Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (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 | |||||
| (A)
CARILION MEDICAL CENTER |
540506332 | 3 | Yes | 0 | 185,823 | |
| (B)
CARILION NEW RIVER VALLEY MEDICAL CENTER |
540553805 | 3 | Yes | 0 | 35,580 | |
| (C)
CARILION GILES COMMUNITY HOSPITAL |
540549603 | 3 | Yes | 0 | 8,437 | |
| (D)
CARILION FRANKLIN MEMORIAL HOSPITAL |
540480606 | 3 | Yes | 0 | 9,493 | |
| (E)
CARILION ROCKBRIDGE COMMUNITY HOSPITAL |
540568001 | 3 | Yes | 0 | 8,670 | |
| (F)
CARILION TAZEWELL COMMUNITY HOSPITAL |
546074580 | 3 | Yes | 0 | 3,563 | |
|
Total 6
|
0 | 251,566 | ||||
Calendar year
(or fiscal year beginning in)
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(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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 on 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.).. | ||||||
| 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 0.015 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 0.035 | 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part I, Line 12 IRS Determination Letter | Although the filing organization has an IRS letter determining that it is a Type I supporting organization under Section 509(a)(3), the organization's status is more appropriately described under the Type II test as an organization supervised or controlled in connection with its supported organizations by having control or management of the supporting organization vested in the same persons that control or manage the supported organizations. |
| Schedule A, Part I, Line 12g Support to Supported Organizations | Carilion Clinic provides leadership, governance, and strategic direction to its supported organizations. |
| Schedule A, Part IV, Section C, Line 1 Majority director detail | The filing organization is supervised or controlled in connection with its supported organizations consistent with the Type II supporting organization requirements because a majority of the officers or directors who control or manage the filing organization also serve as a majority of the officers or directors of its supported organizations. Therefore, the same people who control or manage the filing organization also control or manage its supported organizations. Further, the filing organization's bylaws require that a majority of its directors or officers, as the case may be, must be serving concurrently as directors or officers of at least one of the filing organization's supported organizations. |
| Software ID: | 22016089 |
| Software Version: | 2022v5.0 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 4a Program Service Description | As the parent company for all Carilion affiliates, Carilion Clinic drives fulfillment of Carilion's mission to improve the health of the communities it serves. Carilion Clinic is an organization of physicians working together as a team. In June 2006, Carilion Health System announced plans to transform the not-for-profit hospital system into a Clinic organization headquartered in Roanoke, Virginia. The clinic structure aligns hospital and physician goals with a focus on evidence-based medical practice, consistency in care and service based on proven methods and procedures, attention to the optimal length of each patient's stay in the hospital and to using costly resources as efficiently as possible, and an environment of active medical research and education to further advance the practice of medicine. Integration of inpatient and outpatient services across the continuum of care and seamless, convenient access to services for the patient also are integral to the clinic model. Carilion Clinic emphasizes the integration of care, clinical quality, and safety. Carilion Clinic, through its affiliates, employs a staff of over 900 physicians with continued development of outcomes-based clinical performance metrics, a fully integrated clinical information system, including an Electronic Medical Record (EMR) shared by all hospitals and physician practices, and numerous medical education residency and fellowship programs. Providing leadership and vision, Carilion Clinic also oversees a core hospital business that admitted 43,041 patients, delivered 3,865 babies and provided 254,220 days of care. Carilion's hospitals provided comprehensive heart and vascular care, surgical excellence in orthopaedics, advanced surgery and care for oncology and new pain management protocols. A state-of-the-art communications center coordinates patients' transportation to all our hospitals. All our programs are supported by diagnostic testing capabilities in radiology, including advanced imaging in CT, MRI and PET/CT. We've grown our expertise in molecular imaging and nuclear medicine procedures and ultrasound and provide screening mammography and diagnostic breast imaging. 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. Carilion Children's is our region's only pediatric center of excellence with an inpatient hospital within Carilion Medical Center, a pediatric intensive care unit, NICU, and trauma care. Pediatric sub-specialists support the facility in areas of surgery, pulmonology, oncology, cardiology, gastroenterology, psychiatry, orthopaedics, neurosurgery, dentistry, neurology, endocrinology. The Clinic 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 rehabilitation, and home health and hospice care. Carilion Clinic maintains both a Level I designated trauma center (Carilion Medical Center) serving the western Virginia area and a Level III trauma center (Carilion New River Valley Medical Center) serving its surrounding area. As part of its commitment to trauma response, Carilion staffs medical air transport helicopters which flew 1,784 patients and operates a ground service providing 15,560 medical transports during the year. With 162,010 visits, Carilion's emergency departments are a critical component of the health safety net in its service area, acting as a key health provider for a significant number of uninsured patients, who comprise nearly 6% of emergency visits. Carilion Clinic's hospitals supported community screenings and education on chronic disease prevention and management. In furtherance of its mission to improve health regardless of patient ability to pay, Carilion Clinic provided extensive uncompensated care. Stated at cost, the Carilion Clinic system together provided nearly $81 million in uncompensated care and other community benefits. |
| 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 Clinic's behalf by Carilion Services, Inc., a related organization providing management and administrative services, including payment processing. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | Carilion Clinic has an Executive Committee authorized to act when the Board is not in session. The Executive Committee has 9 members, made up of the Chair of the Board, the CEO, the Chairs of each of the 6 standing committees, and the Chair of the Board of Carilion Medical Center, which is the organization that holds the flagship hospital. The Executive Committee typically meets three (3) times a year, at times the full Board does not meet and can act on behalf of the Board, except it cannot elect directors or take certain extraordinary actions, such as a sale, merger, or dissolution of the corporation. Full board meetings are occasionally substituted for Executive Committee meetings. |
| Form 990, Part VI, Line 2 Family/business relationships amongst interested persons | Nancy Howell Agee, Abney Boxley and Elizabeth McClanahan - Business relationship, Nancy Howell Agee, Steven Arner, Jeanne Armentrout, Nicholas Conte, David Hagadorn, Donald Halliwill, Daniel Harrington, Jeri Lantz, Patrice Weiss, G. Robert Vaughan, Jr, and Julie Smith-Hamilton - Business relationship, NICK CONTE and TERRY AUSTIN - 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 organization to the filing organization. Some or all of the compensation of the following individuals listed in Part VII, Section A was provided by Carilion Services Inc.: Nancy Howell Agee, Jeanne Armentrout, Steven Arner, Nicholas Conte, David Hagadorn, Donald Halliwill, Julie Smith-Hamilton, Daniel Harrington, G. Robert Vaughan, Jr., and Patrice Weiss, M.D. |
| 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. Prior to filing, all Board Members were notified via email that the final Form 990 was posted on the organization'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 Compliance Office and as needed escalated to the appropriate leaders/board members for further discussion/review. If a disclosure is viewed as an actual or potential conflict, an action is recommended to the Compliance Committee of the Carilion Clinic Board and implemented as approved. Actions can include recusal in discussion/voting at board meetings, limitation/termination of the transaction, removal from board appointment or other appropriate controls. In addition, at any time, board members are encouraged to disclose any potential conflicts as they arise at a board meeting and to recuse themselves as deemed appropriate. The same process takes place as described above for key employees (upon hire and annually thereafter), including all officers, members of the management team, physicians/mid-level practitioners, pharmacists and key supply chain buyers. After review and further discussion as needed, action may be required to manage an actual conflict or to reduce the appearance of such as approved by the Compliance Office and other key management team members. As needed, the governing board leaders are notified of any conflicts which may impact board proceedings. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | Executive compensation is reviewed annually by the Carilion Clinic Board of Directors Compensation Committee. This Committee is made up of independent Board Members of Carilion Clinic who do not have a conflict of interest with any of the executives being reviewed. 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 certain 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 other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, which list was reviewed by the Compensation Committee. The Compensation Committee maintained minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives. |
| 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 for the Carilion Clinic companies as a whole is available on the Carilion Clinic website |
| Form 990, Part IX, Line 11g Other Fees | Other Purchased Services - Total Expense: 857153, Program Service Expense: 857153, Management and General Expenses: , Fundraising Expenses: ; Housekeeping Service - Total Expense: 2073012, Program Service Expense: 2073012, Management and General Expenses: , Fundraising Expenses: ; Repairs and Maintenance - Total Expense: 2158952, Program Service Expense: 2158952, Management and General Expenses: , Fundraising Expenses: ; Consulting - Total Expense: 28405, Program Service Expense: , Management and General Expenses: 28405, Fundraising Expenses: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | TRANSFERS (TO)/FROM AFFILIATES - NET - -8197736; Unrelated Business Income - 7405283; |
| Schedule F, Part I, Line 3 Investments | Investment assets are held in custody under the name of Carilion Clinic and allocated to related entities based on their ownership interest in the investment pool. |
| Software ID: | 22016089 |
| Software Version: | 2022v5.0 |