Carilion New River Valley Medical Center

“Nicholas Conte, William Flattery, Donald Halliwill, J. Harrison Lapuasa, G. Robert Vaughan, Jr, Julie Smith-Hamilton, Charles Bissell, and Ashish Raju - Business relationship”

“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.: Nicholas Conte, David Hagadorn, Donald Halliwill, Julie Smith-Hamilton, J. Harrison Lapuasa and G. Robert Vaughan, Jr. Certain management and related services for Carilion New River Valley Surgery Center, LLC, a disregarded entity of the filing organization, are provided by the employees of ASD Management. None of the individuals listed in Part VII, Section A received compensation from ASD Management.”

“The maximum number of Trustees changed from 15 to 16 persons.”

“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.”

“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.”

“The sole member of the organization, Carilion Clinic, holds reserved powers with respect to certain enumerated actions, including appointment of CEO; approval of borrowings, budgets, and strategic plans; and amendments of Articles of Incorporation and Bylaws, among others. Approval by the Board of Directors of Carilion Clinic is required for such actions. In addition to the reserved powers, under the laws of the Commonwealth of Virginia, certain extraordinary actions require member approval, such as mergers, consolidations, liquidations, and the sale of substantially all of the assets of the organization. See also Schedule O disclosure for Form 990, Part VI, Section A, Line 7a”

“The Form 990 was prepared by Carilion's internal Tax Department with input from various Carilion departments as applicable, and reviewed by internal management. Prior to filing, all Board Members were notified via email that the final Form 990 was available for their access on the organization's Board portal and were provided contact information to reach out to for any questions.”

“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.”

“The organization has a single member, Carilion Clinic, a charitable tax-exempt organization which serves as the parent company of the Carilion Clinic integrated health care delivery system. The Carilion Clinic Board of Directors Compensation Committee reviews the compensation of the Carilion Clinic Board of Governors annually, which includes the Carilion Clinic President and Chief Executive Officer, Executive Vice Presidents (Chief Financial Officer, Chief Physician Executive, Chief Operating Officer, Chief Administrative Officer and Chief Legal Officer), and select Senior Vice Presidents who are the physician Chairs of the Clinical Departments. Certain of these same individuals also hold roles as officers of the filing organization. The Compensation 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. The Compensation Committee also annually reviews the compensation philosophy for all executive leaders in the health system, which includes Vice Presidents, Senior Vice Presidents, Executive Vice Presidents, and the CEO, among them the filing organization's top management official and certain other officers. This review included review of a comprehensive report from an independent, outside compensation consultant specializing in healthcare organizations for certain select positions and the prior year's report on all the reviewed positions . The reports reviewed by the Committee included a detailed comparison of total compensation and each element thereof, including base salary, bonus, 'at-risk other cash compensation, and benefits, including deferred and retirement benefits. Compensation was compared to both a national and regional peer group of organizations similar in size and structure to the organization, which list was reviewed by the Compensation Committee. The Compensation Committee maintained minutes of its meetings, setting forth the deliberations and decisions of the Committee regarding the compensation of these executives. For the filing organization's top management official and certain officers who are not directly reviewed by the Compensation Committee, the independent external compensation consultant conducts the same analysis and shares the data/findings with the system EVP/COO. Certain assistant officers of the organization who are not compensated in their capacity as an officer but rather in their role as employee in a position not mentioned above are not subject to Committee or consultant review but are compared to market benchmarks by the Human Resources department.”

“See response to line 15A.”

“The organization's governing documents, conflict of interest statement, and consolidated financial statements are released from time to time during the tax year upon request. The conflict of interest policy is included in our Code of Excellence which is available to the public on our website. The Articles of Incorporation are available from the Virginia State Corporation Commission. Limited consolidated financial information is available on our website.”

“Purchase Discounts - Total Revenue: 15000, Related or Exempt Function Revenue: 15000, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Court Cost Recovery - Total Revenue: 7030, Related or Exempt Function Revenue: 7030, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Miscellaneous - Total Revenue: 1230, Related or Exempt Function Revenue: 1230, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Returned Check Fees - Total Revenue: 60, Related or Exempt Function Revenue: 60, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Affiliate Revenue - Total Revenue: 23598, Related or Exempt Function Revenue: 23598, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Other Revenue - Total Revenue: 32401, Related or Exempt Function Revenue: 32401, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;”

“CNRV has Front Desk volunteers who help with wayfinding, escorting and general office work. Volunteers enhance the department by offering assistance and guidance to our patients, visitors, and staff. We have local music teachers who hold their bi-yearly recitals and concerts at the hospital using the lobby piano. In addition to the piano, music students also play violin, cello, and other instruments to bring cheer to the visitors and staff of the hospital. We also have a past youth volunteer who now, as an adult, plays the piano several times a month as well as a music teacher who plays on a regular basis. We added new Pet Pals volunteers and can accommodate additional visits to units to help uplift staff with "puppy" love several times per month. We held our Summer Youth Volunteer Program again this year. Youth were able to help in several departments doing work in Inpatient Pharmacy, Cardiology, Safety, Guest Services, and helping anywhere needed. Additionally, we added six volunteers to our Emergency Department to help with non-clinical tasks providing patients with excellent care. We have a robust AA program in St. Albans Hospital, adding an additional volunteer to help with this program. We began our No one Dies Alone (NODA) volunteer program to sit with patients who would otherwise be alone during this critical time. Volunteer fundraising efforts were enhanced in Fiscal Year 2024 by holding several new programs including Lights of Love and a Spring Plant Sale. During our Lights of Love program, we involved a local high school art class to design our ornaments and plans to continue this in the future. The Great Grounds Coffee Shop in the lobby is open M - F, 7 - 11 a.m. providing coffee to staff, and guests. All profits from coffee and snacks sold, go to enhance volunteer programs at CNRV. We look to grow our volunteer and fundraising programs in the coming years. Volunteers provide office activities as in helping to prepare grief mailings each month, tuck in calls, helping with Admission binders and other office tasks as needed. Patient care volunteers provide socialization for our patients and families. They also provided respite for our families. Veteran to Veteran volunteer provided socialization and honoring of veteran patient. We also offer pet therapy volunteer. Started a new program of Virtual Reality for patients. We offered End of Life Doula including vigil planning volunteer. Volunteers also made fidget blankets, Veteran Quilts, Patient bibs and bags to carry supplies to patient's homes.”

“Carilion New River Valley Medical Center, part of Carilion Clinic, is a not-for-profit healthcare organization committed to improving health outcomes for every patient while advancing the quality of care in the community it serves. The medical center is a modern hospital facility with diagnostic and medical and surgical care, a Level III Trauma emergency department, and Carilion Clinic Saint Albans Hospital for psychiatry and behavioral medicine. Carilion New River Valley Medical Center (CNRV) exists to serve the health care needs of its community, regardless of a patient's ability to pay. CNRV admitted 7,671 patients, provided 37,506 days of care during the year, and delivered 739 babies. Hospital programs include the provision of nursing care, extensive outpatient and inpatient medical, surgical and endoscopic services, comprehensive heart treatment with interventional cardiac catheterization, diagnostic, therapeutic and rehab solutions, and diagnostic imaging services including CT, MRI, PET/CT, mammography, x-ray and ultrasound. Additional specialty surgical care includes advanced surgery with robotics, general and vascular surgery, orthopedics, urology, gynecologic, neurosurgery, plastic surgery and ENT care. Medical care in pulmonary, neurology, physical medicine and pediatrics support patient care. With 17% of its inpatient admissions representing psychiatric admissions and a significant outpatient presence in behavioral medicine, CNRV plays a critical role in providing mental health services to the region. CNRV is a Level III trauma center and provides a home base for Lifeguard, the emergency medical air transport that serves the surrounding area. CNRV provides several inpatient and outpatient services targeting the specific health needs of its population, including diabetes management, home health and hospice, physical, speech, occupational and pediatric therapy programs, and cardiac and respiratory rehab. CNRV also provides an emergency department with 24-hour care and emergency transportation. With 31,414 visits, CNRV's emergency services are a critical component of the health safety net in its service area, acting as the primary health provider for a significant number of uninsured patients, who comprise nearly 5 percent of ED visits. In furtherance of its mission, CNRV provides extensive uncompensated care and community support. Activities include numerous community screening events and education on chronic disease prevention and management. CNRV also champions and supports a Medication Assistance Program in partnership with community-based social services. Stated at cost, total financial assistance and other community benefits for the year exceeded $4.1 million.”

“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.”

“1099s are issued on Carilion New River Valley Medical Center's behalf by Carilion Services, Inc., a related supporting organization providing management and administrative services, including payment processing. Carilion New River Valley Medical Center's disregarded entity, Carilion New River Valley Surgery Center, LLC, issued 3 1099s for the year.”

“The amount reported as Tax-Exempt Bonds is the portion of Carilion Clinic Bonds allocated to Carilion New River Valley Medical Center. Required information for the Bonds, including Schedule K, is reported in the Carilion Clinic (EIN: 54-1190771) IRS Form 990.”

“Pension-related changes other than net periodic pension costs - -7377968; Transfers from/(to) Affiliates - -21470388;”