Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
THE UNIVERSITY OF VERMONT MEDICAL CENTER |
030219309 | 3 | Yes | 256,021 | 0 | |
|
Total 1
|
256,021 | 0 | ||||
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.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
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.) | ||||||
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.).. | ||||||
| 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 | ||||
| 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. |
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| 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. |
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|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 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..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART IV, SECTION D, LINE 3 | THE UNIVERSITY OF VERMONT MEDICAL CENTER AUXILIARY (AUXILIARY), THE SUPPORTING ORGANIZATION, IS RESPONSIVE TO ITS SUPPORTED ORGANIZATION, THE UNIVERSITY OF VERMONT MEDICAL CENTER (UVMMC) AND UVMMC MAINTAINS SIGNIFICANT INVOLVEMENT IN THE AUXILIARY'S ACTIVITIES. UVMMC ANNUALLY APPOINTS ONE INDIVIDUAL TO SERVE ON THE BOARD OF DIRECTORS OF THE AUXILIARY. IN ADDITION THE DIRECTOR OF VOLUNTARY SERVICES OF UVMMC IS AN APPOINTED LIAISON TO THE AUXILIARY. THE AUXILIARY AND UVMMC HAVE A CLOSE AND CONTINUOUS WORKING RELATIONSHIP AND HAVE A HISTORIC AND CONTINUING RELATIONSHIP. IN GENERAL, MANY OF THE AUXILIARY MEMBERS VOLUNTEER DAILY AT THE HOSPITAL, PROVIDING VOLUNTEER SERVICES FOR VARIOUS PROGRAMS, THE GIFT SHOP, AND THE THRIFT STORE. THE AUXILIARY HAS OVER 160 MEMBERS. MOST OF THE AUXILIARY'S ADMINISTRATIVE CONTACT WITH UVMMC IS VIA UVMMC'S DEVELOPMENT OFFICE, AND THERE ARE CONTINUOUS DISCUSSIONS REGARDING THE ONGOING FINANCIAL NEEDS AND PROJECTED NEEDS OF UVMMC AND HOW THE AUXILIARY MAY NOT ONLY ALLEVIATE CERTAIN FINANCIAL BURDENS OF UVMMC BUT ALSO HOW THE AUXILIARY'S MEMBERS, AS VOLUNTEERS, MAY ASSIST IN IMPLEMENTING PROGRAMS FOR PATIENTS. UVMMC MAKES ORAL AND WRITTEN PRESENTATIONS TO THE AUXILIARY OFFICERS AND DIRECTORS/COMMITTEES, DETAILING SPECIFIC PROJECTS AND FINANCIAL NEEDS OF UVMMC AND THE TIMEFRAME OF THE FINANCIAL NEED TO WHICH UVMMC WOULD LIKE THE AUXILIARY TO EARMARK CONTRIBUTIONS AND/OR SERVICES. IN ADDITION, UVMMC MAKES SPECIFIC REQUESTS TO THE AUXILIARY FOR FUNDS FOR A SPECIFIC PURPOSE DUE TO THE AUXILIARY'S ABILITY TO MAKE LARGER EARMARKED AND RECURRING CONTRIBUTIONS. THE AUXILIARY ALSO COMMUNICATES WITH UVMMC MORE FORMALLY ON AN ANNUAL BASIS BY PROVIDING UVMMC WITH THE AUXILIARY'S ANNUAL REPORT. AS A RESULT, THE AUXILIARY IS DIRECTLY RESPONSIVE TO UVMMC'S REQUESTS NOT ONLY AS TO THE USE OF THE AUXILIARY'S FUNDS BUT ALSO THE TIMING AND MANNER OF CONTRIBUTIONS OR SERVICES PERFORMED, AND UVMMC HAS A SIGNIFICANT VOICE IN DIRECTING THE USE OF THE AUXILIARY'S INCOME OR ASSETS AT ALL TIMES DURING THE YEAR. |
| PART IV, SECTION E, LINE 2A | THE AUXILIARY'S SUPPORTED ORGANIZATION IS UVMMC. THE AUXILIARY MAINTAINS SIGNIFICANT INVOLVEMENT IN THE PROVIDING OF SERVICES BY UVMMC WHICH ARE NOT RELATED TO THE DIRECT PROVIDING OF PROFESSIONAL MEDICAL SERVICES. THESE INCLUDE OVERSIGHT OF THE HOSPITAL GIFT SHOP, PATIENT LIBRARY, WHICH SUPPLIES BOOKS AND MAGAZINES FOR DISTRIBUTION TO PATIENTS AS WELL AS WAITING ROOMS, AND THE THRIFT RETAIL SHOP. THE AUXILIARY'S GOVERNING DOCUMENTS, THE OFFICERS AND DIRECTORS OF THE AUXILIARY, AND ITS CLOSE RELATIONSHIP WITH UVMMC ENSURE THAT SUBSTANTIALLY ALL OF THE AUXILIARY'S ACTIVITIES ARE IN SUPPORT OF THE MISSION OF UVMMC. |
| PART IV, SECTION E, LINE 2B | BUT FOR THE AUXILIARY'S OPERATION AND INVOLVEMENT OF ITS ACTIVITIES, UVMMC ITSELF WOULD HAVE ENGAGED IN THE OPERATION OF THE GIFT SHOP AND WOULD HAVE NEEDED TO ENGAGE IN ADDITIONAL FUNDRAISING TO REPLACE THE ANNUAL FINANCIAL CONTRIBUTIONS PROVIDED BY THE AUXILIARY. THE AUXILIARY PERFORMS ESSENTIAL ACTIVITIES ON BEHALF OF UVMMC AND PROVIDES GOODS, SERVICES AND FUNDS TO UVMMC. THE GOODS ARE PROVIDED DIRECTLY TO THE PATIENTS AND FAMILY MEMBERS AND IT IS LIKELY THAT, IF THE AUXILIARY DID NOT PROVIDE THESE ITEMS, THE HOSPITAL WOULD DO SO ITSELF. SIMILARLY, THE SERVICES PROVIDED TO UVMMC BY THE AUXILIARY ARE SERVICES PERFORMED BY THE AUXILIARY IN FAVOR OF PATIENTS AND/OR FAMILY MEMBERS WHICH UVMMC WOULD LIKELY PROVIDE IF THE AUXILIARY DID NOT DO SO. SUBSTANTIALLY ALL OF THE AUXILIARY'S ACTIVITIES ARE IN DIRECT FURTHERANCE OF UVMMC'S EXEMPT PURPOSES. THE AUXILIARY BELIEVES THAT ITS SUPPORTED ORGANIZATION WOULD HAVE ENGAGED IN THESE ACTIVITIES BUT FOR ITS INVOLVEMENT. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | DIRECTOR CAROLEE BOERGER HAS A FAMILY RELATIONSHIP WITH DIRECTOR AND SECRETARY JENNIFER BOERGER. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE UNIVERSITY OF VERMONT MEDICAL CENTER AUXILIARY (AUXILIARY) IS A MEMBERSHIP ORGANIZATION. MEMBERS ARE RESIDENTS OF THE UNIVERSITY OF VERMONT MEDICAL CENTER SERVICE AREA WHO ARE INTERESTED IN SUPPORTING THE AUXILIARY AND THE WORK THE ORGANIZATION DOES FOR THE HOSPITAL. MEMBERS PAY ANNUAL DUES TO THE ORGANIZATION TO REMAIN IN GOOD STANDING AND ALL MEMBERS IN GOOD STANDING RETAIN VOTING RIGHTS. |
| FORM 990, PART VI, SECTION A, LINE 7A | ALL MEMBERS IN GOOD STANDING HAVE THE RIGHT TO VOTE FOR ALL POSITIONS OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | FROM TIME TO TIME VARIOUS POINTS OF ORDER ARE BROUGHT FORWARD TO THE MEMBERS TO VOTE ON. THIS INCLUDES, BUT IS NOT LIMITED TO, ELECTION OF THE BOARD AND THE DETERMINATION OF LARGE GIFTS OR PLEDGES MADE TO THE MEDICAL CENTER. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE UNIVERSITY OF VERMONT MEDICAL CENTER AUXILIARY'S FORM 990 IS PREPARED BY A PAID PREPARER AND REVIEWED BY THE UNIVERSITY OF VERMONT MEDICAL CENTER (THE SUPPORTED ORGANIZATION) FINANCE MANAGEMENT. THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE UNIVERSITY OF VERMONT MEDICAL CENTER AUXILIARY'S BOARD OF DIRECTORS PRIOR TO THE FORM BEING FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS ADOPTED A CONFLICT OF INTEREST POLICY AS PART OF THE GOVERNING DOCUMENTS OF THE ORGANIZATION. FOR FY 2020, THE MEMBERS OF THE BOARD OF DIRECTORS WERE SENT QUESTIONNAIRES TO COMPLETE REGARDING POTENTIAL OR ACTUAL CONFLICTS. UPON RECEIPT OF THE QUESTIONNAIRES, THE ORGANIZATION REVIEWS THEM FOR ANY POTENTIAL OR ACTUAL CONFLICTS. ANY THAT ARE IDENTIFIED ARE REVIEWED BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS WOULD THEN DETERMINE ANY RESTRICTIONS IMPOSED ON THE PERSON WITH THE CONFLICT, WHICH COULD INCLUDE PROHIBITING THEM FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNANCE DOCUMENTS CONSIST OF THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS. THE ARTICLES OF INCORPORATION ARE FILED WITH THE VERMONT SECRETARY OF STATE AND ARE PUBLICLY AVAILABLE THROUGH THAT OFFICE. THE BYLAWS ARE NOT PUBLICLY POSTED, BUT WOULD BE FURNISHED TO ANY MEMBER OF THE PUBLIC WHO REQUESTS A COPY. THE AUXILIARY'S CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE NOT PUBLICLY POSTED, BUT WOULD BE FURNISHED TO ANY MEMBER OF THE PUBLIC WHO REQUESTS A COPY. |
| FORM 990, PART IX, LINES 7 & 9 | DUE TO THE SIZE AND STRUCTURE OF THE UNIVERSITY OF VERMONT MEDICAL CENTER AUXILIARY, ALL EMPLOYEES ARE LEASED FROM THE UNIVERSITY OF VERMONT MEDICAL CENTER, THE SUPPORTED ORGANIZATION. ALL SALARY AND BENEFIT EXPENSES ARE PAID BY THE UNIVERSITY OF VERMONT MEDICAL CENTER AND ARE REIMBURSED BY THE AUXILIARY. THIS REIMBURSEMENT EXPENSE IS REPORTED AS SALARY AND FRINGE BENEFITS IN PART IX, LINES 7 AND 9. |
| Software ID: | |
| Software Version: |