Carilion Clinic awarded $19.3 million worth of construction work over a three-year period to the company of a builder who sits on its board of directors.

Roanoke-based J.M. Turner & Co. Inc. received $582,724, $9 million and $9.7 million in 2006, 2005 and 2004, respectively. The company's chairman, chief executive officer and co-owner is Jay Turner, a Carilion board member during each of those years.

Turner said Carilion lets board members work for or sell products and services to the system, with oversight, and confirmed that his company provides needed health care construction services.

Carilion's hiring of the firm has not been his decision or a decision he influenced, he said, though he is pleased the company named after his father is a Carilion contractor.

Carilion said it values having business-minded individuals drawn from the community on its board.

"I'm not sure you could have a business-oriented board and not have somebody's company doing business at some level with Carilion in some way. You'd have to bring board members in from outside the state," Carilion spokesman Eric Earnhart said.

For protection, a conflict-of-interest policy exists whose aim, Earnhart said, is to ensure no board member benefits inappropriately from his or her position of power. Carilion spends roughly $1 billion annually in Southwest and Western Virginia.

"We have certainly abided by those rules, and I feel like our company provides a very valuable service," said Turner, 63.

Earnhart said all the work the Turner contracting firm received from Carilion was either competitively bid -- meaning the company beat out other contractors for a project with a designated value -- or awarded in a "design-build" environment in which only the project manager is chosen upfront after negotiations.

The money represents perhaps 10 percent of Carilion's construction spending during the three years under analysis and would have gone to J.M. Turner & Co. even if the company leader wasn't a board member, Earnhart said.

"We've had excellent experience with J.M. Turner & Co.," he said.

Although its board meetings are closed to the public, Carilion annually identifies board members and key personnel and their family members who have Carilion jobs or business relationships with the health system. It by law also tells how much money the people or their companies received and why.

The law requires not-for-profit, tax-exempt organizations to put the information on a Form 990 that is a public record available from the Internal Revenue Service, the organization itself and other sources.

Turner topped Carilion's payout lists that detail which system officials benefited financially for 2004 through 2006.

In other examples, Carilion said it bought $1,698 worth of furniture from Grand Home Furnishings, where former Carilion board Chairman George Cartledge is an executive, and paid salary and benefits of $33,297 in 2005 to the spouse of board member and physician James Nuckolls. Nuckolls' wife works at a Carilion-owned medical practice.

It is not publicly known how much business the Turner company received from Carilion last year. A report covering the final three months of 2006 and most of 2007 is due out in late summer or early fall.

Turner has played a role on many Carilion projects

The millions of dollars listed as going to J.M. Turner are not a surprise because the company, while not Carilion's exclusive builder by any means, has played key roles in many projects.

It is currently involved in erecting the large Carilion Clinic physician services building on South Jefferson Street at Reserve Avenue. It will have a role in a new Pearisburg hospital.

Jay Turner also received a fee of $23,000 for his board service from 2004-06, according to reports. Only Cartledge received more -- $24,300 -- during that time.

Carilion uses other construction companies, too.

"Thor Inc. has performed a number of construction projects for Carilion over the last several years, and we have only positive things to say about our relationship with them as our client," company President Allen Whittle said by e-mail.

Despite the scrutiny given Jay Turner's board service, Earnhart said contracting decisions by and large fall to an internal construction team below board level.

As for compliance with the conflict-of-interest policy, Earnhart noted that the board chairman who presides over meetings is James Hartley, a former county prosecutor.

"The board does and always has run a tight ship," Earnhart said.

Turner said if contracting matters reach the board, he will abstain if his company is involved. He said he did abstain when the board hired J.M. Turner contracting to build a planned athletic club at Smith Mountain Lake. For unrelated reasons, the club was not built.

Several steps removed from the Carilion board, J.M. Turner is also picking up business as a subcontractor for a Swedish construction management firm that Carilion has used for various large construction jobs.

The company, Skanska USA Building in Parsippany, N.J., has chosen J.M. Turner to be part of its local construction team on a number of occasions. These payments, the amount of which is not publicly known, are not included in the $19 million Carilion said it paid Turner, according to Earnhart.

So in addition to the disclosed payments, J.M. Turner & Co. indirectly benefits from Carilion's building projects.

Flynn Auchey, an associate professor for Virginia Tech's Department of Building Construction, said companies needing construction services commonly rely on construction services providers with whom they have prior experience, and general contractors do the same with subcontractors.

"Once you find someone you can trust, when you are used to working with someone and communication is good, staying with the same contractors and subcontractors often makes sense," said Auchey, who is also an architect, engineer and general contractor. "It's not unusual at all."

Concerns about potential conflicts of interest can be quieted, he said, if the client solicits bids from more than one contractor.

Scott Rivenbark, Skanska's on-site project executive in Roanoke, said J.M. Turner has earned all its work received from Skanska through pricing proposals, similar to bids.

Skanska has sometimes invited other Southwest Virginia contractors to bid, though not all of the time, and has in some cases chosen other contractors, he said.

Skanska is not under any pressure from Carilion to use J.M. Turner, but "we do so in the best interests of the project when it does make sense," he said.

Duncan Adams and Chris Winston contributed to this report