Form990
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 10-01-2019 , and ending 09-30-2020
BCheck if applicable:
CName of organization
Carilion Medical Center
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO BOX 12385
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Roanoke, VA240252385
D Employer identification number

54-0506332
E Telephone number

G Gross receipts $ 3,588,090,333
F Name and address of principal officer:
STEVE ARNER
PO BOX 12385
Roanoke,VA240252385
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CARILIONCLINIC.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1899
M State of legal domicile: VA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 13
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 2019 (Part V, line 2a) ...... 5 9,680
6 Total number of volunteers (estimate if necessary) ............. 6 271
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 60,241
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 8,626,043 38,181,365
9 Program service revenue (Part VIII, line 2g) ......... 1,427,067,490 1,378,831,131
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 28,386,481 67,040,275
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 25,470,009 24,159,089
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,489,550,023 1,508,211,860
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 5,882,786 4,561,677
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 649,129,750 649,613,528
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet143,848    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 727,648,180 749,272,389
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,382,660,716 1,403,447,594
19 Revenue less expenses. Subtract line 18 from line 12....... 106,889,307 104,764,266
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,528,858,933 1,930,321,569
21 Total liabilities (Part X, line 26)............. 1,006,971,123 1,347,521,886
22 Net assets or fund balances. Subtract line 21 from line 20..... 521,887,810 582,799,683
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: Our mission is to improve the health of the communities we serve through our commitment to a common purpose of better patient care, better community health, and lower cost.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,200,505,343 including grants of $ 4,561,677 ) (Revenue $ 1,395,317,352 )
SEE SCHEDULE O.
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 expensesMediumBullet1,200,505,343
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III..
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part III..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
9,680
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
13
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
8
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
VA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletTHE CORPORATION ATTN H KRK213 S JEFFERSON ST   ROANOKE,VA24011 (540) 224-5102
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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) 		(D)
Reportable compensation from the organization (W-2/1099-MISC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Damon Williams
 
Director/Chair
 2.0
.................
4.5 		X   X       0 2,175 0
(2) Steven Arner
 
Director/President/CEO
 36.0
.................
14.0 		X   X       0 877,942 363,619
(3) George Cartledge III
 
Director
 2.0
.................
0.0 		X           0 1,075 0
(4) Isabel Thornton
 
Director
 2.0
.................
0 		X           0 0 0
(5) James Drougas MD
 
Director
 4.3
.................
0 		X           12,646 0 0
(6) Janet Frantz
 
Director
 2.0
.................
0.0 		X           0 1,075 0
(7) Jason Bingham
 
Director
 2.0
.................
2.9 		X           0 8,075 0
(8) Katherin Elam
 
Director
 2.0
.................
0 		X           0 0 0
(9) Kianna Price Marshall
 
Director
 2.0
.................
0 		X           0 1,075 0
(10) Lee Learman MD PhD
 
Director
 2.0
.................
0 		X           0 0 0
(11) Michael Nussbaum MD
 
Director
 50.0
.................
0 		X           687,909 0 170,451
(12) Neil Macdonald MD
 
Director
 2.0
.................
0 		X           0 0 0
(13) Paul Haskins MD
 
Director
 50.0
.................
0 		X           371,019 0 241,634
(14) David Hagadorn
 
Asst. Treasurer
 0.5
.................
49.5 		    X       0 149,339 99,463
(15) Donald Halliwill
 
Asst. Treasurer
 0.5
.................
49.5 		    X       0 774,298 360,873
(16) G Robert Vaughan Jr
 
Treasurer
 0.5
.................
49.5 		    X       0 353,112 316,295
(17) Nicholas Conte
 
Secretary
 3.0
.................
47.0 		    X       0 709,682 182,512
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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) 		(D)
Reportable compensation from the organization (W-2/1099-MISC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Patrice Weiss MD
 
Chief Medical Officer/EVP
 46.0
.......................4.0 		    X       0 817,383 253,428
(19) Joseph Moskal MD
 
SVP/Chair, Dept. of Orthopedics
 50.0
.......................0 		      X     1,511,003 0 141,652
(20) Michael Abbott
 
Senior Vice President
 50.0
.......................0 		      X     248,244 0 30,084
(21) Nancy Howell Agee
 
CEO, Carilion Clinic
 2.0
.......................48.0 		      X     0 2,254,723 341,866
(22) Paul Skolnik MD
 
SVP/Chair, Dept. of Medicine
 50.0
.......................0 		      X     539,031 0 88,390
(23) ADEOLU OLASUNKANMI MD
 
Physician
 50.0
.......................0 		        X   1,100,363 0 47,716
(24) Eric Marvin MD
 
Physician
 50.0
.......................0 		        X   1,429,798 0 135,761
(25) Gregory Howes MD
 
Physician
 50.0
.......................0 		        X   1,647,368 0 77,090
(26) Jesse Stem MD
 
Physician
 50.0
.......................0 		        X   1,296,861 0 62,355
(27) Jonathan Carmouche MD
 
Physician
 50.0
.......................0 		        X   1,845,598 0 142,278
(28) Bruce Long MD
 
Physician
 50.0
.......................0 		          X 447,580 0 195,325
(29) Jon Sweet MD
 
Physician
 50.0
.......................0 		          X 323,855 0 209,773
(30) Tracey Criss MD
 
Physician
 50.0
.......................0 		          X 326,080 0 290,935
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 11,787,355 5,949,954 3,751,500
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet997
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
QUEST DIAGNOSTICS

500 PLAZA DRIVE
SECAUCUS,NJ07094 		LABORATORY SERVICES 28,894,269
GE MEDICAL SYSTEMS

5517 COLLECTION CENTER DRIVE
CHICAGO,IL60693 		EQUIPMENT MAINTENANCE 6,268,513
F&S BUILDING INNOVATIONS INC

2944 ORANGE AVE NE
ROANOKE,VA24012 		CONSTRUCTION SERVICES 4,480,203
SIEMENS MEDICAL SOLUTIONS USA INC

40 LIBERTY BOULEVARD
MALVERN,PA19355 		EQUIPMENT MAINTENANCE 4,223,851
EARL SWENSSON ASSOCIATES INC

1033 DEMONBREUN STREET
SUITE 800
NASHVILLE,TN37203 		PROFESSIONAL SERVICES 3,387,983
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet171
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a 78,460
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 505,223
e Government grants (contributions)1e 35,705,281
f All other contributions, gifts, grants, and similar amounts not included above1f 1,892,401
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 38,181,365
Program Service RevenueAmt Business Code
2a Net Patient Revenue 622110 1,329,031,130 1,329,031,130    
b Program Related Investments 621999 6,498,658 6,498,658    
c Clinical Research 541715 914,411 914,411    
d Other Patient Revenue 900099 38,610,407 38,610,407    
e Affiliate Rent Income 531120 938,906 938,906    
f All other program service revenue. 2,837,619 2,837,619 0 0
g Total. Add lines 2a–2f .....MediumBullet 1,378,831,131
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 15,115,978   60,241 15,055,737
4 Income from investment of tax-exempt bond proceedsMediumBullet 318,939     318,939
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   4,783,437 6a
b Less: rental expenses     6b
c Rental income or (loss) 0 4,783,437 6c
d Net rental income or (loss).......MediumBullet 4,783,437     4,783,437
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 411,383 2,131,072,448 7a
b Less: cost or other basis and sales expenses 63,057 2,079,815,416 7b
c Gain or (loss) 348,326 51,257,032 7c
d Net gain or (loss).........MediumBullet 51,605,358     51,605,358
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a Physician & Other Affiliate Income 621111 6,739,826 6,739,826    
b Cafeteria 722514 2,889,431     2,889,431
c Roanoke City Student Health 621440 1,817,098 1,817,098    
d All other revenue .... 7,929,297 7,929,297 0 0
e Total. Add lines 11a–11d ...... MediumBullet 19,375,652
12 Total revenue. See instructions.....MediumBullet 1,508,211,860 1,395,317,352 60,241 74,652,902
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 4,300,548 4,300,548
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 261,129 261,129
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 4,084,457 3,426,887 657,570  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 3,584,898 3,584,898    
7 Other salaries and wages........ 514,020,524 513,595,657 374,878 49,989
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 53,690,160 53,651,003 39,157  
9 Other employee benefits ....... 38,881,928 38,767,214 101,217 13,497
10 Payroll taxes ........... 35,351,561 35,288,835 62,726  
11 Fees for services (non-employees):        
a Management ...... 178,278,116   178,278,116  
b Legal ......... 256,819   256,819  
c Accounting ...........        
d Lobbying ........... 98,107 98,107    
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 1,275,815   1,275,815  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 117,663,791 99,826,364 17,823,126 14,301
12 Advertising and promotion .... 341,383 339,759   1,624
13 Office expenses ....... 18,475,396 18,390,459 82,353 2,584
14 Information technology ...... 4,920,330 4,919,516 814  
15 Royalties ..        
16 Occupancy ........... 26,896,900 26,891,345 5,555  
17 Travel ............ 2,140,639 2,097,045 41,322 2,272
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 16,162,902 16,162,902    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 46,395,824 46,395,824    
23 Insurance ... 15,106,033 11,578,682 3,527,351  
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 194,377,992 194,375,127 2,865  
b Bad Debt 81,549,017 81,549,017    
c Assessment Fees 39,872,605 39,872,605    
d Dues and Subscriptions 2,275,649 2,016,026 200,042 59,581
e All other expenses 3,185,071 3,116,394 68,677 0
25 Total functional expenses. Add lines 1 through 24e 1,403,447,594 1,200,505,343 202,798,403 143,848
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 17,586 1 17,411
2 Savings and temporary cash investments ......... 5,005,959 2 18,923,445
3 Pledges and grants receivable, net ...... 2,463,652 3 1,423,906
4 Accounts receivable, net ............. 246,865,692 4 265,679,526
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 4,208,444 7 1,349,460
8 Inventories for sale or use ............ 10,573,019 8 12,775,422
9 Prepaid expenses and deferred charges ...... 9,165,336 9 4,300,243
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,195,916,839
b Less: accumulated depreciation 10b 885,967,227 283,015,465 10c 309,949,612
11 Investments—publicly traded securities . 204,645,171 11 591,629,581
12 Investments—other securities. See Part IV, line 11 ..... 771,035,206 12 725,926,201
13 Investments—program-related. See Part IV, line 11 .. -8,317,602 13 -1,880,475
14 Intangible assets ............... 65,123 14 65,123
15 Other assets. See Part IV, line 11 ........... 115,882 15 162,114
16 Total assets. Add lines 1 through 15 (must equal line 33)... 1,528,858,933 16 1,930,321,569
Liabilities 17 Accounts payable and accrued expenses ..... 182,029,352 17 211,803,738
18 Grants payable ... 13,240,000 18 7,877,994
19 Deferred revenue ......... 3,297,074 19 160,540,791
20 Tax-exempt bond liabilities ......... 323,771,290 20 467,470,376
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties .. 223,045 24 0
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 484,410,362 25 499,828,987
26 Total liabilities. Add lines 17 through 25.. 1,006,971,123 26 1,347,521,886
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 501,315,131 27 561,406,380
28 Net assets with donor restrictions ........... 20,572,679 28 21,393,303
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 521,887,810 32 582,799,683
33 Total liabilities and net assets/fund balances ........ 1,528,858,933 33 1,930,321,569
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,508,211,860
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,403,447,594
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
104,764,266
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
521,887,810
5
Net unrealized gains (losses) on investments ...............
5
-31,286,438
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-12,565,955
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
582,799,683
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID: 19010655
Software Version: 2019v5.0
Form 990, Special Condition Description:
Special Condition Description
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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
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).
8
 
 
9a
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.
9a
 
 
b
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.
9b
 
 
c
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.
9c
 
 
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
 
 
b
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
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
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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  
7
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 2019 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-2019 		(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.		  
6 Remaining underdistributions for 2019. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.		  
7 Excess distributions carryover to 2020. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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) 2019


Additional Data


Software ID: 19010655
Software Version: 2019v5.0
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
Carilion Medical Center
 
Employer identification number

54-0506332
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




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
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
Carilion Medical Center
  		Employer identification number
54-0506332
Part I
Contributors
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


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2019)

Additional Data


Software ID: 19010655
Software Version: 2019v5.0
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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
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) 2019

Schedule C (Form 990 or 990-EZ) 2019
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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(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? ...................................................................................................................

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) 2016 (b) 2017 (c) 2018 (d) 2019 (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) 2019


Schedule C (Form 990 or 990-EZ) 2019
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|No
(b)
Amount
1
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:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
98,107
j
Total. Add lines 1c through 1i ....................................................................................................
98,107
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
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."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
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
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY A portion of dues paid to various hospital industry associations is attributable to lobbying activities.
Schedule C (Form 990 or 990EZ) 2019


Additional Data


Software ID: 19010655
Software Version: 2019v5.0

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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.
1a
If the organization elected, as permitted under FASB 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.
b
If the organization elected, as permitted under FASB 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 $  
2
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 FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 .... 16,881,056 17,033,643 16,731,963 15,801,516 15,705,697
b Contributions ...          
c Net investment earnings, gains, and losses 609,120 803,774 1,278,959 1,914,128 904,944
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		696,053 956,361 977,279 983,681 809,125
f Administrative expenses ....          
g End of year balance ...... 16,794,123 16,881,056 17,033,643 16,731,963 15,801,516
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet70.71 %
c
Term endowment SchDMd Bullet29.29 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 .....   6,116,287 6,116,287
b Buildings ....   516,136,612 362,967,459 153,169,153
c Leasehold improvements   960,828 840,573 120,255
d Equipment ....   623,292,886 515,469,748 107,823,138
e Other .....   49,410,226 6,689,447 42,720,779
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 309,949,612
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other 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......... 9,628,700 F
(2) Closely-held equity interests........ 1,347,596 C
(3) Other
(A) Comingled Funds		    

(B) Alternative Investments		 714,949,905 F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 725,926,201
Part VIII
Investments—Program 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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
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  
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 499,828,987
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) 2019

Schedule D (Form 990) 2019
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
Schedule D, Part V, Line 4 Intended uses of endowment funds Income from endowment funds are used for the following. (1) Pediatric programs- both internal and external- and/or pediatric equipment. (2) Patient care assistance.
Schedule D (Form 990) 2019


Additional Data


Software ID: 19010655
Software Version: 2019v5.0




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2019
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
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
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"? . . . . . . . . . . . . .

4

 

No
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
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? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
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) . . . 		    14,736,919   14,736,919 1.12 %
b Medicaid (from Worksheet 3, column a) . . . . .     245,705,831 271,565,484 0 0 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 260,442,750 271,565,484 14,736,919 1.12 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 9,481 22,990 4,865,308 788,640 4,076,668 0.31 %
f Health professions education (from Worksheet 5) . . . 3 295 45,970,550 8,339,384 37,631,166 2.85 %
g Subsidized health services (from Worksheet 6) . . . .         0 0 %
h Research (from Worksheet 7) . 2 1,032 1,903,006   1,903,006 0.14 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 65 5,562 618,205 110,000 508,205 0.04 %
j Total. Other Benefits . . 9,551 29,879 53,357,069 9,238,024 44,119,045 3.34 %
k Total. Add lines 7d and 7j . 9,551 29,879 313,799,819 280,803,508 58,855,964 4.46 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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 %
2 Economic development 15 5,000 247,918   247,918 0.02 %
3 Community support 20 0 36,380   36,380 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building 81 357 30,279 2,246 28,033 0 %
7 Community health improvement advocacy 7 0 18,873   18,873 0 %
8 Workforce development 11 10 600,615   600,615 0.05 %
9 Other         0 0 %
10 Total 134 5,367 934,065 2,246 931,819 0.07 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
81,553,905
3
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. ......
3
 
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
232,055,867
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
264,524,668
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-32,468,801
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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 % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1ROANOKE AMBULATORY SURGERY CENTER LLC
  		AMBULATORY SURGERY 49.2 %   46.48 %
2SOUTHWEST VIRGINIA HEALTH PROPETIES LLC
  		REAL ESTATE 51.12 %   46.48 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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?2Name, 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) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 CARILION MEDICAL CENTER -DBA CRMH
1906 BELLEVIEW AVE
ROANOKE,VA24014
HTTPS://CARILIONCLINIC.ORG/LOCATIONS/CARILION-ROANOKE-MEMORIAL-HOSPITAL
H 1840 		X X X X   X X     A
2 CARILION MEDICAL CENTER -DBA CRCH
101 ELM AVE
ROANOKE,VA24013
HTTPS://CARILIONCLINIC.ORG/LOCATIONS/CARILION-ROANOKE-COMMUNITY-HOSPITAL
H 1839 		X               REHABILITATION UNIT A
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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)
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 No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 17
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTPS://WWW.CARILIONCLINIC.ORG/COMMUNITY-HEALTH-ASSESSMENTS#ROANOKE-VALLEY
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE
b
HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
A
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 nonpayment?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 8
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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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
Schedule H, Part V, Section B, Line 3E THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT PRIORITIZES THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED BY THE ASSESSMENT, AND EXPLAINS HOW THE HEALTH NEEDS WERE PRIORITIZED.
Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - GROUP A. Carilion Clinic's Community Health Needs Assessments (CHNAs) are community-driven projects and success is highly dependent on engaging citizens, health and human service agencies, businesses, and community leaders. Community stakeholder collaborations known as "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 populations who are medically underserved, low-income, minority, and suffer from chronic diseases. The following organizations served on the CHAT for the 2018 (tax year 2017) Roanoke Valley Community Health Needs Assessment (RVCHNA): Blue Blaze Consulting, Blue Ridge Behavioral Healthcare, Bradley Free Clinic, Carilion Clinic, CHIP of Roanoke Valley, City of Roanoke - Lead Safe Roanoke, Family Service of Roanoke Valley, Freedom First Credit Union, Healthy Roanoke Valley (HRV), High Street Baptist Church, Jefferson College of Health Sciences, Local Environmental Agricultural Project (LEAP), New Horizons Healthcare, Rescue Mission Ministries, Inc., Roanoke College, Roanoke Redevelopment and Housing Authority, Roanoke Regional Chamber of Commerce, Salem Veteran Affairs Medical Center, United Way of Roanoke Valley, and the Virginia Department of Health. To further obtain input from the community, the RVCHNA conducted focus groups among stakeholders and target populations and administered a community health survey. During the CHNA process, community stakeholders, leaders, and providers were encouraged to complete a Stakeholder Survey (print and electronic versions were available) to provide additional perspectives about our community's health needs and barriers. CHATs conducted stakeholder focus groups with the City of Roanoke (Fire/EMS Station #5 & #6, and Police Department), HRV partners and friends (brought together for a Stakeholder Forum), and the Roanoke Valley Palliative Care Partnership. Target population focus groups were conducted to capture the story of needs and barriers to health for the uninsured, underinsured, low-income, minority, senior, and chronically ill populations. Focus group locations were chosen based on their proximity and convenience to target populations. Ten target population focus groups were held and participants discussed health needs and barriers to health, as well as access to primary, oral, and mental health care. Target population focus groups were conducted with AARP members, a women's group comprised of former immigrants to the United States, a Blue Ridge Literacy English for Speakers of Other Languages (ESOL) class, Bradley Free Clinic patients, residents of Roanoke Redevelopment Housing Authority's Melrose Towers (in the NW Roanoke City Medically Underserved Area (MUA)) and Morningside Manor (in the SE Roanoke City MUA), certified peer recovery specialists, Presbyterian Community Center parents and staff, and Roanoke Rescue Mission guests. A 39-question survey was developed (in English and Spanish) including questions about socioeconomic factors, access to medical, dental, and mental health care, health behaviors, physical environment, health outcomes, and demographics. The survey included commonly used questions and metrics from previously validated community surveys conducted by organizations such as National Association of County and City Health Officials (NACCHO), and Centers for Disease Control and Prevention. The CHAT and HRV Data Tracking and Quality Improvement Action Team identified target populations, collection sites and survey distribution methods. The survey focused on Roanoke Valley residents 18 years of age and older in the following service area of Bedford, Botetourt, Craig and Roanoke counties, Roanoke City, and Salem City. Special efforts were made to include the subpopulations of underserved/vulnerable populations disproportionately impacted by the social determinants of health including Income, race/ethnicity, education, and insurance status. The survey was also made available to all residents living in the Roanoke Valley, and oversampling of the target populations occurred through targeted outreach efforts. In total, 2,308 surveys were collected.
Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - Group A. Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital (Group A), both owned by Carilion Medical Center and serving the same area, jointly conducted their CHNA. The Salem Veteran Affairs Medical Center also participated on the Community Health Assessment Team.
Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - GROUP A. Blue Blaze Consulting, Blue Ridge Behavioral Healthcare, Bradley Free Clinic, Carilion Clinic, CHIP of Roanoke Valley, City of Roanoke - Lead Safe Roanoke, Family Service of Roanoke Valley, Freedom First Credit Union, Healthy Roanoke Valley (HRV), High Street Baptist Church, Jefferson College of Health Sciences, Local Environmental Agricultural Project (LEAP), New Horizons Healthcare, Rescue Mission Ministries, Inc., Roanoke College, Roanoke Redevelopment and Housing Authority, Roanoke Regional Chamber of Commerce, Salem VA Medical Center, United Way of Roanoke Valley, Virginia Department of Health.
Schedule H, Part V, Section B, Line 7 Facility A, 1 Facility A, 1 - Group A. The Community Health Assessment Team (CHAT) shared the 2018 Roanoke Valley CHNA on partner websites and social media. The RVCHNA was also shared through community forums, community presentations and media interviews.
Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - Group A. The following information describes the implementation strategies used by Carilion Medical Center (CMC), comprised of Carilion Roanoke Memorial Hospital (CRMH) and Carilion Roanoke Community Hospital (CRCH), to address the community health needs identified in the 2018 Roanoke Valley Community Health Needs Assessment (RVCHNA). The complete implementation strategies are available online at https://www.carilionclinic.org/community-health-assessments#roanoke-valley According to the Robert Wood Johnson Foundation's (RWJF) County Health Rankings (http://www.countyhealthrankings.org), where an individual lives, works and plays is a strong predictor of their health outcomes. In the United States, a person's zip code can help predict their life expectancy due to its direct link to the social determinants of health such as poverty, race/ethnicity, education and employment status in these areas. (https://www.rwjf.org/en/library/interactives/whereyouliveaffectshowlongyoulive.html). These factors, part of the 10-year national Healthy People 2030 objectives, are crucial to our overall health because they "create social and physical environments that promote good health for all." (https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health) Carilion responds to community health needs in innovative ways- making sure our regions have access to state-of-the-art health care close to home, providing community grants and sponsorships to extend our mission and support other organizations addressing health needs, creating and implementing community-wide strategies to reduce barriers, coordinate resources and enhance community strengths, and providing community-based health and wellness programs. Commitment to community health is evident at all levels of the organization. Carilion's infrastructure includes a Planning and Community Development division dedicated to assessing and addressing community needs. The division is responsible for leading and facilitating the Community Health Improvement Plan (CHIP), CHNAs, Carilion's community grant process, community health education, community benefit collection, and neighborhood health initiatives. There are Community Health and Outreach (CHO) staff at the system level and each community hospital. They work with hospital Board of Directors and Carilion Clinic's Board of Governors to create health improvement strategies. A Community Benefit Council provides oversight and strategic guidance for Carilion's community health improvement work and for community benefit strategy, collection and submission. Carilion's response strategies follow the RWJF framework for what influences health, health behaviors, social and economic factors, clinical care access and quality and physical environment. With the onset of COVID-19, Carilion immediately recognized the prominent role we would play in both prevention and treatment for our region. The pandemic demanded a shift in operations and priorities. While some of our implementation strategies were delayed or altered, Carilion quickly responded to the new and unique health-related social needs arising from COVID-19. An addendum to the CMC implementation strategies was approved in July 2020 to reflect the organization's planning and response to the pandemic. The complete addendum is available online at https://www.carilionclinic.org/sites/default/files/2020-10/CMC%20IS%20COVID%20Addendum_0.pdf. -COVID-19 Community Response- Carilion worked with local media partners to provide expert advice and guidance to the community for COVID-19 prevention, detection and recovery. In a historic collaborative effort, competing hospitals and broadcasting organizations publicized a community town hall. We coordinated efforts to ensure the public received the most accurate and up-to-date information about the pandemic. We developed the COVID-19 Community Hotline as a dedicated phone line to answer community member questions about COVID-19 signs and symptoms, Carilion guidelines, and resources. We also established a recovery support phone line to ensure employees, patients, and community members have access to mental health and recovery support. Peer Recovery Specialists created five virtual peer support community groups. These provide options for individuals in recovery to maintain recovery-oriented support during stay-at-home orders. Carilion is actively providing counsel to community partners, businesses, universities and colleges regarding COVID-19 through consultation with our infectious disease physicians and our management team. This service, offered free of charge, aims to promote safety and reduces hospitalizations and deaths. -Home Alone and Patient Outreach- Because older adults are especially vulnerable to COVID-19, accessing essential resources presented another serious challenge for them during the pandemic. Amid stay-at-home orders, business closures and medical appointment cancellations, we made it our mission to check on seniors in need who were living alone. Carilion's Planning and Community Development, Geriatric Medicine, Home Care and Hospice and Accountable Care Organization departments coordinated efforts to establish Home Alone. Through this initiative, Carilion made more than 1,200 phone calls to provide up-to-date information and connect seniors with local governments and community resources. From delivering masks to offering support over the phone, the program helped meet a wide-range of needs head-on. Seniors were able to stay home safely, reduce their exposure to COVID and avoid the hospital -Community Partnerships- Carilion Clinic believes in the power of collaboration. Carilion also understands the most significant health issues are addressed through cooperation with the community. Carilion participates in and provides financial and in-kind support to community health coalitions addressing the Roanoke Valley health needs. We also partner with multiple community and business organizations to improve health and wellness and to impact the social determinants of health for everyone we serve. -Healthy Roanoke Valley (HRV)- Forming a true community collaborative with lasting impact is no small feat. In 2012, using the Strive Collective Impact model, Carilion and United Way brought together strategic community partners to create HRV. An initiative supported by United Way of Roanoke Valley, HRV is now a partnership of more than 50 organizations striving to enhance health equity and create a "culture of wellness" across our region. For years, HRV has been serving as a valuable partner with Carilion Clinic. The collaborative updated HRV's strategic framework to align with the triennial Community Health Needs Assessment (CHNA), a community-driven process and a significant component of Carilion's Health Improvement Implementation Strategy for the Roanoke Valley. Through strategic planning in response to the 2018 Roanoke Valley Community Health Needs Assessment priorities, HRV identified four goals- 1. Reduce barriers to resources that address the social determinants of health, 2. Expand access to quality care and support a culture of health, 3. Encourage and support lifestyle behaviors that result in improved health and wellbeing, 4. Support and advocate for natural and built environments that cultivate vibrant neighborhoods. Carilion provides in-kind support to HRV with representatives active on the HRV steering committee and action teams focused on wellness, mental health, primary care, oral health and coordination of care. In response to the COVID-19 pandemic, HRV focused on engaging partners and supporting the United Way of Roanoke Valley-led community response effort. HRV staff members were deeply involved in supporting community efforts around health care access and resources, personal protective equipment shortages and sourcing, community food resources, and financial education and literacy. HRV's Mental Health & Substance Use and Wellness Action Teams developed a shared message to address behavioral health issues in the community related to the pandemic and racial unrest. Meanwhile, the Healthy Start initiative pivoted its focus from family education to providing emergency supplies of fresh produce to families with children. (Continued in Schedule H, Part VI)
Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - Group A. Individuals with Out of Network insurance are not eligible for Financial Assistance unless the plan does not meet minimum essential coverage as defined in PPACA or it is a governmental plan.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 9
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?103
Name and address Type of Facility (describe)
1 Carilion Roanoke Memorial Rehab
2017 South Jefferson Street
Roanoke,VA24014 		Psychiatry Services
2 CNRV Emergency Services
2900 Lamb Circle
Christiansburg,VA24073 		Emergency Physicians
3 CES - Franklin
180 Floyd Avenue
Rocky Mount,VA24151 		Emergency Physicians
4 CES - Tazewell
388 Ben Bolt Avenue
Tazewell,VA24651 		Emergency Physicians
5 Carilion Clinic Pain Management
1 Riverside Circle
Roanoke,VA24016 		Pain Management
6 Carilion Clinic Genetic Counseling
1 Riverside Circle
Roanoke,VA24016 		Genetic Counseling
7 Carilion GYN Oncology
1 Riverside Circle Suite 300
Roanoke,VA24016 		Gynecological Oncology
8 Carilion Clinic Dermatology & Mohs Surgery
1 Riverside Circle Suite 300M
Roanoke,VA24016 		Dermatology and Mohs Surgery
9 Carilion Clinic Occupational Medicine Elm Ave
101 Elm Avenue SE
Roanoke,VA24013 		Occupational Medicine
10 Carilion Wound Care Center Carilion Roanoke Community Hospital
101 Elm Avenue SE
Roanoke,VA24013 		Wound Care
11 Carilion Dentistry Pediatric Surgery
101 Elm Avenue SE
Roanoke,VA24013 		Dental Service
12 Community Care
101 Elm Avenue SE
Roanoke,VA24013 		Family Medicine
13 Carilion Maternal Fetal Medicine
101 Elm Avenue Suite 400
Roanoke,VA24013 		Maternal Fetal Medicine
14 Carilion Clinic Urogynecology
101 Elm Avenue Suite 400
Roanoke,VA24013 		Obstetrics
15 Carilion Prenatal Diagnostic Center
102 Highland Ave Suite 455
Roanoke,VA24013 		Prenatal Testing
16 Carilion Breast Care Diagnostic Center
102 Highland Ave Ste 202
Roanoke,VA24013 		Breast Care Center
17 Pediatric Cardiology Clinic
102 Highland Avenue Suite 101
Roanoke,VA24013 		Cardiology
18 Carilion Genetics
102 Highland Avenue Suite 104
Roanoke,VA24013 		Genetic Counseling
19 Carilion Pediatric Neurology
102 Highland Avenue Suite 104
Roanoke,VA24013 		Neurosciences
20 Carilion Pediatric Pulmonology and Allergy Clinic
102 Highland Avenue Suite 203
Roanoke,VA24013 		Pulmonology
21 Carilion GYN Clinic
102 Highland Avenue Suite 303
Roanoke,VA24013 		Gynecological Services
22 Pediatric Gastroenterology
102 Highland Avenue Suite 305
Roanoke,VA24013 		Gastroenterology
23 Carilion Clinic Pediatric Surgery Clinic
102 Highland Avenue Suite 404
Roanoke,VA24013 		Surgical Services
24 Carilion Pediatric Endocrinology Clinic
102 Highland Avenue Suite 455
Roanoke,VA24013 		Endocrinology
25 Carilion Sleep Center
1030 S Jefferson St Ste G100
Roanoke,VA24016 		Sleep Disorder
26 Carilion Anticoagulation Clinic
1030 S Jefferson St Ste G101
Roanoke,VA24016 		Anticoagulation Clinic
27 Carilion Clinic Pediatric Child Developmental Clinic
1030 S Jefferson Street
Roanoke,VA24016 		Child Development Services
28 Carilion General Pediatric Clinic
1030 S Jefferson Street Suite 106
Roanoke,VA24016 		General Pediatrics
29 Pediatric Developmental Clinic
1030 S Jefferson Street Suite 201
Roanoke,VA24016 		Pediatric Development
30 Carilion Diabetic Education
1030 S Jefferson Suite G101
Roanoke,VA24016 		Diabetic Education
31 Carilion Uro-Gynecology Associates
1030 S Jefferson St Ste 109
Roanoke,VA24016 		Urogynecology
32 Carilion Wellness-Botetourt
105 Summerfield Court
Roanoke,VA24019 		Outpatient Therapy Services
33 Carilion Clinic Urology Christiansburg
120 Akers Farm Road NE
Christiansburg,VA24073 		Urology
34 Carilion Clinic Reproductive Medicine and Fertility
1231 S Jefferson Street
Roanoke,VA24016 		Reproductive Endocrinology
35 Carilion Clinic Vascular McClanahan
127 McClanahan Street
Roanoke,VA24014 		Vascular Services
36 Carilion Cardiac Rehab
127 McClanahan Street
Roanoke,VA24014 		Cardiac Rehab
37 Carilion Heart Failure Clinic
127 McClanahan Street
Roanoke,VA24014 		Heart Failure Services
38 Physical Therapy Westlake
12970 Booker T Washington HWY
Hardy,VA24101 		Physical Therapy Services
39 CFM Roanoke Salem
1314 Peters Creek Road
Roanoke,VA24017 		Family Practice
40 Carilion Clinic OBGYN Daleville
150 Market Ridge Lane
Daleville,VA24083 		Obstetrics and Gynecology
41 Daleville Imaging
150 Market Ridge Lane
Daleville,VA24083 		Imaging Services
42 Pediatric Subspecialty Clinic
1620 Graves Mill Road
Lynchburg,VA24502 		Pediatrics
43 General Surgery Clinic
180 Floyd Avenue
Rocky Mount,VA24151 		Surgical Services
44 Carilion Clinic Cardiology Services - Rocky Mount
180 Floyd Avenue
Rocky Mount,VA24151 		Cardiology
45 Physical Therapy West Salem
1955 West Main Street
Salem,VA24153 		Physical Therapy Services
46 Carilion Clinic OBGYN Salem
1957 W Main Street
Salem,VA24153 		Obstetrics and Gynecology
47 Carilion Clinic Imaging - Crystal Spring
2001 Crystal Spring Ave SW
Roanoke,VA24014 		Imaging Services
48 Carilion Cardiothoracic Surgery
2001 Crystal Spring Avenue Suite 20
1
Roanoke,VA24014 		Cardiac Surgery Services
49 Carilion Clinic Cardiology
2001 Crystal Spring Avenue Suite 20
3
Roanoke,VA24014 		Cardiology Services
50 Carilion Clinic Pulmonary and Sleep Medicine
2001 Crystal Spring Avenue Suite 30
0
Roanoke,VA24014 		Pulmonary and Sleep Services
51 Carilion Infectious Disease Clinic
2001 Crystal Spring Avenue Suite 30
1
Roanoke,VA24014 		Infectious Disease
52 Carilion Center for Healthy Aging
2001 Crystal Spring Avenue Suite 30
2
Roanoke,VA24014 		Geriatrics
53 Carilion Clinic Dentistry General Surgery Jefferson
2017 S Jefferson St
Roanoke,VA24014 		Surgical Services
54 Carilion Clinic Department of Psychiatry and Behavioral Medicine Adult Outp
atient
2017 S Jefferson Street
Roanoke,VA24014 		Behavioral Health
55 Carilion Dental Care
2017 S Jefferson Street
Roanoke,VA24014 		Dental Service
56 Child and Adolescent Psychiatry
2017 S Jefferson Street
Roanoke,VA24014 		Child and Adolescent Psychiatry Services
57 Community Psychiatry
2017 S Jefferson Street
Roanoke,VA24014 		Psychiatry Services
58 CFM Southeast
2145 Mount Pleasant Boulevard
Roanoke,VA24014 		Family Practice
59 Carilion Clinic Imaging ION
2331 Franklin Road
Roanoke,VA24014 		Imaging Services
60 Carilion Clinic Neurosurgery - ION
2331 Franklin Road
Roanoke,VA24014 		Neurosurgery
61 Carilion Clinic Pain Management - ION
2331 Franklin Road
Roanoke,VA24014 		Pain Management
62 Carilion Physical Medicine and Rehabilitation
2331 Franklin Road
Roanoke,VA24014 		Physical Medicine
63 Carilion Clinic Orthopaedics - ION
2331 Franklin Road SW
Roanoke,VA24014 		Orthopaedics
64 Carilion Clinic Department of Psychiatry and Behavioral Medicine
2900 Lamb Circle
Christiansburg,VA24073 		Psychiatry and Behavioral Health Services
65 CNRVMC - Neurosciences
2900 Lamb Circle
Christiansburg,VA24073 		Neurology
66 CNRVMC - Radiology
2900 Lamb Circle
Christiansburg,VA24073 		Radiology Services
67 Carilion Children's Pediatrics - New River
2900 Lamb Circle
Christiansburg,VA24073 		Pediatrics
68 Carilion Clinic Sleep Center - New River Valley
2900 Lamb Circle Suite 7-700A
Christiansburg,VA24073 		Sleep Medicine
69 Carilion Clinic Genetics - Lynchburg
2900 Old Forest Rd
Lynchburg,VA24501 		Pediatric Genetics
70 Carilion Clinic Neuropsychology CCR3
3 Riverside Cir
Roanoke,VA24016 		Neuropsychology Services
71 Carilion Clinic General Surgery
3 Riverside Circle
Roanoke,VA24016 		Surgical Services
72 Carilion Clinic Internal Medicine
3 Riverside Circle
Roanoke,VA24016 		Internal Medicine
73 Carilion Clinic Neurology
3 Riverside Circle
Roanoke,VA24016 		Neurology
74 Carilion Clinic Orthopaedics Trauma
3 Riverside Circle
Roanoke,VA24016 		Orthopaedic Trauma
75 Carilion Clinic TraumaCritical Care
3 Riverside Circle
Roanoke,VA24016 		Surgical Services
76 Carilion Imaging
3 Riverside Circle
Roanoke,VA24016 		Imaging Services
77 Carilion OBGYN - Riverside
3 Riverside Circle
Roanoke,VA24016 		Obstetrics and Gynecology
78 CRMH Rheumatology Clinic
3 Riverside Circle
Roanoke,VA24016 		Rheumatology
79 Carilion Clinic Gastroenterology
3 Riverside Circle
Roanoke,VA24016 		Gastroenterology
80 Carilion Clinic Orthopaedics
3 Riverside Circle
Roanoke,VA24016 		Orthopaedics
81 Carilion Clinic Endocrinology
3 Riverside Circle
Roanoke,VA24016 		Endocrinology
82 Carilion OtolaryngologyENT
3 Riverside Circle 4th Floor
Roanoke,VA24016 		Otolaryngology and ENT Services
83 Carilion Pediatric OtolaryngologyENT
3 Riverside Circle 4th Floor
Roanoke,VA24016 		Pediatric Otolaryngology and ENT Services
84 Carilion Plastic and Reconstructive Surgery
3 Riverside Circle Suite 400
Roanoke,VA24016 		Plastic and Reconstructive Surgery
85 Carilion Cardiology Westlake
35 Medical Court
Hardy,VA24101 		Cardiology Services
86 Carilion Sleep Center Westlake
35 Medical Court
Hardy,VA24101 		Sleep Disorder
87 Carilion Surgery Westlake
35 Medical Court
Hardy,VA24101 		Surgical Services
88 Urogynecology Westlake
35 Medical Court
Hardy,VA24101 		Urogynecology
89 Carilion Clinic Dermatology and Mohs Surgery - Westlake
35 Medical Court
Hardy,VA24101 		Dermatology and Mohs Surgery
90 Carilion Clinic Orthopaedic Surgery - Westlake
35 Medical Court
Hardy,VA24101 		Orthopaedics
91 Carilion Clinic Otolaryngology and Audiology - Westlake
35 Medical Court
Hardy,VA24101 		Otolaryngology and ENT Services
92 Carilion Clinic Imaging - Westlake
35 Medical Court
Hardy,VA24101 		Imaging Services
93 Brambleton Radiology Services
3707 Brambleton Avenue
Roanoke,VA24018 		Radiology Services
94 Carilion Clinic Family Medicine Tazewell
388 Ben Bolt Avenue
Tazewell,VA24651 		Family Medicine
95 Carilion Clinic Orthopaedics - Franklin
390 S Main Street Suite 103
Rocky Mount,VA24151 		Orthopaedics
96 Carilion Clinic Plastic and Reconstructive Surgery
390 S Main Street Suite 103
Rocky Mount,VA24151 		Plastic and Reconstructive Surgery
97 General Surgery Rocky Mount
390 South Main Street
Rocky Mount,VA24151 		Surgical Services
98 Carilion Wellness - Roanoke
4508 Starkey Road
Roanoke,VA24018 		Physical Therapy Services
99 Carilion Clinic Allergy and Immunology
46 Wesley Road
Daleville,VA24083 		Allergy and Immunology Services
100 Carilion Clinic Pediatric Medicine Rocky Mount
490 S Main St
Rocky Mount,VA24151 		Pediatric Medicine
101 Breast Mammography - North
6415 Peters Creek Road
Roanoke,VA24019 		Breast Mammography
102 Carilion Children's Pediatric Behavioral Medicine
902 Jefferson St
Roanoke,VA24016 		Pediatric Child Development
103 Carilion Obstetrics and Gynecology Clinic
902 South Jefferson Street Upper Le
vel
Roanoke,VA24016 		Obstetrics and Gynecology
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 10
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
Schedule H, Part V, Section B, Line 11 Addressing Needs Identified in CHNA (Continued From Part V Section C) Through HRV, multiple programs and strategies have arisen in response to community needs, such as the Pathways Community HUB. This community-based care coordination system is anchored by Community Health Workers strategically located in two Carilion teaching practices in the City of Roanoke, at Carilion Community Care and Carilion Internal Medicine Riverside 3, and partners' clinics. Through a model addressing social determinants of health, Community Health Workers link clients and their families to resources and services. The program reduces barriers to good health for uninsured adults who regularly visit the CRMH Emergency Department and have chronic disease diagnoses. Community partners include Bradley Free Clinic, the Rescue Mission's G. Wayne Fralin Free Clinic, Mental Health America of Roanoke Valley, New Horizons Healthcare and HRV. -Community Grants - Carilion fulfills our commitment to addressing key health priorities through targeted grants for community health improvement programs and those affecting the social determinants of health. Carilion provides many community grants and community health sponsorships to help local charitable organizations fulfill their missions related to the health and well-being of our communities. Community grant dollars are allocated across the entire Carilion Clinic service area based on requests received. During the fall cycle of 2020 fiscal year (2019 tax year), $85,000 in grants were awarded to nine programs in the Roanoke Valley to improve mental health access, transportation, disease prevention, literacy services and to increase the availability of affordable healthy foods. Carilion's COVID-19 Community Health Fund replaced the traditional spring grant process, focusing on acute COVID-related health care needs and health-related social needs in our region. In the Roanoke Valley, we awarded $69,500 in funding to support a facility for people experiencing homelessness and recovering from COVID-19 to live and quarantine, programs addressing food insecurity throughout various Southwest Virginia communities, medication access and delivery for free clinic patients in Southwest Virginia, expanded access to mental health care through the free clinic and access to refurbished rehabilitation equipment. -Targeted Neighborhood Initiatives - CMC's community health goal is to improve health and well-being for the Roanoke Valley, especially for those individuals living in medically underserved areas (MUAs). The City of Roanoke tends to perform worse than other neighboring communities in many health and social determinant indicators. Efforts often focused on the Northwest and Southeast quadrants of the city-the MUAs most in need. CMC is addressing essential community health needs identified in the 2018 assessment by focusing additional investment in the Southeast MUA, located adjacent to CRMH. Through greater access to clinical care and community outreach programs, creative community partnerships and focused financial and in-kind support of initiatives, CMC is improving community health in the Southeast neighborhood. Key focus areas of this health improvement project include access to services, coordination of care and wellness. -LIFT Project- Carilion is working with Roanoke City Public Schools (RCPS) and other partners to expand access to health care services for families through Local Impact for Tomorrow (LIFT). LIFT is a partnership between Carilion, RCPS, Freedom First Credit Union, Delta Dental of Virginia and Roanoke Women's Foundation. Plans are underway to create a community health center in Southeast's Fallon Park Elementary School. The community health center will provide physical, mental and oral health care services and financial wellness programs for local students and families. Groundbreaking for the facility is scheduled for 2021. Additionally, LIFT's Asthma in Schools program at Fallon Park Elementary allows school nurses to administer medication to students with asthma. Roanoke City provided funding to extend care into the home, working with the Child Health Investment Partnership during the COVID-19 pandemic. -Significant Health Priorities to be Addressed- -Health Behaviors - Needs include a culture of healthy behaviors not a priority, and poor diet. Carilion Clinic continues to address health behavior-related priorities from the 2018 RVCHNA. To improve overall health culture and promote healthy diets, Carilion provides various free health education classes, screenings and flu immunizations in community settings. In fiscal year 2020, Carilion provided 393 health education, screening and immunization opportunities/events in the Roanoke Valley, serving 8,593 people. Community health education is provided by the Community Health and Outreach (CHO) department as well as by Trauma Outreach, dieticians, Carilion Wellness, homecare, hospice and select other departments. Health and wellness education topics include general wellness, healthy eating and exercise, stress management, and infant and child safety. During the COVID-19 pandemic, CHO transitioned to "Take a Break" virtual education sessions providing timely, relevant tips focused on improving well-being and maintaining a healthy lifestyle during an uncertain time. As the year progressed, we added well-being support groups, cooking videos, online gardening classes, guided walks and hikes, and limited in-person outdoor education. Resources committed to these programs include staff time, volunteer hours, and food and giveaway items that encourage healthy behaviors. Carilion remains committed to addressing poor diets. Through the Local Foods Program, Carilion provides hundreds of thousands of dollars of support to improve healthy food access. Community grants make healthy, wholesome foods more affordable and accessible in the Roanoke Valley, including one that doubles the value of the Supplemental Nutrition Assistance Program (SNAP) benefit. Carilion's Morningside Urban Farm brings fresh foods to the Southeast Roanoke City community. The farm offers health education and incentives to adopt healthy lifestyles. The farm's programs focused on wellness through gardening, nutrition, physical activity/movement, the arts and music. Produce grown at the farm is donated to those attending Morningside classes and events and community groups such as the Presbyterian Community Center, Boys and Girls Club, and the Rescue Mission. In addition to community events, Carilion fosters healthy behaviors by offering classes to employees and through partnerships with other Roanoke Valley employers. As the largest employer in the region, efforts to engage our employees and their families in healthy lifestyles impact community health overall. Carilion offers Virgin Pulse. The program enables employees to connect personal activity trackers and a platform to encourage daily healthy behaviors such as exercise, climbing stairs, and planning healthy meals. Additionally, CMC makes a Farm Share program available to employees and their families through payroll deduction. Farm Share widens the impact of nutritious fresh food and diets for our Carilion staff. Carilion remains committed to the Healthier Hospital Initiative pledge and continues to improve quantities of healthy, local, sustainable foods purchased and served through its cafeterias. Wellness comprises a multitude of factors, from mental and social support to prevention and safety. We offer support groups for grief and loss counseling, cancer treatment and recovery, and attention to diabetes and other chronic conditions. CMC also coordinates child passenger safety training and child safety seat checks to reduce injuries from car accidents. Carilion family practices offer gun locks for free to members of the community to encourage gun safety. As part of infant safe sleep classes, Carilion provides participants with a free Pack and Play and free Sleep Sack to promote safe sleep practices. Infants born in Carilion hospitals also receive a free Sleep Sack when available.
Schedule H, Part V, Section B, Line 11 Addressing Needs Identified in CHNA (Continued) -Clinical Care - Needs include access to mental health and substance use services, access to dental care, high uninsured/underinsured population, high cost of care. Issues with access to care are essential to CMC when addressing community health needs. In addition to providing financial support to qualifying patients who cannot afford care, Carilion works to improve affordable access to care and resources. -Mental health and substance use services - Through the #AllIn program, Carilion provides additional access to non-traditional mental health and substance use services. A key component of #AllIn is peer support which has expanded the type of care people in the Roanoke Valley can access. Peer recovery specialists have a unique perspective and can connect with patients through shared experiences. In fiscal year 2020, Carilion trained 90 peer recovery specialists in the Roanoke Valley and taught more than 150 laypeople to utilize Narcan through the REVIVE program. We formed five peer recovery center groups pre-COVID. We also convened virtual groups for individuals in recovery to maintain support during the stay-at-home order. Carilion's Addiction Task Force brings together expertise from throughout the Carilion system to better understand and address the opioid epidemic in Southwest Virginia. Efforts include developing system-wide guidelines and a system dashboard for opioid prescriptions, developing treatment pathways for opioid addiction in specific high-risk groups, developing best practices for risk assessment, treatment and standard orders in Carilion's electronic medical record system, growing an inventory of community resources related to prevention, treatment and recovery services for patients and community members, and providing locations for free, safe, prescription drug returns or deactivation bags. Carilion provides both financial and in-kind support for the Bradley Free Clinic Mental Health Collaborative program to increase access to psychiatric care and medication for people without health insurance in the Roanoke Valley. Carilion psychiatry residents and physicians volunteer their time and provide in-kind services through this program. Physicians and residents also provide in-kind services to individuals through the Rescue Mission's Fralin Free Clinic. -Dental care - Carilion hosts pediatric and adult dental clinics in Roanoke and operates a dental residency program. Dental residents provide in-kind dental services through the Rescue Mission's Fralin Free Clinic. Located in Southeast Roanoke, the Rescue Mission is a comprehensive crisis intervention center for men, women and children. Additionally, oral health is also prioritized through the HRV Oral Health Action Team with the DentaQuest Foundation's support. -High uninsured / underinsured population and high cost of care - Carilion is committed to helping improve access to affordable medical care in our communities. Since the expansion of Medicaid in the Commonwealth of Virginia in 2019, Carilion has worked diligently on outreach and enrollment for newly eligible beneficiaries. By the end of fiscal year 2020 (tax year 2019), more than 15,754 people were newly enrolled in Medicaid in the Roanoke Valley. Community Health Workers and other partners also helped clients complete insurance pathways pairing them with appropriate services once they were enrolled. Carilion physicians regularly serve uninsured people through hours donated in-kind to the Bradley Free Clinic. Medication access for Bradley Free Clinic patients is improved by the RX Partnership, which Carilion supports financially. Additionally, Individuals can access regular care and medications as well as coordinate lab services through Carilion financial assistance. To increase access to primary care and resources for adolescents, CMC partners with RCPS to operate adolescent health clinics in Patrick Henry High School and William Fleming High School in the City of Roanoke, plus a stand-alone clinic in downtown Roanoke. Through parent waivers signed at the start of the school year, students can visit health professionals as needed at clinics conveniently located in the schools, regardless of their ability to pay. - Social and Economic Factors - Needs include poverty, transportation, affordable / safe housing, educational attainment. In its commitment to reducing inequities in care, Carilion provides financial support for people who cannot afford insurance or health care. Carilion also manages a Medication Assistance Program to increase access to affordable medication and replenishes medication carried aboard emergency medical services vehicles. Support is provided to various not-for-profit organizations. Our support reduces the impact of poverty on health through investments in social determinants such as housing, transportation, employment, education, access to healthy foods and many other worthwhile causes. Each year, Carilion Clinic coordinates a system-wide United Way campaign through which employees can provide additional support to these causes. The Virginia Tech Carilion (VTC) Health Sciences and Technology Campus is located in the City of Roanoke. The VTC partnership continues to spur economic growth for the region through job growth, spending at the campus, student populations and research grant funds. Growth is expected to continue through at least 2026. Community partners, including Carilion, start early outreach in schools to inspire future health care workers and to create educational pathways for all. Virginia Western Community College and local universities have partnered with the community to make it possible for local students to access affordable or no-cost education. - Transportation - Carilion recognizes the impact that lack of reliable transportation can have on health. To improve access to transportation for patients in need of regular health care, Carilion supports the City of Roanoke's trolleys. The trolleys provide free transportation from downtown Roanoke to Carilion Roanoke Memorial Hospital and points in between, including the Riverside Center campus that houses the Virginia Tech Carilion School of Medicine, the Fralin Biomedical Research Institute at Virginia Tech Carilion and many Carilion clinical services.
Schedule H, Part V, Section B, Line 11 Addressing Needs Identified in CHNA, Continued - Physical Environment - While physical environment did not necessarily arise as a top priority in the 2018 RVCHNA, Carilion still recognizes the impact the environment has on the health of our communities. Efforts continue to make our hospitals and other facilities more energy efficient, increase recycling and the use of recyclable or bio-degradable materials, reduce waste materials and serve local, sustainable foods to patients and in our cafeterias. - Implementation and Measurement - Carilion has invested in multiple systems to manage data and track outcomes of our community work. We assessed program-level outcomes for community health education classes and screening events. We tracked these outcomes using pre- and post-tests for education and screening results such as blood pressure, cholesterol, diabetes risk assessments and glucose readings. Community programs supported by Carilion grants were responsible for regularly reporting program outcomes. Scorecards developed contain key secondary data points. They are updated annually to track the community health initiatives' impact. Specifically, Carilion tracked and measured impact on specific aligned indicators contributing to the RWJF County Health Factors Rankings and County Health Outcomes Rankings. Our goal is to improve County Health Rankings for the entire Roanoke Valley. Still, we understand that improvements are relative to progress in other communities in the Commonwealth of Virginia by these rankings' nature. The REDCap software program enabled internal data to be utilized at the aggregate level to display outcomes of targeted health initiatives for research teams. The initiatives included asthma interventions at Fallon Park Elementary School. The results will be used for future planning and decision-making. - Priority Areas Not being Addressed and the Reasons - Earlier, we described using a community approach to determine and address priority needs. We used a similar approach to determine which needs cannot be immediately addressed. We considered several needs during the prioritization process. However, we did not actively address these needs during this period due to low feasibility or low potential impact. These needs are alcohol and drug use, lack of exercise, lack of health literacy, lack of understanding of healthy behaviors, lack of knowledge of community resources, risky sexual activity, tobacco use, access to primary care, access to specialty care (general), communication barriers with providers, coordination of care, quality of care, child abuse/neglect, community safety/violence, domestic violence, lack of family / social support systems, unemployment, air quality, injury prevention/safety of the environment, outdoor recreation, water quality, high prevalence of chronic disease (general).
Schedule H, Part I, Line 3c Financial Assistance Eligibility Criteria Patients' eligibility is determined by family size, family income, real property equity and liquid assets. Families with family income equal or below 200% of the Federal Poverty Guidelines (FPG) and assets equal or below $15,000 are eligible to receive 100% adjustment under the financial assistance policy (FAP). Families with family income greater than 200% of the FPG but less than or equal to 400% of the FPG or assets above $15,000 and less than or equal to $100,000 are eligible to receive a partial adjustment under FAP. The partial adjustment matches the amounts generally billed (AGB) percentage for each service area.
Schedule H, Part I, Line 6a Community Benefit Report Information on community benefit is reported annually through a consolidated report prepared by Carilion Clinic (EIN 54-1190771). Printed copies of this report are distributed throughout communities served by hospitals affiliated with Carilion Clinic. Additionally, the community benefit report is available on Carilion Clinic's website: https://carilionclinic.org/about-carilion-clinic#our-values
Schedule H, Part I, Line 7 Col (F) Percent of Total Expense Patient -related bad debt expense of $81,553,905 was excluded from the calculation of Part I Line 7 Column (f) Percent of total expense.
Schedule H, Part I, Line 7e Community health improvement services and community benefit operations This line is reported at actual cost. Carilion's commitment to community health is evident at all levels of the organization. Our infrastructure includes a Planning and Community Health division dedicated to assessing and addressing community needs. The division leads and facilitates the Community Health Improvement Plan, Community Health Needs Assessments, community grants, community health education, collection of community benefit data and neighborhood health initiatives. Some Community Health and Outreach staff work with the hospital's Board of Directors and Carilion Clinic's Board of Governors to create health improvement strategies to address community health needs. The hospital also has a Community Benefit Council providing oversight for Carilion's community health improvement work and for community benefit strategy, data collection and submission. Carilion Medical Center educates the public about health risks and steps that can be taken to improve health. Events include regularly scheduled health screenings for blood pressure, blood glucose and cholesterol and seasonal screenings to detect facial damage due to sun exposure. Carilion Medical Center's community health education department hosts the local chapter of the National Safe Kids Coalition. The department also offers guidance about childhood injury prevention to the community and other providers. Carilion Medical Center's Safe Kids Coalition coordinator also provides free training and national certification on proper car seat installation for other health and safety providers. Due to COVID-19, work shifted from the typical health education and improvement programming to education and outreach aimed at lessening the impact of the pandemic. For many months, representatives across the organization were involved in the Home Alone program-an outreach effort to connect vulnerable patients to community resources and help them overcome any barriers caused by supply shortages, business closures, and cancellation of medical appointments. Carilion received federal relief funding that will offset the Community Benefit expenses generated by this and other similar work. In efforts to increase access to health care, Carilion physicians dedicate hours to providing ongoing care for patients of local free clinics. Carilion also connects patients to resources for enrollment in public health care programs such as Medicaid. Following the rollout of Medicaid expansion in Virginia, Carilion began contracting with MedAssist for Medicaid enrollment outreach, ensuring access to a wide range of health services across the community. MedAssist screens uninsured patients to identify eligibility and helps them with the application process, including documentation and substantiation of eligibility. Greater coverage increases access to benefits not only for general health, but for dental and mental health services as well. The increase in scope for Medicaid eligibility and enrollment led to an increase in Community Benefit dollars invested in this category. Community benefit operations include expenses associated with tracking community health improvement activities, and the cost associated with coordinating responses to community health needs identified through the most recent Roanoke Valley Community Health Assessment. This coordination includes participation in various community partnerships such as Healthy Roanoke Valley, a collaboration of health and human service agencies developing initiatives to address prioritized community health needs.
Schedule H, Part I, Line 7f Health professions education This line is reported at actual cost. Carilion Medical Center mentors nursing students, provides continuing education opportunities for local providers and operates a residency program.
Schedule H, Part I, Line 7g Subsidized Health Services N/A
Schedule H, Part I, Line 7h Research This line is reported at cost. Carilion Medical Center participates in clinical research projects and provides a Human Research Protections Office, which includes the Institutional Review Board. The Human Research Protections Office is designed to protect the rights, dignity and welfare of individuals who are the subject of research conducted by the organization's clinicians, staff or students. The Health Analytics Research Team provides accurate and timely reporting, informatics and actionable analytics to forward the mission of Carilion, including clinical, financial, research, and claims data. Additionally, community research is provided through a cancer registry to assist public health professionals in understanding and addressing the cancer burden more effectively. The information collected is used to develop programs on cancer prevention, early detection, and successful treatment and care. Another example is an at-home pulmonary rehabilitation program developed to help patients with high-risk chronic obstructive pulmonary disease in rural areas improve health outcomes and healthy behaviors by engaging in at-home self-care.
Schedule H, Part I, Line 7i Cash and in-kind contributions for community benefit At cost. Carilion's dedication to our mission of improving the health of the communities we serve is evidenced by the annual financial and in-kind contributions we provide to dozens of nonprofit partners. Our support directly impacts the issues identified in our triennial Community Health Needs Assessment and various social determinants that impact health. This support helps provide access to nutrient dense foods, promotion of exercise and healthy activities, chronic disease management, access to mental health services and coordination of care, and many other community health improvement goals.
Schedule H, Part II Community Building Activities Line 1 - Physical improvements and housing - N/A Line 2 - Economic development - As the largest employer in Southwest Virginia, Carilion impacts economic development by investing in jobs, increased wages for employees and various capital building projects. In addition, Carilion had direct economic development expenses from programming and support of local Chambers of Commerce, the Better Business Bureau, and the Roanoke Regional Partnership, improving economic development efforts through pro-business advocacy. We supported the Partnership's Accelerate 2022 campaign to quicken the region's growth through leveraging livability, the outdoors, and higher education to achieve job growth, investment, qualified workforce and economic impact. Carilion is active in local economic development endeavors, including supporting the Valleys Innovation Council, investing in research and technology and communicating with local businesses about the region's current business climate and prospective companies. Funding provided to the Greater Roanoke Transit Company for the Star Line Trolley offers free transportation around downtown Roanoke. It serves as a critical link to the Carilion and Virginia Tech Carilion locations in Roanoke's Innovation Corridor along Jefferson Street. Line 3 - Community support - Research demonstrates the strong connection between social determinants of health such as transportation, housing and education, and communities' overall health and well-being. Carilion supports nonprofit organizations addressing barriers to good health arising from these social determinants in various ways. Carilion also collaborates with local partners to support better education and opportunities for children and families and improved housing, better nutrition and additional resources for its neighbors in need. These efforts make progress in removing a range of obstacles to good health for residents of our region. In fiscal year 2020 (tax year 2019), Carilion worked with the Rescue Mission homeless shelter to support the Back to School Blast, which provides around 1,000 area students with new backpacks containing school supplies at the start of the school year and engages Carilion physicians in providing physicals and immunizations. Through monetary donations and organizational support, Carilion reduces inequity, promotes community development and repair, provides for veterans and seniors' social needs, maintains essential community-building amenities, and supports events for organizations like the Boys and Girls Club of Southwest Virginia, the NAACP and Local Colors of Western Virginia. Line 4 - Environmental improvements - N/A Line 5 - Leadership development and training for community members - N/A Line 6 - Coalition building - Carilion believes in the power of collaboration and understands that we must address our most significant health issues in concert with the community. To ensure lasting impact from the health assessment and community health improvement process, Carilion participates in community health coalitions that address health, safety and social determinant needs in the Roanoke Valley. Also, we partner with multiple community and business organizations around initiatives to improve health and wellness for everyone living in the Roanoke Valley. An example is Carilion's representation and participation on the Injury and Violence Prevention Collaborative Network, a group of organizations across Virginia working to strengthen injury and violence prevention efforts and enforce positive change on one of the leading causes of hospitalizations and deaths for both children and adults. Carilion also works with Children's Trust on coalition-building efforts to decrease child abuse and neglect. Other coalition-building activities include board participation with the Child Health Investment Partnership of the Roanoke Valley, Feeding Southwest Virginia, the Boys and Girls Club of Southwest Virginia, DePaul Community Resources, the Virginia Rural Health Association, and many more. Line 7 - Community health improvement advocacy - Carilion's mission of community health improvement focuses not only on what the organization does directly but also on supporting advocacy through other organizations' work. During fiscal year 2020 (2019 tax year), Carilion worked with various groups. These included Equality Virginia, an organization focused on ensuring protection in legislation for LGBTQ Virginians and providing advocacy for transgender Virginians. We also worked with the Virginia Tech Carilion School of Medicine's Inclusivity Task Force, which advances inclusivity across all aspects of the student experience. Financial support also furthers our advocacy efforts. We contribute to many causes, including the Children's Trust "Save Jane" campaign, which brings awareness to child abuse in the Roanoke Valley; the Humble Hustle Company, which empowers black youth and connects diverse communities; and Girls on the Run, an organization that promotes running as a method of empowering young girls. Line 8 - Workforce development - With the understanding that employment is directly linked to health and wellness, Carilion partners to provide workforce development and training for community members. These efforts also develop a pipeline of future health care workers. In fiscal year 2020 (tax year 2019), Carilion Medical Center partnered to offer Project SEARCH, a one-year high school transition program providing employment and educational opportunities for individuals with significant disabilities. This collaborative program includes Goodwill Industries of the Valleys, the Virginia Department of Aging and Rehabilitative Services, and local school systems. Carilion was a founding partner in VA Ready. This new initiative focuses on helping Virginians impacted by the pandemic return to work through training for in-demand jobs in high-growth sectors. Carilion is involved in the Virginia Business Higher Education Council Growth4VA coalition, promoting reform and reinvestment in the higher education system. Through the Virginia Foundation for Independent Colleges, Carilion provided fellowship funds to help students strengthen their research experience and prepare them for a career in the sciences. In addition, Carilion deploys special recruitment efforts for specific types of providers to improve access to needed care and meet the needs of underserved individuals in the Roanoke Valley.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Carilion Medical Center estimates bad debt expense by reserving a percentage of all self-pay patient accounts receivable by aging category, based on collection history, adjusted for expected recoveries and, if present, anticipated changes in trends.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Accounts receivable are stated at net realizable amounts due from patients, third-party payors, and other insurers for which Carilion Medical Center expects to be entitled in exchange for providing patient care. In accordance with Accounting Standards Update (ASU) No. 2014-09, Revenue from Contracts with Customers (Topic 606) (ASU 2014-09), the estimated uncollectible amounts are generally considered implicit price concessions that are a direct reduction to patient accounts receivable.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Medicare allowable costs are determined from the Medicare cost report using the cost-to-charge ratio. The Hospital believes our Medicare shortfall is a cost we incur as a benefit to the community. IRS Rev. Rul. 69-545 provides that one of the factors demonstrating community benefit is operating an emergency room open to all persons regardless of ability to pay and providing other hospital care for all patients able to pay, including those who pay their bills through public programs such as Medicare. In order to operate for the benefit of the broad community that we serve we must include our significant Medicare population, even if we are required to subsidize care to our Medicare patients due to being reimbursed at less than cost by Medicare's nonnegotiable rates.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance When accounts receivable efforts are exhausted, the account may be placed with a collection agency and extraodinary collection actions (ECAs) 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. Reasonable efforts will be made to identify appropriate forwarding addresses. When a Financial Assistance Application (FAA) is received during the application period (within 240 days after the date the first billing statement is provided), but after initiation of ECAs, all ECAs will be suspended. Best efforts will be made to process completed applications within 30 days of receipt of the application; financial assistance eligibility will be determined and communicated to the individual. Incomplete applications must be completed within 30 days of the initial notification of additional items required; otherwise, the application will be deemed incomplete and closed. If an individual is eligible for financial assistance, ECAs, other than the sale of debt, will be reversed and any payments related to eligible care refunded to the extent no longer owed. ECAs will be reinstated if the individual is not eligible for financial assistance or does not complete the FAA by the deadline. At least 30 days before initiating an ECA, Carilion will send the patient written notice of intended ECA(s), a plain language summary explaining financial assistance available and the process for determining eligibility, and the deadline for applying for assistance. Carilion will also attempt to call individuals at least 30 days before initiating an ECA to make them aware of the financial assistance available and how to obtain assistance with the application process. Carilion shall enter into a written contract with any collection agency to which it refers bad debt. The contract will obligate the collection agency to observe and comply with Carilion's obligations under this Policy and the Financial Assistance Policy. A collection agency to which bad debt is referred for collection may not engage in any ECAs without the prior written consent of Carilion. After making reasonable efforts to determine if a patient qualifies for Financial Assistance and the patient either does not qualify for Financial Assistance or fails to submit an application as requested, within 240 days from the date the first 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, in cases of a deceased patient, auto accident, or any other unique circumstances requiring special handling, the accounts are placed with the DRD. When all collection efforts have been exhausted, all hospital accounts will be returned and closed as uncollectible. No further collection activity is taken at that time. Accounts with satisfactory payment arrangements, legal activity or accounts with pending payment will be considered active and are not returned.
Schedule H, Part V, Section B, Line 16a FAP website A - CARILION MEDICAL CENTER -DBA CRMH: Line 16a URL: HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE;
Schedule H, Part V, Section B, Line 16b FAP Application website A - CARILION MEDICAL CENTER -DBA CRMH: Line 16b URL: HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - CARILION MEDICAL CENTER -DBA CRMH: Line 16c URL: HTTPS://WWW.CARILIONCLINIC.ORG/BILLING/FINANCIAL-ASSISTANCE;
Schedule H, Part VI, Line 2 Needs assessment In addition to conducting regular Community Health Needs Assessments (CHNA), Carilion Clinic closely monitors community health indicators and responds to needs as they arise. Each year, Carilion updates scorecards with refreshed County Health Rankings indicators provided by the Robert Wood Johnson Foundation. Carilion is also responsive to needs identified through clinical data and internal departments. Carilion's call center, Carilion Direct, is available for community members to ask questions and connect with community resources. The Planning and Community Development department studies chronic disease incidence and prevalence rates, monitors health status indicators and assesses health disparities. Carilion adapted its community health improvement process from Associates in Process Improvement's Model for Improvement and the Plan-Do-Study-Act cycle developed by Walter Shewhart. It consists of five 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. Needs are also identified through advisory boards and focus groups conducted in key neighborhoods or aligned with community initiatives. Ongoing collaboration with community stakeholders allows for regular communication of community needs and gives our partners opportunities to respond cohesively. Carilion fosters community development in its CHNA and community health improvement processes through the Strive Collective Impact Model for the Community Health Assessment Team. 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 toward shared strategies.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Information on Financial Assistance is provided to the patient at hospital admission and ambulatory areas in the form of signage, a plain language summary which includes contact information, financial assistance application and documentation in the inpatient handbook. Patient Access staff, Hospital social workers and customer service representatives verbally inform patients on availability of assistance. Each patient statement and patient financial responsibility letter includes information on the Financial Assistance policy including who to contact for additional information and location of in-person assisters. The Application, the Policy, and the plain language summary are available free of charge to the patient. They are available by mail and on the web site if the patient did not receive written information at the time of service. Financial Assistance policy and application are also distributed to community partners through electronic mailing groups. Carilion Clinic employs an Eligibility staff that counsel patients on federal and state programs. The staff completes applications for Medicaid, Social Security, Social Security Disability and Medicare. The staff provides support services ensuring the applications are processed correctly based on federal and state policy. In addition, the Eligibility staff is trained as Certified Application Counselors and will assist patients in enrollment in the insurance exchange Marketplace. Eligibility staff will also complete Carilion's financial assistance application and counsel patient on the requirements for financial assistance.
Schedule H, Part VI, Line 4 Community information The Roanoke Metropolitan Statistical Area (MSA) is home to Carilion Clinic's flagship hospital, Carilion Roanoke Memorial Hospital. The MSA is commonly known as the Roanoke Valley and comprises the independent cities of Roanoke and Salem and the counties of Botetourt, Craig, Franklin and Roanoke. It is nestled among the Blue Ridge Mountains with the City of Roanoke at its heart. Roanoke is a destination venue rich in cultural diversity, arts, shopping, recreational opportunities, natural beauty and services not available in the region's more rural areas. In addition to Carilion, key safety net providers in the region include Veterans Administrations; New Horizons, a federally qualified health center; free clinics; local offices of the Virginia Department of Health; and other human service organizations. Despite these entities' presence, however, thousands of low-income, uninsured and underinsured residents do not have access to affordable health care services. The 2018 RVCHNA revealed distinct communities with significant differences in size and population and significant disparities in health and social determinants. The 2015-2019 American Community Survey (ACS) found the Roanoke MSA's total population to be 313,009. The cities of Roanoke and Salem had 99,229 residents and 25,317 residents, respectively. The counties of Botetourt, Craig, Franklin and Roanoke had 33,343, 5,110, 56,187 and 93,823 residents, respectively. The median age in the MSA localities ranges from 37.8 in the City of Roanoke to 47.2 in Craig and Franklin Counties, all above the state median of 38.2 (U.S. Census Bureau, 2015-2019 5-year American Community Survey, Table S0101, https://data.census.gov/cedsci/table?q=S0101&tid=ACSST5Y2019.S0101&hidePreview=true). The Weldon Cooper Center for Public Service predicts positive population change by 2040 for all communities except Craig County, which may have very slight population loss (Weldon Cooper Center for Public Service, https://demographics.coopercenter.org/virginia-population-projections). The ACS finds that for most of the Roanoke MSA, a more significant percentage of the population is White than in the Commonwealth of Virginia as a whole, with rates ranging up to 98.6% in Craig County (U.S. Census Bureau, 2015-2019 5-year estimates, American Community Survey, Table DP05, https://data.census.gov/cedsci/table?tid=ACSDP5Y2019.DP05&hidePreview=true). The Roanoke Valley's urban hub, the City of Roanoke, is more racially and ethnically diverse than the rest of the MSA. Roanoke's population is 62.4% White, 29.0% Black, and 3.0% Asian, with 4.4% representing more than one race. The remainder represents small minorities of American Indian/Alaskan Native, Native Hawaiian/Pacific Islander or some other race. Of the population, 6.3% are Hispanic or Latino (U.S. Census Bureau, 2015-2019 5-year estimates, American Community Survey, Table DP05, https://data.census.gov/cedsci/table?tid=ACSDP5Y2019.DP05&hidePreview=true). The city is divided into quadrants (Northwest, Northeast, Southwest and Southeast) separated geographically by railroad tracks, the Roanoke River and Interstate 581. These quadrants vary significantly in the demographic and economic make-up of their residents. Specifically, two of the quadrants- Northwest and Southeast-have federal designations as Medically Underserved Areas. The quadrants are home to a large proportion of the low-income individuals and families in the city who may be uninsured, underinsured or are Medicaid recipients who face additional barriers due to cultural differences.
Schedule H, Part VI, Line 5 Promotion of community health Carilion Clinic is a not-for-profit, integrated health care system located among the Blue Ridge Mountains. Our flagship hospital in the heart of the City of Roanoke, the largest urban hub in western Virginia. Carilion provides quality care for nearly one million individuals through a comprehensive network of hospitals, primary and specialty physician practices, wellness centers, and other complementary services. Carilion's roots go back more than a century when a group of dedicated citizens came together and built a hospital to meet the community's health care needs. Today, Carilion is a vital anchor institution focused on health care and dedicated to our mission of improving the health of the communities we serve. With an enduring commitment to our region's health, care is advanced through clinical services, medical education, research and community health investments. Carilion believes in service, collaboration and caring for all. Carilion invests in discovering and responding to local and regional health needs, understanding that we must involve additional stakeholders to address community health issues and create change effectively. Carilion Medical Center (CMC) includes Carilion's flagship facility, Carilion Roanoke Memorial Hospital (CRMH) (https://www.carilionclinic.org/locations/carilion-roanoke-memorial-hospital). A 703-bed hospital, CRMH consists of a Neonatal Intensive Care Unit, Carilion Children's Hospital, specialty and advanced clinical care, and the region's only Level 1 Trauma Center and Level 1 Pediatric Trauma Center. U.S. News & World Report ranks CRMH among Virginia's top five hospitals. CRMH provides access to the region's most experienced providers and specialty services while teaching and developing tomorrow's medical leaders through residencies and fellowships sponsored by the Virginia Tech Carilion School of Medicine. CMC serves patients regardless of their ability to pay. The hospital's governing board members are elected annually and reside in the region. The majority of members are neither hospital employees nor contractors. Medical staff privileges are extended to qualified providers. Surplus funds are reinvested in new technology, clinical initiatives, education and charitable efforts. Reinvestments include providing free, discounted and subsidized care and critical medical services not otherwise offered in our region.
Schedule H, Part VI, Line 6 Affiliated health care system Carilion Medical Center is wholly owned by Carilion Clinic, a not-for-profit health care organization based in Roanoke, Virginia. Through a comprehensive network of hospitals, primary and specialty physician practices, and complementary services, Carilion provides exceptional care for nearly one million Virginians. With an enduring commitment to the region's health, Carilion advances care through medical education and research, helps its community stay healthy and inspires the region to grow stronger. In the mid-2000s, Carilion made the strategic decision to transform from a collection of hospitals to a physician-led, integrated health care system. Advances include developing a multi-specialty physician group, transforming our primary care practices into patient-centered medical homes, implementing electronic health records system-wide, and creating a robust partnership with Virginia Tech, including developing the Virginia Tech Carilion (VTC) School of Medicine and the Fralin Biomedical Research Institute at VTC. In addition, Carilion continues to evolve its long relationship with what is now Radford University Carilion to assist with educating students in various health professions. Each decision and adaptation have fundamentally changed the way Carilion collaborates and provides care (https://www.carilionclinic.org/about-carilion-clinic). Carilion's community and population health infrastructure is the health system's engine for providing collaborative opportunities to improve and promote the community's health. Carilion's Community Health Assessments process helps identify the strengths and barriers impacting health. Its community-based programs reflect the Robert Wood Johnson Foundation's framework of four main influences of health-health behaviors, social and economic factors, clinical care access and quality, and physical environment. The health system's many partnerships with cross-sector organizations create a collaborative culture of community health and wellness.
Schedule H (Form 990) 2019
Additional Data


Software ID: 19010655
Software Version: 2019v5.0

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
Carilion Medical Center
 
Employer identification number
54-0506332
Part I
General Information on Grants and Assistance
1
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? ........................
2
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
noncash assistance		 (h) Purpose of grant
or assistance
(1) American Heart Association
4217 PARK PLACE COURT
GLEN ALLEN,VA23060 		13-5613797 501(c)3 18,500       Event Sponsorship
(2) ARCH Roanoke
404 Elm Ave SW
Roanoke,VA24016 		23-7064477 501(c)3 17,000       COVID Isolation Center
(3) Center in the Square
1 Market Square
Roanoke,VA24011 		51-0238900 501(c)3 50,000       Children's Museum
(4) Children's Trust Roanoke Valley
541 Luck Avenue
Roanoke,VA24016 		51-0235891 501(c)3 70,000       General Support
(5) Family Service of Roanoke Valley
360 Campbell Ave SW
Roanoke,VA24016 		54-0505946 501(c)3 12,000       Mental Health Support
(6) Roanoke Symphony Orchestra
128 East Campbell Ave
Roanoke,VA24011 		54-6019736 501(c)3 20,000       Corporate Sponsorship
(7) (7) Virginia Blue Ridge Affiliate of Susan G Komen
4910 Valley View Blvd
Roanoke,VA24012 		56-2619425 501(c)3 20,000       Event sponsorship
(8) (8) Virginia Foundation for Independent Colleges
901 East Byrd St
Richmond,VA23219 		54-0554396 501(c)3 10,000       General Support
(9) Virginia Health Care Foundation
707 E Main St
Richmond,VA23219 		54-1639924 501(c)3 50,000       Leadership Partner Support
(10) Virginia Tech Foundation Inc
902 Prices Fork Rd
Blacksburg,VA24061 		54-0721690 501(c)3 8,403       Regional Leadership Forum
(11) Virginia Tech
300 Turner St NW
Blacksburg,VA24061 		54-6001805 Virginia 52,500       COVID Innovation
(12) United Way of Roanoke Valley
325 Campbell Ave SW
Roanoke,VA24016 		54-0535302 501(c)3 15,000       Family Self-Sufficiency
(13) 2019 Commemoration Inc
PO Box 1607
Williamsburg,VA23187 		81-0703911 501(c)3 25,000       Event Sponsorship
(14) National Academy of Sciences
500 Fifth Street NW
Keck Ctr Rm 731
Washington,DC20001 		53-0196932 501(c)3 25,000       General Support
(15) The Roanoke-Blacksburg Innovation Network
1700 Kraft Dr
Blacksburg,VA24060 		46-2975294 501(c)3 100,000       General Support
(16) VA Business Higher Education
1108 East Main Street
Richmond,VA23219 		54-1827038 501(c)3 50,000       General Support
(17) Virginia Ready Initiative
107 S West Street
Alexandria,VA22314 		85-1103573 501(c)3 62,500       General Support
(18) Ronald McDonald House Charities of SW VA
2224 S Jefferson St
Roanoke,VA24014 		54-1244769 501(c)3   263,675 FMV Donated Rent Donated Rent
(19) CHIP of Roanoke Valley
1201 Third Street
Roanoke,VA24016 		54-1566451 501(c)3 50,000       General Support
(20) Blue Ridge Literacy
706 S Jefferson Street
Roanoke,VA24016 		54-1377063 501(c)3 10,000       English and Health Literacy Class
(21) Boys and Girls Club of SWVA
1714 9th Street SE
Roanoke,VA24013 		54-1867366 501(c)3 35,000       Food Access Program and Van
(22) Bradley Free Clinic
1240 Third Street SW
Roanoke,VA24016 		23-7380491 501(c)3 25,000       Continuity of Care & Behavioral Health Services
(23) City of Roanoke
215 Church Ave
Roanoke,VA24011 		54-6001569 City of Roanoke 20,000       Financial Empowerment Center
(24) Kid's Soar
305 Mountain Ave SW
Roanoke,VA24016 		01-0583325 501(c)3 8,500       Literacy initiative
(25) Local Environmental Agricultural Project
PO Box 3249
Roanoke,VA24015 		27-1050909 501(c)3 15,000       Healthy Foods Incentive
(26) Greater Roanoke Transit Company
1108 Campbell Avenue
Roanoke,VA24013 		54-0982022 City of Roanoke 43,831       General Support
(27) Renovation Alliance
530 Eighth St SW
Roanoke,VA24016 		54-1961045 501(c)3 10,000       Repairs for Low Income Homeowners
(28) Virginia Tech Carilion School of Medicine
2 Riverside Circle
Roanoke,VA24016 		26-4556177 501(c)3 3,126,044       Medical School Support
(29) Radford University
232 Cook Hall
Radford,VA24142 		23-7219782 VIRGINIA 10,200       Transfusion Project
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
29
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

Schedule I (Form 990) 2019
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
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) PATIENTS 8 252,129      
(2) SCHOLARSHIPS 5 9,000      
(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 Procedures for monitoring use of grant funds. The hospital donates funds to other charitable organizations in support of health and community improvement. Such organizations also have community boards which oversee the expenditure of such funds. Carilion Clinic is committed to improving the health of the communities we serve by addressing key health priorities identified through our triennial Community Health Assessments. Carilion fulfills this commitment in many ways, one of which is through targeted grants for community health improvement programs and those that impact the social determinants of health. For Carilion Clinic's Community Grant Program, each grantee must sign a letter of agreement with Carilion Clinic that delineates the terms and specific objectives of the project. By accepting a Carilion award, grantees are asked to acknowledge the support of Carilion Clinic in all materials and/or related special events or fundraisers throughout the award cycle where other donors are publicly recognized. One mid-cycle progress report and a final program evaluation are required for each funded project. Site visits may be made to grantees. A grant cycle specifically addressing needs resulting from the impacts of COVID-19 was held in fiscal year 2020 (tax year 2019) and due to the nature of the funding, awardees were required to submit only one, final report. Program evaluation includes alignment with Community Health Assessment priorities, program impact, organizational effectiveness and community benefit through collection of data including clients served, cost effectiveness of the program (cost per client or service), tangible community or client outcomes, 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. Carilion Medical Center also has a program under which endowment funds are granted to community organizations with a focus on children's health and well-being. A committee of Carilion Medical Center employees reviews the applications and selects the recipients. Recipients sign a letter of agreement that delineates the terms and objectives of the project. Recipients submit a mid-year report, and a final program evaluation to report on the program's services, outcomes and budget. Site visits may be made to grantees as needed.
Schedule I (Form 990) 2019



Additional Data


Software ID: 19010655
Software Version: 2019v5.0


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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Carilion Medical Center
 
Employer identification number

54-0506332
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
If any of the boxes on 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 .........
1b
 
No
2
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 on Line 1a? ..
2
Yes
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1Steven Arner
 
Director/President/CEO 		(i)

(ii)		 0
-------------
647,421 		0
-------------
225,708 		0
-------------
4,813 		0
-------------
345,071 		0
-------------
18,548 		0
-------------
1,241,561 		0
-------------
0
2Paul Haskins MD
 
Director 		(i)

(ii)		 300,894
-------------
0 		65,545
-------------
0 		4,580
-------------
0 		221,683
-------------
0 		19,951
-------------
0 		612,653
-------------
0 		0
-------------
0
3Michael Nussbaum MD
 
Director 		(i)

(ii)		 561,198
-------------
0 		116,870
-------------
0 		9,841
-------------
0 		155,196
-------------
0 		15,255
-------------
0 		858,360
-------------
0 		0
-------------
0
4Tracey Criss MD
 
Physician 		(i)

(ii)		 247,516
-------------
0 		74,302
-------------
0 		4,262
-------------
0 		273,662
-------------
0 		17,273
-------------
0 		617,015
-------------
0 		0
-------------
0
5Nicholas Conte
 
Secretary 		(i)

(ii)		 0
-------------
501,457 		0
-------------
201,967 		0
-------------
6,258 		0
-------------
163,964 		0
-------------
18,548 		0
-------------
892,194 		0
-------------
0
6David Hagadorn
 
Asst. Treasurer 		(i)

(ii)		 0
-------------
138,561 		0
-------------
2,000 		0
-------------
8,778 		0
-------------
98,598 		0
-------------
865 		0
-------------
248,802 		0
-------------
0
7Donald Halliwill
 
Asst. Treasurer 		(i)

(ii)		 0
-------------
568,290 		0
-------------
201,281 		0
-------------
4,727 		0
-------------
343,625 		0
-------------
17,248 		0
-------------
1,135,171 		0
-------------
0
8G Robert Vaughan Jr
 
Treasurer 		(i)

(ii)		 0
-------------
270,749 		0
-------------
78,415 		0
-------------
3,948 		0
-------------
297,970 		0
-------------
18,325 		0
-------------
669,407 		0
-------------
0
9Patrice Weiss MD
 
Chief Medical Officer/EVP 		(i)

(ii)		 0
-------------
592,094 		0
-------------
218,870 		0
-------------
6,419 		0
-------------
233,397 		0
-------------
20,031 		0
-------------
1,070,811 		0
-------------
0
10Bruce Long MD
 
Physician 		(i)

(ii)		 381,683
-------------
0 		60,544
-------------
0 		5,353
-------------
0 		177,682
-------------
0 		17,643
-------------
0 		642,905
-------------
0 		0
-------------
0
11Jon Sweet MD
 
Physician 		(i)

(ii)		 235,870
-------------
0 		84,626
-------------
0 		3,359
-------------
0 		198,007
-------------
0 		11,766
-------------
0 		533,628
-------------
0 		0
-------------
0
12Michael Abbott
 
Senior Vice President 		(i)

(ii)		 203,065
-------------
0 		43,438
-------------
0 		1,741
-------------
0 		23,249
-------------
0 		6,835
-------------
0 		278,328
-------------
0 		0
-------------
0
13Nancy Howell Agee
 
CEO, Carilion Clinic 		(i)

(ii)		 0
-------------
1,292,284 		0
-------------
555,922 		0
-------------
406,517 		0
-------------
329,565 		0
-------------
12,301 		0
-------------
2,596,589 		0
-------------
195,503
14Joseph Moskal MD
 
SVP/Chair, Dept. of Orthopedics 		(i)

(ii)		 1,059,011
-------------
0 		242,434
-------------
0 		209,558
-------------
0 		121,621
-------------
0 		20,031
-------------
0 		1,652,655
-------------
0 		195,000
-------------
0
15Paul Skolnik MD
 
SVP/Chair, Dept. of Medicine 		(i)

(ii)		 420,042
-------------
0 		109,178
-------------
0 		9,811
-------------
0 		78,752
-------------
0 		9,638
-------------
0 		627,421
-------------
0 		0
-------------
0
16Jonathan Carmouche MD
 
Physician 		(i)

(ii)		 1,348,131
-------------
0 		494,365
-------------
0 		3,102
-------------
0 		124,635
-------------
0 		17,643
-------------
0 		1,987,876
-------------
0 		0
-------------
0
17Gregory Howes MD
 
Physician 		(i)

(ii)		 1,053,523
-------------
0 		591,012
-------------
0 		2,833
-------------
0 		60,747
-------------
0 		16,343
-------------
0 		1,724,458
-------------
0 		0
-------------
0
18Eric Marvin MD
 
Physician 		(i)

(ii)		 968,562
-------------
0 		458,733
-------------
0 		2,503
-------------
0 		119,418
-------------
0 		16,343
-------------
0 		1,565,559
-------------
0 		0
-------------
0
19ADEOLU OLASUNKANMI MD
 
Physician 		(i)

(ii)		 747,581
-------------
0 		344,332
-------------
0 		8,450
-------------
0 		28,514
-------------
0 		19,202
-------------
0 		1,148,079
-------------
0 		0
-------------
0
20Jesse Stem MD
 
Physician 		(i)

(ii)		 756,856
-------------
0 		536,452
-------------
0 		3,553
-------------
0 		44,712
-------------
0 		17,643
-------------
0 		1,359,216
-------------
0 		0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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
Schedule J, Part I, Line 1a Health or social club dues or initiation fees All Directors are offered a free family or individual membership to a health club owned by a related organization if they choose to accept it. Five reported individuals received this benefit, the value of which is included in reported compensation.
Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses Provision of the health club benefit is documented in Board meeting minutes and Carilion internally tracks the memberships and pays the health club directly.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. Executive compensation, including that of the organization's 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. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, "at-risk" 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.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Mr. Arner, Mr. Conte, Mr. Halliwill, Dr. Moskal, Dr. Nussbaum, Dr. Skolnik, Mr. Vaughan, and Dr. Weiss participate in a Defined Contribution Supplemental Executive Retirement Plan (DC SERP) in which the employer, at the discretion of Carilion Clinic's Compensation Committee, makes a contribution to an account established on its books for each eligible participant. If a participant ceases to be a participant prior to the vesting date, the account shall be forfeited. A lump sum distribution shall be made upon the participant's vesting date, death, or disability. Unvested contributions made to the DC SERP in the reporting period are included in Part II of this schedule with "retirement and other deferred compensation." $195,000 of prior year deferrals were paid to Dr. Moskal under this plan in the reporting year. Ms. Agee participated in an executive flexible benefit plan, in which an allowance is provided annually to the participant for use in obtaining certain insurance benefits. In prior years, the amount of allowance in excess of elected benefits was credited to a capital accumulation account (CAA) with various deferred vesting dates of at least two years from the first day of the plan year, distributable upon vesting while employed by a Carilion Clinic affiliate, death, disability, or 24 months following certain qualifying separations from service. Deferrals no longer occur under this plan. $195,503 was distributed under this plan in the reporting year.
Schedule J, Part I, Line 7 Non-fixed payments The organization pays annual "at-risk" compensation to certain members of management based on performance of an applicable scorecard. While the scorecard contains a formula as a basis for determining overall performance, in certain cases, senior managers have discretion to include additional elements in their assessment of managers reporting to them. In addition, for top management, the actual non-fixed payment awarded is in the discretion of the Carilion Clinic Board of Directors and its Compensation Committee.
Schedule J (Form 990) 2019

Additional Data


Software ID: 19010655
Software Version: 2019v5.0
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet 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.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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 section 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 (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
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?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
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) 2019
Schedule L (Form 990 or 990-EZ) 2019
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?
Yes No
(1) MARY SWEET MD
  		FAMILY MEMBER OF JON SWEET, FORMER KEY EMPLOYEE 374,284 EMPLOYEE   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2019


Additional Data


Software ID: 19010655
Software Version: 2019v5.0




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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
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 Volunteers The hospital operates a Customer Service-based program for volunteers and we do anything to make our patients and patients 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, check in calls, take care of patients' pets, sing to patients, pet therapy, deliver supplies, help in the hospice office, assist with fundraisers, assist with bereavement support activities, facilitate children's grief support groups, deliver birthday gifts, make holiday gifts and memory quilts and record patient's life stories. Total volunteer hours worked were 12,170. NOTE: THE VOLUNTEER PROGRAM WAS SUSPENDED ON MARCH 16,2020 DUE TO COVID WHICH AFFECTED THE AMOUNT OF VOLUNTEER HOURS WORKED.
Form 990, Part III, Line 4a Program Service Description Carilion Medical Center (CMC) d/b/a Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital exists to serve the health care needs of its communities and region, regardless of the patient's ability to pay. CMC admitted 31,269 patients and provided 179,750 days of care during fiscal year 2020. Hospital programs and accomplishments include the Cardiovascular Institute. It includes extensive expertise in cardiology for advanced heart failure, structural heart disease, electrophysiology labs for complex arrhythmias and a robust cardiothoracic surgery program with advanced procedures for complex aortic and vascular disease. Our vascular program remains a leader in treatment and surgical intervention. CMC is known for tertiary level care with expertise in Level 1 trauma for adults and pediatric patients, primary and comprehensive stroke care, neurosurgery for adults and children, and women's services for obstetrics (3,070 babies delivered), high-risk pregnancy, urogynecology, gynecologic oncology and fertility and reproductive care. Another area of surgical excellence is orthopaedics. It includes joint replacement, ortho spine surgery, sports medicine, trauma surgery, foot and ankle, hand and upper extremity and pediatrics. Other medical programs include specialized intensive care units for neurotrauma, cardiac care and cardiac surgery, vascular, medical intensive care, and dedicated units for oncology and thoracic surgery patients. The programs are supported by our acclaimed Magnet nursing program, receiving four Magnet designations over the years. Additional programs include the region's only neonatal intensive care unit, advanced diagnostics and expertise for gastroenterology conditions, inpatient and outpatient psychiatric services, a comprehensive inpatient rehabilitation unit, and inpatient and outpatient surgical care utilizing advanced techniques in robotic and endovascular procedures. Diagnostic testing capabilities in radiology support all CMC programs, including advanced imaging in CT, MRI and PET/CT. We've expanded our field of experts in molecular imaging and nuclear medicine procedures and ultrasound and provide screening mammography and diagnostic breast imaging. Carilion Children's is our region's only pediatric center of excellence with an inpatient hospital within CMC, a pediatric intensive care unit, NICU, and trauma care. Pediatric sub-specialists support the facility in surgery, pulmonology, oncology, cardiology, gastroenterology, psychiatry, orthopaedics, neurosurgery, dentistry, neurology, and endocrinology. CMC provides several services and programs to target the specific health needs of the area, including diabetes management, medically supervised weight loss, urgent care, physical, speech and occupational therapy programs, cardiac and pulmonary rehab and home health and hospice care. Supporting our communities is our 24/7 Level 1 trauma center, full-service emergency department, three medical service helicopters and a highly advanced medical communications center to support the region's emergency transportation needs. Carilion Roanoke Memorial Hospital (CRMH) has been consistently ranked among the nation's top 100 hospitals by Becker's Hospital Review, among the top three hospitals in Virginia by U.S. News and World Report, and it is the region's preferred hospital according to surveys conducted by National Research Corporation (NRC) Health. With 75,712 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 nearly 9 percent of ED visits. The urgent care centers also provide access points for cost effective care at an appropriate level. CMC also supports community screenings and education on chronic disease prevention and management, sponsoring 9,685 events touching over 35,246 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, financial assistance for the year exceeded $14 million.
Form 990, Part IV, Line 11f Disclosure of Uncertain Tax Positions Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.
Form 990, Part V, Line 1a FORMS 1099 1099s are issued on Carilion Medical Center's behalf by Carilion Services, Inc., a related supporting organization providing management and administrative services, including payment processing.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons Nancy Howell Agee, Steve Arner, Nicholas Conte, David Hagadorn, Donald Halliwill, G. Robert Vaughan, Jr., and Patrice Weiss. - Business relationship
Form 990, Part VI, Line 3 Delegation of management duties Certain management and related services for the organization are provided by the management and employees of Carilion Services, Inc., a related and supporting organization of the filing organization. Some or all of the compensation of the following individuals listed in Part VII, Section A was provided by Carilion Services Inc.: Nancy Howell Agee, Steven Arner, Nicholas Conte, David Hagadorn, Donald Halliwill, G. Robert Vaughan, Jr., and Patrice Weiss.
Form 990, Part VI, Line 6 Classes of members or stockholders The organization has a single member. The sole member is Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The sole member elects the directors of the organization and has certain other reserved powers.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The sole member of the organization, Carilion Clinic, elects the members of the governing body of the organization periodically as terms expire. The sole member also has the right to remove directors and fill any vacancies on the board that may occur for any reason.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO; approval of borrowings, budgets, and strategic plans; and amendments of Articles of Incorporation and Bylaws. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia, certain extraordinary actions require member approval, such as mergers, consolidations, liquidations, and the sale of substantially all of the assets of the organization. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a.
Form 990, Part VI, Line 11b Review of form 990 by governing body The Form 990 was prepared by Carilion's internal Tax Department with input from various Carilion departments as applicable, and reviewed by internal Accounting Management and an independent 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, Line 12c Conflict of interest policy Our organization monitors and reviews proposed and current transactions for conflicts of interest in a variety of ways. At the governing board level, we have board members complete an initial (upon appointment) and annual conflict of interest questionnaire to disclose actual or potential conflicts. Board members are required to update their disclosure as needed in between questionnaires. All disclosures are reviewed by the Organizational Integrity & Compliance Office and as needed escalated to the appropriate leaders/board members for further discussion/review. If a disclosure is viewed as an actual or potential conflict, an action is recommended to the Compliance Committee of the Carilion Clinic Board and implemented as approved. Actions can include recusal in discussion/voting at board meetings, limitation/termination of the transaction, removal from board appointment or other appropriate controls. In addition, at any time, board members are encouraged to disclose any potential conflicts as they arise at a board meeting and to recuse themselves as deemed appropriate. The same process takes place as described above for key employees (upon hire and annually thereafter), including all officers, members of the management team, physicians/mid-level practitioners, pharmacists and key supply chain buyers. After review and further discussion as needed, action may be required to manage an actual conflict or to reduce the appearance of such as approved by Organizational Integrity & Compliance Office and other key management team members. As needed, the governing board leaders are notified of any conflicts which may impact board proceedings.
Form 990, Part VI, Line 15a Process to establish compensation of top management official The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. 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, the Executive Vice Presidents (Chief Financial Officer, Chief Medical Officer, Chief Operating Officer, Chief Administrative Officer and Chief Legal Officer), and select Senior Vice Presidents who are the physician Chairs of the Clinical Departments. For the fiscal year covered by this return, the Compensation Committee also used the same process to review the compensation of other Disqualified Individuals, including the Hospital Vice Presidents. In addition, the Compensation Committee annually reviews the compensation philosophy for all executive leaders, which includes Vice Presidents, Senior Vice Presidents, Executive Vice Presidents, and the CEO, as well as the compensation philosophy for employed physicians. Some officers of the organization who are not compensated in their capacity as an officer but rather in their role as employee in a position not mentioned above are not subject to Committee review. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for select positions and the prior year's report on all of the reviewed positions. The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk' 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.
Form 990, Part VI, Line 15b Process to establish compensation of other employees See response to line 15A
Form 990, Part VI, Line 19 Required documents available to the public The organization's governing documents, conflict of interest statement, and financial statements are released from time to time during the tax year upon request. The conflict of interest policy is included in our Code of Excellence which is available to the public on our website. The Articles of Incorporation are available from the Virginia State Corporation Commission. Limited financial information is available on our website.
Form 990, Part VIII, Line 2f Other Program Service Revenue Other - Total Revenue: 2837619, Related or Exempt Function Revenue: 2837619, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Revenue - Total Revenue: 7929297, Related or Exempt Function Revenue: 7929297, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part X, Line 20 Tax Exempt Bond Liabilities The amount reported as Tax-Exempt Bonds is the portion of Carilion Clinic Bonds allocated to Carilion Medical Center. Required information for the Bonds, including Schedule K, is reported in the Carilion Clinic (EIN: 54-1190771) IRS Form 990.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfers from/(to) Affiliates - -9290109; Pension-related changes other than net periodic pension costs - -3078245; Transfer Accumulated FCV LLC Investment from Carilion Clinic - -197601;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID: 19010655
Software Version: 2019v5.0
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
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?
Yes No
(1)CARILION CLINIC
PO BOX 12385

ROANOKE,VA24025
54-1190771 		SUPPORTING ORGANIZATION VA 501(c)(3) Type II NA
 
 
No
(2)CARILION CLINIC FOUNDATION
PO BOX 12385

ROANOKE,VA24025
54-1190773 		FUNDRAISING VA 501(c)(3) 7 CARILION CLINIC
 
Yes
 
(3)CARILION FRANKLIN MEMORIAL HOSPITAL
PO BOX 12385

ROANOKE,VA24025
54-0480606 		HEALTHCARE VA 501(c)(3) 3 CARILION CLINIC
 
Yes
 
(4)CARILION GILES COMMUNITY HOSPITAL
PO BOX 12385

ROANOKE,VA24025
54-0549603 		HEALTHCARE VA 501(c)(3) 3 CARILION CLINIC
 
Yes
 
(5)CARILION NEW RIVER VALLEY MEDICAL CENTER
PO BOX 12385

ROANOKE,VA24025
54-0553805 		HEALTHCARE VA 501(c)(3) 3 CARILION CLINIC
 
Yes
 
(6)CARILION SERVICES INC
PO BOX 12385

ROANOKE,VA24025
54-1190879 		SUPPORTING ORGANIZATION VA 501(c)(3) Type II CARILION CLINIC
 
Yes
 
(7)CARILION STONEWALL JACKSON HOSPITAL
PO BOX 12385

ROANOKE,VA24025
54-0568001 		HEALTHCARE VA 501(c)(3) 3 CARILION CLINIC
 
Yes
 
(8)CARILION TAZEWELL COMMUNITY HOSPITAL
PO BOX 12385

ROANOKE,VA24025
54-6074580 		HEALTHCARE VA 501(c)(3) 3 CARILION CLINIC
 
Yes
 
(9)CARILION BIOMEDICAL INSTITUTE
PO BOX 12385

ROANOKE,VA24025
54-1965057 		SUPPORTING ORGANIZATION VA 501(c)(3) Type I CARILION CLINIC
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
Yes No Yes No
(1) FRANKLIN COUNTY VENTURES LLC

PO BOX 12385
ROANOKE,VA24025
47-4365316 		REAL ESTATE VA CARILION CLINIC
  		Related -1,497 201,189   No     No 10 %
(2) CARILION CLINIC MEDICARE SHARED SAVINGS COMPANY LLC

PO BOX 12385
ROANOKE,VA24025
45-5235473 		MEDICARE HMO VA CARILION CLINIC
  		Related 6,471,910 0   No     No 50 %
(3) SOUTHWEST VIRGINIA HEALTH PROPERTIES LLC

1102 Jefferson Street SE
Roanoke,VA24016
01-0691570 		REAL ESTATE VA Carilion Medical Center
  		Related 86,256 1,299,766   No     No 51.12 %
(4) RAVEN ASSET BASED OPPORTUNITY FUND IV LP

110 Greene St Suite 9G
New York,NY10012
82-4119491 		Private Equity DE NA
  		N/A                
(5) TI PLATFORM CC SMA LP

1160 Battery Street East
San Francisco,CA94111
84-2852539 		Investments DE NA
  		N/A                
(6) STARWOOD VEP II CO-INVEST LLC

591 W Putman Avenue
Greenwich,CT06830
83-3262407 		Investments DE NA
  		N/A                


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
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) CHS INC

PO BOX 12385
ROANOKE,VA24025
54-1725732 		SERVICES VA NA
  		C Corporation       Yes  
(2) CARILION CLINIC MEDICARE RESOURCES LLC

PO BOX 12385
ROANOKE,VA24025
26-3729975 		MEDICARE HMO VA NA
  		C Corporation       Yes  
(3) CARILION BEHAVIORAL HEALTH INC

PO BOX 12385
ROANOKE,VA24025
20-3136891 		HEALTHCARE VA NA
  		C Corporation       Yes  
(4) CARILION EMERGENCY SERVICES INC

PO BOX 12385
ROANOKE,VA24025
54-2033006 		HEALTHCARE VA NA
  		C Corporation       Yes  
(5) SCA CREDIT SERVICES INC

PO BOX 12385
ROANOKE,VA24025
54-1180398 		COLLECTION AGENCY VA NA
  		C Corporation       Yes  
(6) CARILION HEALTHCARE CORPORATION

PO BOX 12385
ROANOKE,VA24025
54-1586601 		HEALTHCARE VA NA
  		C Corporation       Yes  
(7) MEDKEY INC

PO BOX 12385
ROANOKE,VA24025
54-1645357 		FINANCING SERVICES VA NA
  		C Corporation       Yes  
(8) SPROTT PRIVATE RESOURCE LENDING (C-CO-INVEST) LP

 
 
98-1378742 		INVESTMENTS CA NA
  		C Corporation       Yes  
(9) BLACKMOOR OWNERSHIP HOLDINGS LIMITED

 
 
INVESTMENTS CJ NA
  		C Corporation       Yes  
(10) MAGNITUDE SYSTEMATIC LONG SHORT FUND

 
 
INVESTMENTS CJ NA
  		C Corporation       Yes  
(11) TANGIBLE SEGREGATED PORTFOLIO OF THE SOUTH AFRICA ALPHA SPC

 
 
INVESTMENTS CJ NA
  		C Corporation       Yes  
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
No
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 .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
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 CLINIC FOUNDATION

 A 38,784 COST
(2) CARILION EMERGENCY SERVICES

 A 95,940 COST
(3) CARILION HEALTHCARE CORPORATION

 A 27,000 COST
(4) CHS INC

 A 56,392 COST
(5) CARILION SERVICES INC

 A 720,790 COST
(6) CARILION EMERGENCY SERVICES

 L 302,902 COST
(7) CARILION FRANKLIN MEMORIAL HOSPITAL

 L 1,943,999 COST
(8) CARILION GILES COMMUNITY HOSPITAL

 L 487,032 COST
(9) CARILION HEALTHCARE CORPORATION

 L 252,764 COST
(10) CARILION NEW RIVER VALLEY MEDICAL CENTER

 L 2,919,690 COST
(11) CARILION SERVICES INC

 L 79,638 COST
(12) CARILION STONEWALL JACKSON HOSPITAL

 L 709,341 COST
(13) CARILION TAZEWELL COMMUNITY HOSPITAL

 L 1,996,945 COST
(14) CARILION BEHAVIORAL HEALTH

 M 133,062 COST
(15) CHS INC

 K 1,773,512 COST
(16) CHS INC

 M 5,237,442 COST
(17) CARILION NEW RIVER VALLEY MEDICAL CENTER

 K 215,495 COST
(18) CARILION SERVICES INC

 M 199,125,574 COST
(19) CARILION TAZEWELL COMMUNITY HOSPITAL

 K 152,009 COST
(20) SCA CREDIT SERVICES INC

 M 883,791 COST
(21) CARILION SERVICES INC

 R 9,294,593 CASH
(22) Carilion Clinic Foundation

 C 505,223 CASH
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) 2019

Additional Data


Software ID: 19010655
Software Version: 2019v5.0