SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
THE UNIVERSITY OF VERMONT MEDICAL CENTER
 
Employer identification number

03-0219309
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) UVM MEDICAL CTR SKILLED NURSING
111 COLCHESTER AVENUE
BURLINGTON,VT05401
03-0219309
HOLDING COMPANY VT 0 0 UVMMC
 
(2) UVMHN SPECIALTY CARE TRNSPT
111 COLCHESTER AVENUE
BURLINGTON,VT05401
03-0219309
AMBULANCE SVC VT -10,491,966 1,925,131 UVMMC
 
(3) UVM MEDICAL CTR EXEC SERVICES
111 COLCHESTER AVENUE
BURLINGTON,VT05401
03-0219309
EXEC STAFFING VT 0 0 UVMMC
 






Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)UVM HEALTH NETWORK MEDICAL GROUP INC
111 COLCHESTER AVENUE

BURLINGTON,VT05401
03-0225105
PHYSICIAN SVC VT 501(C)(3) 12A-I UVMHN
 
Yes
 
(2)UNIVERSITY OF VERMONT MED GROUP-NEW YORK
70 CONSTABLE STREET

MALONE,NY12953
20-3905216
PHYSICIAN SVC NY 501(C)(3) 3 UVMHNMG
 
Yes
 
(3)THE UNIVERSITY OF VERMONT MED CTR FDN INC
111 COLCHESTER AVENUE

BURLINGTON,VT05401
26-3159849
FUNDRAISING VT 501(C)(3) 12A-I UVMMC
 
Yes
 
(4)UVMMC AUXILLARY INC
111 COLCHESTER AVENUE

BURLINGTON,VT05401
20-8022004
SERVICE VT 501(C)(3) 12C-III-FI N/A
 
No
(5)UNIVERSITY OF VERMONT HEALTH NETWORK INC
111 COLCHESTER AVENUE

BURLINGTON,VT05401
45-2880726
HOLDING COMPANY VT 501(C)(3) 12A-I N/A
 
No
(6)CENTRAL VERMONT MEDICAL CENTER
130 FISHER ROAD

BERLIN,VT05602
22-2547186
HOSPITAL VT 501(C)(3) 3 UVMHN
 
Yes
 
(7)UNIVERSITY HEALTH CENTER
111 COLCHESTER AVENUE

BURLINGTON,VT05401
03-0229931
HOSPITAL VT 501(C)(3) 12C-III-FI UVMHNMG
 
Yes
 
(8)COMMUNITY PROVIDERS INC
75 BEEKMAN STREET

PLATTSBURGH,NY12901
22-2544844
HEALTH SVC COOR NY 501(C)(3) 12A-I UVMHN
 
Yes
 
(9)CHAMPLAIN VALLEY PHYSICIANS HOSPITAL
75 BEEKMAN STREET

PLATTSBURGH,NY12901
14-1338471
HOSPITAL NY 501(C)(3) 3 UVMHN
 
Yes
 
(10)ELIZABETHTOWN COMMUNITY HOSPITAL
75 PARK STREET

ELIZABETHTOWN,NY12932
14-1364513
HOSPITAL NY 501(C)(3) 3 UVMHN
 
Yes
 
(11)EMERGENCY MEDICAL TRANSPORT OF CVPH INC
75 BEEKMAN STREET

PLATTSBURGH,NY12901
06-1718419
AMBULANCE SVC NY 501(C)(3) 12B-II CPI
 
Yes
 
(12)CVPH MEDICAL CENTER FOUNDATION
75 BEEKMAN STREET

PLATTSBURGH,NY12901
14-1727048
HEALTH SVC COOR NY 501(C)(3) 12B-II CVPH
 
Yes
 
(13)UNIVERSITY MEDICAL EDUCATION ASSOCIATES
89 BEUMONT AVENUE

BURLINGTON,VT05405
23-7107832
EDUCATIONAL VT 501(C)(3) 10 UVMHNMG
 
Yes
 
(14)ALICE HYDE MEDICAL CENTER
133 PARK STREET

MALONE,NY12953
15-0346515
HOSPITAL NY 501(C)(3) 3 UVMHN
 
Yes
 
(15)PORTER MEDICAL CENTER INC
115 PORTER DRIVE

MIDDLEBURY,VT05753
03-0310862
SUPPORTING ORG VT 501(C)(3) 12-BII UVMHN
 
Yes
 
(16)HELEN PORTER NURSING HOME
37 PORTER DRIVE

MIDDLEBURY,VT05753
03-0306549
NURSING HOME VT 501(C)(3) 3 PMC
 
Yes
 
(17)AUXILIARY OF PORTER MEDICAL CENTER
37 PORTER DRIVE

MIDDLEBURY,VT05753
23-7363227
SUPPORTING ORG VT 501(C)(3) 12-B,II PMC
 
Yes
 
(18)PORTER HOSPITAL INC
37 PORTER DRIVE

MIDDLEBURY,VT05753
03-0181058
HOSPITAL VT 501(C)(3) 3 PMC
 
Yes
 
(19)UVMHN HOME HEALTHCARE & HOSPICE
1110 PRIM ROAD

COLCHESTER,VT05446
03-0179603
HOME HEALTHCARE VT 501(C)(3) 10 UVMHN
 
Yes
 
(20)LAKE CHAMPLAIN PHYSICIAN SERVICES PC
75 BEEKMAN STREET

PLATTSBURGH,NY12901
27-3785445
PHYSICIAN SVC NY 501(C)(3) 12A-I CVPH
 
Yes
 
(21)VMC INDEMNITY COMPANY INC
95 ST PAUL ST

BURLINGTON,VT05401
83-1102018
INSURANCE VT 501(C)(3) 12A-I UVMHN
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Page 2
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) ADIRONDACK ACO LLC

75 BEEKMAN STREET
PLATTSBURGH,NY12901
46-2840926
ACCOUNTABLE CARE NY N/A
        No     No  












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) UVMHN CREDENTIALING & ENROLLMENT

111 COLCHESTER AVENUE
BURLINGTON,VT05401
03-0333056
ADMIN SERVICE VT N/A
C       Yes  
(2) CHARITABLE REMAINDER TRUSTS (6)

 
 
SUPPORT VT N/A
T       Yes  
(3) PERPETUAL TRUSTS (10)

 
 
SUPPORT VT N/A
T       Yes  
(4) CHARITABLE IRREVOCABLE TRUSTS (8)

 
 
SUPPORT VT N/A
T       Yes  
(5) CHAMPLAIN VALLEY HEALTH NETWORK

75 BEEKMAN STREET
PLATTSBURGH,NY12901
16-1586102
ADMIN SERVICE NY N/A
C       Yes  
(6) MEDIQUEST INC

PO BOX 1656
PLATTSBURGH,NY12901
14-1663061
MED OFFICE LEASE NY N/A
C       Yes  
(7) UVMHN VENTURES INC

111 COLCHESTER AVENUE
BURLINGTON,VT05401
04-3380045
HOLDING COMPANY VT N/A
C       Yes  
(8) YANKEE MEDICAL INC

276 NORTH AVENUE
BURLINGTON,VT05401
03-0225363
HOME MEDICAL EQUIPMENT VT N/A
C       Yes  
Schedule R (Form 990) 2021
Page 3
Schedule R (Form 990) 2021
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
Yes
 
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) UNIVERSITY OF VERMONT MEDICAL GROUP

P 335,867,677 FMV
(2) VMCIC INC

M 6,998,402 FMV
(3) UNIVERSITY OF VERMONT HEALTH NETWORK HOME HEALTH AND HOSPICE

I 125,108 FMV
(4) UNIVERSITY OF VERMONT HEALTH NETWORK HOME HEALTH AND HOSPICE

Q 616,137 FMV
(5) PORTER MEDICAL CENTER INC

I 217,788 FMV
(6) PORTER MEDICAL CENTER INC

Q 18,911,596 FMV
(7) ADIRONDACK ACO LLC

Q 198,963 FMV
(8) ALICE HYDE MEDICAL CENTER

Q 17,014,596 FMV
(9) CENTRAL VERMONT MEDICAL CENTER

A 293,078 FMV
(10) CENTRAL VERMONT MEDICAL CENTER

I 730,973 FMV
(11) CENTRAL VERMONT MEDICAL CENTER

Q 37,466,283 FMV
(12) ELIZABETHTOWN COMMUNITY HOSPITAL

Q 6,799,565 FMV
(13) CHAMPLAIN VALLEY PHYSICIAN'S HOSPITAL

I 1,475,197 FMV
(14) CHAMPLAIN VALLEY PHYSICIAN'S HOSPITAL

Q 60,242,710 FMV
(15) UNIVERSITY OF VERMONT HEALTH NETWORK VENTURES INC

A 51,821 FMV
(16) YANKEE MEDICAL

A 1,565 FMV
(17) UNIVERSITY OF VERMONT HEALTH NETWORK

P 123,832,602 FMV
Schedule R (Form 990) 2021
Page 4
Schedule R (Form 990) 2021
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Page 5
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

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