TY 2017 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Jeffrey R Balser MD PHD President and CEO	40.0 .................	X	X		2,772,510	293,832
(2) Gregory Scott Allen JD Director	1.0 .................	X			0	0
(3) Michael M E Johns MD Director	1.0 .................	X			0	0
(4) Edith Scott Carell Johnson JD Director	1.0 .................	X			0	0
(5) Richard B Johnston Jr MD Director	1.0 .................	X			0	0
(6) Samuel E Lynch DMD DMSC Director	1.0 .................	X			0	0
(7) David W Patterson MD Director	1.0 .................	X			0	0
(8) Robert C Schiff Jr MD Director	1.0 .................	X			0	0
(9) Thomas J Sherrard III JD Director	1.0 .................	X			0	0
(10) John F Stein MBA Director	1.0 .................	X			0	0
(11) Nicholas S Zeppos JD Director	1.0 .................	X			0	0
(12) John F Manning Jr PHD MBA COO and Corporate Chief of Staff	40.0 .................		X		1,018,060	117,677
(13) Cecelia B Moore MHA CPA CHFP CFO and Treasurer	39.8 ................. 0.2		X		1,068,740	111,565
(14) C Wright Pinson MD MBA Deputy CEO and Chief Health System Officer	40.0 .................		X		2,171,531	198,900
(15) Michael J Regier JD General Counsel and Secretary	40.0 .................		X		882,602	105,234
(16) Mitchell C Edgeworth MBA CEO, Vanderbilt University Adult Hospital and Clinics	40.0 .................			X	812,621	86,371
(17) Charles L Gregory MA MBA MH CEO, Monroe Carell Jr. Children's Hospital at Vanderbilt	40.0 .................			X	805,478	83,327

(A) Name and business address	(B) Description of services	(C) Compensation
Vanderbilt University PMB 406310 2301 Vanderbilt Place Nashville,TN37240	Various Services	189,337,313
Turner Universal Construction Co 624 Grassmere Park 4 Nashville,TN37211	Construction Services	29,200,767
Deloitte Consulting LLP 30 Rockefeller Plaza New York,NY10112	Professional Services	14,062,823
Cross Country Staffing Inc 1970 Broadway 1250 Oakland,CA94612	Staffing Services	11,551,153
NTT DATA Services LLC 2413 Nashville Rd Bowling Green,KY42101	Data Services	10,178,821
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 335

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

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

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

Vanderbilt University Medical Center

Employer identification number

35-2528741

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.)

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

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

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

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

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

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

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

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

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 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)		(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.") ..			47,625,339	302,808,739	355,841,563	706,275,641
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....						0
3	The value of services or facilities furnished by a governmental unit to the organization without charge..						0
4	Total. Add lines 1 through 3	0	0	47,625,339	302,808,739	355,841,563	706,275,641
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)..						0
6	Public support. Subtract line 5 from line 4.						706,275,641

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
7	Amounts from line 4..	0	0	47,625,339	302,808,739	355,841,563	706,275,641
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...			2,162,150	22,888,201	29,004,907	54,055,258
9	Net income from unrelated business activities, whether or not the business is regularly carried on..			0	0	0	0
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..	0	0	800,563	4,280,652	4,127,008	9,208,223
11	Total support. Add lines 7 through 10						769,539,122

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

7,928,568,609

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

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 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

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

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

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

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

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

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

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

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

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

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

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

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

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

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

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

10a

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

10a

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

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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

11a

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

11b

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

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

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

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 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, Part II, Line 10	THE AMOUNT REPORTED ON LINE 10 COMPRISES GROSS FUNDRAISING REVENUE of $430,692 AND REVENUE FROM UNCONSOLIDATED ORGANIZATIONS of $3,696,316.
Schedule A, Part II, Line 10 Other Income	DESCRIPTION - UNCONSOLIDATED ORGS AND FUNDRAISING, COLUMN A - , COLUMN B - , COLUMN C - 800563.0, COLUMN D - 4280652.0, COLUMN E - 4127008.0, COLUMN F - 9208223.0;

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

Go 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

Vanderbilt University Medical Center

Employer identification number

35-2528741

Part I-A

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

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

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 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 Bullet

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

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

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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) ........................	335,413
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................	335,413
d	Other exempt purpose expenditures ...............................................................................	4,022,666,749
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................	4,023,002,162
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.	1,000,000	0
	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) .................................................	250,000
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................	0
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................	0
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................		Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) Total

2a	Lobbying nontaxable amount		1,000,000	1,000,000	1,000,000	3,000,000

b	Lobbying ceiling amount (150% of line 2a, column(e))					4,500,000

c	Total lobbying expenditures		57,062	312,352	335,413	704,827

d	Grassroots nontaxable amount		250,000	250,000	250,000	750,000

e	Grassroots ceiling amount (150% of line 2d, column (e))					1,125,000

f	Grassroots lobbying expenditures		0	0	0	0

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
Schedule C, Part II-A, Line 2	VUMC duly filed Federal Form 5768 electing to have the provisions of 501(h) apply to its tax year ending June 30, 2015. This election was not revoked prior to VUMC's tax year beginning July 1, 2017.

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
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

Vanderbilt University Medical Center

Employer identification number

35-2528741

Part I

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

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under 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.

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

$ 9,845

(ii)

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

$ 691,813

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:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....	97,918,225	79,588,874	0	0	0
b	Contributions ...	18,514,911	11,330,429	78,782,338
c	Net investment earnings, gains, and losses	8,271,392	10,665,314	1,142,039
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	2,702,026	3,666,392	335,503
f	Administrative expenses ....
g	End of year balance ......	122,002,502	97,918,225	79,588,874	0	0

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

Board designated or quasi-endowment SchDMd Bullet

77.82 %

Permanent endowment SchDMd Bullet

18.39 %

Term endowment SchDMd Bullet

3.79 %

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

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

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

Part VI

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

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

1a	Land .....	20,132,014		20,132,014
b	Buildings ....	903,660,223	136,225,083	767,435,140
c	Leasehold improvements	67,732,997	10,210,622	57,522,375
d	Equipment ....	411,502,685	62,033,258	349,469,427
e	Other .....	112,080,238	0	112,080,238
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,306,639,194

Schedule D (Form 990) 2019

Page 3

Part VII

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

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

Part VIII

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

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	148,189,452
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

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	ENDOWMENT FUNDS ARE UTILIZED TO GENERATE EARNINGS AND SUBSEQUENT DISTRIBUTIONS FOR THE USE OF FUNDING MEDICAL RESEARCH, MEDICAL CHAIRS IN CLINICAL DEPARTMENTS, MEDICAL TRAINING FELLOWSHIPS, MEDICAL DIRECTORSHIPS, AND OTHER PROGRAMS CONSISTENT WITH THE MISSION OF THE INSTITUTION.
Schedule D, Part III, Line 4 Collections of art - description of collections	VUMC MAINTAINS VARIOUS COLLECTIONS OF ART AND SIMILAR ASSETS. SUCH COLLECTIONS INCLUDE, BUT ARE NOT LIMITED TO, PAINTINGS, PHOTOGRAPHY, SCULPTURES AND OTHER SIMILAR ITEMS. ALL SUCH COLLECTIONS FURTHER VUMC'S EXEMPT PURPOSE BY PROVIDING CULTURAL, HISTORICAL, AND EDUCATIONAL OPPORTUNITIES TO VUMC STAFF AND PATIENTS AND THE COMMUNITY AT LARGE THROUGH EXHIBITS AND DISPLAYS.

Schedule D (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

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
Vanderbilt University Medical Center

Employer identification number

35-2528741

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in the region	(f) Total expenditures for and investments in the region
	Central America and the Caribbean	0	0	,sending agents of the organization to attend and speak at seminars and conferences	N/A	8,080
	East Asia and the Pacific	0	0	,sending agents of the organization to attend and speak at seminars and conferences	N/A	73,950
	Europe (Including Iceland and Greenland)	0	0	,sending agents of the organization to attend and speak at seminars and conferences	N/A	431,737
	Middle East and North Africa	0	0	,sending agents of the organization to attend and speak at seminars and conferences	N/A	7,122
	North America (Canada & Mexico only)	0	0	,sending agents of the organization to attend and speak at seminars and conferences	N/A	174,925
	South America	0	0	,sending agents of the organization to attend and speak at seminars and conferences	N/A	16,502
	South Asia	0	0	,sending agents of the organization to attend and speak at seminars and conferences	N/A	10,045
	Sub-Saharan Africa	0	0	,sending agents of the organization to attend and speak at seminars and conferences	N/A	60,930
	Russia and Neighboring States	0	0	,sending agents of the organization to attend and speak at seminars and conferences	N/A	5,993
	Central America and the Caribbean	0	1	,Grantmaking-subcontracts	N/A	65,926
	East Asia and the Pacific	0	0	,Grantmaking-subcontracts	N/A	535,304
	Europe (Including Iceland and Greenland)	0	1	,Grantmaking-subcontracts	N/A	342,105
	North America (Canada & Mexico only)	0	0	,Grantmaking-subcontracts	N/A	168,434
	South America	0	5	,Grantmaking-subcontracts	N/A	2,411,387
	South Asia	0	0	,Grantmaking-subcontracts	N/A	4,689
	Sub-Saharan Africa	0	6	,Grantmaking-subcontracts	N/A	1,173,426
	Central America and the Caribbean	0	0	Program Services	Education, Health-Care, Research	14,996
	East Asia and the Pacific	0	0	Program Services	Education, Health-Care, Research	114,736
	Europe (Including Iceland and Greenland)	0	0	Program Services	Education, Health-Care, Research	239,621
	Middle East and North Africa	0	0	Program Services	Education, Health-Care, Research	8,809
	North America (Canada & Mexico only)	0	0	Program Services	Education, Health-Care, Research	75,113
	Russia and Neighboring States	0	0	Program Services	Education, Health-Care, Research	5,309
	South America	0	0	Program Services	Education, Health-Care, Research	102,956
	South Asia	0	0	Program Services	Education, Health-Care, Research	1,253
	Sub-Saharan Africa	2	1,340	Program Services	Education, Health-Care, Research	30,437,803
3a	Sub-total ....	0	13			5,490,555
b	Total from continuation sheets to Part I ...	2	1,340			31,000,596
c	Totals (add lines 3a and 3b)	2	1,353			36,491,151

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019

Schedule F (Form 990) 2019

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)
Europe (Including Iceland and Greenland)	Research	30,340	Wire	N/A	N/A
Sub-Saharan Africa	Research	556,394	Wire	N/A	N/A
Sub-Saharan Africa	Research	94,626	Wire	N/A	N/A
East Asia and the Pacific	Research	20,520	Wire	N/A	N/A
Sub-Saharan Africa	General	95,867	Wire	N/A	N/A
South America	Research	998,903	Wire	N/A	N/A
East Asia and the Pacific	Research	145,422	Wire	N/A	N/A
South America	Research	40,000	Wire	N/A	N/A
Central America and the Caribbean	Research	65,926	Wire	N/A	N/A
North America (Canada & Mexico only)	Research	50,100	Check	N/A	N/A
Sub-Saharan Africa	General	74,787	Wire	N/A	N/A
North America (Canada & Mexico only)	Research	20,000	Wire	N/A	N/A
Sub-Saharan Africa	Research	18,174	Wire	N/A	N/A
Sub-Saharan Africa	Research	5,354	Wire	N/A	N/A
East Asia and the Pacific	Research	191,185	Wire	N/A	N/A
Sub-Saharan Africa	Research	16,966	Wire	N/A	N/A
South America	Research	1,103,556	Wire	N/A	N/A
Sub-Saharan Africa	Research	3,562	Wire	N/A	N/A
North America (Canada & Mexico only)	Research	23,760	Check	N/A	N/A
North America (Canada & Mexico only)	Research	74,574	Check	N/A	N/A
Europe (Including Iceland and Greenland)	Research	238,465	Wire	N/A	N/A
Sub-Saharan Africa	General	26,414	Wire	N/A	N/A
South America	Research	225,377	Wire	N/A	N/A
Europe (Including Iceland and Greenland)	Research	73,300	Wire	N/A	N/A
East Asia and the Pacific	Research	47,378	Wire	N/A	N/A
Sub-Saharan Africa	Research	44,404	Wire	N/A	N/A
South America	Research	43,550	Wire	N/A	N/A
Sub-Saharan Africa	General	15,120	Wire	N/A	N/A
Sub-Saharan Africa	General	154,611	Wire	N/A	N/A
Sub-Saharan Africa	Research	14,261	Wire	N/A	N/A
Sub-Saharan Africa	Research	52,885	Wire	N/A	N/A
East Asia and the Pacific	Research	130,799	Wire	N/A	N/A

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......	28
3	Enter total number of other organizations or entities .......................	4

Schedule F (Form 990) 2019

Schedule F (Form 990) 2019Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2019

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2019

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation
Schedule F, Part I, Line 2 Procedures for monitoring use of grant funds	Vanderbilt University Medical Center maintains a formal policy defining its procedures for monitoring the use of sponsored funds by subrecipients located outside of the United States who are performing a portion of a sponsored project externally awarded to Vanderbilt University Medical Center. The policy provides guidance to ensure that subrecipients conduct their portions of sponsored projects in compliance with laws, regulations, terms and conditions of awards and subawards, and that reimbursed costs incurred by subrecipients are allowed. The policy addresses the roles and responsibilities of central offices and departments of the Medical Center and describes the monitoring procedures for each area. The full text of Vanderbilt University Medical Center's subrecipient monitoring guidelines are available online at the following web address: https://finance.mc.vanderbilt.edu/are/ggc/policy.aspx
Schedule F, Part I, Line 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS	Vanderbilt University Medical Center maintains a formal policy defining its procedures for monitoring the use of sponsored funds by subrecipients located outside of the United States who are performing a portion of a sponsored project externally awarded to Vanderbilt University Medical Center. The policy provides guidance to ensure that subrecipients conduct their portions of sponsored projects in compliance with laws, regulations, terms and conditions of awards and subawards, and that reimbursed costs incurred by subrecipients are allowed. The policy addresses the roles and responsibilities of central offices and departments of the Medical Center and describes the monitoring procedures for each area. The full text of Vanderbilt University Medical Center's subrecipient monitoring guidelines are available online at the following web address: https://finance.mc.vanderbilt.edu/are/ggc/policy.aspx

Schedule F (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

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

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

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
Vanderbilt University Medical Center

Employer identification number

35-2528741

Part I

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

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

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

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

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

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

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

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










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

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

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2019

Page 2

Part II

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

		(a) Event #1 RF Celebrity Golf (event type)	(b) Event #2 Friends in Fashion (event type)	(c) Other events 12 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	302,760	255,697	786,111	1,344,568
2	Less: Contributions . . . .	92,040	204,657	617,179	913,876
3	Gross income (line 1 minus line 2) . . . . . .	210,720	51,040	168,932	430,692

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .		18,095		18,095
7	Food and beverages . . .	27,012	41,748	39,462	108,222
8	Entertainment . . . .	705	6,678	347	7,730
9	Other direct expenses . . .	1,183	30,384	231,805	263,372
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				397,419
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				33,273

Part III

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

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

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

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

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

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

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

YesNo

If "No," explain:

10a

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

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2019

Page 3

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

YesNo

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

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

YesNo

Indicate the percentage of gaming activity conducted in:

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

13a

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

13b

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

Name

Address

15a

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

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

YesNo

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

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

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

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

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

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

YesNo

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

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

Part IV

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

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

Vanderbilt University Medical Center

Employer identification number

35-2528741

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			93,163,362		93,163,362	2.30 %
b	Medicaid (from Worksheet 3, column a) . . . . .			658,070,059	523,798,076	134,271,983	3.31 %
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	751,233,421	523,798,076	227,435,345	5.61 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			9,895,785	1,985,988	7,909,797	0.20 %
f	Health professions education (from Worksheet 5) . . .			191,858,245	56,049,264	135,808,981	3.35 %
g	Subsidized health services (from Worksheet 6) . . . .					0	0 %
h	Research (from Worksheet 7) .			635,427,689	506,660,854	128,766,835	3.18 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .					0	0 %
j	Total. Other Benefits . .	0	0	837,181,719	564,696,106	272,485,613	6.72 %
k	Total. Add lines 7d and 7j .	0	0	1,588,415,140	1,088,494,182	499,920,958	12.33 %

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
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	0	0	0	0

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

40,140,643

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. ......

493,329

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

Section B. Medicare

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

449,239,499

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

620,145,970

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

-170,906,471

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1Ambulatory Surgery Center of Cool Springs LLC	Ambulatory Surgery Center	51.02 %	0 %	13.26 %
2Vanderbilt Imaging Services LLC	Radiology Services	66.67 %	0 %	33.33 %
3New Light Imaging LLC	Outpatient Diagnostic Imaging	66.67 %	0 %	33.33 %
4One Hundred Oaks Imaging LLC	Outpatient Diagnostic Imaging	80 %	0 %	20 %
5Williamson Imaging LLC	Outpatient Diagnostic Imaging	53.34 %	0 %	26.66 %
6VIP Midsouth LLC	Pediatric Clinics	51 %	0 %	49 %
7Springfield VIP Realty LLC	Own Real Estate Used as Medical Facility	49 %	0 %	51 %
8
9
10
11
12
13

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)
1	Vanderbilt University Medical Center Hospitals 1211 22nd Avenue South Nashville,TN37212 www.vanderbilthealth.com 0000000027	X	X	X	X	X	X
2	Vanderbilt Stallworth Rehabilitation Hospital 2201 Childrens Way Nashville,TN37212 www.vanderbiltstallworthrehab.com 0000000141	X

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)

	Vanderbilt University Medical Center Hospitals
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

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

Yes

6 a

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): https://www.vanderbilthealth.com/MAIN/38766

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

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

Yes

If "Yes" (list url): https://www.vanderbilthealth.com/MAIN/38766

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Vanderbilt University Medical Center Hospitals
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0%
and FPG family income limit for eligibility for discounted care of 250.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

https://www.vanderbilthealth.com/FINANCIALASSISTANCE/46618

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

https://www.vanderbilthealth.com/FINANCIALASSISTANCE/46619

A plain language summary of the FAP was widely available on a website (list url):
https://www.vanderbilthealth.com/FINANCIALASSISTANCE/

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

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

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

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	Vanderbilt University Medical Center Hospitals
Name of hospital facility or letter of facility reporting group

Yes

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?..................................

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	Vanderbilt University Medical Center Hospitals
Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 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)

	Vanderbilt Stallworth Rehabilitation Hospital
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

Yes

6 a

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): https://www.encompasshealth.com/locations/vanderbiltstallworth

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

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

Yes

If "Yes" (list url): https://www.encompasshealth.com/locations/vanderbiltstallworth

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

10b

12a

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

12a

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

12b

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

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Vanderbilt Stallworth Rehabilitation Hospital
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0%
and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

http://www.encompasshealth.com/locations/vanderbiltstallworth/for-patients/financial-assistance

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

http://www.encompasshealth.com/locations/vanderbiltstallworth/for-patients/financial-assistance

A plain language summary of the FAP was widely available on a website (list url):
http://www.encompasshealth.com/locations/vanderbiltstallworth/for-patients/financial-assistance

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

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

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

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	Vanderbilt Stallworth Rehabilitation Hospital
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	Vanderbilt Stallworth Rehabilitation Hospital
Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 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
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Vanderbilt University Medical Center Hospitals. Input from persons representing the broad interests of the community, including those with expertise in public health, was obtained through face-to-face interviews and via community listening sessions. Interviews took place from February to May 2015. Listening sessions took place from March to July 2015. Community summits were held in September of 2015. VUMC identified leaders from public health, government, education, the faith community, private foundations, community organizations, and academia among others as interviewees. Interviewees were identified in collaboration with local health departments in each county and were selected based on their understanding of the broad interests of the community and underserved populations. Interviewees also included health department directors from the community served, community physicians, public health researchers, and community based organizations that have special knowledge and expertise in public health. In all, 81 community leaders were interviewed with particular attention to underserved, low-income, and minority populations. Organizations represented in Davidson County interviews included Metro Nashville Public Schools, Jobs for Life, Family & Children's Services, Social Services, the Homelessness Commission, Nashville General, the Martha O' Bryan Center, the Council on Aging, Nashville General Hospital, local government, the Healthy Nashville Leadership Council, Nashville CARES, Saint Thomas Health, VUMC, Conexion Americas, Nashville Latino Health Coalition, Mental Health America, the Safety Net Consortium of Middle Tennessee, Faith Family Clinic, Siloam Health, United Neighborhood Health Services, Metro Transit Authority, Interdenominational Ministers Fellowship, HCA, United Way, local faith institutions, Meharry Medical College, Tennessee State University, Vanderbilt University, Nurses for Newborns, Second Harvest, and the Metro Public Health Department. Organizations represented in Rutherford County Interviews included the University of Tennessee Agricultural Extension Office, Middle Tennessee State University, Murfreesboro City Schools, local government, Saint Thomas Health, Interfaith Dental, Primary Care & Hope Clinic, Journey Home, National Healthcare for the Homeless Council, Murfreesboro Police Department, Volunteer Behavioral Health, City of Murfreesboro Transportation (Rover), Boys & Girls Club, Rutherford County Schools, Rutherford County YMCA, Saint Louise Clinic, and the Rutherford County Health Department. Organizations represented in Williamson County interviews included local faith institutions, Franklin Housing Authority, Mercy Community Healthcare, local government, Chamber of Commerce, WAVES, United Way, the Refuge Center, Williamson Medical Center, Workforce Essentials, Graceworks, Franklin Special School District, United Way of Williamson County, the Department of Children's Service, Columbia State Community College, and the Williamson County Health Department . Populations served by these organizations include racial and ethnic minority groups, individuals seeking social services such as housing or food assistance, individuals seeking affordable healthcare, at-risk youth, those experiencing homelessness, Hispanic and Latino community leaders, the medically under-served, those experiencing mental illness, those experiencing addiction, children and other low-income, minority, under-served, and vulnerable populations. To understand community members' opinions of health needs, eleven focus groups were conducted across the three counties that represent the community served. The focus groups in Davidson County were held in collaboration with the United Way of metropolitan Nashville, as well as county health departments. In Davidson County, sessions were held at United Way Family Resource Centers (FRCs), which serve 32,000 low-income residents annually. United Way of Metropolitan Nashville recruited participants in partnership with the FRCs and VUMC and Saint Thomas Health. English and Spanish speakers were included in listening sessions in each county. In Rutherford County, listening sessions were held in coordination with Saint Thomas Health and the Rutherford County Health Department. Recruitment was done in coordination with the host sites, which included Faith and Hope Clinic, the Smyrna Branch of the Rutherford County Health Department, and First Baptist Church in Murfreesboro. In Williamson County, recruitment was done in collaboration with the Williamson County Health Department, and one session each was held in English and in Spanish. Across the three counties, more than three-quarters of participants were female (78%), more than three-quarters spoke English (78%), more than a quarter were uninsured (26%), and more than one-third had not completed more than a high school education (36%).
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - Vanderbilt University Medical Center Hospitals. Vanderbilt University Medical Center conducted a community health needs assessment in partnership with its affiliated hospital, Vanderbilt Stallworth Rehabilitation Hospital.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Vanderbilt University Medical Center Hospitals. Vanderbilt University Medical Center ("VUMC") identified four significant health needs in its most recently conducted CHNA. The four significant health needs identified are - alphabetically - 1) Access to Care and Coordination of Care; 2) Mental and Emotional Health / Substance Abuse; 3) Social Determinants; and 4) Wellness and Disease Prevention. VUMC is addressing all four needs, with a detailed list of programs, investments, and services listed in the 2016 Implementation Strategy (IS). In all three counties, the Community Health Improvement Team released a Request for Proposals for community projects that addressed one or more of the CHNA priority areas, specifically requiring applicants to discuss how their proposal would promote health equity and address broader policy, environmental, or systems change. After a competitive review process with a committee of both academic and community reviewers, five organizations were selected as recipients of these awards. The grantees received up to $7,500 to carry out their work over a period of 12 months. In Williamson County, VUMC collaborated with United Way of Williamson County, the Tennessee Agricultural Extension office, the Williamson County Health Department, and the Town of Fairview to hold a number of listening sessions. These listening sessions were an attempt to have a deeper understanding of some of the barriers to health and wellness that had arisen in the primary and secondary data collection during the CHNA process. Themes that arose included high childhood obesity in Fairview relative to the rest of the county and lack of affordable outdoor activities for families with children. Hearing these themes informed the work that followed in introducing free bike rentals at a free community park called Bowie Park, where visitors can recreate on a playground, wooded trails, or around a nearby lake. Additionally, VUMC collaborated on the introduction of a "born learning" trail and upcoming work to connect Bowie Park with the Fairview branch of the public library. This trail will contain a story written and illustrated by local school children in efforts to enhance both child literacy and physical activity. In addition, VUMC's Community Health Improvement Team participates in local groups such as the anti-drug coalition, the Williamson County Health Council and the Franklin Wellness Council, which promote improvements in community health. In Davidson County, VUMC is involved in collaboratives focused on the four priority needs. The Safety Net Consortium of Middle Tennessee, focused on access to and quality of care for the uninsured, continues to meet monthly at the Meharry-Vanderbilt Alliance and launched My Health Care Home, a web-based tool that facilitates finding and accessing federally qualified health centers and faith-based and charitable clinics that serve the under/uninsured. The Community Health Improvement Team has been involved in sub-projects focused on pharmacy access for the uninsured as well as an environmental scan focused on specialty care access for the uninsured. VUMC collaborated with the Metro Public Health Department and Nashville Health in the Infant Vitality Collaborative, focused on improving outcomes for newborns, toddlers, and families with young children. The infant vitality initiative seeks to eliminate disparities in birth outcomes, while bringing together cross-sector collaborations that can have a meaningful impact on outcomes for all families. VUMC also serves on the Alignment Nashville Behavioral Health Council and helped organize a first-of its-kind national social emotional learning (SEL) conference in 2018, which was attended by over 800 educators and care providers for children from around the world. The Community Health Improvement team has also spearheaded a "Community Youth Behavioral Team," which has enhanced the sharing of VUMC data with the Tennessee Association of Mental Health Organizations (TAMHO), the state Children's Council on Mental Health, ACE Nashville, and other care providers, as well as providing a table for discussion with other local service providers and caretakers of children - such as Metro Nashville Public Schools (MNPS). In Rutherford County, VUMC collaborated with the county health department and Rutherford County Wellness Council to distribute mini-grants to seventeen community organizations which were engaged in programs addressing the needs adopted in the CHNA. Grantees included the Big Brothers & Big Sisters of Middle Tennessee, Salvation Army, the County Board of Education Office of Coordinated School Health, Interfaith Dental Clinic, Nurses for Newborns, and Murfreesboro City schools among many others. Programs such as Howard's Hope addressed "wellness" needs by helping young under-served children learn swimming skills. Murfreesboro City schools ran a "chef academy" which teaches healthy nutrition and food preparation techniques to school-aged children. The Boys and Girls Club of Rutherford County ran programs to address mental health / substance abuse by teaching teens about substance and tobacco use and abuse. Additionally, VUMC helped distribute dozens of copies of "Play Nicely" to service providers. Play Nicely is a healthy discipline handbook used to educate new or prospective parents on healthy discipline strategies. Finally, several VUMC staff have participated in the opioid taskforce spear-headed by Saint Thomas Rutherford, which has become the WE CARE coalition. VUMC's Community Health Improvement team addressed a meeting of the United Way of Rutherford and Cannon Counties' Community Youth Initiative. The data and resources were shared again by the director of Rutherford County schools in a separate presentation to school leaders. Members of the Community Health Improvement team presented local data on substance abuse and mental health to the Prevention Coalition for Success, one of the largest and longest running anti-drug coalitions in the state of Tennessee. VUMC's Community Health Improvement team presented information on the four priority needs and data from the CHNA to United Ways of Rutherford and Cannon Counties' community impact committee.
Schedule H, Part V, Section B, Line 16 Facility , 1	Facility , 1 - VANDERBILT UNIVERSITY MEDICAL CENTER HOSPITALS. PATIENTS ARE NOTIFIED OF AVAILABLE ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S CHARITY CARE POLICY VIA SIGNAGE POSTED IN THE PATIENT CARE REGISTRATION POINTS INCLUDING HOSPITALS, EMERGENCY DEPARTMENTS, AND HOSPITAL BASED CLINICS; BROCHURES AVAILABLE AT REGISTRATION POINTS; AND LANGUAGE INCLUDED ON ALL STATEMENTS MAILED TO PATIENTS ADVISING THAT VUMC HAS A FINANCIAL ASSISTANCE PROGRAM IF HELP IS NEEDED PAYING MEDICAL BILLS. PRE-ADMITTING, REGISTRATION, OR BILLING PERSONNEL MAY REFER UNINSURED OR LOW INCOME PATIENTS TO FINANCIAL COUNSELING PERSONNEL TO DISCUSS QUALIFICATIONS FOR FREE OR DISCOUNTED CARE.
Schedule H, Part V, Section B, Line 3E
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Vanderbilt Stallworth Rehabilitation Hospital. Input from persons representing the broad interests of the community, including those with expertise in public health, was obtained through face-to-face interviews and via community listening sessions. Interviews took place from February to May 2015. Listening sessions took place from March to July 2015. Community summits were held in September of 2015. Stallworth identified leaders from public health, government, education, the faith community, private foundations, community organizations, and academia among others as interviewees. Interviewees were identified in collaboration with local health departments in each county and were selected based on their understanding of the broad interests of the community and underserved populations. Interviewees also included health department directors from the community served, community physicians, public health researchers, and community-based organizations that have special knowledge and expertise in public health. In all, 81 community leaders were interviewed with particular attention to underserved, low-income, and minority populations. Organizations represented in Davidson County interviews included Metro Nashville Public Schools, Jobs for Life, Family & Children's Services, Social Services, the Homelessness Commission, Nashville General, the Martha O' Bryan Center, the Council on Aging, Nashville General Hospital, local government, the Healthy Nashville Leadership Council, Nashville CARES, Saint Thomas Health, Stallworth, Conexion Americas, Nashville Latino Health Coalition, Mental Health America, the Safety Net Consortium of Middle Tennessee, Faith Family Clinic, Siloam Health, United Neighborhood Health Services, Metro Transit Authority, Interdenominational Ministers Fellowship, HCA, United Way, local faith institutions, Meharry Medical College, Tennessee State University, Vanderbilt University, Nurses for Newborns, Second Harvest, and the Metro Public Health Department. Organizations represented in Rutherford County Interviews included the University of Tennessee Agricultural Extension Office, Middle Tennessee State University, Murfreesboro City Schools, local government, Saint Thomas Health, Interfaith Dental, Primary Care & Hope Clinic, Journey Home, National Healthcare for the Homeless Council, Murfreesboro Police Department, Volunteer Behavioral Health, City of Murfreesboro Transportation (Rover), Boys & Girls Club, Rutherford County Schools, Saint Louise Clinic, Rutherford County YMCA, and the Rutherford County Health Department. Organizations represented in Williamson County interviews included local faith institutions, Franklin Housing Authority, Mercy Community Healthcare, local government, Chamber of Commerce, WAVES, United Way, the Refuge Center, Williamson Medical Center, Workforce Essentials, Graceworks, Franklin Special School District, United Way of Williamson County, the Department of Children's Service, Columbia State Community College, and the Williamson County Health Department. Populations served by these organizations include racial and ethnic minority groups, individuals seeking social services such as housing or food assistance, individuals seeking affordable healthcare, at-risk youth, those experiencing homelessness, Hispanic and Latino community leaders, the medically under-served, those experiencing mental illness, those experiencing addiction, children and other low-income, minority, under-served, and vulnerable populations. To understand community members' opinions of health needs, eleven focus groups were conducted across the three counties that represent the community served. The focus groups in Davidson County were held in collaboration with the United Way of metropolitan Nashville, as well as county health departments. In Davidson County, sessions were held at United Way Family Resource Centers (FRCs), which serve 32,000 low-income residents annually. United Way of Metropolitan Nashville recruited participants in partnership with the FRCs and Stallworth and Saint Thomas Health. English and Spanish speakers were included in listening sessions in each county. In Rutherford County, listening sessions were held in coordination with Saint Thomas Health, and the Rutherford County Health Department. Recruitment was done in coordination with the host sites, which included Faith and Hope Clinic, the Smyrna Branch of the Rutherford County Health Department, and First Baptist Church in Murfreesboro. In Williamson County, recruitment was done in collaboration with the Williamson County Health Department, and one session each was held in English and in Spanish. Across the three counties, more than three-quarters of participants were female (78%), more than three-quarters spoke English (78%), more than a quarter were uninsured (26%), and more than one-third had not completed more than a high school education (36%).
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - Vanderbilt Stallworth Rehabilitation Hospital. Vanderbilt Stallworth Rehabilitation Hospital conducted a health needs assessment in partnership with its affiliated health system, Vanderbilt University Medical Center.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Vanderbilt Stallworth Rehabilitation Hospital. Vanderbilt Stallworth Rehabilitation Hospital ("Stallworth") identified four significant health needs in its most recently conducted CHNA. The four significant health needs identified are: 1) access to care and coordination of care, 2) mental and emotional health / substance abuse, 3) social determinants and 4) wellness and disease prevention. Stallworth is addressing all four needs, with a detailed list of programs, investments, and services listed in the 2016 Implementation Strategy (IS). Stallworth holds monthly grand rounds for members of the medical community to discuss topics that have an impact on rehabilitation and post-acute care. In addition, Stallworth offers a number of support groups and educational classes for patients and caregivers. The monthly stroke support group and stroke education classes, which meet weekly, are open to both patients and caregivers. Stallworth works to build strong collaborations throughout the community and throughout the country and currently supports the work of the American Heart and Stroke Association, United Spinal Association, Achilles Foundation, the Arthritis Foundation, Brain Injury Association of Tennessee, Williamson County Senior Expo, the Annual Harold "Jobe" Bernard Stroke and Neurosciences Symposium, Senior Health Fairs, Fifty Forward assisted living facilities, Maury County Senior Center, and the Hendersonville Senior Center. Stallworth is planning to add full time Licensed Independent Social Workers in to its staffing to provide a resource for the inpatient population in addition to expanded psychiatric consultation availability. Stallworth collaborates with the Trauma Survivors Network, which provides a host of free resources to help patients and families cope with the challenges of trauma recovery. In addition, the Spinal Cord Injury Peer Mentor Program, which is held twice monthly, includes training for peer mentor volunteers who help patients as they make the significant life changes often associated with trauma recovery. Finally, housing evaluations are done during the pre-admission process to assess home-readiness after a traumatic injury. Once an individual is admitted as an inpatient at Stallworth, a recurring housing assessment is done, and Stallworth staff often connect patients with community resources to assist in the transition. Through on-going partnerships and engagement of key stakeholders, Stallworth will continue to collaborate to meet the needs identified in the most recent needs assessment.
Schedule H, Part V, Section B, Line 16 Facility , 1	Facility , 1 - VANDERBILT STALLWORTH REHABILITATION HOSPITAL. PATIENTS ARE NOTIFIED OF AVAILABLE ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER STALLWORTH'S CHARITY CARE POLICY VIA SIGNAGE AT THE FRONT DESK, IN THE MAIN ELEVATOR TO THE PATIENT CARE UNITS & ALONG THE BACK HALLWAY OF THE HOSPITAL. PAMPHLETS REGARDING THIS INFORMATION ARE DISTRIBUTED UPON ADMISSION AND A STATEMENT IS INCLUDED ON ANY PATIENT BILLS. IN ADDITION, PRE-ADMITTING, REGISTRATION, CASE MANAGEMENT OR BILLING PERSONNEL MAY REFER UNINSURED OR LOW INCOME PATIENTS TO FINANCIAL PERSONNEL TO DISCUSS QUALIFICATIONS FOR FREE OR DISCOUNTED CARE.

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?27
Name and address		Type of Facility (describe)
1	Ambulatory Surgery Center of Cool Springs LLC 2009 Mallory Lane Suite 100 Franklin,TN37067	Ambulatory Surgery Treatment Center
2	Vanderbilt-Maury Radiation Oncology LLC 1003 Reserve Boulevard Spring Hill,TN37174	Oncology Services
3	One Hundred Oaks Imaging LLC 719 Thompson Lane Nashville,TN37204	Outpatient Diagnostic Center
4	Vanderbilt Health & Williamson Medical Center Clinics and Services LLC 134 Pewitt Drive Brentwood,TN37027	Ambulatory Clinic
5	Spring Hill Imaging Center LLC 5421 Main Street Spring Hill,TN37174	Outpatient Diagnostic Center
6	Williamson Imaging LLC (dba Cool Springs Imaging) 2009 Mallory Lane Suite 150 Franklin,TN37067	Outpatient Diagnostic Center
7	Vanderbilt Health & Williamson Medical Center Clinics and Services LLC 919 Murfreesboro Pike Franklin,TN37064	Ambulatory Clinic
8	Vanderbilt-Gateway Cancer Center GP 375 Alfred Thun Road Clarksville,TN37040	Oncology Services
9	Vanderbilt Imaging Services LLC (dba Vanderbilt Imaging Belle Meade) 4525 Harding Road Suite 102 Nashville,TN37232	Outpatient Diagnostic Center
10	Vanderbilt Imaging Services LLC (dba Hillsboro Imaging Services) 1909 Acklen Avenue Nashville,TN37212	Outpatient Diagnostic Center
11	Vanderbilt Health & Williamson Medical Center Clinics and Services LLC 1834 West McEwen Dr Suite B Franklin,TN37067	Ambulatory Clinic
12	Vanderbilt Health & Williamson Medical Center Clinics and Services LLC 3098 Campbell Station Pkwy Spring Hill,TN37174	Ambulatory Clinic
13	Vanderbilt Health & Williamson Medical Center Clinics and Services LLC 940 Oldham Drive Nolensville,TN37135	AMBULATORY CLINIC
14	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 7601 Highway 70 S Bellevue,TN37221	AMBULATORY CLINIC
15	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 1954 Madison Street Clarksville,TN37043	AMBULATORY CLINIC
16	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 9100 Carothers Pkwy Franklin,TN37067	AMBULATORY CLINIC
17	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 585 Nashville Pike Gallatin,TN37066	AMBULATORY CLINIC
18	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 198 E Main Street Hendersonville,TN37075	AMBULATORY CLINIC
19	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 400 Tulip Grove Road Hermitage,TN37076	AMBULATORY CLINIC
20	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 5000 Murfreesboro Road Lavergne,TN37086	AMBULATORY CLINIC
21	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 1303 W Main Street Lebanon,TN37087	AMBULATORY CLINIC
22	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 2401 Old Fort Pkwy Murfreesboro,TN37128	AMBULATORY CLINIC
23	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 3500 Gallatin Pike Nashville,TN37216	AMBULATORY CLINIC
24	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 5555 Edmondson Pike Nashville,TN37211	AMBULATORY CLINIC
25	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 518 Donelson Pike Nashville,TN37214	AMBULATORY CLINIC
26	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 4243 Harding Pike Nashville,TN37205	AMBULATORY CLINIC
27	Retail Health Clinics LLC (DBA Vanderbilt Health Clinics) 400 Sam Ridley Pkwy Smyrna,TN37167	AMBULATORY CLINIC

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 I, Line 7k VANDERBILT UNIVERSITY MEDICAL CENTER HOSPITALS	Column (f) Community Benefit Expense: The total community benefit expense using Part I, Line 7, Column (c) (before direct offsetting revenue) as a percentage of total expenses is 39.17%.
Schedule H, Part V, Section B, Line 20 Extraordinary Collection Actions	The VUMC Financial Assistance Policy permits the use of ECAs. However, VUMC did not engage in any ECAs during FY2018. The Stallworth Financial Assistance Policy explicitly forbids the use of ECAs.
**	Vanderbilt University Medical Center ("VUMC") conducted an extensive review of its policies and procedures to ensure compliance with the requirements of IRC § 501(r). VUMC identified omissions in FY 2018 as part of this review that VUMC believes are minor and either inadvertent or due to reasonable cause, as described in Rev. Proc. 2015-21. VUMC has decided, in the interests of transparency, to provide this disclosure as part of its Form 990 filing pursuant to Section 6 of Rev. Proc. 2015-21. VUMC operates two hospital facilities for which it must satisfy the requirements of § 501(r). First, VUMC operates its main hospital facility at 1211 22nd Avenue South in Nashville, Tennessee. Second, for purposes of Treas. Reg. §1.501(r)-1(22), VUMC also operates Vanderbilt Stallworth Rehabilitation Hospital ("Stallworth") at 2201 Childrens Way in Nashville. The review that VUMC undertook addressed § 501(r) compliance at each of these hospital facilities. VUMC makes physical copies of its Community Health Needs Assessment ("CHNA") and Financial Assistance Policy ("FAP") available to the public at VUMC and Stallworth as required by §501(r). VUMC's review indicated, however, that VUMC should provide certain patient-facing employees with additional training to ensure that they could identify the physical location within the hospital facility where patients could obtain physical copies of these documents. All VUMC and Stallworth patient-facing, non-clinical staff collecting payments from patients received this additional training during FY18. An online learning module was also developed and is now assigned annually to appropriate VUMC personnel as well as any new hires in applicable areas. VUMC also determined as part of its § 501(r) review to enhance public awareness of its FAP and the financial assistance available to disadvantaged members of its community. Accordingly, VUMC disseminated information to community partners in each of the following categories: (1) a public/government agency serving low-income individuals in the Nashville community; (2) a health clinic in downtown Nashville that provides free or discounted health care to low-income persons; and (3) a nonprofit organization. The community partners identified in each group respectively are Metro Action Commission; Shade Tree Clinic; and Room in the Inn. Similarly, Stallworth designated a community liaison to attend regular functions in the community, display the FAP at these functions, and provide copies of the FAP to community members. Finally, VUMC has implemented quarterly reviews of its website links to ensure information required by § 501(r) is available to the public. VUMC provides a patient billing brochure at both admission and discharge to patients which contained information regarding the FAP and how to obtain financial assistance. During FY18, VUMC updated the patient billing brochure by labeling it the "Plain Language Summary" and revising it to expressly state that no patient who qualified for financial assistance would be charged more than the Amounts Generally Billed ("AGB"), as required by Treas. Reg. §1.501(r)-1(24). Finally, VUMC identified minor errors in the FAPs that applied to VUMC and Stallworth, respectively. Although both VUMC and Stallworth calculated and applied the Amounts Generally Billed ("AGB") correctly, the calculations were not explicitly stated in the FAP. Similarly, VUMC limited charges to AGB in practice, but this fact was not stated in the FAP. VUMC and Stallworth also revised their respective FAPs to state more clearly the specific criteria used to determine eligibility for financial assistance.
Schedule H, Part VI, Line 7	Not applicable.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	THE COSTING METHODOLOGY USED TO CALCULATE CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFIT COSTS REPORTED WAS BASED ON AN OVERALL COST-TO-CHARGE RATIO FOR ALL PATIENT POPULATIONS. THE COST TO CHARGE RATIO WAS CALCULATED USING IRS WORKSHEET 2.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Costing Methodology - Bad Debt Expense: Lines 2 & 3: The costing methodology used to calculate bad debt expense reported in Part III, Lines 2 and 3 was based on an overall cost-to-charge ratio for all patient populations. Discounts and payments on accounts considered as bad debt offset the total bad debt expense recorded. Process to determine amount of bad debt attributable to individuals eligible for financial assistance - The accounts that have not been paid are first reviewed under a presumptive charity policy. For those accounts that do not meet presumptive eligibility criteria, it is estimated that 3% of the balances are attributable to individuals who would qualify for financial assistance. This estimate is based on experience of patient accounting management as well as a methodical review of outstanding patient accounts.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	The audited financial statements of VUMC disclose the consolidated amount of bad debt expense. This information is contained in Footnote 4, Patient Service Revenue, Patient Accounts Receivable, and Estimated Third-party Settlements, on page 17 of the audited financial statements.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Costing Methodology - Medicare Allowable Costs: The methodology for determining Medicare allowable costs consisted of applying an overall hospital cost-to charge ratio to gross Medicare charges from the hospital billing system. The resulting shortfall is entirely deemed as community benefit because the cost of providing related care consistently exceeds reimbursement from Medicare. The hospital accepts all Medicare patients with the knowledge that there may be shortfalls and operates to promote the health of the community. The organization believes the Medicare shortfall should be treated as a community benefit because Medicare does not fully compensate hospitals for the cost of providing hospital care to Medicare beneficiaries. In FY18, such shortfalls amounted to $170,906,471.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	Collection Practices: Although Vanderbilt University Medical Center's policies do not contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance, in practice, if a patient qualifies for a 100% charity care write off, the account is closed and no further collection efforts are made. If a patient qualifies for a partial charity care write off, the account is reduced for the applicable charity discount and normal collection efforts are made. Although no extraordinary collection actions were taken in FY18, the extraordinary collection actions that may be taken, after reasonable efforts are made to ensure a patient is not eligible for financial assistance on the remaining balance, include: - Attachment or seizure of a bank account or other personal property - Commencement of a civil action against an individual - Wage garnishment
Schedule H, Part V, Section B, Line 16a FAP website	- Vanderbilt University Medical Center Hospitals: Line 16a URL: https://www.vanderbilthealth.com/FINANCIALASSISTANCE/46618; - Vanderbilt Stallworth Rehabilitation Hospital: Line 16a URL: http://www.encompasshealth.com/locations/vanderbiltstallworth/for-patients/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Vanderbilt University Medical Center Hospitals: Line 16b URL: https://www.vanderbilthealth.com/FINANCIALASSISTANCE/46619; - Vanderbilt Stallworth Rehabilitation Hospital: Line 16b URL: http://www.encompasshealth.com/locations/vanderbiltstallworth/for-patients/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- Vanderbilt University Medical Center Hospitals: Line 16c URL: https://www.vanderbilthealth.com/FINANCIALASSISTANCE/; - Vanderbilt Stallworth Rehabilitation Hospital: Line 16c URL: http://www.encompasshealth.com/locations/vanderbiltstallworth/for-patients/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessment	VUMC continually assesses the healthcare needs of the communities it serves. The Vanderbilt Patient and Family Advisory Council is made up of community volunteers which partners with VUMC' s health care team and leadership to assess needs and evaluate services and programs. VUMC and Stallworth have also formed the Community Health Improvement Working Group, an internal committee of program managers which meets regularly and makes recommendations to the CHNA Advisory Committee. The CHNA Advisory Committee is made up of VUMC and Stallworth senior leaders who meet to continually assess the needs of the community and drive improvements in care and processes for the communities they serve. VUMC further assesses the health care needs of the communities it serves by playing an active role in groups such as the Healthy Nashville Leadership Council, Williamson County Health Council, and the Rutherford County Wellness Council. VUMC reviews the many needs assessments published by these local groups (Alignment Nashville, Saint Thomas Health, Nashville Area Chamber of Commerce, Metro Social Services, Healthy Nashville, and the TN Department of Health, among others) to help gauge the needs and resources within the community. In 2018, VUMC completed a systematic review of more than 20 recent assessments completed by community partners, highlighting populations served, geographic area covered, and themes highlighted in the report. In addition, VUMC has developed partnerships with the state department of health to stay abreast of important community health needs.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	VUMC patients are notified of available assistance under Federal, State or local government programs or under VUMC's charity care policy via signage posted in the patient care registration points including hospitals, emergency departments, and hospital based clinics; brochures available at registration points; and language included on all statements mailed to patients advising that VUMC has a financial assistance program if help is needed paying medical bills. Pre-Admitting, Registration, or Billing personnel may refer uninsured or low income patients to financial counseling personnel to discuss qualifications for free or discounted care. Stallworth patients are notified of available assistance under Federal, State or local government programs or under Stallworth's charity care policy via signage posted at various locations within the hospital. Pamphlets regarding this information are distributed upon admission and a statement is included on any patient bills. In addition, pre-Admitting, Registration, Case Management or Billing personnel may refer uninsured or low income patients to financial personnel to discuss qualifications for free or discounted care.
Schedule H, Part VI, Line 4 Community information	Vanderbilt University Medical Center, located in Nashville, Tennessee, serves primarily Tennessee, northern Alabama and southern Kentucky. Vanderbilt University Medical Center owns the Vanderbilt University Hospital, the Monroe Carell Jr. Children's Hospital at Vanderbilt, and Vanderbilt Psychiatric Hospital. These facilities operate under one hospital license as Vanderbilt University Medical Center (VUMC). VUMC (excludes Vanderbilt Health Services, LLC and subsidiaries) have approximately 61,000 annual discharges. VUMC also provides approximately 2.2 million annual outpatient visits, including 117,000 to the emergency departments. Vanderbilt University Medical Center Hospitals provide critical and often unique health care resources to the community and provide broad access to care. The majority of VUMC's patients live in four Tennessee counties: Davidson, Williamson, Rutherford and Montgomery. Vanderbilt Stallworth Rehabilitation Hospital, located in Nashville, Tennessee, serves middle Tennessee, southern Kentucky and the northern parts of Mississippi, Alabama and Georgia. This 80-bed hospital is a joint venture between Vanderbilt University Medical Center and HealthSouth and offers comprehensive acute rehabilitation services. Annually, Vanderbilt Stallworth Rehabilitation Hospital has approximately 1,300 discharges. The majority of Stallworth's patients live in four Tennessee counties - Davidson, Williamson, Rutherford and Montgomery.
Schedule H, Part VI, Line 5 Promotion of community health	For information on how VUMC promotes the health of the community please see: "Vanderbilt University Medical Center Facts 2017-2018" as found at: https://www.vanderbilthealth.com/patientandvisitorinfo/48538 "Vanderbilt in Tennessee: County by County" as found at: https://www.vanderbilt.edu/cngr/map/ "Vanderbilt Injects $9.5 billion into Tennessee economy" as found at: https://news.vanderbilt.edu/2017/03/27/vanderbilt-injects-9-5-billion-into-tennessee-economy/
Schedule H, Part VI, Line 6 Affiliated health care system	Vanderbilt University Medical Center owns the Vanderbilt University Hospital, the Monroe Carell Jr. Children's Hospital at Vanderbilt, and Vanderbilt Psychiatric Hospital. These facilities operate under one hospital license as Vanderbilt University Medical Center (VUMC). VUMC also has ownership interest in several affiliated entities, which provide clinical services. VUMC's hospitals, clinics, and affiliated entities provide the following healthcare services to the communities it serves: emergency care, inpatient hospital care, outpatient treatment, diagnostic testing, ancillary care, primary care services, and home health care. VUMC provides a number of clinical services unique to its region including: a Level 1 Trauma Center, a Level 1 Pediatric Trauma Center, a comprehensive Regional Burn Center, a Level 4 Neonatal Intensive Care Unit, Tennessee's only comprehensive solid organ transplant center, the Vanderbilt-Eskind Diabetes Center, and the Vanderbilt-Ingram Cancer Center, the only National Cancer Institute-designated comprehensive cancer center in Tennessee to treat both adult and pediatric cancer patients. In addition, VUMC's health care system includes the Vanderbilt Health Affiliated Network, an affiliated network of doctors, regional health systems and other health care providers that collaborate to provide coordinated and cost-effective health care services to the communities served. These are contractual affiliate relationships only with no ownership interest in the facilities or physician practices. VUMC also collaborates with other hospital systems in the region, providing health care and/or research and academic support. For a list of all organizations related to Vanderbilt University Medical Center and the primary activity of each, please refer to Schedule R.

Schedule H (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

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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
Vanderbilt University Medical Center

Employer identification number
35-2528741

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) Dartmouth College 11 Rope Ferry Road Hanover,NH03755	02-0222111	501(c)(3)	38,862	Not applicable	Not applicable	Research
(2) Northeastern University 360 Huntington Ave Boston,MA02115	04-1679980	501(c)(3)	127,940	Not applicable	Not applicable	Research
(3) Boston University PO Box 28763 New York,NY100878763	04-2103547	501(c)(3)	241,763	Not applicable	Not applicable	Research
(4) Harvard University PO Box 415649 Boston,MA022415649	04-2103580	501(c)(3)	105,988	Not applicable	Not applicable	Research
(5) Massachusetts Institute of Technology 77 Massachusetts Ave Cambridge,MA02139	04-2103594	501(c)(3)	316,565	Not applicable	Not applicable	Research
(6) Beth Israel Deaconess Medical Center 330 Brookline Ave Boston,MA02215	04-2103881	501(c)(3)	840,696	Not applicable	Not applicable	Research
(7) Brigham & Womens Hospital Inc PO Box 3887 Boston,MA022413887	04-2312909	501(c)(3)	155,276	Not applicable	Not applicable	Research
(8) Massachusetts General Hospital PO Box 3829 Boston,MA022413829	04-2697983	501(c)(3)	636,144	Not applicable	Not applicable	Research
(9) Boston's Children's Hospital PO Box 414413 Boston,MA022414413	04-2774441	501(c)(3)	290,188	Not applicable	Not applicable	Research
(10) Baystate Medical Center Inc PO Box 414168 Boston,MA022414168	04-2790311	501(c)(3)	46,477	Not applicable	Not applicable	Research
(11) New England Research Institutes 480 Pleasant Street Watertown,MA02472	04-2919509	N/A	48,551	Not applicable	Not applicable	Research
(12) University of Massachusetts Attn Medical School Bursar 55 Lake Ave North Worcester,MA01655	04-3167352	GOVT	51,862	Not applicable	Not applicable	Research
(13) Dana-Farber Partners Cancer Care Inc 450 Brookline Avenue ATTN Jim Huse Boston,MA022155450	04-3320640	501(c)(3)	40,307	Not applicable	Not applicable	Research
(14) Tufts Medical Center 800 Washington Street Box 453 Boston,MA02111	04-3400617	501(c)(3)	39,066	Not applicable	Not applicable	Research
(15) Brown University Box 1911 69 Brown Street 2nd Floor Providence,RI02912	05-0258809	501(c)(3)	56,717	Not applicable	Not applicable	Research
(16) Yale University PO Box 1873 New Haven,CT065081873	06-0646973	501(c)(3)	69,358	Not applicable	Not applicable	Research
(17) Weill Cornell Medical College 575 Lexington Avenue 9th Floor New York,NY10022	13-1623978	501(c)(3)	399,166	Not applicable	Not applicable	Research
(18) Rockefeller University 1230 York Avenue New York,NY10065	13-1624158	501(c)(3)	49,795	Not applicable	Not applicable	Research
(19) Albert Einstein College of Medicine 1300 Morris Park Avenue Bronx,NY10461	13-1624225	501(c)(3)	78,151	Not applicable	Not applicable	Research
(20) The Foundation for AIDS Research AMFAR 120 Wall Street New York,NY100053908	13-3163817	501(c)(3)	15,000	Not applicable	Not applicable	Research
(21) Data Solutions LLC 2601 Henry Hudson Parkway Suite 1 E Bronx,NY10463	13-3979408	N/A	16,820	Not applicable	Not applicable	Research
(22) New York University School of Medicine P O Box 415026 Bank of America Boston,MA022415026	13-5562308	501(c)(3)	711,813	Not applicable	Not applicable	Research
(23) The Trustees of Columbia University Sponsored Projects Finance PO Box 29789 New York,NY10087	13-5598093	501(c)(3)	1,384,788	Not applicable	Not applicable	Research
(24) Icahn School of Medicine at Mount Sinai Attn Raj Appavu One Gustave L Levy Place New York,NY10029	13-6171197	501(c)(3)	573,847	Not applicable	Not applicable	Research
(25) Research Foundation of State University of New York 35 State Street Albany,NY122072826	14-1368361	501(c)(3)	31,397	Not applicable	Not applicable	Research
(26) Health Research Inc P O Box 2966 Buffalo,NY14240	14-1402155	501(c)(3)	70,709	Not applicable	Not applicable	Research
(27) Syracuse University Bursar Operations 119 Bowne Hall Syracuse,NY132441140	15-0532081	501(c)(3)	362,374	Not applicable	Not applicable	Research
(28) Rambiss LLC PO Box 578 Cheltenham,MD20623	20-1240325	N/A	9,282	Not applicable	Not applicable	Instruction
(29) Hospital Authority of Metro Nashville & Nashville General Hospital 1818 Albion St Nashville,TN37208	20-2844893	GOVT	184,251	Not applicable	Not applicable	Research
(30) Valley Hospital Inc 223 North Van Dien Avenue ATTN Research 1 Linwood Ridgewood,NJ07450	22-1487307	501(c)(3)	5,670	Not applicable	Not applicable	Research
(31) Childrens Hospital of Philadelphia Lockbox 1457 PO Box 8500 Philadelphia,PA191781457	23-1352166	501(c)(3)	702,459	Not applicable	Not applicable	Research
(32) Thomas Jefferson University 125 9th Street 2nd floor Philadelphia,PA19107	23-1352651	501(c)(3)	9,100	Not applicable	Not applicable	Research
(33) The Trustees of the University of Pennsylvania PO Box 785541 Philadelphia,PA191785541	23-1352685	501(c)(3)	64,986	Not applicable	Not applicable	Research
(34) Geisinger Clinic 100 N Academy Avenue Danville,PA17822	23-6291113	501(c)(3)	386,005	Not applicable	Not applicable	Research
(35) Institute for Cancer Research Attn Accounts Receivable 333 Cottman Ave Philadelphia,PA19111	23-6296135	501(c)(3)	54,791	Not applicable	Not applicable	Research
(36) Fred Hutchinson Cancer Research Center 1100 Fairview Avenue North J6-330 PO Box 19024 Seattle,WA981091024	23-7156071	501(c)(3)	23,411	Not applicable	Not applicable	Research
(37) Cancer Prevention Inst of California 2201 Walnut Avenue Suite 300 Fremont,CA94538	23-7427232	501(c)(3)	7,635	Not applicable	Not applicable	Research
(38) University of Pittsburgh Office of Research/Cost Accounting 3109 Cathedral of Learning Pittsburgh,PA15260	25-0965591	501(c)(3)	1,251,266	Not applicable	Not applicable	Research
(39) Allegheny Singer Research Institute Research Accounting and Reporting PO Box 951765 Cleveland,OH44193	25-1320493	501(c)(3)	188,596	Not applicable	Not applicable	Research
(40) Progreso Community Center 5666 Nolensville Pike Nashville,TN37211	26-0635611	501(c)(3)	21,243	Not applicable	Not applicable	Research
(41) The Broad Institute Inc 415 Main St Cambridge,MA02142	26-3428781	501(c)(3)	4,330,547	Not applicable	Not applicable	Research
(42) Health Research TX LLC 5 Neshaminy Interplex Plaza Suite 205 Trevose,PA19053	27-1776538	N/A	192,638	Not applicable	Not applicable	Research
(43) Select Physicians Alliance PL 1127 Nikki View Dr Brandon,FL33511	27-3337174	N/A	34,736	Not applicable	Not applicable	Research
(44) Regenstrief Institute Inc 1101 West 10th Street Indianapolis,IN46202	30-0007730	501(c)(3)	59,149	Not applicable	Not applicable	Research
(45) Childrens Hospital Medical Center Accounting Office MLC 4900 3333 Burnet Avenue Cincinnati,OH452293039	31-0833936	501(c)(3)	373,397	Not applicable	Not applicable	Research
(46) University of Cincinnati PO Box 932641 SRS Accounting Cleveland,OH44193	31-6000989	GOVT	748,834	Not applicable	Not applicable	Research
(47) Ohio State University Office of Sponsored Programs OBIC ATTN Michael Adkins Columbus,OH43210	31-6025986	GOVT	81,319	Not applicable	Not applicable	Research
(48) The Research Institute at Nationwide PO BOX 781653 Detroit,MI482781653	31-6056230	501(c)(3)	78,864	Not applicable	Not applicable	Research
(49) Ohio State University Research Foundation Financial Services Procurements 1960 Kenny Road 4th Floor Columbus,OH43210	31-6401599	501(c)(3)	20,416	Not applicable	Not applicable	Research
(50) The Scripps Research Institute 10550 North Torrey Pines Road La Jolla,CA92037	33-0435954	501(c)(3)	708,164	Not applicable	Not applicable	Research
(51) Illumina Inc 12864 Collections Center Drive Chicago,IL60693	33-0804655	N/A	30,000	Not applicable	Not applicable	Research
(52) Positive Oral Health Consulting LLC 3020 NE 32nd Ave 1119 Fort Lauderdale,FL33308	33-3087230	N/A	9,537	Not applicable	Not applicable	Instruction
(53) Cleveland Clinic Lerner College of Medicine 9500 Euclid Avenue JJN5-01 Cleveland,OH44195	34-0714585	501(c)(3)	209,061	Not applicable	Not applicable	Research
(54) Case Western Reserve University 10900 Euclid Avenue 417 Yost Hall Cleveland,OH44106	34-1018992	501(c)(3)	319,986	Not applicable	Not applicable	Research
(55) Central American Medical Outreach Inc 322 Westwood Avenue Orrville,OH44667	34-1740695	501(c)(3)	123,904	Not applicable	Not applicable	Research
(56) MetroHealth System PO Box 73308 Cleveland,OH44193	34-6004382	N/A	15,400	Not applicable	Not applicable	Research
(57) Indiana University Dept 78867 PO Box 78000 Detroit,MI482780867	35-6001673	GOVT	249,544	Not applicable	Not applicable	Research
(58) Purdue University 23510 Network Place Sponsored Program Services Chicago,IL606731235	35-6002041	GOVT	327,228	Not applicable	Not applicable	Research
(59) Chapin Hall Center for Children 1313 East 60th Street Accounts Receivable Chicago,IL60637	36-2167012	501(c)(3)	64,596	Not applicable	Not applicable	Public Service
(60) Northwestern University 633 Clark Street Evanston,IL602081112	36-2167817	501(c)(3)	900,940	Not applicable	Not applicable	Research
(61) Rush University Medical Center Fund Accounting 1700 West Van Buren Chicago,IL606123244	36-2174823	501(c)(3)	218,921	Not applicable	Not applicable	Research
(62) University of Chicago Financial Services 6054 South Drexel Avenue Chicago,IL60637	36-2177139	501(c)(3)	107,870	Not applicable	Not applicable	Research
(63) University of Illinois Grants and Contracts 28395 Network Place Springfield,IL627084610	37-6000511	GOVT	157,279	Not applicable	Not applicable	Research
(64) University of Vermont 217 Waterman Building 85 South Prospect Street Burlington,VT054050160	37-6047339	GOVT	636,740	Not applicable	Not applicable	Research
(65) Oakland University Office of Research Administration 529 Wilson Hall Rochester,MI48309	38-1714400	GOVT	66,349	Not applicable	Not applicable	Research
(66) Arbor Research Collaborative for Health ATTN Accounting 340 E Huron Street Ann Arbor,MI48104	38-3289521	501(c)(3)	97,744	Not applicable	Not applicable	Research
(67) Michigan State University Contract Grant Administration Hannah Administration East Lansing,MI48824	38-6005984	GOVT	80,101	Not applicable	Not applicable	Research
(68) Regents of the University of Michigan Box 223131 Pittsburgh,PA152512131	38-6006309	GOVT	493,120	Not applicable	Not applicable	Research
(69) Wayne State University Cashiers Office PO Box 02788 Detroit,MI48202	38-6028429	GOVT	89,320	Not applicable	Not applicable	Research
(70) Medical College of Wisconsin PO Box 26509 8701 Watertown Plank Road Milwaukee,WI53226	39-0806261	501(c)(3)	34,366	Not applicable	Not applicable	Research
(71) BloodCenter of Wisconsin Inc Box 78961 Milwaukee,WI532780961	39-0807235	501(c)(3)	150,001	Not applicable	Not applicable	Research
(72) Aurora Health Care Inc PO Box 341880 Attn Seng Cheung Milwaukee,WI532341881	39-1442285	501(c)(3)	107,736	Not applicable	Not applicable	Research
(73) University of Wisconsin - Madison 21 North Park Street Suite 6401 Milwaukee,WI532780538	39-1805963	GOVT	64,340	Not applicable	Not applicable	Research
(74) Board of Regents of University of Wisconsin UW-Madison Gar Account Drawer 538 Milwaukee,WI532780538	39-6006492	GOVT	162,211	Not applicable	Not applicable	Research
(75) Mayo Clinic Rochester PO Box 860334 Research Finance - Rochester Minneapolis,MN554860334	41-6011702	501(c)(3)	427,976	Not applicable	Not applicable	Research
(76) University of Iowa Grant Accounting B5 Jessup Hall Iowa City,IA52242	42-6004813	GOVT	9,100	Not applicable	Not applicable	Research
(77) Washington University School of Medicine Sponsored Projects Accounting 700 Rosedale Avenue Saint Louis,MO631121408	43-0653611	501(c)(3)	2,464,227	Not applicable	Not applicable	Research
(78) Hudson Alpha Institute for Biotechnology 601 Genome Way Attn Accounts Receivable Huntsville,AL35806	43-2059317	501(c)(3)	19,718	Not applicable	Not applicable	Research
(79) Childrens Mercy Hospitals & Clinics PO Box 803852 Kansas City,MO641803852	44-0605373	501(c)(3)	26,092	Not applicable	Not applicable	Research
(80) Baptist Clinical Research Institute Baptist Memorial Healthcare Corporation Attn Jennifer Memphis,TN38120	45-3032246	501(c)(3)	386,275	Not applicable	Not applicable	Research
(81) Orthopedic Institute 810 East 23rd Street Sioux Falls,SD571175116	46-0316404	N/A	20,228	Not applicable	Not applicable	Research
(82) Sanford Research PO Box 5064 Sioux Falls,SD571045064	46-0450378	501(c)(3)	210,796	Not applicable	Not applicable	Research
(83) Rutgers The State University of New Jersey 65 Davidson Road Room 306 Piscataway,NJ088545602	46-2354111	GOVT	40,021	Not applicable	Not applicable	Research
(84) Florida Community Health Worker Coalition 6605 5th Ave North SPC SA Building Saint Petersburg,FL33710	47-3503638	501(c)(3)	18,600	Not applicable	Not applicable	Research
(85) Pulmonix LLC 1200 North Elm Street Room 2M150 Greensboro,NC27401	47-4299622	N/A	19,055	Not applicable	Not applicable	Research
(86) University of Kansas Center for Research Mail Stop 1039 3901 Rainbow Boulevard Kansas City,KS66160	48-0680117	501(c)(3)	10,500	Not applicable	Not applicable	Research
(87) Johns Hopkins University Central Lockbox Services Bank of America Chicago,IL60693	52-0595110	501(c)(3)	359,299	Not applicable	Not applicable	Research
(88) Atlantic Health System Inc 475 South Street Morristown,NJ07962	52-1958352	501(c)(3)	8,350	Not applicable	Not applicable	Research
(89) University of Maryland Baltimore Sponsored Projects Accounting PO Box 41428 Baltimore,MD212036428	52-6002033	GOVT	374,801	Not applicable	Not applicable	Research
(90) Georgetown University Clinical Research Openstions Office 3970 Reservoir Road NW 212 Washington,DC20057	53-0196603	501(c)(3)	12,088	Not applicable	Not applicable	Research
(91) Virginia Commonwealth University Grants and Contracts Accounting 730 East Broad Street Richmond,VA23284	54-6001758	GOVT	11,795	Not applicable	Not applicable	Research
(92) Virginia Polytechnic Institute & State Office of Sponsored Programs North End Center MC 0170 Blacksburg,VA24061	54-6001805	GOVT	19,140	Not applicable	Not applicable	Research
(93) West Virginia University Research Corp 886 Chestnut Ridge Rd Second Floor Room 202 Morgantown,WV26506	55-0665758	501(c)(3)	21,475	Not applicable	Not applicable	Research
(94) Duke University Duke University Accounts Receivable PO Box 602651 Charlotte,NC28260	56-0532129	501(c)(3)	626,701	Not applicable	Not applicable	Research
(95) Wake Forest University Health Sciences Translational Science Institute Office of Clinical Research Winston Salem,NC27157	56-0532138	501(c)(3)	5,020	Not applicable	Not applicable	Research
(96) University of North Carolina Charlotte 9201 University City Blvd Grants Contracts Admin Charlotte,NC28223	56-0791228	GOVT	70,840	Not applicable	Not applicable	Research
(97) University of North Carolina Chapel Hill Office of Sponsored Research c/o Bank of America Lockbox Service Atlanta,GA30384	56-6001393	GOVT	1,440,274	Not applicable	Not applicable	Research & Instruction
(98) Medical University of South Carolina 19 Hagood Ave Suite 604 MSC 808 Charleston,SC29425	57-6000722	GOVT	40,982	Not applicable	Not applicable	Research
(99) University of South Carolina 1600 Hampton St Room 612 Columbia,SC29208	57-6001153	GOVT	1,420,616	Not applicable	Not applicable	Instruction
(100) Emory University PO Box 935084 Atlanta,GA311935084	58-0566256	501(c)(3)	776,348	Not applicable	Not applicable	Research
(101) MOREHOUSE SCHOOL OF MEDICINE Attn Accounts Receivable Cashier 720 WESTVIEW DRIVE SW Atlanta,GA30310	58-1438873	501(c)(3)	450,482	Not applicable	Not applicable	Instruction
(102) Saint Thomas Hospital Foundation ATTN Dan Thompson 4220 Harding Road Nashville,TN37205	58-1663055	501(c)(3)	73,553	Not applicable	Not applicable	Research
(103) Saint Thomas Health ATTN Lynn Peterson 4220 Harding Rd Nashville,TN37205	58-1716804	501(c)(3)	40,600	Not applicable	Not applicable	Research
(104) Georgia State University Research Foundation PO Box 3999 Atlanta,GA303023999	58-1845423	501(c)(3)	6,462	Not applicable	Not applicable	Research
(105) Children's Healthcare of Atlanta Inc ATTN Shakeeta Nicholson Finance Office of Grants Accounting Atlanta,GA30329	58-2367819	501(c)(3)	29,996	Not applicable	Not applicable	Research
(106) Hearts for Hearing Foundation 11500 North Portland Ave Oklahoma City,OK73120	58-2670613	501(c)(3)	42,358	Not applicable	Not applicable	Research
(107) University of Miami Office of Research Admin PO Box 405803 Atlanta,GA303845803	59-0624458	501(c)(3)	1,686,972	Not applicable	Not applicable	Research
(108) H Lee Moffitt Cancer Center 1209 Magnolia Dr Tampa,FL336129497	59-2451713	501(c)(3)	377,464	Not applicable	Not applicable	Research
(109) University of South Florida ATTN Research Projects Receivables PO Box 864568 Orlando,FL328864568	59-3102112	GOVT	44,631	Not applicable	Not applicable	Research
(110) Florida Health Sciences Center Office of Clinical Research 5 Tampa General Circle Tampa,FL33606	59-3458145	501(c)(3)	8,295	Not applicable	Not applicable	Research
(111) University of Florida CFO Contracts Grants Office Box 113001 Gainesville,FL32611	59-6002052	GOVT	1,615,937	Not applicable	Not applicable	Research
(112) University of Louisville Research Foundation Office of Sponsored Programs Admin 300 East Market St Louisville,KY402021959	61-1029626	501(c)(3)	43,841	Not applicable	Not applicable	Research
(113) Oregon State University A312 Kerr Admin Bldg Corvallis,OR973312140	61-1730890	GOVT	57,484	Not applicable	Not applicable	Research
(114) University of Kentucky Research c/o PNC Bank PO Box 931113 Cleveland,OH44193	61-6033693	501(c)(3)	215,058	Not applicable	Not applicable	Instruction
(115) Fisk University Attn Thelma Jackson Office of Budget and Grants Nashville,TN37208	62-0202000	501(c)(3)	13,864	Not applicable	Not applicable	Research
(116) Belmont University 1900 Belmont Blvd Nashville,TN37212	62-0465076	501(c)(3)	15,958	Not applicable	Not applicable	Research
(117) Vanderbilt University Contract & Grant PMB 401591 Nashville,TN372401591	62-0476822	501(c)(3)	14,288,557	Not applicable	Not applicable	Research & Instruction & Public Service & Contribution
(118) Tennessee Valley Healthcare System Attn Debbie Moore Department of Veteran Affairs Nashville,TN372122637	62-0484828	GOVT	26,617	Not applicable	Not applicable	Research
(119) David Lipscomb University College of Pharmacy One University Park Dr Nashville,TN37204	62-0485733	501(c)(3)	6,199	Not applicable	Not applicable	Research
(120) Meharry Medical College Attn Grants Contracts 1005 Dr D B Todd Blvd Nashville,TN37208	62-0488046	501(c)(3)	2,213,186	Not applicable	Not applicable	Instruction
(121) St Judes Childrens Research Hospital PO Box 1000 Dept 949 Memphis,TN381480949	62-0646012	501(c)(3)	21,070	Not applicable	Not applicable	Research
(122) University of Memphis PO Box 1000 Department 313 Memphis,TN381480313	62-0648618	GOVT	49,350	Not applicable	Not applicable	Research
(123) Metro Public Health Department 222 3rd Avenue North Suite 750 Nashville,TN37201	62-0694743	GOVT	76,083	Not applicable	Not applicable	Research
(124) Tennessee State University 3500 John A Merritt Boulevard Nashville,TN37209	62-0786119	GOVT	8,179	Not applicable	Not applicable	Research
(125) Nashville CARES 633 Thompson Lane Nashville,TN37204	62-1274532	501(c)(3)	8,226	Not applicable	Not applicable	Research
(126) Middle Tennessee Research Institute 1310 24th Avenue South Room F-201 Nashville,TN37212	62-1387860	501(c)(3)	155,112	Not applicable	Not applicable	Research
(127) Cumberland Pediatric Foundation 3102 West End Avenue Suite 175 Nashville,TN37203	62-1615913	501(c)(3)	349,821	Not applicable	Not applicable	Research
(128) University of Tennessee Memphis 62 South Dunlap Street Suite 300 Memphis,TN38163	62-6001636	GOVT	408,314	Not applicable	Not applicable	Research
(129) Jackson Madison County General Hospital Attn Debra Lewis 620 Skyline Drive Jackson,TN383013956	62-6010402	GOVT	48,100	Not applicable	Not applicable	Research
(130) East Tennessee State University Financial Services PO Box 70732 Johnson City,TN376140732	62-6021046	GOVT	82,420	Not applicable	Not applicable	Instruction
(131) Franklin Primary Health Center Inc PO Box 2048 Mobile,AL366522048	63-0695975	501(c)(3)	78,300	Not applicable	Not applicable	Research
(132) Montgomery Aids Outreach Inc PO Box 11087 Montgomery,AL36111	63-0959628	501(c)(3)	252,225	Not applicable	Not applicable	Instruction
(133) Auburn University Contract and Grants Accounting 208 M White Smith Hall Auburn University,AL368495110	63-6000724	GOVT	7,420	Not applicable	Not applicable	Research
(134) University of Alabama at Birmingham Grants and Contracts Accounting 1720 Second Ave South Birmingham,AL352940109	63-6005396	GOVT	784,114	Not applicable	Not applicable	Instruction
(135) University of Mississippi Medical Center Attn Office of Sponsored Program Post Award Division Jackson,MS392164505	64-6008520	GOVT	288,375	Not applicable	Not applicable	Instruction
(136) Miami-Dade Area Health Education Center 1200 NW 78th Ave Suite 209 Miami,FL33126	65-0009277	501(c)(3)	19,251	Not applicable	Not applicable	Research
(137) Administrators of the Tulane Educational Tulane University 800 East Commerce Road Suite 203 Harahan,LA70123	72-0423889	501(c)(3)	35,968	Not applicable	Not applicable	Research
(138) Louisiana State University Health Science Center Sponsored Projects 433 Bolivar Street New Orleans,LA701122223	72-6000848	GOVT	16,239	Not applicable	Not applicable	Research
(139) LSU Health Sciences Center New Orleans 1901 Perdido Street Suite 3205 New Orleans,LA70112	72-6087770	GOVT	304,112	Not applicable	Not applicable	Research
(140) University of Texas Health Science Financial Administrative Support PO Box 301418 Dallas,TX753031418	74-1586031	GOVT	180,294	Not applicable	Not applicable	Research
(141) Baylor College of Medicine ATTN Mereena Francis Manackal 1504 Taub Loop Houston,TX77030	74-1613878	501(c)(3)	294,687	Not applicable	Not applicable	Research
(142) University of Texas Health Science Financial Admin Support PO Box 301418 Dallas,TX75303	74-1761309	GOVT	183,126	Not applicable	Not applicable	Research
(143) National Jewish Health ATTN Treasury Dept M216 1400 Jackson Street Denver,CO80206	74-2044647	501(c)(3)	67,442	Not applicable	Not applicable	Research
(144) University of Texas at Austin ATTN Katy Cotten 105 East 24th Street Austin,TX787121224	74-6000203	GOVT	79,112	Not applicable	Not applicable	Research
(145) University of Texas Medical Branch Office of Sponsored Programs Dept 750 Dallas,TX75266	74-6000949	GOVT	224,172	Not applicable	Not applicable	Research
(146) The University of Texas MD Anderson Cancer Center Accounts Receivable Houston,TX772104461	74-6001118	GOVT	41,766	Not applicable	Not applicable	Research
(147) University of Texas Dallas ATTN Accounts Receivable 800 W Campbell Road Richardson,TX750803021	75-1305566	GOVT	99,064	Not applicable	Not applicable	Research
(148) Texas Health Research and Education Inst 612 East Lamar Blvd Suite 600 Arlington,TX76011	75-2562191	501(c)(3)	5,049	Not applicable	Not applicable	Research
(149) University of Texas Southwestern Medical Office of Post Award Administration PO Box 841765 Dallas,TX752841765	75-6002868	GOVT	43,870	Not applicable	Not applicable	Research
(150) Palo Alto Veterans Institute for Research Post Office Box V-38 Palo Alto,CA94304	77-0207331	501(c)(3)	141,942	Not applicable	Not applicable	Research
(151) Naval Medical Research Center 503 Robert Grant Ave Silver Spring,MD209107500	80-0520146	GOVT	175,000	Not applicable	Not applicable	Research
(152) Greenway Health LLC 4301 West Boy Scout Blvd Suite 800 Tampa,FL33607	80-0847459	N/A	218,567	Not applicable	Not applicable	Research
(153) Radiology Imaging Associates PC 10700 East Geddes Ave Suite 200 Englewood,CO80112	84-0597929	N/A	9,055	Not applicable	Not applicable	Research
(154) Denver Health and Hospital Authority UMB Bank of Colorado PO Box 17093 Denver,CO802170093	84-1343242	GOVT	24,299	Not applicable	Not applicable	Research
(155) University of Colorado Denver Office of Grants Contracts F428 PO Box 910238 Denver,CO802910238	84-6000555	GOVT	348,720	Not applicable	Not applicable	Research
(156) Dignity Health Attn Misc A/R Cash File 57431 Los Angeles,CA900748781	86-0096787	N/A	66,581	Not applicable	Not applicable	Research
(157) Mayo Clinic Research Finance - Arizona PO Box 860334 Minneapolis,MN554860334	86-0800150	501(c)(3)	25,305	Not applicable	Not applicable	Research
(158) Western Institute for Biomedical Research PO Box 58719 Salt Lake City,UT84158	87-0470748	501(c)(3)	61,993	Not applicable	Not applicable	Research
(159) Methodist Hospital Research Institute Office of Grants and Contracts PO Box 4805 Houston,TX772104805	87-0721923	501(c)(3)	67,523	Not applicable	Not applicable	Research
(160) University of Utah Grants Contracts Accounting 201 S Presidents Cir Salt Lake City,UT841129020	87-6000525	GOVT	217,451	Not applicable	Not applicable	Research
(161) Seattle Children's Hospital PO Box 24728 Seattle,WA981240728	91-0564748	501(c)(3)	60,653	Not applicable	Not applicable	Research
(162) Center for Infectious Disease Research 307 Westlake Ave North Suite 500 Seattle,WA98109	91-0961784	501(c)(3)	309,995	Not applicable	Not applicable	Research
(163) Infectious Disease Research Institute 1616 Eastlake Ave East 400 Seattle,WA98102	91-1608978	501(c)(3)	667,347	Not applicable	Not applicable	Research
(164) University of Washington Box 354966 Seattle,WA981254966	91-6001537	GOVT	1,984,370	Not applicable	Not applicable	Research
(165) Leland Stanford Junior University PO Box 44253 San Francisco,CA941444253	94-1156365	501(c)(3)	918,663	Not applicable	Not applicable	Research
(166) Regents of the University of California Contracts Grants Accounting 1855 Folsom Street San Francisco,CA941430897	94-6036493	GOVT	226,416	Not applicable	Not applicable	Research
(167) University of Southern California Sponsored Projects 3500 S Figueroa Street Los Angeles,CA900742095	95-1642394	501(c)(3)	2,033,741	Not applicable	Not applicable	Research
(168) California Institute of Technology Treasury Services 1200 E California Boulevard Pasadena,CA91125	95-1643307	501(c)(3)	380,619	Not applicable	Not applicable	Research
(169) Cedars Sinai Medical Center 6500 Wilshire Blvd Los Angeles,CA90048	95-1644600	501(c)(3)	649,349	Not applicable	Not applicable	Research
(170) City of Hope National Medical Center 1450 East Duarte Road Room 1012 Duarte,CA91010	95-1683875	501(c)(3)	186,028	Not applicable	Not applicable	Research
(171) University of California Irvine ATTN Accounting Office 120 Theory Irvine,CA926971050	95-2226406	GOVT	23,468	Not applicable	Not applicable	Research
(172) University of California San Diego 9500 Gilman Dr MC0009 La Jolla,CA920930009	95-6006144	GOVT	291,102	Not applicable	Not applicable	Research
(173) University of Hawaii Office of Research Services 2440 Campus Road Honolulu,HI96822	99-6000354	GOVT	60,387	Not applicable	Not applicable	Research
(174) Instituto De Investigacion Nutrucional 121 Alhambra Plaza Suite 1200 Coral Gables,FL33134		N/A	364,581	Not applicable	Not applicable	Research
(175) City Publications Nashville Lifestyles PO Box 5061 Brentwood,TN37024	06-1032273	N/A	6,000	Not applicable	Not applicable	Contribution
(176) March of Dimes 1275 Mamaroneck Ave White Plains,NY10605	13-1846366	501(c)(3)	15,000	Not applicable	Not applicable	Contribution
(177) Association of Operating Room Nurses Inc 2170 S Parker Rd Suite 400 Denver,CO80231	13-1882322	501(c)(6)	11,400	Not applicable	Not applicable	Contribution
(178) American Heart Association 1818 Patterson St Nashville,TN37203	13-5613797	501(c)(3)	261,000	Not applicable	Not applicable	Contribution
(179) Tennessee Emergency Medical Services for Children Foundation 3841 Green Hills Village Drive Suite 3045 Nashville,TN37215	20-2802786	501(c)(3)	12,500	Not applicable	Not applicable	Contribution
(180) JDRF Diabetes Foundation 105 Westpark Dr 415 Brentwood,TN37027	23-1907729	501(c)(3)	20,000	Not applicable	Not applicable	Contribution
(181) Acoustic Neuroma Association 600 Peachtree Parkway Suite 108 Cumming,GA30041	23-2170836	501(c)(3)	15,000	Not applicable	Not applicable	Contribution
(182) Heritage Foundation 112 Bridge St Franklin,TN37064	23-7042596	501(c)(3)	13,375	Not applicable	Not applicable	Contribution
(183) Tennessee Kidney Foundation 37 Peabody Street Suite 206 Nashville,TN37210	27-0812507	501(c)(3)	7,000	Not applicable	Not applicable	Contribution
(184) TEDx Nashville 330 Hudson St 11th Floor New York,NY10013	27-2013937	501(c)(3)	30,000	Not applicable	Not applicable	Contribution
(185) Jackson Generals Baseball Club LP 4 Fun Place Jackson,TN38305	32-0303574	N/A	8,500	Not applicable	Not applicable	Contribution
(186) Williamson Inc 5005 Meridian Blvd 150 Franklin,TN37067	36-4720381	501(c)(6)	23,500	Not applicable	Not applicable	Contribution
(187) Green Hills Mall 2126 Abbott Martin Rd Nashville,TN37215	38-2033632	N/A	35,000	Not applicable	Not applicable	Contribution
(188) Institute for Healthcare Improvement 20 University Road 7th Floor Cambridge,MA02138	38-3017223	501(c)(3)	6,500	Not applicable	Not applicable	Contribution
(189) Spring Hill Chamber of Commerce PO BOX 1815 Spring Hill,TN37174	45-0484327	501(c)(6)	5,700	Not applicable	Not applicable	Contribution
(190) The Nashville Food Project 3605 Hillsboro Pike Nashville,TN37215	45-2905951	501(c)(3)	10,000	Not applicable	Not applicable	Contribution
(191) The Governor's Foundation for Health 511 Union St 720 Nashville,TN37219	45-3635908	501(c)(3)	16,666	Not applicable	Not applicable	Contribution
(192) Scott Hamilton CARES PO BOX 30619 Nashville,TN37230	47-2328142	501(c)(3)	10,000	Not applicable	Not applicable	Contribution
(193) Pilgrimage Presents LLC PO Box 3314 Houma,LA70361	47-3296867	N/A	17,500	Not applicable	Not applicable	Contribution
(194) T J Martell Foundation 1114 17th Ave S Suite 101 Nashville,TN37212	51-0180178	501(c)(3)	65,000	Not applicable	Not applicable	Contribution
(195) National Business Group on Health 20 F St New Suite 200 Washington,DC20001	52-1147591	501(c)(3)	250,000	Not applicable	Not applicable	Contribution
(196) National Academy of Sciences ATTN Office of Contracts and Grants 500 Fifth St NW Washington,DC20001	53-0196932	501(c)(3)	30,000	Not applicable	Not applicable	Contribution
(197) Belmont University 1900 Belmont Blvd Nashville,TN37212	62-0465076	501(c)(3)	12,500	Not applicable	Not applicable	Contribution
(198) Junior League of Nashville 2202 Crestmoor Rd Nashville,TN37215	62-0476815	501(c)(3)	20,000	Not applicable	Not applicable	Contribution
(199) Nashville Symphony Orchestra 209 10th Avenue South Ticket Office Nashville,TN37203	62-0550979	501(c)(3)	25,000	Not applicable	Not applicable	Contribution
(200) Mental Health America of MD TN 446 Metroplex Dr Suite A-224 Nashville,TN37211	62-0637710	501(c)(3)	15,200	Not applicable	Not applicable	Contribution
(201) Hospital Hospitality House 214 Reidhurst Avenue Nashville,TN37214	62-0909363	501(c)(3)	34,000	Not applicable	Not applicable	Contribution
(202) Ronald McDonald House Charities of Nashville 2144 Fairfax Avenue Nashville,TN37212	62-1310717	501(c)(3)	8,200	Not applicable	Not applicable	Contribution
(203) Community Foundation of Middle TN 3833 Cleghorn Avenue Suite 400 Nashville,TN37215	62-1471789	501(c)(3)	54,500	Not applicable	Not applicable	Contribution
(204) Cumberland Pediatric Foundation 3102 West End Avenue Suite 175 Nashville,TN37203	62-1615913	501(c)(3)	10,000	Not applicable	Not applicable	Contribution
(205) National Alliance on Mental Illness Davidson County 1101 Kermit Dr Suite 506 Nashville,TN37217	80-0597038	501(c)(3)	6,950	Not applicable	Not applicable	Contribution
(206) American Society for Matrix Biology (ASMB) 9650 Rockville Pike Bethesda,MD20814	91-2055099	501(c)(3)	17,500	Not applicable	Not applicable	Contribution

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

185

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

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

Cat. No. 50055P

Schedule I (Form 990) 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) Patient Assistance	129	170,579
(2) Patient Assistance	337		98,085	FMV	Healthcare Supplies, Medicine
(3) Patient Assistance	1300		15,126	FMV	Car seats, home safety kits
(4) Patient Assistance	10462		16,874,107	FMV	Prescription Drugs
(5) Patient Assistance	460		1,356,287	FMV	Post Acute Care
(6) Patient Assistance	21		107,983	FMV	Patient Temporary Housing
(7) Awards and Research Grants	437	6,273,584
(8) Patient Assistance	638		62,074	FMV	Ambulance Rides
(9) Patient Assistance	224		1,724	FMV	Cab Rides

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.

Vanderbilt University Medical Center maintains a formal policy defining its procedures for monitoring the use of sponsored funds by subrecipients who are performing a portion of a sponsored project externally awarded to Vanderbilt University Medical Center. The policy provides guidance to ensure that subrecipients conduct their portions of sponsored projects in compliance with laws, regulations, terms and conditions of awards and subawards, and that reimbursed costs incurred by subrecipients are allowed. The policy addresses the roles and responsibilities of central offices and departments of the Medical Center and describes the monitoring procedures for each area. The full text of Vanderbilt University Medical Center's subrecipient policy is available online at the following web address: https://finance.mc.vanderbilt.edu/are/ggc/policy.aspx

Schedule I (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

Vanderbilt University Medical Center

Employer identification number

35-2528741

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes 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 .........

Yes

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? ..

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Jeffrey R Balser MD PHD President and CEO	(i) (ii)	1,976,514 ------------- 0	764,580 ------------- 0	31,416 ------------- 0	263,338 ------------- 0	30,494 ------------- 0	3,066,342 ------------- 0	0 ------------- 0
2John F Manning Jr PHD MBA COO and Corporate Chief of Staff	(i) (ii)	791,156 ------------- 0	214,082 ------------- 0	12,822 ------------- 0	93,338 ------------- 0	24,339 ------------- 0	1,135,737 ------------- 0	0 ------------- 0
3Cecelia B Moore MHA CPA CHFP CFO and Treasurer	(i) (ii)	819,563 ------------- 0	219,435 ------------- 0	29,742 ------------- 0	95,338 ------------- 0	16,227 ------------- 0	1,180,305 ------------- 0	0 ------------- 0
4C Wright Pinson MD MBA Deputy CEO and Chief Health System Officer	(i) (ii)	1,682,240 ------------- 0	454,925 ------------- 0	34,366 ------------- 0	183,151 ------------- 0	15,749 ------------- 0	2,370,431 ------------- 0	0 ------------- 0
5Michael J Regier JD General Counsel and Secretary	(i) (ii)	666,171 ------------- 0	185,609 ------------- 0	30,822 ------------- 0	80,974 ------------- 0	24,260 ------------- 0	987,836 ------------- 0	0 ------------- 0
6Mitchell C Edgeworth MBA CEO, Vanderbilt University Adult Hospital and Clinics	(i) (ii)	632,446 ------------- 0	168,590 ------------- 0	11,585 ------------- 0	60,588 ------------- 0	25,783 ------------- 0	898,992 ------------- 0	0 ------------- 0
7Charles L Gregory MA MBA MH CEO, Monroe Carell Jr. Children's Hospital at Vanderbilt	(i) (ii)	604,284 ------------- 0	168,590 ------------- 0	32,604 ------------- 0	60,588 ------------- 0	22,739 ------------- 0	888,805 ------------- 0	0 ------------- 0
8Traci K Nordberg JD Chief HR Officer	(i) (ii)	527,491 ------------- 0	147,182 ------------- 0	29,310 ------------- 0	68,338 ------------- 0	9,594 ------------- 0	781,915 ------------- 0	0 ------------- 0
9David R Posch Executive Vice President for Population Health	(i) (ii)	684,546 ------------- 0	184,245 ------------- 0	14,843 ------------- 0	13,338 ------------- 0	17,396 ------------- 0	914,368 ------------- 0	0 ------------- 0
10David S Raiford MD Chief of Clinical Staff	(i) (ii)	672,740 ------------- 0	195,094 ------------- 0	30,822 ------------- 0	83,151 ------------- 0	24,421 ------------- 0	1,006,228 ------------- 0	0 ------------- 0
11William W Stead MD Chief Strategy Officer	(i) (ii)	711,192 ------------- 0	191,972 ------------- 0	15,385 ------------- 0	13,151 ------------- 0	16,259 ------------- 0	947,959 ------------- 0	0 ------------- 0
12Scott T Arthur MD VBJ Faculty - Asst Professor	(i) (ii)	840,021 ------------- 0	420,052 ------------- 0	11,040 ------------- 0	13,151 ------------- 0	16,668 ------------- 0	1,300,932 ------------- 0	0 ------------- 0
13Clinton J Devin MD Comprehensive Spine Center - Assoc Professor	(i) (ii)	836,942 ------------- 0	642,350 ------------- 0	11,040 ------------- 0	13,151 ------------- 0	7,457 ------------- 0	1,510,940 ------------- 0	0 ------------- 0
14John W Klekamp MD VBJ Faculty - Asst Professor	(i) (ii)	926,443 ------------- 0	344,768 ------------- 0	29,742 ------------- 0	13,151 ------------- 0	23,043 ------------- 0	1,337,147 ------------- 0	0 ------------- 0
15Paul A Thomas MD VBJ Faculty - Assoc Professor	(i) (ii)	1,473,308 ------------- 0	403,906 ------------- 0	32,064 ------------- 0	13,151 ------------- 0	26,734 ------------- 0	1,949,163 ------------- 0	0 ------------- 0
16Todd R Wurth MD VBJ Faculty - Asst Professor	(i) (ii)	904,723 ------------- 0	431,654 ------------- 0	29,310 ------------- 0	13,151 ------------- 0	27,484 ------------- 0	1,406,322 ------------- 0	0 ------------- 0

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 First-class or charter travel	Vanderbilt University Medical Center excludes the benefits from taxable income when a documented business purpose is served. 1 officer received charter travel benefits that were not included in taxable compensation. 2 officers and 1 director received first-class travel benefits that were not included in taxable compensation.
Schedule J, Part I, Line 1a Travel for companions	3 directors received companion travel benefits that were not included in taxable compensation. 1 officer received companion travel benefits that were and were not included in taxable compensation.
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments	2 key employees received tax gross-up payment benefits that were included in taxable compensation.
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	2 officers and 3 key employees received social club dues benefits included in taxable compensation.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	Certain individuals listed in Form 990, Schedule J, Part II participate in nonqualified deferred compensation plans. Amounts contributed to the plans include fixed percentages of annual bonus payments and fixed dollar amounts. Contributions to the plan vest when individuals complete their contract term or continue employment to a designated date. Current year accruals of compensation associated with these plans are included in the amounts reported for each individual in Schedule J, Part II, Column (C). The payout of these amounts in future years will be included in the amounts reported in Schedule J, Part II, Column (B)(iii) for such individuals. Amounts accrued in prior years and previously reported in Schedule J, Part II, Column (C) will be reported in Schedule J, Part II, Column (F). No payouts were made under these plans to participating individuals in 2017.
Schedule J, Part I, Line 7 Non-fixed payments	Certain individuals listed in Schedule J, Part II received variable incentive compensation based on the achievement of pre-established goals where judgment was determined by the Compensation Committee. Incentive payments are shown in Schedule J, Part II, Column B(ii).

Schedule J (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

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
Vanderbilt University Medical Center

Employer identification number
35-2528741

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	THE HEALTH AND EDUCATIONAL FACILITIES BOARD OF THE METROPOLITAN GOVERNMENT OF NASHVILLE AND DAVIDSON COUNTY TENNESSEE - Series 2018	62-6139016	000000000	04-20-2018	53,385,000	Refunding of the 2016F Issue		X		X		X
B	THE HEALTH AND EDUCATIONAL FACILITIES BOARD OF THE METROPOLITAN GOVERNMENT OF NASHVILLE AND DAVIDSON COUNTY TENNESSEE Series 2017A	62-6139016	592041YC5	07-26-2017	126,334,390	(See Statement)		X		X		X
C	THE HEALTH AND EDUCATIONAL FACILITIES BOARD OF THE METROPOLITAN GOVERNMENT OF NASHVILLE AND DAVIDSON COUNTY TENNESSEE - Series 2016A	62-6139016	592041WH6	04-29-2016	536,573,506	(SEE STATEMENT)		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	53,385,000		126,967,477		536,573,506
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	285,000		1,334,390		10,700,399
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............			91,187,075		525,873,107
11 Other spent proceeds .............	53,100,000
12 Other unspent proceeds .............			34,446,012
13 Year of substantial completion .............	2018				2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........
16 Has the final allocation of proceeds been made? ..........	X			X	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X

Part Ⅲ

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.59 %		0 %		1.03 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0.11 %
6 Total of lines 4 and 5 .............	0.59 %		0 %		1.14 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X

Part Ⅳ

Arbitrage

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

Schedule K (Form 990) 2019

Page 3

Part Ⅳ

Arbitrage (Continued)

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

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
Schedule K, Part I, Column (f) Description of Purpose	Row (B) - The issue is financing various new capital projects for the medical center. Row (C) - Cost of construction, renovation, remodeling and equipping of capital projects for the Borrower.
Schedule K, Part II, Line 3 Total Proceeds of Issue	Column (B) - The 2017A issue generated $633,087 in accumulated earnings during the tax year ending June 30, 2018. As of June 30, 2018, the accumulated earnings were unspent proceeds that are duly included in Schedule K, Part II, Line 12.

Schedule K (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

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

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Vanderbilt University Medical Center

Employer identification number

35-2528741

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....	X	21	9,845	Market value
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..	X		1,085	Selling cost
5 Clothing and household goods .......	X		60,805	Selling cost
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	79	3,259,532	Market value
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....	X	13	2,565	Market value
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Meals )	X	7	2,353	Market value
26 Other ( Gift Certificates )	X	35	7,547	Market value
27 Other ( )
28 Other ( )

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

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

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

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

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

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

32a

If "Yes," describe in Part II.

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

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2019)

Page 2

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

Return Reference	Explanation
Schedule M, Part I Column (b) - Number of Contributions or Items Contributed	Column (b) reports the number of contributions made.
Schedule M, Part I Line 5 - Clothing and household goods	Donation of various household items for silent auction benefiting the Monroe Carell Jr. Children's Hospital at Vanderbilt.

Schedule M (Form 990) (2019)

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

Vanderbilt University Medical Center

Employer identification number

35-2528741

Return Reference	Explanation
Form 990, Part III, Line 1	Vanderbilt University Medical Center ("VUMC") is one of the nation's longest serving and most prestigious academic medical centers. Through its historic bond with Vanderbilt University, VUMC cultivates distinguished research and educational programs to advance a clinical enterprise that provides compassionate and personalized care and support for millions of patients and family members each year. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries, transformational educational and clinical advancements across the entire spectrum of health and disease. Through the exceptional capabilities and caring spirit of its people, VUMC will lead in improving the healthcare of individuals and communities regionally, nationally, and internationally, combining its transformative learning programs and compelling discoveries to provide distinctive personalized care.
Form 990, Part III, Line 4a	4a. Patient Services - VUMC provides high quality medical and health care services regardless of race, creed, gender, national origin, handicap, age or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of VUMC, it is recognized that not all individuals possess the ability to purchase essential medical services, and further that part of VUMC's mission is to serve the community. Therefore, in keeping with VUMC's commitment to serve all members of its community, free care and/or subsidized care, care provided to persons covered by governmental programs at below cost, and health activities and programs to support the community are provided where the need and/or an individual's inability to pay coexists. These activities include wellness programs, community education programs, special programs for the elderly, handicapped, medically underserved, and a variety of broad community support activities. Charity care is also provided through many reduced-price services and free programs offered throughout the year based upon activities and services which VUMC believes will serve a bona fide community health need. During the fiscal year, VUMC serviced 61,381 inpatients and 2,161,423 emergency and outpatient clinic visits. VUMC's leadership in the delivery of academically based health care is recognized by the nation's most trusted advisory bodies and reporting organizations, including the National Academies, the Magnet Recognition Program, U.S. News & World Report, the Leapfrog Group, Becker's Hospital Review and others: * U.S. News & World Report: for 2018 named to 'Honor Roll' of nation's top 20 hospitals, #1 hospital in Tennessee for the seventh consecutive year; #1 Metro Nashville; 10 adult clinical specialties ranked among the nation's best; Monroe Carell Jr. Children's Hospital at Vanderbilt is named as one of the elite children's hospital in the nation by U.S. News, with 10 out of 10 specialties nationally ranked in 2018 * Becker's Hospital Review: one of the "100 Great Hospitals in America" and the only health care facility in Tennessee to make the list in 2018 * The Leapfrog Group: Monroe Carell Jr. Children's Hospital at Vanderbilt named a Leapfrog Top Hospital for 2017, making it one of only nine pediatric hospitals in the nation to receive this designation * National Institutes of Health: Vanderbilt University School of Medicine currently ranked 10th among the top grant awardees for medical research in the U.S. as of December 2017 * Magnet Designation from American Nurses Credentialing Center: Vanderbilt University Medical Center is the only organization that is Magnet-designated in Middle Tennessee, having achieved its third consecutive designation in 2017 * American Hospital Association's Health Forum: among the nation's 100 "Most Wired" hospitals and health systems for its efforts in innovative medical technology in 2018 * The Accreditation Council for Graduate Medical Education and the Arnold P. Gold Foundation awarded VUMC the Dewitt C. "Bud" Baldwin Award for excellence in medical education in 2017 * VUMC was named to the 'Honor Roll' of the nation's top hospitals by U.S. News and World Report in its 2018-2019 ranking of 'America's Best Hospitals.' VUMC was one of only 20 hospitals nationwide to earn this distinction. * For the seventh time, VUMC was named a Leader in LGBTQ Healthcare Equality by the Human Rights Campaign Healthcare Equality Index (HEI) 2018. VUMC is the only organization in Tennessee to repeatedly be recognized for its commitment to adopting LGBTQ-inclusive patient, visitation and employment policies. * The CEO Roundtable on Cancer re-accredited VUMC as a CEO Cancer Gold Standard employer for VUMC's efforts to reduce the risk of cancer for employees and their families. VUMC has earned the CEO Cancer Gold Standard designation every year since 2008. Along with the various national rankings, there are several VUMC programs unique to Tennessee or the region, which include: * Only Level 1 (highest level) Trauma Center in Middle Tennessee * Only Level 4 (highest level) Neonatal Intensive Care Unit, as well as a dedicated pediatric emergency department and pediatric trauma program * Vanderbilt-Ingram Cancer Center, the only National Cancer Institute-designated Comprehensive Cancer Center in Tennessee that conducts research and cares for children and adults; also, a member of the elite National Comprehensive Cancer Network, a group of the nation's top 21 clinical cancer institutes * Only Joint Commission-accredited program for traumatic brain injury rehabilitation (one of seven nationally) * Dedicated regional burn center * LifeFlight, an integrated air and ground emergency patient transport system * Tennessee Poison Center * Tennessee's only comprehensive solid organ transplant center, serving both adult and pediatric patients For more information regarding health care at Vanderbilt University Medical Center, visit https://www.vanderbilthealth.com/patientandvisitorinfo/48538
Form 990, Part III, Line 4b	4b. Academic and Scientific Research - VUMC is an internationally recognized research institution. A majority of VUMC's research funding, including substantial support from the National Institutes of Health, is received from the federal government. Funding is also received from foundations, associations, corporations, and other sources. VUMC's researchers are at the forefront of discovery and are posing innovative solutions to some of the most challenging questions about diseases affecting humankind. Our programs in Graduate Medical Education are consistently among the most selective, and are nationally recognized for their diversity & inclusion, innovation and capacity to transform the educational experience, while the breadth of our scientific discovery is propelled by a research enterprise that is consistently ranked among the nation's top 10 in total federal funding. For more information regarding research at Vanderbilt University Medical Center visit: https://www.vumc.org/oor/
Form 990, Part III, Line 4d Description of other program services	(Expenses $ 138,529,136 including grants of $ 0)(Revenue $ 170,762,784) 4d. Other Program Services - Other program services include public health service, academic support, institutional support, and other auxiliary services. Vanderbilt University Medical Center engages in a variety of public service projects, including, but not limited to formulating new approaches to increase health, safety, quality and outcomes, while decreasing total costs; and many other sponsored community health and educational programs. To read more about VUMC's role in the community, visit https://www.vanderbilthealth.com/main/38766
Form 990, Part VI, Line 1a Delegate Broad Authority to a Committee	The Executive Committee of the Board of the Directors consists of at least three directors, including the board chairperson, the CEO of VUMC, and the Chancellor of Vanderbilt University. The Executive Committee is empowered to exercise all of the powers of the board when the board is not in session, subject to certain restrictions involving major corporate decisions.
Form 990, Part VI, Line 2 Family/Business Relationships Amongst Interested Parties	As a result of VUMC's continuing relationship with Vanderbilt University, David W. Patterson, Robert C. Schiff, Jr., Gregory Scott Allen, and Nicholas S. Zeppos serve on the Vanderbilt University Board of Trust and were appointed by Vanderbilt University to serve on the VUMC Board of Directors.
Form 990, Part VI, Line 11b Review of form 990 by governing body	The Form 990 is prepared by VUMC and provided to Ernst & Young, VUMC's independent accounting firm for review. After review by Ernst & Young, VUMC provides a draft copy of the Form 990 and all required schedules for review to all General Officers, which includes the Chief Executive Officer, Chief Financial Officer and Secretary. Once this review process is complete, the Audit and Compliance Committee is provided electronic access to the draft Form 990 and all required schedules for review. The final Form 990 and all required schedules are made available to the full Board of Directors for review prior to the filing of the return.
Form 990, Part VI, Line 12c Conflict of interest policy	VUMC requires that for any staff member disclosing a potential conflict of interest, the conflict be reviewed by the individual's manager, as well as by the Director of Conflict of Interest. For VUMC-employed Vanderbilt Faculty, the COI process is managed by the Office of Faculty Affairs. Any reported conflict will be managed, mitigated, or eliminated. The manager is required to respond that any recommended management plan has been implemented or that the reported conflict no longer exists. For those conflicts in which VUMC may have an institutional interest, those in which human subject research is performed, or those deemed unmanageable, are reviewed by the Medical Center COI Committee (VUMC-employed Vanderbilt Faculty) and the Staff COI Committee determines appropriate actions. The Medical Center COI Committee members are appointed by the CEO of VUMC. The Staff COI Committee members are selected by the General Counsel/Corporate Secretary for VUMC. The Staff COI Committee is chaired by the General Counsel/Corporate Secretary. Both committees report bi-annually to the Audit Committee of the Board of Directors, the matters brought before the committees and the resulting actions. Members of the VUMC Board of Directors (BOD) and VUMC General Officers also must complete annual conflict of interest disclosures and management plans are developed to manage, mitigate, or eliminate any potential conflicts of interest. BOD members are notified of their plans and the plans are thoroughly discussed with them to ensure compliance. Those with disclosed potential conflict of interest are presented to the Audit Committee of the Board of Directors, along with their respective management action plans, where applicable. Management plans may include restrictions on members such as recusing themselves during deliberations and decisions in which a potential conflict may exist, with the minutes of the meeting reflecting their recusal. Additionally, all members of the VUMC community are required to disclose potential conflicts as they arise throughout the year. The same processes noted above occur for these disclosures.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	FORM 990, PART VI, LINES 15A & 15B - To ensure that VUMC is paying reasonable total compensation, is not violating the private inurement prohibition, which requires that none of the organization's income or assets unreasonably benefit any of its directors, officers, or key employees, and is in compliance with the intermediate sanctions provisions with respect to the general officers, VUMC's Board of Directors has designated a Compensation Committee made up of outside, independent, board members to review and recommend to the Executive Committee of the Board of Directors the total compensation annually for the general officers. The committee utilizes an outside consulting firm to provide expert information regarding industry-wide compensation norms and compliance with all Internal Revenue Service rules concerning executive compensation, including the Internal Revenue Code provision related to intermediate sanctions, deferred compensation, and private inurement. The Compensation Committee reviews the executive compensation philosophy and affirms that it is in line with the Board's expectation. Each year the total compensation review and recommendations are recorded in the minutes of the Compensation Committee meetings. The full Board is informed annually of the total compensation of the general officers during private session.
Form 990, Part VI, Line 19 Required documents available to the public	VUMC's governing documents are made available for public inspection upon request. VUMC's financial statements are posted to the EMMA (Electronic Municipal Market Access) website. The conflict of interest policy is available on the following website: https://ww2.mc.vanderbilt.edu/DCCI/23390.
Form 990, Part IX, Line 11g Other Fees	Shared Services Agreements - Total Expense: XXX-XX-XXXX, Program Service Expense: 11907899, Management and General Expenses: XXX-XX-XXXX, Fundraising Expenses: 62411; Consulting and Other Professional Fees - Total Expense: 88214629, Program Service Expense: 52327848, Management and General Expenses: 35724185, Fundraising Expenses: 162596; Other Purchased Services - Total Expense: 93553543, Program Service Expense: 82044754, Management and General Expenses: 11508347, Fundraising Expenses: 442;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Temporarily and Permanently Restricted Contributions - 34987000; Net Assets Released From Restrictions - -7042000; Endowment Appreciation - 759000; Change in Non-Controlling Interest Net Assets - -167000; Other Changes in Net Assets - 49944;

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:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

Vanderbilt University Medical Center

Employer identification number

35-2528741

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) Vanderbilt Health Services LLC 2100 West End Ave Suite 750 Nashville,TN37203 62-1176354	Holding Company	TN	927,939	-3,250,535	VUMC
(2) Friends in Global Health LLC 2525 West End Ave Suite 750 Nashville,TN37203 26-0170070	Public Health	TN	30,025,069	-306	VHS
(3) Vanderbilt-Wilson Radiation Oncology LLC 2100 West End Ave Suite 750 Nashville,TN37203 26-1241612	Holding Company	TN	1,927,380	1,605,033	VHS
(4) Vanderbilt Health Affiliated Network LLC 3401 West End Ave Suite 290 Nashville,TN37203 46-1571024	Clinical Network	TN	23,447,922	13,938,992	VHS
(5) Project Holding Company LLC 4350 Lassiter at North Hills Ave Suite 300 Raleigh,NC276095793 81-3915926	Holding Company	TN	0	9,645,014	VUMC
(6) Vanderbilt Health Professional Solutions LLC 3319 West End Ave Suite 700 Nashville,TN37203 30-0964540	Holding Company	TN	6	4,857,691	VUMC
(7) Vanderbilt Health Rx Solutions LLC 3319 West End Ave Suite 700 Nashville,TN37203 82-1456647	Pharmacy Administration	TN	223,445	1,110,146	VHPS
(8) Vanderbilt Health Pharmacy Group LLC 3319 West End Ave Suite 700 Nashville,TN37203 82-1462688	Pharmacy Services	TN	35,017	134,883	VHRxS
(9) Retail Health Clinics LLC 2525 West End Ave Suite 700 Nashville,TN37203 82-1942209	Walk-in Clinics	TN	5,554,261	-401,275	VHS
(10) Nashville BioSciences LLC 2525 West End Ave Suite 930 Nashville,TN37203 82-4174759	Research & Development in Biotechnology	TN	1,167,900	1,163,840	VUMC
(11) Vanderbilt Health Supply Chain Solutions LLC MCN 1161 21st Ave D-3300 Nashville,TN37203 82-4143617	Consulting	TN	553,413	928,800	VHPS
(12) Vanderbilt Health Purchasing Collaborative LLC MCN 1161 21st Ave D-3300 Nashville,TN37203 82-4148840	Group Purchasing Organization	TN	2,651,517	269,600	VHSCS
(13) ACO of Central Alabama 1 LLC 3401 West End Ave Suite 290 Nashville,TN372036866 82-1681443	Accountable Care Organization	TN	703,030	1,065,895	VWRO
(14) ACO of Louisiana LLC 3401 West End Ave Suite 290 Nashville,TN372036866 82-1686154	Accountable Care Organization	TN	439,950	634,625	VWRO
(15) ACO of North Delaware LLC 3401 West End Ave Suite 290 Nashville,TN372036866 81-2692564	Accountable Care Organization	TN	209,400	418,702	VWRO
(16) Mid South ACO LLC 3401 West End Ave Suite 290 Nashville,TN372036866 82-1685569	Accountable Care Organization	TN	570,000	574,529	VWRO

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)Vanderbilt Home Care Services Inc 2120 Belcourt Avenue Nashville,TN37212 62-1404948	Home Health	TN	501(c)(3)	9	VHS	Yes

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

Cat. No. 50135Y

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Ambulatory Surgery Center of Cool Springs LLC 40 Burton Hills Blvd Ste 500 Nashville,TN37215 62-1809227	Ambulatory Surgery	TN	VHS	Related	3,497,280	3,462,426		No			No	51.02 %
(2) New Light Imaging LLC 2000 Richard Jones Road Ste 270 Nashville,TN37215 14-1895171	Management Services	TN	VHS	Related	1,073,012	149,755		No			No	66.67 %
(3) One Hundred Oaks Imaging LLC 2000 Richard Jones Road Ste 270 Nashville,TN37215 26-3762022	Diagnostic Imaging	TN	VHSVIS	Related	3,349,305	2,249,673		No			No	80 %
(4) Springfield VIP Realty LLC 3319 West End Ave Ste 700 Nashville,TN37203 26-1237360	Real Estate	TN	VUMC	Excluded	14,019	427,429		No		Yes		49 %
(5) Vanderbilt Gateway Cancer 3319 West End Ave Ste 700 Nashville,TN37203 20-3844791	Oncology Services	DE	VHS	Related	614,186	2,270,267		No		Yes		50 %
(6) Vanderbilt Imaging Services LLC 2000 Richard Jones Road Ste 270 Nashville,TN37215 62-1787098	Radiology Services	TN	VHS	Related	5,689,276	1,583,015		No			No	66.67 %
(7) Vanderbilt Stallworth Rehabilitation Hospital LP 3660 Grandview Parkway Ste 200 Birmingham,AL35243 63-1077470	Rehab Services	TN	VUMCVHS	Related	-6,234	4,120,571		No		Yes		50 %
(8) Vanderbilt-Maury Radiation Oncology LLC 1003 Reserve Blvd Ste 120 Spring Hill,TN37174 46-0757412	Oncology Services	TN	VHS	Related	104,125	1,323,091		No		Yes		40 %
(9) Vanderbilt Health and Williamson Medical Center Clinics and Services 512 Autumn Springs Ct Ste C Franklin,TN37067 62-1864145	Walk-in Clinics	TN	VHS	Related	443,589	4,210,017		No		Yes		51 %
(10) VIP MidSouth LLC 3319 West End Ave Ste 700 Nashville,TN37203 62-1654580	Physician Offices	TN	VIP	Related	163,254	1,972,306		No		Yes		51 %
(11) Williamson Imaging LLC 2000 Richard Jones Road Ste 270 Nashville,TN37215 62-1855535	Diag. Imaging	TN	VIS	Related	1,773,841	1,134,056		No			No	53.34 %

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) Vanderbilt Integrated Providers 3319 West End Ave Suite 700 Nashville,TN37203 62-1650124	Physician Offices	TN	VHS	C Corporation	2,078,282	2,101,536	100 %	Yes
(2) Charitable Remainder Trust (5)	Charitable Trust	TN	VUMC	Trust				Yes
(3) Perpetual Trusts (1)	Charitable Trust	TN	VUMC	Trust				Yes

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

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 .....................

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

Yes

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

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

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

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

Yes

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

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

Yes

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) Ambulatory Surgery Center of Cool Springs LLC	O	95,296	FMV
(2) Ambulatory Surgery Center of Cool Springs LLC	S	3,459,717	FMV
(3) Vanderbilt Gateway Cancer Center GP	L	730,443	FMV
(4) Vanderbilt Gateway Cancer Center GP	O	96,007	FMV
(5) Vanderbilt Gateway Cancer Center GP	Q	263,714	FMV
(6) Vanderbilt Maury Radiation Oncology LLC	L	366,036	FMV
(7) Vanderbilt Maury Radiation Oncology LLC	O	97,087	FMV
(8) Vanderbilt Maury Radiation Oncology LLC	Q	299,168	FMV
(9) Vanderbilt Stallworth Rehabilitation Hospital LP	K	410,620	FMV
(10) Vanderbilt Stallworth Rehabilitation Hospital LP	Q	2,510,045	FMV
(11) Vanderbilt Stallworth Rehabilitation Hospital LP	S	425,933	FMV
(12) Vanderbilt Home Care Services Inc	B	1,679,534	FMV
(13) Vanderbilt Home Care Services Inc	L	566,444	FMV
(14) Vanderbilt Home Care Services Inc	M	3,749,908	FMV
(15) Vanderbilt Home Care Services Inc	O	262,440	FMV
(16) Vanderbilt Home Care Services Inc	Q	246,322	FMV
(17) Vanderbilt Home Care Services Inc	S	3,497,738	FMV
(18) VIP MidSouth LLC	L	120,310	FMV
(19) VIP MidSouth LLC	O	68,257	FMV
(20) VIP MidSouth LLC	Q	234,909	FMV
(21) Vanderbilt Integrated Providers	B	337,498	FMV
(22) Vanderbilt Integrated Providers	L	57,118	FMV
(23) Vanderbilt Integrated Providers	Q	57,197	FMV
(24) Vanderbilt Integrated Providers	O	78,008	FMV
(25) Vanderbilt Health and Williamson Medical Center Clinics and Services LLC	O	9,209,393	FMV
(26) Vanderbilt Health and Williamson Medical Center Clinics and Services LLC	Q	2,885,278	FMV
(27) Vanderbilt Imaging Services LLC	O	316,707	FMV
(28) Vanderbilt Imaging Services LLC	Q	178,061	FMV
(29) Vanderbilt Imaging Services LLC	S	5,223,259	FMV
(30) New Light Imaging LLC	O	259,495	FMV
(31) New Light Imaging LLC	S	968,911	FMV
(32) Williamson Imaging LLC (Cool Springs Imaging)	Q	104,518	FMV
(33) One Hundred Oaks Imaging LLC	Q	435,450	FMV
(34) One Hundred Oaks Imaging LLC	S	1,527,488	FMV
(35) Perpetual Trusts (1)	S	123,480	FMV

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

Schedule R (Form 990) 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:	17005876
Software Version:	2017v2.2

1	Briefly describe the organization’s mission or most significant activities: See Schedule O, Form 990, Part III, Line 1
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	26,949
6	Total number of volunteers (estimate if necessary) .............	6	1,266
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	24,676,538
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	302,808,739	355,841,563
9	Program service revenue (Part VIII, line 2g) .........	3,608,520,465	3,740,845,973
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	21,250,369	36,001,277
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	5,609,895	4,843,829
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	3,938,189,468	4,137,532,642
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	79,456,591	105,176,985
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)	2,035,260,271	2,179,645,238
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	92,802	0
b	Total fundraising expenses (Part IX, column (D), line 25) 11,430,765
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,621,217,366	1,761,807,022
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	3,736,027,030	4,046,629,245
19	Revenue less expenses. Subtract line 18 from line 12.......	202,162,438	90,903,397
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,801,330,205	3,192,191,146
21	Total liabilities (Part X, line 26).............	2,000,428,282	2,264,561,545
22	Net assets or fund balances. Subtract line 21 from line 20.....	800,901,923	927,629,601

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 2,522,911,080 including grants of $ 18,685,965 ) (Revenue $ 3,442,776,569 )
	Patient Services - See Schedule O Form 990, Part III, Line 4a

4b	(Code: ) (Expenses $ 654,767,134 including grants of $ 86,491,020 ) (Revenue $ 131,002,936 )
	Academic and Scientific Research - See Schedule O Form 990, Part III, Line 4b

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












	(Code: ) (Expenses $ 138,529,136 including grants of $ 0 ) (Revenue $ 170,762,784 )
	4d. Other Program Services - Other program services include public health service, academic support, institutional support, and other auxiliary services. Vanderbilt University Medical Center engages in a variety of public service projects, including, but not limited to formulating new approaches to increase health, safety, quality and outcomes, while decreasing total costs; and many other sponsored community health and educational programs. To read more about VUMC's role in the community, visit https://www.vanderbilthealth.com/main/38766

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 138,529,136 including grants of $ ) (Revenue $ 170,762,784 )
4e	Total program service expenses3,316,207,350

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(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
(A) Name and title
(18) Traci K Nordberg JD Chief HR Officer	39.0 .......................1.0	X		703,983	0	77,932
(19) David R Posch Executive Vice President for Population Health	38.8 .......................1.2	X		883,634	0	30,734
(20) David S Raiford MD Chief of Clinical Staff	40.0 .......................	X		898,656	0	107,572
(21) William W Stead MD Chief Strategy Officer	40.0 .......................	X		918,549	0	29,410
(22) Scott T Arthur MD VBJ Faculty - Asst Professor	40.0 .......................		X	1,271,113	0	29,819
(23) Clinton J Devin MD Comprehensive Spine Center - Assoc Professor	40.0 .......................		X	1,490,332	0	20,608
(24) John W Klekamp MD VBJ Faculty - Asst Professor	40.0 .......................		X	1,300,953	0	36,194
(25) Paul A Thomas MD VBJ Faculty - Assoc Professor	40.0 .......................		X	1,909,278	0	39,885
(26) Todd R Wurth MD VBJ Faculty - Asst Professor	40.0 .......................		X	1,365,687	0	40,635

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	20,273,727	0	1,409,695

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	913,876
d	Related organizations		1d
e	Government grants (contributions)		1e	282,436,360

f	All other contributions, gifts, grants, and similar amounts not included above		1f	72,491,327

g	Noncash contributions included in lines 1a - 1f:$		1g	3,343,732

h Total. Add lines 1a-1f.......		355,841,563

		Business Code
2a	NET PATIENT SERVICE REVENUE	622110	3,442,776,569	3,439,873,898	2,902,671
b	ACADEMIC AND RESEARCH REVENUE	611310	131,002,936	131,002,936
c	OTHER PROGRAM REVENUE	611310	167,066,468	145,768,937	21,297,531
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		3,740,845,973

3 Investment income (including dividends, interest, and othersimilar amounts) ......			13,091,018		476,336	12,614,682
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			477,335			477,335
		(ii) Personal	(i) Real
6a	Gross rents		748,641	6a
b	Less: rental expenses		111,736	6b
c	Rental income or (loss)	0	636,905	6c
d	Net rental income or (loss).......			636,905			636,905
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	19,746,169	338,239,760	7a
b	Less: cost or other basis and sales expenses	11,523,823	323,551,847	7b
c	Gain or (loss)	8,222,346	14,687,913	7c
d	Net gain or (loss).........			22,910,259			22,910,259
8a	Gross income from fundraising events (not including $ 913,876of contributions reported on line 1c). See Part IV, line 18 ....
			8a	430,692
b	Less: direct expenses ...		8b	397,419
c	Net income or (loss) from fundraising events..			33,273			33,273
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..
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..
Business Code			Miscellaneous Revenue
11a	REVENUE FROM UNCOLSOLILDATED ORGS		900099	3,696,316	3,696,316
b
c
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			3,696,316
12	Total revenue. See instructions.....			4,137,532,642	3,720,342,087	24,676,538	36,672,454

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	75,516,165	75,516,165
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	24,959,549	24,959,549
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	4,701,271	4,701,271
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	13,227,456	1,051,968	11,729,824	445,664
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	10,379	10,379
7	Other salaries and wages........	1,769,347,844	1,539,107,619	225,679,886	4,560,339
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	60,194,103	41,875,824	17,922,146	396,133
9	Other employee benefits .......	223,028,268	187,133,497	35,118,547	776,224
10	Payroll taxes ...........	113,837,188	104,147,886	9,479,771	209,531
11	Fees for services (non-employees):
a	Management ......	3,107,781	1,238,383	1,869,398
b	Legal .........	1,628,163	1,410,418	217,745
c	Accounting ...........	1,058,476	23,876	1,034,600
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	414,256,213	146,280,501	267,750,263	225,449
12	Advertising and promotion ....	12,628,782	5,079,861	7,522,403	26,518
13	Office expenses .......	96,020,388	76,712,903	17,754,107	1,553,378
14	Information technology ......	64,902,238	17,200,801	47,682,533	18,904
15	Royalties ..	4,377	4,377
16	Occupancy ...........	221,145,979	179,672,085	39,147,663	2,326,231
17	Travel ............	20,374,713	18,077,328	2,182,444	114,941
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	14,448,439	12,484,036	1,911,324	53,079
20	Interest ...........	62,695,544	60,270,777	2,424,767
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	105,653,599	83,209,120	22,444,479
23	Insurance ...	14,565,060	14,564,085		975
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	DRUGS AND MEDICAL SUPPLIES	706,125,249	704,428,059	1,183,377	513,813
b	OTHER ACADEMIC AND RESEARCH	6,262,392	2,289,428	3,858,276	114,688
c	TAXES	3,302,748	3,031,220	271,528
d	PROVISION FOR BAD DEBTS	-1,406,826	-1,406,826
e	All other expenses	15,033,707	13,132,760	1,806,049	94,898
25	Total functional expenses. Add lines 1 through 24e	4,046,629,245	3,316,207,350	718,991,130	11,430,765
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			43,465,820	1	109,809,546
2	Savings and temporary cash investments .........			510,269,465	2	472,837,831
3	Pledges and grants receivable, net ......			84,304,594	3	75,937,681
4	Accounts receivable, net .............			447,731,680	4	541,129,165
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) ...
					6	0
7	Notes and loans receivable, net ...........			275,133	7	1,473,349
8	Inventories for sale or use ............			67,478,430	8	72,636,245
9	Prepaid expenses and deferred charges ......			6,888,179	9	11,028,380
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,515,108,157
b	Less: accumulated depreciation	10b	208,468,963	1,219,767,733	10c	1,306,639,194
11	Investments—publicly traded securities .			398,102,347	11	576,414,677
12	Investments—other securities. See Part IV, line 11 .....			20,183,704	12	21,822,303
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			2,863,120	15	2,462,775
16	Total assets. Add lines 1 through 15 (must equal line 33)...			2,801,330,205	16	3,192,191,146

17	Accounts payable and accrued expenses .....	588,379,289	17	632,617,711
18	Grants payable ...		18
19	Deferred revenue .........	50,047,272	19	56,021,883
20	Tax-exempt bond liabilities .........	528,375,952	20	705,661,946
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 .........
			22	0
23	Secured mortgages and notes payable to unrelated third parties ..	647,418,477	23	693,141,612
24	Unsecured notes and loans payable to unrelated third parties ..	22,273,292	24	28,928,941
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	163,934,000	25	148,189,452
26	Total liabilities. Add lines 17 through 25..	2,000,428,282	26	2,264,561,545

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here 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 ...........	800,901,923	32	927,629,601
33	Total liabilities and net assets/fund balances ........	2,801,330,205	33	3,192,191,146

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No