2024-08-14T11:06:24-05:00 2023-09-30 920460586 PWC US TAX LLP 101 SEAPORT BLVD BOSTON MA 02210 990 2022-10-01 030179603 THE UNIVERSITY OF VERMONT HEALTH NETWORK HOME HEALTH & HOSPICE UNIV 8026581900 1110 PRIM ROAD COLCHESTER VT 05446 MICHAEL TOWLE VP FINANCE & CFO 8028604434 2024-08-12 1 0 PAUL J TANIS P01441612 6175305000 2022 2024-08-08 14:25:15Z CHRISTINE WERNEKE 1110 PRIM ROAD COLCHESTER VT 05446 29436533 0 X WWW.UVMHOMEHEALTH.ORG X 1934 VT THE UVMHNHHH CARES FOR INDIVIDUALS AND FAMILIES THROUGH HEALTH AND RELATED SERVICES IN HOME AND OTHER COMMUNITY SETTINGS FOR THE RESIDENTS OF CHITTENDEN AND GRAND ISLE COUNTIES. 11 7 452 227 0 0 2610676 2127055 23307995 23956265 6889309 -118528 70530 50499 32878510 26015291 3500 3500 0 0 26246907 24063663 0 0 265087 7249702 5457115 33500109 29524278 -621599 -3508987 29820859 29599952 10720502 11516035 19100357 18083917 X THE UVMHNHHH HELPS PEOPLE LIVE THEIR FULLEST LIVES BY PROVIDING INNOVATIVE, HIGH VALUE, COMPASSIONATE CARE WHEREVER THEY CALL HOME. 0 0 8311744 1182 8090024 HOME CARE SERVING 2,694 PATIENTS AND DOING 45,760 VISITS FOR SKILLED NURSING AND THERAPY SERVICES INCLUDING CLINICAL ASSESSMENT, CARE MANAGEMENT AND COORDINATION, TEACHING, AND PROVIDER-ORDERED TREATMENTS; MEDICAL SOCIAL WORK; WOUND CARE; AND FOOT CARE SERVICES. 5624958 800 5474909 MCCLURE MILLER RESPITE HOUSE, A 21-ROOM, MEDICARE-CERTIFIED HOSPICE RESIDENCE SERVING 385 PATIENTS AND 3,871 BED DAYS AND PROVIDING SERVICES INCLUDING NURSING CARE, PHYSICIAN VISITS, PAIN AND SYMPTOM MANAGEMENT, MEDICATIONS, AND EMOTIONAL AND SPIRITUAL SUPPORT SERVICES. 4663005 663 4538617 HOSPICE END OF LIFE SERVING 591 PATIENTS AND 25,672 PER DIEM DAYS, PROVIDING THE FOLLOWING SERVICES: MEDICATION (EDUCATION, SYMPTOM MANAGEMENT, 24/7 PHONE SUPPORT); PERSONAL CARE INCLUDING DAILY VISITS, EDUCATION/EVALUATION OF SAFETY, AND HOMEMAKER SERVICES; EMOTIONIAL AND SPIRITUAL SUPPORT ; AND VOLUNTEER SUPPORT. 6013114 855 5852715 FAMILY & CHILDREN SERVICES SERVING 752 PATIENTS AND DOING 7,685 VISITS INCLUDING VIDEO VISITS FOR NURSING AND FAMILY SUPPORT, WELLNESS PROGRAMS, PEDIATRIC CARE FOR ACUTELY AND CHRONICALLY ILL CHILDREN, AND PEDIATRIC REHABILITATION INCLUDING ASSESSMENT AND INTERVENTIONS FOR CHILDREN WITH DEVELOPMENTAL DELAYS; PERSONAL CARE SERVICES TO 244 FINANCIALLY-ELIGIBLE PATIENTS UNDER THE VERMONT MEDICAID CHOICES FOR CARE PROGRAM; ADULT DAY PROGRAM FORM OLDER CLIENTS, ADULTS WITH DISABILITIES, AND INDIVIDUALS WITH ALZHEIMER'S DISEASE AND OTHER MEMORY IMPAIRMENTS, SERVING 40 PATIENTS AT 1 LOCATION; ADULT AND PEDIATRIC HIGH-TECH SERVICES TO 13 PATIENTS AND DOING 23,628 HOURS OF SERVICE, RENDERED TO PAITIENTS REQUIRING NURSING THAT IS MORE EXTENSIVE THAN THOSE TYPICALLY PROVIDED VIA INTERMITTENT SKILLED NURSING OR PERSONAL CARE ASSISTANTS; HOMEMAKER PROGRAM SERVICING 45 CLIENTS; SASH (SUPPORT AND SERVICES AT HOME) PROVIDING SERVICES AT 13 SENIOR HOUSING LOCATIONS. 6013114 855 5852715 24612821 1 1 0 0 0 0 0 1 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 51 0 1 452 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 7 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X MICHAEL TOWLE 8028604434 1110 PRIM ROAD COLCHESTER VT 05446 HEATHER RIDER-HAMMOND TRUSTEE; CHAIR (AS OF 1/2023) 1.00 0.00 X X 0 0 0 CATHERINE SIMONSON TRUSTEE; VICE CHAIR (AS OF 1/2023) 1.00 0.00 X X 0 0 0 CJ CHARLEBOIS MELENDY TRUSTEE; TREASURER 1.00 0.00 X X 0 0 0 JAN DEMERS TRUSTEE; SECRETARY (AS OF 1/2023) 1.00 0.00 X X 0 0 0 PAM MACKENZIE TRUSTEE 1.00 0.00 X 0 0 0 DR THOMAS PETERSON TRUSTEE 1.00 34.00 X 0 358576 39666 JILL KAPLAN TRUSTEE 1.00 0.00 X 0 0 0 ANNETTE MACIAS-HOAG TRUSTEE 1.00 49.00 X 0 546555 76031 ALEXANDER WATSON TRUSTEE 1.00 0.00 X 0 0 0 DR ELIZABETH MCGEE TRUSTEE 1.00 44.00 X 0 383503 63465 CHRISTINE WERNEKE PRES & COO (AS OF 5/2023) 45.00 5.00 X X 0 186012 42556 ADRIANNE JOHNSON ROSS PRES & COO (TIL 1/2023) 45.00 5.00 X X 319484 0 49673 TARA PACY CHAIR (TIL 12/2022) 1.00 44.00 X X 0 221704 46758 ERIKA SCHRAMM SECRETARY (TIL 12/2022) 1.00 0.00 X X 0 0 0 BRIAN HARWOOD TRUSTEE (TIL 12/2022) 1.00 0.00 X 0 0 0 MICHAEL TOWLE VP FINANCE & CFO 45.00 5.00 X 185113 0 34854 ANDREE SMITH CHIEF NURSING OFFICER 45.00 0.00 X 131430 0 14803 LINDSAY GAGNON NURSE PRACTITIONER 45.00 0.00 X 122709 0 30196 ALLISON MERCURE DIR REV CYCLE 45.00 0.00 X 117010 0 29013 JESSICA HENDELA DIR OR FIN REP & BUDGET 45.00 0.00 X 116415 0 1838 HEATHER SMITH CLIN TEAM MANAGER 45.00 0.00 X 103035 0 11822 JUDY PEEK-LEE FMR INTERIM CFO 0.00 50.00 X 0 409410 31192 1095196 2105760 471867 14 1 1 0 CROSS COUNTRY STAFFING INC PO BOX 404674 ATLANTA GA 30384 TRAVELING NURSING SERVICES 1023818 AMN HEALTHCARE INC 8840 CYPRESS WATERS BLVD COPPELL TX 75019 ADMINISTRATIVE STAFFING 340219 TLC NURSING ASSOCIATES INC 1550 WILLISTON ROAD SOUTH BURLINGTON VT 05403 TRAVELING NURSING SERVICES 222540 PRIME TIME HEALTHCARE LLC 15380 WEIR STR OMAHAMA NE 68137 TRAVELING NURSING SERVICES 148594 4 7080 45128 300914 1773933 5191 2127055 PATIENT SERVICE REVENUE 621610 23956265 23956265 23956265 185913 185913 3098311 3402752 -304441 -304441 -304441 68989 45128 18490 50499 50499 26015291 23956265 0 -68029 3500 3500 702755 702755 18867066 16157491 2514906 194669 420222 361253 54617 4352 2691789 2262721 401806 27262 1381831 1146920 221093 13818 21459 17811 3433 215 170082 140573 27773 1736 1739484 1443772 278317 17395 480568 398871 76891 4806 502947 417446 80472 5029 497104 412596 79537 4971 104361 88692 14747 922 492856 409070 78857 4929 55589 55589 PROVIDER TAX 809302 809302 OPERATING LEASES 266695 266695 BOOKS, DUES & SUBSCRIPT 201799 167493 32288 2018 114869 108615 23289 -17035 29524278 24612821 4646370 265087 2 3413409 2195825 3207837 3224775 383888 443286 16944203 11239110 6096621 5705093 16709297 18021168 9805 9805 29820859 29599952 10021396 11226834 368318 330788 289201 10720502 11516035 X 8773096 6713686 10327261 11370231 19100357 18083917 29820859 29599952 X -3508987 2499351 -6804 X 0 1 X 1 1 1 X 3700141 4411462 2320440 2610676 2127055 15169774 36654717 25996696 27153943 23307995 23956265 137069616 40354858 30408158 29474383 25918671 26083320 152239390 0 0 0 152239390 1103762 524285 538126 623167 185913 2975253 1103762 524285 538126 623167 185913 2975253 48326 38829 38932 70530 50499 247116 108549 108549 41615495 30971272 30051441 26612368 26319732 155570308 0.97860 0.97580 0.01910 0.02020 X 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. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9805 0 9517440 1289530 402012 7575 10397383 11918726 -1978144 405487 17655 9517440 10185809 1951268 218351 11918726 10044070 453357 311618 10185809 9647443 500 737994 341867 10044070 0.00000 0.62552 0.37448 0 0 346673 346673 7362096 4427637 2934459 9235434 6811473 2423961 5705093 CHARITABLE REMAINDER TRUST LIABILITY 289201 289201 X PART V, LINE 4: THE FUNDS ARE INTENDED TO FUND PROGRAMS IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PURPOSE. PART X, LINE 2: THE UNIVERSITY OF VERMONT HEALTH NETWORK HOME HEALTH & HOSPICE IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE UNIVERSITY OF VERMONT HEALTH NETWORK ("UVM HEALTH NETWORK"). PAGES 17 AND 18 OF THE CONSOLIDATED FINANCIAL STATEMENTS CONTAINS A FOOTNOTE INDICATING THAT NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN RECORDED. FUN RUN 114117 45128 68989 18490 114117 45128 68989 18490 18490 50499 X 0 0 0 1 0 0 0 0 0 1 1 1 ANNETTE MACIAS-HOAG TRUSTEE 0 405530 0 105231 0 35794 0 50315 0 25716 0 622586 0 0 DR ELIZABETH MCGEE TRUSTEE 0 372978 0 0 0 10525 0 27450 0 36015 0 446968 0 0 JUDY PEEK-LEE FMR INTERIM CFO 0 349587 0 37030 0 22793 0 14754 0 16438 0 440602 0 0 DR THOMAS PETERSON TRUSTEE 0 292270 0 42532 0 23774 0 35380 0 4286 0 398242 0 0 ADRIANNE JOHNSON ROSS PRES & COO (TIL 1/2023) 276969 0 33777 0 8738 0 16262 0 33411 0 369157 0 0 0 TARA PACY CHAIR (TIL 12/2022) 0 200526 0 9691 0 11487 0 24188 0 22570 0 268462 0 0 CHRISTINE WERNEKE PRES & COO (AS OF 5/2023) 0 162224 0 13447 0 10341 0 12519 0 30037 0 228568 0 0 MICHAEL TOWLE VP FINANCE & CFO 166356 0 18667 0 90 0 0 0 34854 0 219967 0 0 0 LINDSAY GAGNON NURSE PRACTITIONER 112625 0 8625 0 1459 0 0 0 30196 0 152905 0 0 0 PART I, LINE 1A PRESIDENT AND COO ADRIANNE JOHNSON-ROSS RECEIVED COMPENSATION OF $1,400 TO COVER TAX PREPARATION AND FINANCIAL ADVISORY SERVICES. WHILE THERE IS NO ORGANIZATION-WIDE WRITTEN POLICY REGARDING SUCH PAYMENTS, THE AMOUNT IS INCLUDED THE EMPLOYMENT CONTRACT, WHICH IS SUBJECT TO ANNUAL REVIEW (AS DISCUSSED IN SCHEDULE O). PERSONAL SERVICE COMPENSATION IS INCLUDED ON FORM W-2 AS TAXABLE INCOME. NO REIMBURSEMENT IS MADE UNDER AN ACCOUNTABLE PLAN AND THE COMPENSATION IS OFFERED ON A TAXABLE BASIS. THEREFORE, SUBSTANTIATION OF EXPENSE IS NOT REQUIRED. PART I, LINE 3 UVMHNHHH RELIED ON THE UNIVERSITY OF VERMONT HEALTH NETWORK ("UVM HEALTH NETWORK"), THE PARENT ORGANIZATION OF UVM MEDICAL CENTER, TO ESTABLISH SENIOR EXECUTIVE COMPENSATION. UVM HEALTH NETWORK UTILIZED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE UNIVERSITY OF VERMONT HEALTH NETWORK, BY AND THROUGH ITS AFFILIATED SUBSIDIARIES, MAINTAINED A SUPPLEMENTAL RETIREMENT BENEFIT PLAN (SRP) UNDER CONTRACTUAL ARRANGEMENTS WITH SEVERAL PERSONS LISTED ON FORM 990, PART VII, AND SECTION A, LINE 1A. PURSUANT TO THE TERMS OF THE SRP, ANNUAL CREDITS WERE MADE EQUAL TO A FIXED PERCENTAGE OF BASE SALARY. THE FOLLOWING PERSONS PARTICIPATED IN THE SRP IN CALENDAR YEAR 2022 AND THEIR RESPECTIVE FIXED PERCENTAGE IS DESIGNATED IN PARENTHESES: ANNETTE MACIAS-HOAG (8.68%); AND ADRIANNE JOHNSON ROSS (6.42%). THE AMOUNT DEFERRED FOR CALENDAR YEAR 2022 IS INCLUDED ON SCHEDULE J, PART II, COLUMN C. AMOUNTS DEFERRED REMAIN SUBJECT TO FORFEITURE IF CERTAIN CONDITIONS ARE NOT MET. PART I, LINE 7 UVMHNHHH PAID AWARDS TO CERTAIN MEMBERS OF UPPER MANAGEMENT (DIRECTORS, VICE PRESIDENTS, PHYSICIAN CHAIRS AND SENIOR EXECUTIVES) THROUGH ITS ANNUAL VARIABLE PAY PLAN AS THE PLAN'S PERFORMANCE MEASURES WERE MET. THE MEASURES WERE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THESE MEASURES INCLUDED FINANCIAL, POPULATION HEALTH & QUALITY, AND OPERATIONAL RELATED METRICS. PART I, LINE 8 SALARIES AND OTHER FIXED AMOUNTS PAYABLE TO EXECUTIVES SUCH AS OFFICERS AND CERTAIN KEY EMPLOYEES ARE SET BY CONTRACTS THAT ARE NEGOTIATED AND ENTERED INTO PRIOR TO THE COMMENCEMENT OF EACH EXECUTIVES' EMPLOYMENT. THE TERMS OF SUCH CONTRACTS ARE APPROVED IN ADVANCE BY THE APPROPRIATE COMPENSATION COMMITTEE OR OTHER BOARD-AUTHORIZED BODY, WHICH OBTAINS AND RELIES ON APPROPRIATE DATA AS TO COMPARABILITY PRIOR TO MAKING SUCH OFFER, AND CONCURRENTLY DOCUMENTS ITS BASIS FOR DETERMINATION. 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. UVM HEALTH NETWORK MEDICAL GROUP INC 111 COLCHESTER AVENUE BURLINGTON VT 05401 030225105 PHYSICIAN SVC VT 501(C)(3) 12A-I UVMHN 1 THE UNIVERSITY OF VERMONT MED CTR FDN INC 111 COLCHESTER AVENUE BURLINGTON VT 05401 263159849 FUNDRAISING VT 501(C)(3) 12A-I UVMMC 1 UNIVERSITY OF VERMONT HEALTH NETWORK INC 111 COLCHESTER AVENUE BURLINGTON VT 05401 452880726 HOLDING COMPANY VT 501(C)(3) 12A-I N/A 0 CENTRAL VERMONT MEDICAL CENTER 130 FISHER ROAD BERLIN VT 05602 222547186 HOSPITAL VT 501(C)(3) 3 UVMHN 1 UNIVERSITY HEALTH CENTER 111 COLCHESTER AVENUE BURLINGTON VT 05401 030229931 HOSPITAL VT 501(C)(3) 12C-III-FI UVMHNMG 1 COMMUNITY PROVIDERS INC 75 BEEKMAN STREET PLATTSBURGH NY 12901 222544844 HEALTH SVC COOR NY 501(C)(3) 12A-I UVMHN 1 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL 75 BEEKMAN STREET PLATTSBURGH NY 12901 141338471 HOSPITAL NY 501(C)(3) 3 UVMHN 1 ELIZABETHTOWN COMMUNITY HOSPITAL 75 PARK STREET ELIZABETHTOWN NY 12932 141364513 HOSPITAL NY 501(C)(3) 3 UVMHN 1 EMERGENCY MEDICAL TRANSPORT OF CVPH INC 75 BEEKMAN STREET PLATTSBURGH NY 12901 061718419 AMBULANCE SVC NY 501(C)(3) 12B-II CPI 1 CVPH MEDICAL CENTER FOUNDATION 75 BEEKMAN STREET PLATTSBURGH NY 12901 141727048 HEALTH SVC COOR NY 501(C)(3) 12B-II CVPH 1 UNIVERSITY MEDICAL EDUCATION ASSOCIATES 89 BEUMONT AVENUE BURLINGTON VT 05405 237107832 EDUCATIONAL VT 501(C)(3) 10 UVMHNMG 1 ALICE HYDE MEDICAL CENTER 133 PARK STREET MALONE NY 12953 150346515 HOSPITAL NY 501(C)(3) 3 UVMHN 1 PORTER MEDICAL CENTER INC 115 PORTER DRIVE MIDDLEBURY VT 05753 030310862 SUPPORTING ORG VT 501(C)(3) 12-BII UVMHN 1 HELEN PORTER NURSING HOME 37 PORTER DRIVE MIDDLEBURY VT 05753 030306549 NURSING HOME VT 501(C)(3) 3 PMC 1 AUXILIARY OF PORTER MEDICAL CENTER 37 PORTER DRIVE MIDDLEBURY VT 05753 237363227 SUPPORTING ORG VT 501(C)(3) 12-B,II PMC 1 PORTER HOSPITAL INC 37 PORTER DRIVE MIDDLEBURY VT 05753 030181058 HOSPITAL VT 501(C)(3) 3 PMC 1 THE UNIVERSITY OF VERMONT MEDICAL CENTER 111 COLCHESTER AVENUE BURLINGTON VT 05401 030219309 HOSPITAL VT 501(C)(3) 3 UVMHN 1 LAKE CHAMPLAIN PHYSICIAN SERVICES PC 75 BEEKMAN STREET PLATTSBURGH NY 12901 273785445 PHYSICIAN SVC NY 501(C)(3) 12A-I CVPH 1 VMC INDEMNITY COMPANY INC 95 ST PAUL ST BURLINGTON VT 05401 831102018 INSURANCE VT 501(C)(3) 12A-I UVMHN 1 UVMHN VENTURES INC 111 COLCHESTER AVENUE BURLINGTON VT 05401 043380045 HOLDING COMPANY VT N/A C 1 UVM HEALTH NETWORK CREDENTIALING & ENROLLMENT 111 COLCHESTER AVENUE BURLINGTON VT 05401 030333056 ADMIN SVC VT N/A C 1 CHARITABLE REMAINDER TRUSTS (6) SUPPORT VT N/A T 1 PERPETUAL TRUSTS (10) SUPPORT VT N/A T 1 CHARITABLE IRREVOCABLE TRUSTS (8) SUPPORT VT N/A T 1 CHAMPLAIN VALLEY HEALTH NETWORK 75 BEEKMAN STREET PLATTSBURGH NY 12901 161586102 ADMIN SVCS NY N/A C 1 MEDIQUEST INC PO BOX 1656 PLATTSBURGH NY 12901 141663061 MED OFFICE LEASE NY N/A C 1 YANKEE MEDICAL INC 276 NORTH AVENUE BURLINGTON VT 05401 030225363 HOME MEDICAL EQUIPMENT VT N/A C 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 THE UNIVERSITY OF VERMONT MEDICAL CENTER I 86112 FMV THE UNIVERSITY OF VERMONT MEDICAL CENTER Q 3501928 FMV THE UNIVERSITY OF VERMONT MEDICAL CENTER S 500000 FMV