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 | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 3,700,141 | 4,411,462 | 2,320,440 | 2,610,676 | 2,127,055 | 15,169,774 |
| 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 | 36,654,717 | 25,996,696 | 27,153,943 | 23,307,995 | 23,956,265 | 137,069,616 |
| 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 | 40,354,858 | 30,408,158 | 29,474,383 | 25,918,671 | 26,083,320 | 152,239,390 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 152,239,390 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 40,354,858 | 30,408,158 | 29,474,383 | 25,918,671 | 26,083,320 | 152,239,390 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,103,762 | 524,285 | 538,126 | 623,167 | 185,913 | 2,975,253 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 1,103,762 | 524,285 | 538,126 | 623,167 | 185,913 | 2,975,253 |
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | 48,326 | 38,829 | 38,932 | 70,530 | 50,499 | 247,116 |
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 108,549 | 108,549 | ||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 41,615,495 | 30,971,272 | 30,051,441 | 26,612,368 | 26,319,732 | 155,570,308 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2023. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | MISCELLANEOUS PROGRAM REVENUE - 2018 AMOUNT: $ 108,549. |
| SCHEDULE A, PART III, COLUMN (A) | THE NUMBERS IN COLUMN (A), YEAR 2018, CONTAIN AMOUNTS FOR THE PERIOD 7/1/2018 - 9/30/2019, AS A SHORT PERIOD RETURN WAS FILED FOR THE 7/1/2018 - 9/30/2018 PERIOD. |
| 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 | DR. ELIZABETH MCGEE AND DR. THOMAS PETERSON WERE EMPLOYED BY THE UNIVERSITY OF VERMONT HEALTH NETWORK MEDICAL GROUP, INC., A RELATED ORGANIZATION AT WHICH DR. THOMAS PETERSON SERVED AS AN OFFICER. |
| FORM 990, PART VI, SECTION A, LINE 4 | EFFECTIVE OCTOBER 1, 2022, THE CERTIFICATE OF INCORPORATION AND THE BYLAWS OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, INC. (THE "NETWORK") WERE AMENDED AND RESTATED TO FACILITATE TIMELY DECISION MAKING AND TO CLARIFY ROLES AND RELATIONSHIPS BETWEEN THE NETWORK AND ITS HOSPITAL AND HOME HEALTH CARE SUBSIDIARIES (THE "AFFILIATES"), INCLUDING THE UNIVERSITY OF VERMONT HEALTH NETWORK HOME HEALTH & HOSPICE ("HHH"). CORRESPONDING AMENDMENTS WERE MADE TO THE ORGANIZATIONAL DOCUMENTS OF THE AFFILIATES. HHH'S DOCUMENTS CHANGED IN THE FOLLOWING SIGNIFICANT RESPECTS: FIRST, THE CERTIFICATE OF INCORPORATION AND BYLAWS WERE AMENDED TO CREATE RESERVED POWERS OF THE NETWORK BOARD. THESE RESERVED POWERS INCLUDE: THE NETWORK'S ELECTION OF TRUSTEES FOR HHH FROM NOMINEES SUBMITTED BY HHH; ADOPTION OF ANNUAL OPERATING AND CAPITAL BUDGETS; ADOPTION OF STRATEGIC PLANS; AND APPROVAL OF MAJOR FINANCIAL DECISIONS INCLUDING MERGERS, BANKRUPTCIES, COMMENCEMENT OF PROJECTS REQUIRING THE ISSUANCE OF A CERTIFICATE OF NEED, THE INCURRENCE OF LONG-TERM INDEBTEDNESS, AND THE DEVELOPMENT OR TERMINATION OF PROGRAMS OR SERVICES. ADDITIONALLY, THE COMPENSATION COMMITTEE OF THE NETWORK IS GRANTED RESPONSIBILITY FOR DETERMINING COMPENSATION AND BENEFITS FOR HHH'S PRESIDENT AND ANY OTHER EXECUTIVE CLASSIFIED AS A "DISQUALIFIED PERSON" UNDER APPLICABLE LAW. SECOND, AMENDMENTS WERE MADE TO GRANT REPRESENTATION TO MEMBERS OF HHH'S BOARD OF TRUSTEES ON STANDING COMMITTEES OF THE NETWORK BOARD. UP TO TWO VOTING MEMBERS OF EACH NETWORK STANDING COMMITTEE ARE APPOINTED BY HHH. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS THE UNIVERSITY OF VERMONT HEALTH NETWORK, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | AS SOLE MEMBER, THE UVM HEALTH NETWORK HAS ALL OF THE POWERS RESERVED TO MEMBERS OF A VERMONT NON-PROFIT CORPORATION INCLUDING THE POWER TO ELECT DIRECTORS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | AS SOLE MEMBER, THE MEMBER RETAINS FINAL APPROVAL AUTHORITY OVER THE FOLLOWING ACTIONS OF THE CORPORATION: A. ELECTION OF DIRECTORS OF THE CORPORATION; B. ADOPTION OF THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; C. ADOPTION OF STRATEGIC PLANS; D. SALE, LEASE, DISPOSITION, MORTGAGE, OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; E. ANY MERGER, CONSOLIDATION, BUSINESS COMBINATION OR JOINT VENTURE, OR THE CREATION OR ACQUISITION OF ANY SUBSIDIARY ORGANIZATION; F. FILING OF A VOLUNTARY PETITION OR APPLICATION UNDER FEDERAL OR STATE BANKRUPTCY LAW; G. COMMENCEMENT OF ANY PROJECT OR THE MAKING OF ANY EXPENDITURE REQUIRING ISSUANCE OF A CERTIFICATE OF NEED; H. AMENDMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS; I. INCURRENCE OF ANY LONG-TERM INDEBTEDNESS; J. DEVELOPING OR TERMINATING PROGRAMS AND SERVICES; AND K. ELECTION OR APPOINTMENT, BUT NOT TERMINATION, OF THE PRESIDENT / COO OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 FOR UVMHNHHH IS PREPARED BY STAFF FROM THE UVM MEDICAL CENTER AND REVIEWED BY PWC US TAX LLP. FOLLOWING PWC'S REVIEW, THE RETURN IS REVIEWED BY MEMBERS OF UVMHNHHH AND SENIOR LEADERSHIP. THE FORM 990, ONCE COMPLETED, IS PROVIDED TO ALL DIRECTORS OF UVMHNHHH PRIOR TO THE FORM BEING FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | HHH HAS TWO POLICIES FOR CONFLICT OF INTEREST, ONE FOR BOARD MEMBERS AND ONE FOR STAFF INCLUDING OFFICERS AND HIGHLY COMPENSATED EMPLOYEES. HHH MONITORS COMPLIANCE OF ITS BOARD MEMBERS WITH ITS CONFLICT OF INTEREST POLICY REQUIRING A YEARLY SIGNED CONFLICT OF INTEREST FORM WHERE BOARD MEMBERS ACKNOWLEDGE READING THE POLICY AND DISCLOSE POTENTIAL CONFLICTS OF INTEREST. THE BOARD MEMBER THEN SIGNS AND DATES A FORM INDICATING THAT THE BOARD MEMBER IS NOT ENGAGED IN ACTIONS CONTRAVENING THE POLICY. EMPLOYEES ARE REQUIRED TO NOTIFY HHH IF CONFLICTS ARISE. FAILURE TO DO SO IS SUBJECT TO RAMIFICATIONS UP TO AND INCLUDING TERMINATION. BOARD MEMBERS HAVING A POSSIBLE CONFLICT OF INTEREST IN ANY MATTER ARE PROHIBITED FROM VOTING OR USING HIS OR HER PERSONAL INFLUENCE ON THE MATTER AND HE OR SHE IS NOT COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHEN PERMITTED BY LAW. HHH MONITORS COMPLIANCE OF ITS STAFF BY SOLICITING SIGNATURE OF A CONFLICT OF INTEREST FORM, WHEREIN THE STAFF MEMBER AGREES TO DISCLOSE ANY OUTSIDE WORKING RELATIONSHIP THAT HAS ACTUAL OR PERCEIVED POTENTIAL FOR ADVERSARIAL OR COMPETITIVE CONFLICT WITH HHH. STAFF WHO WISH TO PARTICIPATE IN SUCH A RELATIONSHIP MUST DISCLOSE SUCH INTENTION FOR REVIEW AND DECISION BY TWO OR MORE MEMBERS OF THE MANAGEMENT TEAM PRIOR TO ENGAGING IN SUCH RELATIONSHIP. STAFF MUST DISCLOSE TO THEIR IMMEDIATE SUPERVISOR ANY AFFLIATIONS THAT THEY OR THEIR IMMEDIATE FAMILY HAVE WITH ANY FIRM THAT DOES BUSINESS WITH OR THAT COMPETES WITH HHH, AND ANY FAMILY RELATIONSHIP WITH EITHER AN EMPLOYEE OR A CLIENT OF HHH. FAILURE TO COMPLY IS SUBJECT TO RAMIFICATIONS UP TO AND INCLUDING TERMINATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE COMPENSATION AND PERFORMANCE OF THE PRESIDENT AS WELL AS THE PRESIDENT'S PROPOSALS REGARDING OTHER KEY EMPLOYEES ON AN ANNUAL BASIS. THE BOARD EXECUTIVE COMMITTEE RELIES ON COMPARATIVE DATA AND EXISTING AGENCY POLICIES IN THEIR REVIEW AND APPROVAL PROCESS. THE UVM HEALTH NETWORK, THROUGH ITS COMPENSATION COMMITTEE, RETAINS FINAL DISCRETION OVER COMPENSATION OF THE ORGANIZATION'S EXECUTIVES INCLUDING BUT NOT LIMITED TO THE PRESIDENT, CHIEF OPERATING OFFICER, AND CHIEF FINANCIAL OFFICER, AND REVIEWS ANY RECOMMENDATION BY THE EXECUTIVE COMMITTEE OF THE HHH BOARD OF DIRECTORS. AFTER MAKING ANY APPROPRIATE MODIFICATIONS AND DETERMINING THAT THE TOTAL COMPENSATION TO BE PAID TO EACH EXECUTIVE IS REASONABLE, APPROPRIATE, AND CONSISTENT WITH THE BOARD'S COMPENSATION POLICIES, THE NETWORK EXECUTIVE COMMITTEE APPROVES THE COMPENSATION OF SUCH EMPLOYEES AND CONTEMPORANEOUSLY SUBSTANTIATES THE DELIBERATION AND DECISION. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNANCE DOCUMENTS CONSIST OF THE 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 THE ORGANIZATION WILL FURNISH A COPY TO ANY MEMBER OF THE PUBLIC WHO REQUESTS ONE. THE CONFLICT OF INTEREST POLICY IS NOT PUBLICLY POSTED, BUT THE ORGANIZATION WILL FURNISH A COPY TO ANY MEMBER OF THE PUBLIC WHO REQUESTS ONE. WITH THE ENACTMENT OF VERMONT'S ACT 48 IN MAY 2011 THE GREEN MOUNTAIN CARE BOARD (GMCB) BECAME THE REGULATORY BODY OVERSEEING HOSPITALS IN THE STATE OF VERMONT. AS A RESULT, THE BUDGETS FOR SEVERAL HOSPITAL ORGANIZATIONS AFFILIATED WITH UVMHNHHH ARE SUBJECT TO REVIEW BY THE GMCB ON AN ANNUAL BASIS. ONGOING DISCLOSURE OF OPERATING RESULTS IS ALSO REQUIRED, AND THE AFFILIATED HOSPITALS SUBMIT FINANCIAL STATEMENTS REGULARLY THROUGHOUT THE YEAR. THE UVM HEALTH NETWORK REGULARLY DISCLOSES ITS CONSOLIDATED FINANCIAL RESULTS ON ITS WEBSITES AND SUBMITS PRESS RELEASES RELATING TO PERFORMANCE ON A REGULAR BASIS TO LOCAL MEDIA OUTLETS. |
| FORM 990, PART XI, LINE 9: | NET ASSET TRANSFER 500,000. UNDETERMINED VARIANCE 1,223. CHANGES TO RESTRICTED/TEMP RESTRICTED ASSETS -508,027. |
| Software ID: | |
| Software Version: |