2022-08-05T14:23:15-05:00 2021-09-30 010523282 Berry Dunn McNeil & Parker LLC 1000 Elm Street 4th Floor Manchester NH 03101 990 2020-10-01 030179603 The University of Vermont Health Network Home Health & Hospice UNIV 8026581900 1110 Prim Road Colchester VT 05446 Michael Towle VP of Finance & Administration CFO 8026581900 2022-08-05 1 Michael Towle 999009999 Melissa Magoon CPA P01712842 6036697337 2022-08-05 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Michael Towle 1110 Prim Road Colchester VT 05446 31298666 0 X www.uvmhomehealth.org X 1906 VT The UVMHNHHH cares for individuals and families through health and related services in home and other community setting for the residents of Chittenden and Grand Isle Counties. 12 11 509 257 0 0 4411462 2320440 25996696 27153943 607678 657295 38829 39412 31054665 30171090 0 0 0 0 23371633 24796575 0 0 0 8155416 9038600 31527049 33835175 -472384 -3664085 38539765 37675315 8041160 7474099 30498605 30201216 X The UVMHNHHH helps people live their fullest lives by providing innovative, high value, compassionate care wherever they call home. 0 0 8044645 12544956 Home Care serving 3,226 patients and doing 64,176 visits 3767203 5453936 Hospice End of Life Serving 680 patients with 32,474 per diem days. 3480761 2951791 VNA Respite House Serving 387 patients and 4,537 bed days. 12957837 6203260 Family Child Services serving 568 patients and doing 3,872 visitsChoice for Care highest needs personal care services to 311 patientsAdult Day Program serving 52 clients at 1 locationAdult and Pediatric Hi Tech services to 13 patients and doing 21,013 hours of serviceAnderson Parkway personal care services to 9 disabled adultsChoices for Care Homemaker Program servicing 88 clientsSASH (support and services at home) providing hours at 12 senior housing locations 12957837 6203260 28250446 1 1 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 34 0 1 509 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 VT X Michael Towle 8028604434 1110 Prim Road Colchester VT 05446 Judy Peterson Past CEO 40.00 0.00 X X 84953 0 10698 Adrianne Jonson Ross President & Chief Operating Officer 40.00 0.00 X X 254608 0 36975 Tara Pacy Board Chair 0.65 0.00 X X 0 0 0 Heather Hammond Vice Chair 0.65 0.00 X X 0 0 0 CJ Charlebois Melendy Treasurer 0.65 0.00 X X 0 0 0 Erika Schramn Secretary 0.65 0.00 X X 0 0 0 Brian Hardwood Board Member 0.65 0.00 X 0 0 0 Catherine Simnson Board Member 0.65 0.00 X 0 0 0 Jan Demers Board Member 0.65 0.00 X 0 0 0 Pam McKenzie Board Member 0.65 0.00 X 0 0 0 Linda Tarr-Whelan Board Member 0.65 0.00 X 0 0 0 Thomas Peterson Board Member 0.65 0.00 X 0 0 0 Allie Stickney Board Member 0.65 0.00 X 0 0 0 Jeanne Hutchens Past Board Chair 0.65 0.00 X 0 0 0 Evan Goldsmith Past Board Chair 0.65 0.00 X 0 0 0 Joe Hamline Past Board Chair 0.65 0.00 X 0 0 0 Judy Carpenter Past Board Chair 0.65 0.00 X 0 0 0 James Manahan II Past CFO 40.00 0.00 X 155751 0 6041 Michael J Towle Chief Financial Officer 16.66 23.33 X 140885 117613 46404 Gretchen Bates VP of Clinical Operations 40.00 0.00 X 170823 0 5198 Linsay Gagnon Nurse Practitioner 40.00 0.00 X 112049 0 36371 Gale K Smith Hospice Nurse III 40.00 0.00 X 110262 0 12315 Sara Kennedy Hospice Nurse II 40.00 0.00 X 105132 0 22865 Todd Patterson Director of Home Health Services 40.00 0.00 X 105049 0 16261 1239512 117613 193128 19 0 1 0 Cross Country Staffing - East PO Box 404674 Atlanta GA 30384 Nurse Staffing 785962 1 102455 1511759 706226 61915 2320440 Patient Service Revenue 621610 27153943 27153943 27153943 538126 538126 1244424 1125255 119169 119169 119169 41733 2321 39412 39412 30171090 27153943 0 696707 707815 707815 19350450 16706475 2643975 335564 288357 47207 2926092 2497866 428226 1476654 1234308 242346 13874 13874 85000 85000 36449 36449 2272056 1508544 763512 804017 683188 120829 1123191 954396 168795 438506 372606 65900 532716 452658 80058 684958 572556 112402 165561 140680 24881 Provider Tax 1087225 1087225 Program Supplies 1024855 1024855 Miscellaneous Expense 732792 726732 6060 UBI Tax 37400 37400 33835175 28250446 5584729 0 X 527 527 5243270 2059275 447034 393782 3505496 4111318 552563 305470 16724205 10213858 7154984 6510347 21402145 24284791 233746 9805 38539765 37675315 7021942 6071778 415406 13175 603812 1389146 8041160 7474099 X 19179552 17138479 11319053 13062737 30498605 30201216 38539765 37675315 X -3664085 3124399 242297 X 0 1 X 1 1 1 X 3174917 3171759 3700141 4411462 2320440 16778719 31343702 30308520 36654717 25996696 27153943 151457578 34518619 33480279 40354858 30408158 29474383 168236297 0 0 0 168236297 404429 520465 1103762 524285 538126 3091067 404429 520465 1103762 524285 538126 3091067 48326 38829 38932 126087 118045 339748 108549 566342 35041093 34340492 41615495 30971272 30051441 172019793 0.97800 0.97730 0.01800 0.01760 X Schedule A, Part III, Line 12, Explanation of Other Income: Miscellaneous Program Revenue - 2016 Amount: $ 118,045. 2017 Amount: $ 339,748. 2018 Amount: $ 108,549. Schedule A, Part III, Column D The numbers in Column D, 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 10185809 1951268 218351 11918726 10044070 453357 311618 10185809 9647443 500 737994 341867 10044070 9709546 11134 803208 876445 9647443 9274066 10775 1341661 400000 10226502 0.00000 0.54560 0.45440 0 0 329882 329882 9168166 3781737 5386429 7226157 6432121 794036 6510347 Charitable Remainder Trust Liability 372495 Due to Affiliate 1016651 1389146 X 33503658 3124399 502321 3626720 29876938 36449 257703 294152 30171090 33801047 2321 2321 33798726 36449 36449 33835175 Part V, Line 4: To fund future losses in programs that do not breakeven. Part X, Line 2: The Association is a public charity under Section 501(c)(3) of the Internal Revenue Code. As a public charity, the Association is exempt from state and federal income taxes on income earned in accordance with it tax-exempt purpose. Unrelated business income is subject to state and federal income tax. Management has evaluated the Association's tax positions and concluded that the Association has no unrelated business income or uncertain tax positions that require adjustment to the financial statements. Part XI, Line 2d - Other Adjustments: Fundraising Expenses 2,321. Net Asset Transfer From Affiliate 500,000. Part XI, Line 4b - Other Adjustments: Family Room Distribution 234,932. Change in Value of Charitable Remainder Trust 22,771. Part XII, Line 2d - Other Adjustments: Fundraising Expenses 2,321. Fun Run 35164 35164 2321 Tree Lighting 6569 6569 41733 41733 2321 2321 39412 X X 0 0 0 0 0 0 0 1 0 Michael J Towle Chief Financial Officer 68814 89601 72071 0 0 28012 0 7777 17634 20993 158519 146383 0 0 Adrianne Jonson Ross President & Chief Operating Officer 215201 0 29455 0 9952 0 0 0 36975 0 291583 0 0 0 Gretchen Bates VP of Clinical Operations 149226 0 21597 0 0 0 0 0 5198 0 176021 0 0 0 James Manahan II Past CFO 143661 0 0 0 12090 0 3144 0 2897 0 161792 0 0 0 Part I, Line 7 All bonuses paid are at the discretion of the President with Board review. X 7 61915 Coverted Stock to Cash 0 0 1 0 Form 990, Part VI, Section A, line 7a The sole member of the Corporation shall be The University of Vermont Health Network, Inc. Form 990, Part VI, Section A, line 7b The Member shall have all the rights and responsibilities conferred to members under the Act. In addition, the following powers shall be expressly reserved to the member: a. election of the Directors of the Corporation b. adoption of the annual operating and capital budgets of the Corporation and any change to a budget previously approved 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 orgainization 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 k. election or appointment, but not termination, of the President/COO of the Corporation Form 990, Part VI, Section B, line 11b The 990 is posted on the board forum and both the finance committee and board can review and ask any questions. Form 990, Part VI, Section B, line 12c The UVMHNHHH has two policies for Conflict of Interest, one for Board Members and one for staff including officers and highly compensated employees. The UVMHNHHH monitors compliance of its Board Members with its conflict of interest policy by 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 states that there is no action that would contravene the policy. The Board Member then signs and dates the form. Employees are required to notify UVMHNHHH if conficts arise. Failure to do so will have ramification up to 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 reviewing and approving the presidents proposal for other key employees, on an annual basis. The Board Executive committee relies on comparative data and existing agency policies in their review and approval. Form 990, Part VI, Section C, line 19 The UVMHNHHH makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: The University of Vermont Health Network - Home Health & Hospice, Inc. 1110 Prim Road Colchester, VT 05446 EIN: 03-0179603 The University of Vermont Health Network - Home Health & Hospice, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part XI, line 9: Net Asset Transfer From Affiliate 500,000. Family Room Distribution -234,932. Change in Value of Charitable Remainder Trust -22,771. UVM Health Network Medical Group Inc 111 Colchester Ave Burlington VT 05401 030225105 Physician SVC VT 501(c)(3) Line 12a, I UVMHN 0 UVM Medical Group New York PLLC 183 Park Street Malone NY 12953 203905216 Physician SVC NY 501(c)(3) Line 3 UVMHNMG 0 The University of Vermont Med Ctr FDN INC 111 Colchester Ave Burlington VT 05401 263159849 Fundraising VT 501(c)(3) Line 12a, I UVMMC 0 The University of Vermont Medical Center 111 Colchester Ave Burlington VT 05401 030219309 Hospital VT 501(c)(3) Line 3 UVMHN 0 Central Vermont Medical Center 130 Fisher Road Berlin VT 05602 222547186 Hospital VT 501(c)(3) Line 3 UVMHN 0 Community Providers Inc 75 Beekman Street Plattsburgh NY 12901 222544844 Health SVC Coor NY 501(c)(3) Line 12a, I UVMHN 0 Champlain Valley Physicians Hospital 75 Beekman Street Plattsburgh NY 12901 141338471 Hospital NY 501(c)(3) Line 3 UVMHN 0 Elizabethtown Community Hospital 75 Park Street Elizabethtown NY 12932 141364513 Hospital NY 501(c)(3) Line 3 UVMHN 0 Emergency Medical Transport of CVPH INC 75 Beekman Street Plattsburgh NY 12901 061718419 Ambulance SVC NY 501(c)(3) Line 12b, II CPI 0 CVPH Medical Center Foundation 75 Beekman Street Plattsburgh NY 12901 141727048 Health SVC SUPP NY 501(c)(3) Line 12b, II CVPH 0 University Health Center 111 Colchester Ave Burlington VT 05401 030229931 Hospital VT 501(c)(3) Line 12c, III-FI UVMHNMG 0 University Medical Education Associates 89 Beaumont Avenue Burlington VT 05405 237107832 Educational VT 501(c)(3) Line 10 UVMHNMG 0 Alice Hyde Medical Center 133 Park Street Malone NY 12953 150346515 Hospital NY 501(c)(3) Line 3 UVMHN 0 UVM Medical Center Auxiliary Inc 111 Colchester Ave Burlington VT 05401 208022004 Service VT 501(c)(3) Line 12c, III-FI N/A 0 Porter Medical Center INC 115 Porter Drive Middlebury VT 05753 030310862 Supporting Org VT 501(c)(3) Line 12b, II UVMHN 0 Helen Porter Nursing Home 37 Porter Drive Middlebury VT 05753 030306549 Nursing Home VT 501(c)(3) Line 3 PMC 0 Auxiliary of Porter Medical CTR 37 Porter Drive Middlebury VT 05753 237363227 Supporting Org VT 501(c)(3) Line 12b, II PMC 0 Porter Hospital Inc 37 Porter Drive Middlebury VT 05753 030181058 Hospital VT 501(c)(3) Line 3 PMC 0 Lake Champlain Physicians Services PC 75 Beekman Street Plattsburgh NY 12901 273785445 Physician SVC NY 501(c)(3) Line 12a, I CVPH 0 VMC Indemnity Company Inc 95 St Paul St Burlington VT 05401 831102018 Insurance VT 501(c)(3) Line 12a, I UVMHN 0 The University of Vermont Health Network Inc 111 Colchester Ave Burlington VT 05401 452880726 Supporting Org VT 501(c)(3) Line 12a, I 0 Onecare Vermont ACO LLC 111 Colcester Ave Burlington VT 05401 455399218 Accountable Care VT N/A 0 0 Adirondack ACO LLC 75 Beekman Street Plattsburgh NY 12901 462840926 Accountable Care NY N/A 0 0 UVMHN Ventures Inc 111 Colchester Ave Burlington VT 05401 043380045 Holding Company VT N/A C 0 VMC Indemnity Company LTD PO Box HM 3103 25 Church St Hamilton HM FX BD Captive Insurance BD N/A C 0 UVMHN Credentialing & Enrollment 111 Colchester Ave Burlington VT 05401 030333056 ADMIN SVC VT N/A C 0 Charitable Remainder Trust (5) Support VT N/A T 0 Perpetual Trust (4) Support VT N/A T 0 Champlain Valley Health Network 75 Beekman Street Plattsburgh NY 12901 151586102 ADMIN Service NY N/A C 0 Charitable Irrevocable Trust (7) Support VT N/A T 0 Mediquest Inc PO Box 1656 Plattsburgh NY 12901 141663061 Med Office Lease NY N/A C 0 Yankee Medical Inc 276 North Avenue Burlington VT 05401 030225363 Home Medical Equipment VT N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0