FANNY ALLEN CORPORATION: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
FANNY ALLEN CORPORATION (EIN 22-2495808)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-09
IRS object ID
202023149349301462
Schema version
2019v5.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-11-09T09:29:25-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010494526PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Baker Newman & NoyesBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 507AddressLine1Txt
CityPortlandCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04112ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN222495808EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Fanny Allen CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFANNBusinessNameControlTxt
Phone9786546363PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 Ames Pond Drive No 102AddressLine1Txt
CityTewksburyCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01876ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonStephen W ForneyPersonNm
Person TitleSVP/CFOPersonTitleTxt
Phone9786546363PhoneNum
Signature2020-11-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNicholas E PortoPreparerPersonNm
PTINP01310283PTIN
Phone2078792100PhoneNum
Preparation2020-11-02PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address208.105.168.164IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-02IPDt
IP Tm15:20:43IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id38659DA796957EF4727498C6F5EA77981E0D27E4AtSubmissionCreationDeviceId
At Submission Filing Device IdDA1D1F22D002DE74304CAE64996AD19EA354FE22AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Fanny Allen FoundationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerChristine WernekePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 Ames Pond Drive No 102AddressLine1Txt
CityTewksburyCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01876ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$685,487GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.fannyallen.org/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1983FormationYr
Legal Domicile StateVTLegalDomicileStateCd
Activity Or MissionTo provide grants to other not-for-profits in Vermont that serve the poor and needy.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers8TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$200,000PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$173,020PYInvestmentIncomeAmt
CY Investment Income$685,487CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$373,020PYTotalRevenueAmt
CY Total Revenue$685,487CYTotalRevenueAmt
PY Grants And Similar Paid$288,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$305,658CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$242PYOtherExpensesAmt
CY Other Expenses$759CYOtherExpensesAmt
PY Total Expenses$288,242PYTotalExpensesAmt
CY Total Expenses$306,417CYTotalExpensesAmt
PY Revenues Less Expenses$84,778PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$379,070CYRevenuesLessExpensesAmt
Total Assets BOY$8,787,697TotalAssetsBOYAmt
Total Assets EOY$10,189,092TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,667TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$8,787,697NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$10,187,425NetAssetsOrFundBalancesEOYAmt
MissionThe Fanny Allen Corporation provides support and grants to other not-for-profit organizations in Vermont that serve the poor and the most needy.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$306,417ExpenseAmt
Grant$305,658GrantAmt
Revenue$0RevenueAmt
DescThe Fanny Allen Corporation provides support and grants to other not-for-profit organizations in Vermont that serve the poor and the most needy.Desc
Total Program Service Expenses$306,417TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Stephen W Forney Treasurer SVPCFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9786546363PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 Ames Pond Drive No 102AddressLine1Txt
CityTewksburyCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01876ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
Stephen Grubbs
Director1.0043.00Yes (X)$0$712,592$31,007
Stephen W Forney
Chair, Treasurer, SVP/CFO3.0042.00Yes (X)$0$155,201$7,108Yes (X)
Jennifer Archambault
Director1.000.00Yes (X)$0$0$0
Thomas Barritt
Director1.000.00Yes (X)$0$0$0
Tracy Huntington
Director1.000.00Yes (X)$0$0$0
Ellen Kane
Director1.000.00Yes (X)$0$0$0
Peter Moino
Director1.000.00Yes (X)$0$0$0
Maureen O'Reilly
Director1.000.00Yes (X)$0$0$0
Christine Werneke
Director3.001.00Yes (X)$0$0$0Yes (X)
Heidi St Peter
Secretary1.000.00Yes (X)$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$867,793TotReportableCompRltdOrgAmt
Total Other Compensation$38,115TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$685,487TotalRevenueColumnAmt
Exclusion$685,487ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$685,487TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$685,487ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$305,658TotalAmt
Program Services$305,658ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$759TotalAmt
Program Services$759ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$306,417TotalAmt
Program Services$306,417ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$195,787BOYAmt
EOY$166,956EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$6,601,622BOYAmt
EOY$8,400,353EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,990,288BOYAmt
EOY$1,621,783EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$8,787,697BOYAmt
EOY$10,189,092EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,667EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,667EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,843,681BOYAmt
EOY$8,243,409EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,944,016BOYAmt
EOY$1,944,016EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,787,697BOYAmt
EOY$10,187,425EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,787,697BOYAmt
EOY$10,189,092EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$379,070ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$820,658NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$200,000OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Covenant Health IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN222484505EIN
Organization Type10OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported OrgYes (1)SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990, Schedule A, Part IV, Section A, Line 6:FormAndLineReferenceDesc
ExplanationThe Organization makes grants to certain unrelated organizations consistent with the mission of Covenant Health Inc., which is to provide health and human services-assistance in the manner consistent with the Healing Ministry of Jesus Christ in the Roman Catholic Church. The Organization was organized to operate exclusively for the benefit of, to perform the functions of, or to carry out the purposes of Covenant Health, Inc., other organizations within or affiliated with the Covenant Health System that are exempt as 501(c)(3) public charities under Section 501(a)(1) or 509(a)(2), and/or other organizations that are exempt as 501(c)(3) public charities under Section 501(a)(1) or 509(a)(2). But for the existence of Fanny Allen Corporation, Covenant Health, Inc. would be responsible for making grants to the Organizations provided grants by Fanny Allen Corporation.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,944,016BeginningYearBalanceAmt
End Year Balance$1,944,016EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,944,016BeginningYearBalanceAmt
End Year Balance$1,944,016EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,944,016BeginningYearBalanceAmt
End Year Balance$1,944,016EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,944,016BeginningYearBalanceAmt
End Year Balance$1,944,016EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,944,016BeginningYearBalanceAmt
End Year Balance$1,944,016EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.29920PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.70080TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescInvestment in Providentia Prima TrustDesc
Book Value$8,400,353BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$8,400,353TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescSplit interest restricted fundsDesc
Book Value$1,621,783BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,621,783TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationCovenant and its member organizations are considered not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code, except as noted below. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The System has evaluated the position taken on its filed tax returns. The System has concluded no uncertain income tax positions exist at December 31, 2019.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (32 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
Vermont Catholic Charities Inc
55 Joy DriveSouth BurlingtonVT05403030181216501(c)(3)$20,000General program support
Faith In Action Northern Communities Partnership
PO Box 157CabotVT05647208406050501(c)(3)$15,000General program support
Community Health Center of Burlington
617 Riverside AvenueBurlingtonVT05401237182584501(c)(3)$13,750General program support
Open Door Clinic
100 Porter DriveMiddleburyVT05753030359531501(c)(3)$13,000Community Health Services of Addison County
Charter House Coalition
PO Box 344E MiddleburyVT05740562531802501(c)(3)$12,126General program support
Samaritan House
24 Kingman StreetSaint AlbansVT05478030330331501(c)(3)$12,000General program support
Sara M Holbrook Community Center
PO Box 3039BurlingtonVT05408030179595501(c)(3)$10,000General program support
Camp Agape Vermont
PO Box 8283EssexVT05451263990854501(c)(3)$10,000General program support
Addison County Community Action Group (dba HOPE)
282 Broadman Street Suite 1AMiddleburyVT05753237393720501(c)(3)$10,000General program support
John W Graham Emergency Shelter Service Inc
69 Main StreetVergennesVT05491032575219501(c)(3)$10,000General program support
Joint Urban Ministry Project (aka JUMP)
38 South Winooski AvenueBurlingtonVT05401202055113501(c)(3)$10,000General program support
The Janet S Munt Family Room
20 Allen StreetBurlingtonVT05401815449524501(c)(3)$10,000General program support
Spectrum Inc (aka Spectrum Youth & Family Services)
31 Elmwood AvenueBurlingtonVT05401030253232501(c)(3)$10,000General program support
Vermont FoodBank
33 Parker RoadBarreVT05641223021942501(c)(3)$10,000General program support
Upper Valley Haven Inc
713 Hartford AvenueWhite River JunctionVT05001030277908501(c)(3)$10,000General program support
ANEW PLACE Inc
PO Box 1481BurlingtonVT05402030287599501(c)(3)$10,000General program support
Dismas of Vermont
103 East Allen StreetWinooskiVT05404030369442501(c)(3)$10,500Burlington Dismas House
Lund Family Center Inc
PO Box 4009BurlingtonVT05406030179434501(c)(3)$9,500General program support
Pathways Vermont
125 College Street 2nd FloorBurlingtonVT05401300604758501(c)(3)$9,500General program support
Boys & Girls Club of Burlington
62 Oak StreetBurlingtonVT05401030179307501(c)(3)$9,250General program support
Martha's Kitchen
PO Box 1561St AlbansVT05478030290790501(c)(3)$8,000General program support
Burlington Children's Space
241 N Winooski AvenueBurlingtonVT05401222533646501(c)(3)$7,500General program support
Green Mountain Habitat for Humanity
300 Cornerstone Drive Suite 335WillstonVT05495222558923501(c)(3)$7,500General program support
Greater Burlington YMCA Inc
298 College StreetBurlingtonVT05401030185810501(c)(3)$7,500General program support
Our Community Cares Camp
PO Box 503RichmondVT05477264398448501(c)(3)$7,500General program support
Vermont Youth Conservation Corps Inc
1949 East Main StreetRichmondVT05477030328834501(c)(3)$7,500General program support
Camp Exclamation Point Inc
PO Box 91RichmondVT05477030329568501(c)(3)$6,000General program support
Vermonts Camp Ta-Kum-Ta
PO Box 459South HeroVT05486030362578501(c)(3)$5,000General program support
University of Vermont Medical Center
111 Colchester AvenueBurlingtonVT05401030219309501(c)(3)$5,000Fletcher Allen Health Care, LeRoyrer Employee Assistance Fund
Prevent Child Abuse - Vermont (aka PCAVT)
PO Box 829MontpelierVT05601030267183501(c)(3)$5,000General program support
Champlain Valley Office of Economic Opportunity
PO Box 1603BurlingtonVT05402030216837501(c)(3)$10,000General program support
Vermont Works for Women
32A Mallets Bay AvenueWinooskiVT05404222894557501(c)(3)$4,000General program support
FieldValueIRS element (for citing)
Total501c3 Org32Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationRepresentatives of Fanny Allen Corporation interview potential grantee organizations that are seeking donations from the Corporation prior to issuing any grants. The Corporation also monitors the grantee organization by receiving and reviewing outcome reports from each grantee in order to ensure all grants and awards are properly utilized and accounted for.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Stephen Grubbs
Director$0$691,522$0$0$0$21,070$0$2,800$0$28,207$0$743,599$0$0
Stephen W Forney
Chair, Treasurer, SVP/CFO$0$154,719$0$0$0$482$0$0$0$7,108$0$162,309$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3Any compensation paid to the trustees, directors, officers or key employees of the Organization is subject to the oversight and decisions of Covenant Health, a related tax-exempt organization. Every two-to-three years the Compensation Committee of the Covenant Health Board of Directors engages an external consultant to provide competitive market data from various survey sources, which is then used to develop recommendations for changes to the compensation program. Since 2003, the Compensation Committee has engaged a human resources consultant to conduct this analysis. Objectives of the analysis are to assess the compositeness of the total cash compensation levels of the senior leadership team, develop market based competitive salary ranges for all executive positions, and ensure that the annual incentive opportunities, if there are any, are competitive and reasonable.
Part I, Line 4bCovenant Health, Inc., a related organization and sole member of Fanny Allen Corporation, maintains a supplemental executive retirement program for certain executives under which the related organization makes a contribution for the benefit of its executive that is intended to provide a specified level of retirement benefits at a retirement age that is commensurate with the retirement benefits provided to other executives in comparable positions with similarly situated organizations. Amounts contributed to the program are held for the benefit of the executive until he or she reaches age 60, at which time the benefits are released to the executive. The full amount is taxable to the executive when so paid, and is included in the executive's reportable compensation. Mr. Stephen Grubbs participated in this program during the tax year and $19,000 has been included in Schedule J, Part II, Column B(iii) relative to this program.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6Covenant Health, Inc. is the sole corporate member of the Organization.
Form 990, Part VI, Section A, line 7aAs the sole corporate member of the Organization, Covenant Health, Inc. retains the ability to elect and remove the Organization's board of directors with or without cause.
Form 990, Part VI, Section A, line 7bAs the sole corporate member of the Organization, Covenant Health, Inc. has the following powers and rights over the Organization and its subsidiaries as outlined in the Organization's bylaws: 1. To approve any change in the written statements of philosophy and mission; 2. To amend and to repeal the organizing and governing documents; 3. To elect the Board of Directors or remove them with or without cause; 4. To appoint and remove the president; 5. To ratify the Board of Director's election of the Chair of the Board; 6. To approve all plans of merger, consolidation, reorganization, dissolution, or the sale, lease assignment, or transfer of substantially all of the assets, or the purchase or acquisition of an interest in any corporation, partnership, joint venture, or other entity; 7. To approve all long-range strategic plans before implementation; 8. To approve the acquisition, sale, or encumberance of any real estate valued in excess of an amount set by the Member in writing; 9. To approve all capital budgets and non-budgeted expeness in excess of an amount set by the Member in writing; 10. To approve all debt in excess of limits set by the Member in writing; 11. To appoint the auditors; 12. To approve the sale, assignment, or transfer of any equity interest or membership interest in any subsidiary; 13. To approve any reclassification or other change of any capital stock or other equity security; and, 14. To approve the issuance of, or the creation of any obligation to issue, any equity security.
Form 990, Part VI, Section B, line 11bThe Form 990 is provided to the governing body for their review and approval prior to filing.
Form 990, Part VI, Section B, line 12cThis process is the responsibility of the Compliance Officer. A conflict of interest disclosure form is submitted to all leadership, board members, board committee members, employed physicians, medical directors and certain employees in key positions annually to be completed. Reminders are sent to all persons of interest to ensure that all conflict of interest disclosure forms are completed and collected.
Form 990, Part VI, Section B, line 15Any compensation paid to the trustees, directors, officers or key employees of the Organization is subject to the oversight and decisions of Covenant Health, a related tax-exempt organization. Every two-to-three years the Compensation Committee of the Covenant Health Board of Directors engages an external consultant to provide competitive market data from various survey sources, which is then used to develop recommendations for changes to the compensation program. Since 2003, the Compensation Committee has engaged a human resources consultant to conduct this analysis. Objectives of the analysis are to assess the compositeness of the total cash compensation levels of the senior leadership team, develop market based competitive salary ranges for all executive positions, and ensure that the annual incentive opportunities, if there are any, are competitive and reasonable.
Form 990, Part VI, Section C, line 19The Organization's Form 990, governing documents, conflict of interest policy, and financial statements are made available to the public upon request. The Organization's Form 990 is also made available on the website of its parent organization, Covenant Health, at the following web address: https://www.covenanthealth.net/financial-information/financial-information
Form 990, Part XI, line 9:Transfers from affiliates 200,000.
Form 990, Part XII, Line 2c:The audit process has not changed from the previous year.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (38 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Youville Lifecare Inc
1575 Cambridge StreetCambridgeMA02138042103582Hospital and health care facilityMA501(c)(3)Line 10Covenant Health Inc0
St Joseph Manor Health Care
215 Thatcher StreetBrocktonMA02302042565937Nursing home and restorative facilityMA501(c)(3)Line 10Covenant Health Inc0
St Mary's Health System
PO Box 7291LewistonME04243222504349Hospital and health care facilityME501(c)(3)Line 12a, ICovenant Health Inc0
St Joseph's Hospital of Nashua NH Inc
172 Kinsley StreetNashuaNH03061020222215Hospital and health care facilityNH501(c)(3)Line 3Covenant Health Inc0
Youville Place
10 Pelham RoadLexingtonMA02421043297834Assisted living servicesMA501(c)(3)Line 10Covenant Health Inc0
St Mary's Villa Nursing Home Inc
675 St Marys Villa RoadMoscowPA18444232057177Nursing home and restorative facilityPA501(c)(3)Line 10Covenant Health Inc0
CHS of Waltham Inc dba Maristhill Nursing & Rehab Center
66 Newton StreetWalthamMA02453043333609Nursing home and restorative facilityMA501(c)(3)Line 10Covenant Health Inc0
CHS of Worcester Inc dba St Mary Care Center
39 Queen StreetWorchesterMA01610043419625Nursing home and restorative facilityMA501(c)(3)Line 10Covenant Health Inc0
Fanny Allen Holdings Inc
790 College ParkwayColchesterVT05446030181052Real estate holding companyVT501(c)(3)Line 12a, ICovenant Health Inc0
St Andre Health Care
407 Pool StreetBiddefordME04005010342399Nursing home and restorative facilityME501(c)(3)Line 10Covenant Health Inc0
MI Nursing Restorative Center Inc
172 Lawrence StreetLawrenceMA01841042104851Nursing home and restorative facilityMA501(c)(3)Line 10Covenant Health Inc0
Helping Hands of St Marguerite Inc
799 Concord AvenueCambridgeMA02138800199674Private home-care health servicesMA501(c)(3)Line 10Covenant Health Inc0
Providentia Prima Trust
420 Bedford StreetLexingtonMA02420046835128Investment trustMA501(c)(3)Line 12a, ICovenant Health Inc0
Youville House Inc
1573 Cambridge StreetCambridgeMA02138043239593Assisted living servicesMA501(c)(3)Line 10Youville Lifecare Inc0
Youville Hospital and Rehabilitation Center Inc
1575 Cambridge StreetCambridgeMA02138043239563Hospital and health care facilityMA501(c)(3)Line 10Youville Lifecare Inc0
St Mary's Regional Medical Center
PO Box 7291LewistonME04243010211551Hospital and health care facilityME501(c)(3)Line 3St Mary's Health System0
Community Clinical Services
PO Box 7291LewistonME04243010409788Physician practiceME501(c)(3)Line 10St Mary's Health System0
St Mary's D'Youville Pavilion
PO Box 7291LewistonME04243010211558Nursing home and restorative facilityME501(c)(3)Line 10St Mary's Health System0
St Mary's Residences
PO Box 7291LewistonME04243222504356Low income housingME501(c)(3)Line 10St Mary's Health System0
Neighborhood Housing Initiative
PO Box 7291LewistonME04243010539730Affordable housing servicesME501(c)(3)Line 10St Mary's Health System0
Souhegan Nursing Association
24 North River RoadMilfordNH03055020222795Home health and hospiceNH501(c)(3)Line 10St Joseph Hospital of Nashua NH Inc0
The Surgicenter at St Joseph Hospital Inc
172 Kinsley StreetNashuaNH03061020222215Healthcare and surgery centerNH501(c)(3)Line 10St Joseph Hospital of Nashua NH Inc0
MI Management Inc
172 Lawrence StreetLawrenceMA01841042857794Assisted living servicesMA501(c)(3)Line 12a, ICovenant Health Inc0
MI Adult Day Health Care Center Inc
189 Maple StreetLawrenceMA01841042921888Adult day care servicesMA501(c)(3)Line 10Covenant Health Inc0
MI Residential Community Inc
189 Maple StreetLawrenceMA01841042647207HUD low income housingMA501(c)(3)Line 10Covenant Health Inc0
MI Residential Community II Inc
189 Maple StreetLawrenceMA01841042679954HUD low income housingMA501(c)(3)Line 10Covenant Health Inc0
MI Residential Community III Inc
189 Maple StreetLawrenceMA01841042186043HUD low income housingMA501(c)(3)Line 10Covenant Health Inc0
MI Transportation Inc
189 Maple StreetLawrenceMA01841042921889Elderly transportation servicesMA501(c)(3)Line 10Covenant Health Inc0
Mary Immaculate Guild Inc
172 Lawrence StreetLawrenceMA01841463073987Supporting grants and donationsMA501(c)(3)Line 12a, ICovenant Health Inc0
St Joseph Healthcare Foundation
360 BroadwayBangorME04402222480149Healthcare foundationME501(c)(3)Line 10Covenant Health Inc0
St Joseph Hospital
360 BroadwayBangorME04402010212435Hospital and health care facilityME501(c)(3)Line 3St Joseph Healthcare Foundation0
M & J Company
360 BroadwayBangorME04402222480150Lease holding companyME501(c)(2)St Joseph Healthcare Foundation0
St Joseph Ambulatory Care Inc
360 BroadwayBangorME04402222480373Physician practiceME501(c)(3)Line 10St Joseph Healthcare Foundation0
Alternative Health Services
360 BroadwayBangorME04402010422885Home health and hospiceME501(c)(3)Line 10St Joseph Healthcare Foundation0
Mount St Rita Health Centre
15 Sumner Brown RoadCumberlandRI02864050342330Nursing homeRI501(c)(3)Line 10Covenant Health Inc0
Penacook Place Inc
150 Water StreetHaverhillMA01830237090088Nursing homeMA501(c)(3)Line 10Covenant Health Inc0
Covenant Health Inc
100 Ames Pond DriveTewksburyMA01876222484505Health care management and resource organizationMA501(c)(3)Line 100N/A
Covenant Health Foundation Inc
100 Ames Pond DriveTewksburyMA01876800199674Charitable foundationMA501(c)(3)Line 12a, ICovenant Health Inc0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLegal Domicile StateLegalDomicileStateCd
Covenant Health Insurance LTD
PO Box 69Grand CaymanCJKY1-1102043360127Self-insurance companyCJN/AC0
Campus Holding
010406049Holding companyN/AC0PO box 7291LewistonME04240ME
St Joseph Corporate Services Inc
020405197Holding companyN/AC0172 Kinsley StreetNashuaNH03060NH
Strauss Incorporated
010391369Repairs and transcriptionsN/AC0360 BroadwayBangorME04402ME
GNM Corporation
020400550Real estate holding companyN/AC0172 Kinsley StreetNashuaNH03060NH
SJ Physicians Services
020522234Physician practiceN/AC0172 Kinsley StreetNashuaNH03060NH
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

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