILION MEDICAL CENTER

Employer identification number

54-0506332

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			51,800,015	0	51,800,015	4.640 %
b	Medicaid (from Worksheet 3, column a) . . . . .			112,426,661	107,491,897	4,934,764	0.440 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			164,226,676	107,491,897	56,734,779	5.080 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	4,143	34,065	2,736,319	50,593	2,685,726	0.240 %
f	Health professions education (from Worksheet 5) . . .	26	2,285	42,645,825	9,990,769	32,655,056	2.930 %
g	Subsidized health services (from Worksheet 6) . . . .	0	0	0	0
h	Research (from Worksheet 7) .	2	2,515	824,369	0	824,369	0.070 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	138	11,115	7,034,829	0	7,034,829	0.630 %
j	Total. Other Benefits . .	4,309	49,980	53,241,342	10,041,362	43,199,980	3.870 %
k	Total. Add lines 7d and 7j .	4,309	49,980	217,468,018	117,533,259	99,934,759	8.950 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	0	0	0	0
2	Economic development	10	9,760	65,378	0	65,378	0.010 %
3	Community support	56	1,408	73,031	0	73,031	0.010 %
4	Environmental improvements	3	0	1,996	0	1,996	0 %
5	Leadership development and training for community members	0	0	0	0
6	Coalition building	161	1,160	52,914	0	52,914	0 %
7	Community health improvement advocacy	6	3,930	1,344	0	1,344	0 %
8	Workforce development	4	6	180,895	0	180,895	0.020 %
9	Other	0	0	0	0
10	Total	240	16,264	375,558		375,558	0.040 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

70,617,579

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

247,326,476

Enter Medicare allowable costs of care relating to payments on line 5.....

255,050,958

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-7,724,482

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 Roanoke Ambulatory Surgery Center LLC	Ambulatory surgery	43.500 %	46.080 %
22 Southwest Virginia Health Properties LLC	Real estate	45.680 %	48.040 %
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?2 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)								Other (Describe)	Facility reporting group
1	Carilion Medical Center- DBA CRMH 1906 Belleview Avenue Roanoke,VA24014 www.carilionclinic.org H 1840	X	X	X	X	X	X		A
2	Carilion Medical Center- DBA CRCH 101 Elm Avenue Roanoke,VA24013 www.carilionclinic.org H1839	X						Rehabilitation Unit; Urgent Care	A

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Facility Group A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 14

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): See Part V, Section C

Other website (list url): https://www.carilionclinic.org/about/chna

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): https://www.carilionclinic.org/about/chna

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Facility Group A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000% and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

See Part V, Section C

The FAP application form was widely available on a website (list url):

See Part V, Section C

A plain language summary of the FAP was widely available on a website (list url):
See Part V, Section C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	Facility Group A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
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).

Schedule H (Form 990) 2015

Page 8

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?85
Name and address		Type of Facility (describe)
1	1 - DBA - Carilion Roanoke Memorial Rehab 2017 South Jefferson Street Roanoke,VA24153	Psych Unit, Outpatient Rehabilitation
2	2 - Carilion Breast Care Center 102 Highland Ave Ste 202 Roanoke,VA24014	Breast Care Center
3	3 - Carilion Clinic Cardiology 2001 Crystal Spring Avenue Suite 203 Roanoke,VA24014	Cardiology
4	4 - Carilion Clinic Cardiology 127 McClanahan Street SW Suite 300 Roanoke,VA24014	Cardiology
5	5 - Carilion Clinic Cardiology 2001 Crystal Spring Ave Suite 300 Roanoke,VA24014	Cardiology Services
6	6 - Carilion Sleep Center 1030 Jefferson Plaza Ste G100 Roanoke,VA24016	Sleep Disorder
7	7 - Carilion Clinic Orthopaedics - ION 2331 Franklin Road SW Roanoke,VA24014	Orthopaedics
8	8 - Carilion Clinic Internal Medicine 3 Riverside Circle Roanoke,VA24016	Internal Medicine
9	9 - CSC - Roanoke 213 McClanahan Suite 404 Roanoke,VA24014	Surgical Services
10	10 - Carilion Clinic Neurosurgery - ION 2331 Franklin Road Roanoke,VA24014	Neurosurgery
11	11 - Carilion Pulmonary Clinic 2001 Crystal Spring Avenue Suite 205 Roanoke,VA24014	Pulmonary Services
12	12 - Carilion Clinic Gastroenterology 3 Riverside Circle Roanoke,VA24016	Gastroenterology
13	13 - Carilion Dental Care 2017 S Jefferson Street Roanoke,VA24014	Dental Service
14	14 - Carilion Clinic Neurology 3 Riverside Circle Roanoke,VA24016	Neurosciences
15	15 - Daleville Imaging 46 Wesley Road Daleville,VA24014	Imaging Services
16	16 - CNRV Emergency Services 2900 Lamb Circle Christiansburg,VA24073	Emergency Physicians
17	17 - Botetourt Athletic Center 105 Summerfield Court Roanoke,VA24019	Outpatient Therapy Services
18	18 - Carilion Clinic Dermatology 1 Riverside Circle Suite 300 Roanoke,VA24016	Dermatology
19	19 - Roanoke Athletic Club 4508 Starkey Road Roanoke,VA24018	Physical Therapy Services
20	20 - Carilion Imaging Professionals 1 Taylor Avenue Pearisburg,VA24134	Imaging Services
21	21 - CNRVMC - Radiology 2900 Lamb Circle Christiansburg,VA24073	Radiology
22	22 - Carilion GYN Clinic 102 Highland Avenue Suite 303 Roanoke,VA24013	Gynecolgical services
23	23 - Carilion ObstetricsGynecology Clinic 902 South Jefferson Street Upper Level Roanoke,VA24016	Obstetrics and Gynecology
24	24 - Carilion Clinic Dept of Psychiatry 2900 Lamb Circle Christiansburg,VA24073	Psych and Behavioral Medicine
25	25 - Carilion Clinic Orthopaedics Trauma ION 2331 Franklin Road Roanoke,VA24014	Ortho Trauma
26	26 - Carilion Cardiothoracic Surgery 2001 Crystal Spring Avenue Suite 201 Roanoke,VA24014	Cardiac Surgery Office
27	27 - Carilion ENTPlastic Surgery 1 Riversde Circle Suite 300 Roanoke,VA24016	Plastic Surgery
28	28 - Carilion General Pediatric Clinic 1030 S Jefferson Street Suite 106 Roanoke,VA24016	General Pediatrics
29	29 - Carilion Clinic Orthopaedics 3 Riverside Circle Roanoke,VA24016	Orthopaedic Services
30	30 - CES - Tazewell 141 Ben Bolt Ave Tazewell,VA24651	Emergency Physicians
31	31 - Carilion Clinic Pediatric Surgery 102 Highland Avenue Suite 404 Roanoke,VA24013	Surgical Services
32	32 - CES - Giles 1611 Wenonah Avenue Pearisburg,VA24134	Emergency Physicians
33	33 - Carilion Center for Healthy Aging 2001 Crystal Spring Avenue Suite 302 Roanoke,VA24014	Geriatrics
34	34 - CES - Franklin 180 Floyd Avenue Rocky Mount,VA24017	Emergency Physicians
35	35 - CFM - Salem 2102 West Main Street Salem,VA24153	Family Practice
36	36 - CSJH Emergency Department 1 Health Circle Lexington,VA24450	Emergency Physicians
37	37 - CFM Southeast 2145 Mount Pleasant Boulevard Roanoke,VA24014	Family Practice
38	38 - CFM Roanoke Salem 1314 Peters Creek Road Roanoke,VA24017	Family Practice
39	39 - Carilion Anticoagulation Clinic 1030 S Jefferson St Ste G101 Roanoke,VA24014	Anticoagulation Clinic
40	40 - CRMH Rheumatology Clinic 3 Riverside Circle Roanoke,VA24016	Rheumatology
41	41 - Carilion Infectious Disease Clinic 2001 Crystal Spring Avenue Suite 301 Roanoke,VA24014	Infectious Disease
42	42 - Breast Mammography - North 6415 Peters Creek Road Roanoke,VA24014	Breast Mammography
43	43 - Carilion Clinic Physiatry 3 Riverside Circle Roanoke,VA24016	Physical Medicine and Rehab
44	44 - Community Psychiatry 611 McDowell Avenue Roanoke,VA24016	Behavioral Health
45	45 - Carilion Plastic and Reconstructive 3 Riverside Circle Roanoke,VA24016	Plastic Surgery
46	46 - Pediatric Developmental Clinic 1030 S Jefferson Street Suite 201 Roanoke,VA24016	Pediatrics
47	47 - Community Care 101 Elm Avenue SE Roanoke,VA24013	Family Medicine
48	48 - Carilion Dept of Psychiatry Roanoke 2017 S Jefferson Street Roanoke,VA24014	Behavioral Health
49	49 - Carilion Sleep Center Westlake 35 Medical Court Hardy,VA24101	Sleep Disorder
50	50 - Carilion Clinic Urogynecology 101 Elm Avenue Suite 400 Roanoke,VA24013	Urogynecology Services
51	51 - Carilion Cardiac Rehab 127 McClanahan Street Roanoke,VA24016	Cardiac Rehab
52	52 - Pediatric Gastroenterology 102 Highland Avenue Suite 305 Roanoke,VA24013	Gastroenterology
53	53 - Carilion Pediatric Neurology 102 Highland Avenue Suite 104 Roanoke,VA24013	Neurosciences
54	54 - Carilion Child & Adolescent Psychiatry 213 McClanahan Street Suite 310 Roanoke,VA24014	Child and Adolescent Psychiatry Services
55	55 - Carilion Prenatal Diagnostic Center 102 Highland Ave Ste 455 Roanoke,VA24014	Prenatal Testing
56	56 - Pediatric Pulmonology and Allergy 102 Highland Avenue Suite 203 Roanoke,VA24013	Pulmonology
57	57 - Carilion Clinic Family Med Tazewell 141 Ben Bolt Avenue Tazewell,VA24651	Family Practice
58	58 - CRCH Occupational Medicine PO Box 12946 Roanoke,VA24029	Occupational Medicine
59	59 - Carilion Clinic Pulmonary and Sleep 2001 Crystal Spring Avenue Suite 300 Roanoke,VA24014	Pulmonary and Sleep Services
60	60 - Carilion Roanoke IP Psychiatry 2017 S Jefferson Street 1st Floor Roanoke,VA24014	Psychiatry Services
61	61 - Carilion Clinic OBGYN Spartan Drive 150 Spartan Drive Salem,VA24153	Obstetrics and Gynecology
62	62 - Carilion Pediatric Endocrinology 102 Highland Avenue MOB Suite 203 Roanoke,VA24013	Endocrinology
63	63 - Department of Psychiatry & Behavioral 213 McClanahan Street Suite 310 Roanoke,VA24014	Behavioral Health
64	64 - Pediatric Cardiology Clinic 102 Highland Avenue Suite 101 Roanoke,VA24013	Cardiology
65	65 - Carilion Clinic OBGYN Botetourt 150 Market Ridge Lane Daleville,VA24083	Obstetrics and Gynecology
66	66 - Carilion Reproductive Endocrinology 102 Highland Avenue Suite 304 Roanoke,VA24013	Reproductive Endocrinology
67	67 - Carilion Wound Care Center 101 Elm Ave SE Roanoke,VA24019	Wound Care
68	68 - Carilion Clinic TraumaCritical Care 3 Riverside Circle Roanoke,VA24016	Surgical Services
69	69 - Carilion Dentistry Pediatric Surgery 101 Elm Avenue Roanoke,VA24017	Dental Service
70	70 - Carilion Diabetic Education 1030 S Jefferson Suite G101 Roanoke,VA24016	Diabetic Eduation
71	71 - CNRVMC - Neurosciences 2900 Lamb Circle Christiansburg,VA24073	Neurology
72	72 - Carilion Clinic Pain Management - ION 2331 Franklin Road Roanoke,VA24014	Pain Management
73	73 - Carilion Clinic Gastroenterology 1201 Franklin Rd Roanoke,VA24016	Gastroenterology
74	74 - Carilion Genetics 102 Highland Avenue Suite 104 Roanoke,VA24013	Genetic Counseling
75	75 - General Surgery Clinic 180 Floyd Avenue Rocky Mount,VA24151	General Surgery
76	76 - Carilion Clinic Internal Medicine 3 Riverside Circle Roanoke,VA24016	Internal Medicine
77	77 - Carilion GYN Oncology 1 Riverside Circle Suite 300 Roanoke,VA24016	Gynecolgical Oncology
78	78 - Carilion Clinic Urology Christiansburg 120 Akers Farm Road NE Christiansburg,VA24073	Urology
79	79 - Carilion Pediatric OtolaryngologyENT 3 Riverside Circle 4th Floor Roanoke,VA24016	ENT Services
80	80 - Carilion Surgery Westlake 35 Medical Court Hardy,VA24101	Surgical Services
81	81 - Carilion Clinic AllergyImmunology 46 Wesley Road Daleville,VA24083	Allergy Services
82	82 - Carilion OBGYN - Riverside 3 Riverside Circle Roanoke,VA24016	Obstetrics and Gynecology
83	83 - Tazewell Veterans Affairs Community 141 Ben Bolt Avenue Tazewell,VA24651	VA Clinic
84	84 - Carilion Heart Failure Clinic 127 McClanahan Street Roanoke,VA24016	Heart Failure Services
85	85 - Carilion Cardiology Westlake 35 Medical Court Hardy,VA24101	Cardiology Services

Schedule H (Form 990) 2015

Page 9

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
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.

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
CARILION MEDICAL CENTER

Employer identification number
54-0506332

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) Ronald McDonald House 2224 S Jefferson St Roanoke,VA24014	54-1244769	501(c)(3)		246,800	FMV	Donated Rent	General Support
(2) Virginia Tech Carilion School of Medicine Inc Two Riverside Circle Roanoke,VA24016	26-4556177	501(c)(3)	4,497,406	0	0	0	General Support
(3) Taubman Museum of Art 110 Salem Ave Roanoke,VA24011	54-6026841	501(c)(3)	508,000	0	0	0	General Support
(4) Valley AFC Inc PO Box 20045 Roanoke,VA24018	54-1608581	501(c)(3)	75,000	0	0	0	General Support
(5) The Rescue Mission of Roanoke Inc PO Box 11525 Roanoke,VA24022	54-0573900	501(c)(3)	113,100	0	0	0	Food Access Program/Homelessness Support
(6) Virginia Business Higher Education Council 1108 E Main St 1100 Richmond,VA23219	54-1827038	501(c)(3)	110,000	0	0	0	General Support
(7) Virginia Healthcare Foundation 707 East Main Street Suite 1350 Richmond,VA23219	54-1639924	501(c)(3)	100,000	0	0	0	General Support
(8) Virginia Tech Foundation Inc 902 Prices Fork Rd University Gateway Center STE 400 Blacksburg,VA24061	54-0721690	501(c)(3)	90,000	0	0	0	Scholarship
(9) City of Roanoke 215 Church Ave Room 254 Roanoke,VA24011	54-6001569	Roanoke, VA	70,250	0	0	0	Playground
(10) United Way of Roanoke Valley 325 Campbell Avenue Roanoke,VA24016	54-0535302	501(c)(3)	67,688	0	0	0	Fresh Foods RX Pilot Program/ Healthy Roanoke Valley Collab./General Support
(11) Children's Trust of Roanoke Valley Inc 541 Luck Ave Suite 308 Roanoke,VA24016	51-0235891	501(c)(3)	61,800	0	0	0	Operational Support
(12) The Virginia Foundation for Community College Education Inc 300 Arboretum Parkway No 200 Richmond,VA23236	23-7004354	501(c)(3)	60,000	0	0	0	Sponsorship
(13) CHIP of Roanoke Valley 1201 3rd Street Roanoke,VA24016	54-1566451	501(c)(3)	51,500	0	0	0	Operational Support
(14) Carilion Clinic Patient Transportation 431 McClanahan St SW Roanoke,VA24014	54-1864693	501(c)(3)	50,000	0	0	0	General Support
(15) Roanoke Symphony Orchestra 128 East Campbell Ave SE Roanoke,VA24011	54-6019736	501(c)(3)	37,309	0	0	0	General Support
(16) Local Environmental Agriculture Project PO Box 3249 Roanoke,VA24015	27-1050909	501(c)(3)	35,000	0	0	0	Community Kitchen/SNAP Double Value
(17) Mental Health of America Rke Valley PO Box 592 Roanoke,VA24004	54-0703132	501(c)(3)	32,500	0	0	0	Mental Health Collaboration/Operational support
(18) American Cancer Society 2840 Electric Road 106A Roanoke,VA24018	13-1788491	501(c)(3)	25,000	0	0	0	General Support
(19) Depaul Community Resources 5650 Hollins Road Roanoke,VA24019	54-1108079	501(c)(3)	25,000	0	0	0	General Support
(20) Grandin Theatre Foundation Inc 1310 Grandin Road Roanoke,VA24015	01-0557881	501(c)(3)	25,000	0	0	0	Community Engagement
(21) Feeding America Southwest Virginia 1025 Electirc Rd Salem,VA24153	54-1939556	501(c)(3)	22,000	0	0	0	VeggieMobile-Nutrition
(22) VA Blue Ridge Affiliate of Susan G Komen for the Cure 4910 Valley View Blvd Ste212 Roanoke,VA24012	56-2619425	501(c)(3)	20,000	0	0	0	General Support
(23) Virginia Foundation for Independent Colleges 8010 Ridge Road Richmond,VA23229	54-0554396	501(c)(3)	20,000	0	0	0	Educational Attainment
(24) Happy Healthy Cooks 1914 Belleview Rd Roanoke,VA24013	46-4937238	501(c)(3)	19,000	0	0	0	School Nutrition Program
(25) American Heart Association PO Box 4002906 Des Moines,IA503402906	13-5613797	501(c)(3)	17,500	0	0	0	General Support
(26) Total Action for Progress PO Box 2868 Roanoke,VA24001	54-6057095	501(c)(3)	16,000	0	0	0	Dental Health Initiative/General Support
(27) Foundation for Rehabilitation Equipment & Endowment PO Box 8873 Roanoke,VA24014	54-1934695	501(c)(3)	15,800	0	0	0	Operational Support
(28) Junior Achievement of Southwest Virginia 3433 Brambleton Ave Suite 202B Roanoke,VA24018	54-0628293	501(c)(3)	15,094	0	0	0	General Support
(29) Family Services of Roanoke Valley 360 Campbell Ave SW Roanoke,VA24016	54-0505946	501(c)(3)	15,000	0	0	0	Counselling
(30) Mill Mountain Theatre One Market Square SE - 2nd Floor Roanoke,VA24011	54-0792067	501(c)(3)	15,000	0	0	0	General Support
(31) Young Audiences Arts for Learning Virginia 420 North Center Drive Ste 239 Norfolk,VA23502	54-6063377	501(c)(3)	12,200	0	0	0	Youth Dance/Math Program
(32) Opera Roanoke 20 East Church Avenue 3rd Floor Roanoke,VA24011	51-0213334	501(c)(3)	10,000	0	0	0	General Support
(33) Roanoke Community Garden Association 655 Highland AveSE Roanoke,VA24013	26-2082150	501(c)(3)	10,000	0	0	0	Community Gardens
(34) Roanoke Outside 111 Franklin Plaza Roanoke,VA24011	45-1648056	501(c)(3)	10,000	0	0	0	Marathon
(35) Scott Robertson Memorial Junior Golf Academy 3707 Densmore Road NW Roanoke,VA24017	20-1237999	501(c)(3)	10,000	0	0	0	Parent-Child Tournament
(36) The Medical Society of Virginia 2924 Emerywood Parkway Suite 300 Richmond,VA23294	54-0299956	501(c)(3)	10,000	0	0	0	Sponsorship
(37) RX Partnership 2924 Emerywood Pky Ste 300 Richmond,VA23294	57-1186937	501(c)(3)	9,310	0	0	0	Rx Access Program
(38) National Multiple Sclerosis Society Central & Eastern Virginia Chapter 4200 Innslake Drive Glen Allen,VA23060	54-0633474	501(c)(3)	7,500	0	0	0	General Support
(39) Roanoke Academy of Medicine Alliance Foundation 2911 Crystal Spring Ave Roanoke,VA24014	51-0218435	501(c)(3)	7,500	0	0	0	General Support
(40) Western Virginia Foundation For The Arts And Sciences One Market Square Roanoke,VA24011	51-0238900	501(c)(3)	7,500	0	0	0	General Support
(41) Juvenile Diabetes 3959 Electric Rd Ste222 Roanoke,VA24012	23-1907729	501(c)(3)	6,500	0	0	0	General Support
(42) Arthritis Foundation Inc 1355 Peachtree Street NE Sutie 600 Atlanta,GA30309	58-1341679	501(c)(3)	5,000	0	0	0	General Support
(43) Boys & Girls Clubs of Southwest Virginia Inc 1714 9th Street SE Roanoke,VA24013	54-1867366	501(c)(3)	5,000	0	0	0	Wellness Program
(44) Hollins University Corporation PO Box 9658 Roanoke,VA24020	54-0506314	501(c)(3)	5,000	0	0	0	Scholarship
(45) March of Dimes Greater Roanoke 2840 Electric Road - Suite 102A Roanoke,VA24018	13-1846366	501(c)(3)	5,000	0	0	0	General Support
(46) Greater Roanoke Transit 1108 Campbell Ave SE Roanoke,VA24013	54-0982022	501(c)(3)	38,754				Trolley Service

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of non-cash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of non-cash assistance

(1) Endowment-funded indigent patient medical bills	36	86,063
(2) Transportation Assistance	1733	60,100
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference

Explanation

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.

Schedule I (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CARILION MEDICAL CENTER

Employer identification number

54-0506332

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1John H Burton MDDirector	(i) (ii)	479,335 ------------- 0	96,918 ------------- 0	3,102 ------------- 0	52,261 ------------- 0	11,535 ------------- 0	643,151 ------------- 0	0 ------------- 0
2Cynda A Johnson MDDirector	(i) (ii)	0 ------------- 593,756	0 ------------- 10,000	0 ------------- 7,423	0 ------------- 71,531	0 ------------- 8,697	0 ------------- 691,407	0 ------------- 0
3Clifford A Nottingham MDDirector	(i) (ii)	0 ------------- 303,423	0 ------------- 36,944	0 ------------- 6,697	0 ------------- 134,784	0 ------------- 8,428	0 ------------- 490,276	0 ------------- 0
4Patrice M Weiss MDDirector	(i) (ii)	0 ------------- 560,900	0 ------------- 112,459	0 ------------- 6,277	0 ------------- 118,149	0 ------------- 14,187	0 ------------- 811,972	0 ------------- 0
5Ralph E WhatleyIII MDDirector	(i) (ii)	461,603 ------------- 0	85,555 ------------- 0	10,344 ------------- 0	81,573 ------------- 0	11,349 ------------- 0	650,424 ------------- 0	0 ------------- 0
6Nancy Howell AgeeDirector/CEO	(i) (ii)	0 ------------- 1,137,025	0 ------------- 332,354	0 ------------- 152,222	0 ------------- 2,158,081	0 ------------- 10,118	0 ------------- 3,789,800	0 ------------- 141,071
7Steve C ArnerDirector/President/CEO	(i) (ii)	0 ------------- 404,698	0 ------------- 75,226	0 ------------- 3,985	0 ------------- 111,082	0 ------------- 12,704	0 ------------- 607,695	0 ------------- 0
8Tracy W Criss MDDirector/Chief of Medical Staff	(i) (ii)	183,093 ------------- 0	50,076 ------------- 0	2,461 ------------- 0	67,611 ------------- 0	10,695 ------------- 0	313,936 ------------- 0	0 ------------- 0
9David S HagadornAssistant Treasurer	(i) (ii)	0 ------------- 128,218	0 ------------- 2,500	0 ------------- 7,499	0 ------------- 26,279	0 ------------- 819	0 ------------- 165,315	0 ------------- 0
10Donald B HalliwillAssistant Treasurer/EVP/CFO	(i) (ii)	0 ------------- 460,065	0 ------------- 86,171	0 ------------- 4,271	0 ------------- 108,666	0 ------------- 11,404	0 ------------- 670,577	0 ------------- 0
11G Robert Vaughan JrTreasurer	(i) (ii)	0 ------------- 248,071	0 ------------- 47,425	0 ------------- 10,549	0 ------------- 70,577	0 ------------- 11,254	0 ------------- 387,876	0 ------------- 0
12Bruce A Long MDPhysician, Dept. Chair	(i) (ii)	489,572 ------------- 0	223,307 ------------- 0	3,553 ------------- 0	45,112 ------------- 0	11,535 ------------- 0	773,079 ------------- 0	0 ------------- 0
13Joseph T Moskal MDPhysician, Dept. Chair	(i) (ii)	1,080,145 ------------- 0	218,109 ------------- 0	7,343 ------------- 0	75,199 ------------- 0	11,535 ------------- 0	1,392,331 ------------- 0	0 ------------- 0
14Jon M Sweet MDPhysician, Dept. Chair	(i) (ii)	238,669 ------------- 0	71,884 ------------- 0	2,378 ------------- 0	47,745 ------------- 0	7,640 ------------- 0	368,316 ------------- 0	0 ------------- 0
15Jonathan J Carmouche MDPhysician	(i) (ii)	1,036,482 ------------- 0	546,282 ------------- 0	2,549 ------------- 0	19,831 ------------- 0	11,535 ------------- 0	1,616,679 ------------- 0	0 ------------- 0
16Cay M Mierisch MDPhysician	(i) (ii)	823,078 ------------- 0	208,389 ------------- 0	2,833 ------------- 0	35,568 ------------- 0	11,795 ------------- 0	1,081,663 ------------- 0	0 ------------- 0
17Gary R Simonds MDPhysician	(i) (ii)	869,842 ------------- 0	326,108 ------------- 0	5,353 ------------- 0	58,547 ------------- 0	11,535 ------------- 0	1,271,385 ------------- 0	0 ------------- 0
18Caleb J Behrend MDPhysician	(i) (ii)	652,920 ------------- 0	330,239 ------------- 0	2,562 ------------- 0	6,483 ------------- 0	11,535 ------------- 0	1,003,739 ------------- 0	0 ------------- 0
19Gregory A Howes MDPhysician	(i) (ii)	736,978 ------------- 0	228,597 ------------- 0	20,204 ------------- 0	0 ------------- 0	11,795 ------------- 0	997,574 ------------- 0	0 ------------- 0
20Thomas D Denberg MD PhDFormer Chief Strategy Officer	(i) (ii)	0 ------------- 395,252	0 ------------- 88,182	0 ------------- 21,905	0 ------------- -21,708	0 ------------- 11,680	0 ------------- 495,311	0 ------------- 0
21Briggs W AndrewsFormer Secretary	(i) (ii)	0 ------------- 294,741	0 ------------- 71,120	0 ------------- 113,407	0 ------------- 61,932	0 ------------- 2,652	0 ------------- 543,852	0 ------------- 109,782
22Donald E LortonFormer CFO	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 130,613	0 ------------- 0	0 ------------- 0	0 ------------- 130,613	0 ------------- 130,613
23Edward Murphy MDFormer CEO	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 18,155	0 ------------- 0	0 ------------- 0	0 ------------- 18,155	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
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.

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
CARILION MEDICAL CENTER

Employer identification number
54-0506332

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Industrial Development Authority of the City of Roanoke VA	54-1106038	770084EQ0	04-09-2014	125,000,000	Reissuance of Series 2005A originally issued on 12/14/05		X		X		X
B	VA Small Business Financing Authority Hospital Revenue Bonds	54-1300845	928101AE4	03-25-2014	11,950,000	Reissuance of Series 2008A and 2008B originally issued on 07/16/08		X		X		X
C	Industrial Development Authority of the City of Roanoke VA	54-1106038	770082AB1	10-13-2010	96,404,094	Refunding of Series 2003A-C Bonds (08/03), Issuance Costs		X		X		X
D	Economic Development Authority of the City of Roanoke VA	54-1106038	770082AW5	02-09-2012	69,968,434	Refunding of Series 2000 and 2002A Bonds, Issuance Costs, Capital Projects		X		X		X
	Industrial Development Authority of the City of Roanoke VA	54-1106038	770084FU0	10-13-2010	98,852,291	Reoffering Circular and interest rate conversion to fixed, Issuance Costs		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	1,890,000						21,045,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	125,000,000		11,950,000		96,404,094		69,968,434
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	797,940		107,259		1,229,094		771,282
8 Credit enhancement from proceeds .............	1,940,086
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............			11,842,741				5,189,198
11 Other spent proceeds .............	122,261,974				95,175,000		64,007,954
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2009				2011
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X			X	X			X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X			X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2015

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X			X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.120 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %
6 Total of lines 4 and 5 .............	0.120 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X			X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2015

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?	X			X		X		X
b Name of provider ..........	AIG
c Term of GIC .........	30.0000000000 %
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........	X
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
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.

Schedule K (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
CARILION MEDICAL CENTER

Employer identification number
54-0506332

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Industrial Development Authority of the City of Roanoke VA	54-1106038	770084EQ0	04-09-2014	125,000,000	Reissuance of Series 2005A originally issued on 12/14/05		X		X		X
B	VA Small Business Financing Authority Hospital Revenue Bonds	54-1300845	928101AE4	03-25-2014	11,950,000	Reissuance of Series 2008A and 2008B originally issued on 07/16/08		X		X		X
C	Industrial Development Authority of the City of Roanoke VA	54-1106038	770082AB1	10-13-2010	96,404,094	Refunding of Series 2003A-C Bonds (08/03), Issuance Costs		X		X		X
D	Economic Development Authority of the City of Roanoke VA	54-1106038	770082AW5	02-09-2012	69,968,434	Refunding of Series 2000 and 2002A Bonds, Issuance Costs, Capital Projects		X		X		X
	Industrial Development Authority of the City of Roanoke VA	54-1106038	770084FU0	10-13-2010	98,852,291	Reoffering Circular and interest rate conversion to fixed, Issuance Costs		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	1,890,000						21,045,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	125,000,000		11,950,000		96,404,094		69,968,434
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	797,940		107,259		1,229,094		771,282
8 Credit enhancement from proceeds .............	1,940,086
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............			11,842,741				5,189,198
11 Other spent proceeds .............	122,261,974				95,175,000		64,007,954
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2009				2011
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X			X	X			X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X			X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2015

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X			X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.120 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %
6 Total of lines 4 and 5 .............	0.120 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X			X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2015

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?	X			X		X		X
b Name of provider ..........	AIG
c Term of GIC .........	30.0000000000 %
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........	X
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
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.

Schedule K (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CARILION MEDICAL CENTER

Employer identification number

54-0506332

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No










Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) 1 Eric Chen MD	See Part V	313,814	Employee		No
(2) 2 Bruce Johnson MD	See Part V	331,982	Employee		No
(3) 3 Mary Sweet MD	See Part V	360,516	Employee		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
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.

Schedule L (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Information about Schedule M (Form 990) and its instructions is at www.irs.gov/form990

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CARILION MEDICAL CENTER

Employer identification number

54-0506332

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......	X		5,334	FMV
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....	X	23	11,516	FMV
19 Food inventory ...	X	37	10,052	FMV
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Gift Cards )	X	66	28,653	FMV
26 Other ( Event Prizes )	X	1	2,000	FMV
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that

it must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2015)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
Part I, Column (b):	Number of contributions represents the number of items contributed.

Schedule M (Form 990) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

CARILION MEDICAL CENTER

Employer identification number

54-0506332

Return Reference	Explanation
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.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CARILION MEDICAL CENTER

Employer identification number

54-0506332

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) RMH Emergency Services LLC PO Box 12385 Roanoke,VA24025 54-1686589	Physician billing	VA	0	0	Carilion Medical Center

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)Carilion Clinic PO Box 12385 Roanoke,VA24025 54-1190771	Supporting organization	VA	501(c)(3)	Line 11b, II	N/A		No
(2)Carilion Clinic Foundation PO Box 12385 Roanoke,VA24025 54-1190773	Fundraising	VA	501(c)(3)	Line 7	Carilion Clinic	Yes
(3)Carilion Franklin Memorial Hospital PO Box 12385 Roanoke,VA24025 54-0480606	Healthcare	VA	501(c)(3)	Line 3	Carilion Clinic	Yes
(4)Carilion Giles Community Hospital PO Box 12385 Roanoke,VA24025 54-0549603	Healthcare	VA	501(c)(3)	Line 3	Carilion Clinic	Yes
(5)Carilion New River Valley Medical Center PO Box 12385 Roanoke,VA24025 54-0553805	Healthcare	VA	501(c)(3)	Line 3	Carilion Clinic	Yes
(6)Carilion Services Inc PO Box 12385 Roanoke,VA24025 54-1190879	Supporting organization	VA	501(c)(3)	Line 11b, II	Carilion Clinic	Yes
(7)Carilion Stonewall Jackson Hospital PO Box 12385 Roanoke,VA24025 54-0568001	Healthcare	VA	501(c)(3)	Line 3	Carilion Clinic	Yes
(8)Carilion Tazewell Community Hospital PO Box 12385 Roanoke,VA24025 54-6074580	Healthcare	VA	501(c)(3)	Line 3	Carilion Clinic	Yes
(9)Carilion Biomedical Institute PO Box 12385 Roanoke,VA24025 54-1965057	Supporting organization	VA	501(c)(3)	Line 11a, I	Carilion Clinic	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Franklin County Ventures LLC PO Box 12385 Roanoke,VA24025 47-4365316	Real estate	VA	Carilion Clinic	Related	-609	41,942		No			No	10.000 %
(2) Carilion Clinic Medicare Shared Savings Company LLC PO Box 12385 Roanoke,VA24025 45-5235473	Medicare HMO	VA	Carilion Clinic	Related	-801,314	1		No			No	50.000 %
(3) Community Medical Associates LLP PO Box 12385 Roanoke,VA24025 54-1517662	Real estate	VA	Carilion Medical Center	Related	87,525	865,030		No			No	47.300 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) CHS Inc PO Box 12385 Roanoke,VA24025 54-1725732	Services	VA	N/A	C			Yes
(2) Carilion Clinic Medicare Resources LLC PO Box 12385 Roanoke,VA24025 26-3729975	Medicare HMO	VA	N/A	C			Yes
(3) Carilion Behavioral Health Inc PO Box 12385 Roanoke,VA24025 20-3136891	Healthcare	VA	N/A	C			Yes
(4) Carilion Emergency Services Inc PO Box 12385 Roanoke,VA24025 54-2033006	Healthcare	VA	N/A	C			Yes
(5) SCA Credit Services Inc PO Box 12385 Roanoke,VA24025 54-1180398	Collection agency	VA	N/A	C			Yes
(6) Carilion Healthcare Corporation PO Box 12385 Roanoke,VA24025 54-1586601	Healthcare	VA	N/A	C			Yes
(7) MedKey Inc PO Box 12385 Roanoke,VA24025 54-1645357	Financing services	VA	N/A	C			Yes

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

Yes

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Carilion Services Inc	A	2,270,001	Cost
(2) Carilion Clinic Foundation	A	37,560	Cost
(3) CHS Inc	A	74,033	Cost
(4) Carilion Emergency Services	A	93,132	Cost
(5) Carilion Healthcare Corporation	A	26,208	Cost
(6) Carilion New River Valley Medical Center	L	3,823,720	Cost
(7) Carilion Giles Community Hospital	L	1,341,578	Cost
(8) Carilion Franklin Memorial Hospital	L	1,804,068	Cost
(9) Carilion Stonewall Jackson Hospital	L	1,499,238	Cost
(10) Carilion Tazewell Community Hospital	L	1,441,788	Cost
(11) Carilion Services Inc	L	1,197,701	Cost
(12) Carilion Behavioral Health	L	126,567	Cost
(13) Carilion Emergency Services	L	117,401	Cost
(14) Carilion Healthcare Corporation	L	313,039	Cost
(15) MedKey Inc	L	-352,161	Cost
(16) Carilion New River Valley Medical Center	K	84,653	Cost
(17) Carilion Tazewell Community Hospital	M	84,160	Cost
(18) Carilion Services Inc	K	52,805	Cost
(19) Carilion Services Inc	M	157,519,721	Cost
(20) CHS Inc	K	3,126,285	Cost
(21) CHS Inc	M	5,505,302	Cost
(22) Carilion Behavioral Health	M	121,778	Cost
(23) SCA Credit Services Inc	M	680,547	Cost
(24) Carilion Services Inc	R	3,425,699	Cash

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: To improve the health of the communities we serve.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	8,596
6	Total number of volunteers (estimate if necessary) .............	6	312
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	19,133
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,444,978	5,236,580
9	Program service revenue (Part VIII, line 2g) .........	1,134,789,192	1,213,958,161
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	54,291,878	11,550,416
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	23,198,283	25,472,814
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,216,724,331	1,256,217,971
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	4,510,033	6,838,575
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	535,009,191	576,424,275
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 249,402
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	574,489,716	601,695,854
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,114,008,940	1,184,958,704
19	Revenue less expenses. Subtract line 18 from line 12.......	102,715,391	71,259,267
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,185,047,389	1,292,474,198
21	Total liabilities (Part X, line 26).............	798,493,941	900,982,606
22	Net assets or fund balances. Subtract line 21 from line 20.....	386,553,448	391,491,592

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,033,507,080 including grants of $ 6,838,575 ) (Revenue $ 1,234,215,806 )
	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.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses1,033,507,080

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	9,499,863	5,977,466	3,558,531

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	89,459
d	Related organizations		1d	137,295
e	Government grants (contributions)		1e	4,803,590

f	All other contributions, gifts, grants, and similar amounts not included above		1f	206,236

g	Noncash contributions included in lines 1a-1f:$ 57,555
h Total.Add lines 1a-1f.......		5,236,580

		Business Code
2a	Net Patient Revenue	622110	1,184,221,158	1,184,221,158
b	College Tuition/Other	611310	25,742,349	25,742,349
c	Program-related Investments	531120	2,867,350	2,867,350
d	Other Health Education	611710	607,541	607,541
e	Clinical Research	541700	519,763	519,763
f	All other program service revenue.
g Total.Add lines 2a–2f.....			1,213,958,161

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			6,436,285		19,133	6,417,152
4 Income from investment of tax-exempt bond proceeds			218			218
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		1,884,229
b	Less: rental expenses		0
c	Rental income or (loss)		1,884,229
d	Net rental income or (loss)......			1,884,229			1,884,229
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	21,974	763,772,168
b	Less: cost or other basis and sales expenses	8,405	758,671,824
c	Gain or (loss)	13,569	5,100,344
d	Net gain or (loss).....			5,113,913			5,113,913
8a	Gross income from fundraising events (not including $ 89,459of contributions reported on line 1c). See Part IV, line 18 ....
	a		83,718
b	Less: direct expenses ...b		113,177
c	Net income or (loss) from fundraising events..			-29,459			-29,459
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	Physician & Other Affil. Income		621111	8,678,887	8,678,887
b	Cafeteria & Vending Income		722514	3,360,399			3,360,399
c	EHR Incentive Income		622110	1,256,352	1,256,352
d	All other revenue ....			10,322,406	10,322,406
e	Total. Add lines 11a–11d ......			23,618,044
12	Total revenue. See Instructions......			1,256,217,971	1,234,215,806	19,133	16,746,452

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	6,692,412	6,692,412
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	146,163	146,163
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	4,589,931		4,589,931
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	1,067,763	1,067,763
7	Other salaries and wages	464,240,124	463,861,132	271,375	107,617
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	37,262,637	37,262,637
9	Other employee benefits .......	39,278,506	39,181,058	70,376	27,072
10	Payroll taxes ...........	29,985,314	29,985,314
11	Fees for services (non-employees):
a	Management ......	137,313,176		137,313,176
b	Legal .........	31,433		31,433
c	Accounting ...........	23,633		23,633
d	Lobbying ...........	62,752	62,752
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	539,219		539,219
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	97,169,749	93,625,211	3,524,860	19,678
12	Advertising and promotion ....	428,571	418,866	249	9,456
13	Office expenses .......	17,087,351	16,894,647	186,054	6,650
14	Information technology ......	3,736,757	2,960,137	776,620
15	Royalties ..
16	Occupancy ...........	26,802,170	26,787,025	2,000	13,145
17	Travel ............	2,799,127	2,774,402	15,981	8,744
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	14,459,085	14,459,085
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	40,722,073	40,722,073
23	Insurance ...	14,705,277	11,154,399	3,550,878
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical Supplies	165,030,660	165,030,581	79
b	Bad Debt	70,617,579	70,617,579
c	College Expense	4,724,372	4,724,372
d	Dues & Subscriptions	1,952,473	1,653,541	298,932
e	All other expenses	3,490,397	3,425,931	7,426	57,040
25	Total functional expenses. Add lines 1 through 24e	1,184,958,704	1,033,507,080	151,202,222	249,402
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			22,649	1	19,570
2	Savings and temporary cash investments .........			4,327,700	2	3,627,349
3	Pledges and grants receivable, net ......			1,821,705	3	1,456,995
4	Accounts receivable, net .............			179,179,958	4	177,015,218
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net ....			6,684,722	7	5,893,651
8	Inventories for sale or use ........			5,981,889	8	6,242,898
9	Prepaid expenses and deferred charges ......			4,446,028	9	6,303,745
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	983,070,614
b	Less: accumulated depreciation	10b	710,627,972	263,267,160	10c	272,442,642
11	Investments—publicly traded securities .			658,861,169	11	738,583,705
12	Investments—other securities. See Part IV, line 11 .....			44,343,795	12	62,848,683
13	Investments—program-related. See Part IV, line 11 ..			1,000	13	1,000
14	Intangible assets ...............			65,123	14	65,123
15	Other assets. See Part IV, line 11 ...........			16,044,491	15	17,973,619
16	Total assets. Add lines 1 through 15 (must equal line 34)...			1,185,047,389	16	1,292,474,198

17	Accounts payable and accrued expenses .....	141,949,193	17	149,801,878
18	Grants payable ...		18	500,000
19	Deferred revenue .........	6,012,057	19	6,406,627
20	Tax-exempt bond liabilities .........	362,087,698	20	352,778,501
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24	1,626,435
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	288,444,993	25	389,869,165
26	Total liabilities. Add lines 17 through 25..	798,493,941	26	900,982,606

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	367,010,757	27	372,346,875
28	Temporarily restricted net assets ...........	7,666,782	28	7,268,808
29	Permanently restricted net assets	11,875,909	29	11,875,909
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	386,553,448	33	391,491,592
34	Total liabilities and net assets/fund balances ........	1,185,047,389	34	1,292,474,198