4A (Expenses $ 728394296 including grants of $ 1156411) (Revenue $ 861137681)
OUTPATIENT SERVICES. FOR MORE INFORMATION, SEE SCHEDULE O.

4B (Expenses $ 517575425 including grants of $ 821712) (Revenue $ 611898945)
INPATIENT SERVICES. FOR MORE INFORMATION, SEE SCHEDULE O.

4C (Expenses $ 295733582 including grants of $ 469512) (Revenue $ 349628399)
PROFESSIONAL SERVICES. FOR MORE INFORMATION, SEE SCHEDULE O.

UNIVERSITY OF VERMONT MEDICAL CENTER
PART V, SECTION B, LINE 3J: THE CHNA CONDUCTED IN FY 2022 / TY 2021 CONTAINS INFORMATION AND ANALYSIS THAT EXTENDS BEYOND THE SUBJECTS DESCRIBED IN PART V, LINE 3, INCLUDING BUT NOT LIMITED TO: SECONDARY DATA SOURCES LISTING; KEY HEALTH AND WELLBEING INDICATORS AND THEIR SOURCES; A DESCRIPTION OF A NUMBER OF ONGOING PROGRAMS AND FUNDING THAT HAVE OCCURRED AS A RESULT OF THE CHNA PROCESS; AND UPDATES ON INITIATIVES RELATED TO THE PRIOR CHNA. AT PAGE 80, THE CHNA ALSO CONTAINS AN INDEX OF KEY SCHEDULE H REQUIREMENTS AND INFORMATION ABOUT WHERE THOSE ITEMS ARE ADDRESSED WITHIN THE CHNA.

UNIVERSITY OF VERMONT MEDICAL CENTER
"PART V, SECTION B, LINE 5: THE UNIVERSITY OF VERMONT MEDICAL CENTER (""UVMMC"") AND 37 MEMBERS OF THE 2022 CHNA STEERING COMMITTEE COLLABORATED ON THE 2022 CHNA FOR THE DESIGNATED HEALTH SERVICE AREA OF CHITTENDEN AND GRAND ISLE COUNTIES. THE STEERING COMMITEE MEMBERS INCLUDED REPRESENTATIVES FROM UVMMC AS WELL AS COMMUNITY PARTNERS SUCH AS COMMUNITY-BASED ORGANIZATIONS, LOCAL AND REGIONAL INSTITUTIONS, AND STATE AGENCIES INCLUDING: BUILDING BRIGHT FUTURES, LAKE CHAMPLAIN CHAMBER OF COMMERCE; VERMONT DEPARTMENT OF HEALTH; VERMONT AGENCY OF HUMAN SERVICES; ABENAKI NATION OF MISSISQUOI; CENTER FOR HEALTH & LEARNING; HUNGER FREE VERMONT; COMMUNITY HEALTH CENTERS OF BURLINGTON; CHAMPLAIN HOUSING TRUST; CITY OF BURLINGTON (RACIAL EQUITY, INCLUSION & BELONGING OFFICE); HOWARD CENTER; CHITTENDEN COUNTY REGIONAL PLANNING COMMISSION; SASH AT CATHEDRAL SQUARE; PRIDE CENTER OF VERMONT; WINOOSKI HIGH SCHOOL; US COMMITTEE FOR REFUGEES AND IMMIGRANTS VERMONT; VERMONT PUBLIC HEALTH INSTITUTE; UNITED WAY OF NORTHWEST VERMONT MERCY CONNECTIONS; CHAMPLAIN ISLANDERS DEVELOPING ESSENTIAL RESOURCES; MENTAL HEALTH FIRST BTV; CHAMPLAIN VALLEY SUPERINTENDENTS ASSOCIATION; ASSOCIATION OF AFRICANS LIVING IN VERMONT; AND THE CHAMPLAIN VALLEY OFFICE OF ECONOMIC OPPORTUNITY.THE CHNA PURSUED INPUT FROM PERSONS REPRESENTING BROAD INTERESTS OF THE COMMUNITY, INCLUDING BUT NOT LIMITED TO 32 INTERVIEWS WITH COMMUNITY LEADERS INCLUDING MEMBERS OF THE ABOVE-MENTIONED ORGANIZATIONS (JULY 2021); A COMMUNITY SURVEY COMPLETED BY 3,771 COMMUNITY MEMBERS ACROSS A WIDE RANGE OF BACKGROUNDS (SEPTEMBER AND OCTOBER 2021); 5 FOCUS GROUPS (NOVEMBER 2021), AND COMMUNITY HEALTH PRIORITY SESSIONS INVOLVING 140 PARTICIPANTS FROM 57 ORGANIZATIONS AND AGENCIES (JANUARY 2022). THE CHNA ALSO GATHERED SECONDARY DATA ON 70+ POPULATION-LEVEL HEALTH AND WELLBEING INDICATORS.TWO VIRTUAL SESSIONS WERE HELD IN JANUARY 2022 TO ENGAGE COMMUNITY LEADERS AND CHAMPIONS IN PRIORITIZING HEALTH PRIORITES THAT EMERGED FROM THE DATA GATHERING PHASE (NAMELY, ACCESSIBLE AND COORDINATED CARE, CULTURAL HUMILITY AND INCLUSIVE CARE, FOOD ACCESS AND SECURITY, HOUSING, MENTAL HEALTH AND WELLBEING, AND WORKFORCE DEVELOPMENT). 140 PARTICIPANTS FROM 57 DIFFERENT ORGANIZATIONS AND AGENCIES PARTICIPATED AND PROVIDED RATINGS BY THREE CRITERIA: IMPACT, COMMUNITY READINESS, AND EQUITY.THE DATA GATHERING AND COMMUNITY ENGAGEMENT ACTIVITIES PROVIDED INSIGHTS INTO THE UNIQUE EXPERIENCES AND PERSPECTIVES OF POPULATIONS WHO HAVE BEEN HISTORICALLY UNDER OR UNREPRESENTED. POPULATIONS OF FOCUS INCLUDED: BLACK, NATIVE AMERICAN, AND PEOPLE OF COLOR; PEOPLE WHO ARE NON-BINARY, GENDERQUEER, FLUID, AND TRANSGENDER; PEOPLE WITH LIMITED ENGLISH PROFICIENCY (LEP); PEOPLE WITH DISABILITIES; PEOPLE WHO ARE LGBTQ+; OLDER ADULTS OVER 65 YEARS OF AGE; REFUGEES & NEWLY IMMIGRATED INDIVIDUALS; PEOPLE EXPERIENCING POVERTY OR LOWER SOCIO-ECONOMIC STATUS; AND YOUTH."

UNIVERSITY OF VERMONT MEDICAL CENTER
PART V, SECTION B, LINE 6B: THE 2022 CHNA PROJECT TEAM INCLUDED MEMBERS OF THE UVMMC, COMMUNITY BENEFITS TEAM AS WELL AS THE REPRESENTATIVES FROM THE CENTER FOR RURAL STUDIES AT THE CENTRAL VERMONT. AS DISCUSSED ABOVE, THE CHNA PROJECT WAS ALSO GUIDED BY A STEERING COMMITTEE THAT INCLUDED MEMBERS OF COMMUNITY-BASED ORGANIZATIONS, LOCAL AND REGIONAL INSTITUTIONS, AND STATE AGENCIES INCLUDING: BUILDING BRIGHT FUTURES, LAKE CHAMPLAIN CHAMBER OF COMMERCE; VERMONT DEPARTMENT OF HEALTH; VERMONT AGENCY OF HUMAN SERVICES; ABENAKI NATION OF MISSISQUOI; CENTER FOR HEALTH & LEARNING; HUNGER FREE VERMONT; COMMUNITY HEALTH CENTERS OF BURLINGTON; CHAMPLAIN HOUSING TRUST; CITY OF BURLINGTON (RACIAL EQUITY, INCLUSION & BELONGING OFFICE); HOWARD CENTER; CHITTENDEN COUNTY REGIONAL PLANNING COMMISSION; SASH AT CATHEDRAL SQUARE; PRIDE CENTER OF VERMONT; WINOOSKI HIGH SCHOOL; US COMMITTEE FOR REFUGEES AND IMMIGRANTS VERMONT; VERMONT PUBLIC HEALTH INSTITUTE; UNITED WAY OF NORTHWEST VERMONT MERCY CONNECTIONS; CHAMPLAIN ISLANDERS DEVELOPING ESSENTIAL RESOURCES; MENTAL HEALTH FIRST BTV; CHAMPLAIN VALLEY SUPERINTENDENTS ASSOCIATION; ASSOCIATION OF AFRICANS LIVING IN VERMONT; AND THE CHAMPLAIN VALLEY OFFICE OF ECONOMIC OPPORTUNITY.

UNIVERSITY OF VERMONT MEDICAL CENTER
PART V, SECTION B, LINE 11: THE UNIVERSITY OF VERMONT MEDICAL CENTER'S CHNA IDENTIFIED THE FOLLOWING PRIORITIES AND SETS OUT ACTION PLANS FOR EACH PRIORITY WITH TOP STRATEGIES AS DISCUSSED BELOW. ACCESSIBLE AND COORDINATED CARE- EXPAND ACCESS BEYOND TRADITIONAL HOURS AND REDUCE WAIT TIMES- IMPROVE COORDINATION OF CARE- ADDRESS BARRIERS TO TREATMENT SUCH AS COMMUNICATION AND TRANSPORTATION LIMITATIONSCULTURAL HUMILITY AND INCLUSIVE HEALTH CARE: - INCREASE PROVIDER COMPETENCIES TO BETTER SERVE DIVERSE PATIENTS- ESTABLISH TRUSTING RELATIONSHIPS WITH HISTORICALLY MARGINALIZED COMMUNITIES- INVEST IN LANGUAGE ACCESS SERVICES, INCLUDING MEDICALLY TRAINED INTERPRETERSFOOD ACCESS AND SECURITY- INCREASE FOOD ACCESS AND MEAL DELIVERY PROGRAMS INCLUDING CULTURALLY APPROPRIATE FOODS AND SUPPORTING PROGRAMS FOR CHILDREN- IMPLEMENT FOOD SECURITY SCREENINGS AND REFERRAL PROCESSES- INCREASE ACCESS TO LOCAL GROWERS AND PROGRAMS THAT REDIRECT SURPLUS FOODHOUSING:- EXPAND WRAP AROUND SERVICES FOR PEOPLE IN PERMANENT AND AFFORDABLE HOUSING- PROMOTE CULTURAL HUMILITY TRAINING FOR HOUSING SERVICES PROVIDERS- DECREASE THE GAP IN LIVABLE WAGES AND HOUSING AFFORDABILITYMENTAL HEALTH AND WELLBEING:- SUPPORT CULTURAL CENTERS AND COMMUITY GATHERING SPACES- ENGAGE WITH YOUTH TO UNDERSTAND THEIR NEEDS AND INCREASE RESOURCES AVAILABLE FOR THEM- INTEGRATE MENTAL HEALTH SERVICES INTO ALL PEDIATRIC AND PRIMARY CARE CLINICSWORKFORCE DEVELOPMENT- ADDRESS WAGE GAPS IN EDUCATION AND HELPING PROFESSIONS- DIVERSIFY WORKFORCE AND INCREASE INVESTMENTS IN GROUPS ADRESSING SOCIAL DETERMINANTS OF HEALTH- ADDRESS COST AND HOUSING STOCK LIMITATIONS THAT ARE A BARRIER TO RECRUITMENT AND RETENTIONFOR EACH ENGAGEMENT WHEREIN COMMUNITY MEMBERS PARTICIPATED, A SURVEY WAS SHARED THAT ASKED PARTICIPANTS TO IDENTIFY THE TOP PRIORITIES. BASED ON COMMUNITY IMPUT, THE PRIORITIES THAT ADVANCED TO THE UVMMC BOARD WERE INCLUSIVE CARE, HOUSING, AND MENTAL HEALTH AND WELLBEING. THE IMPLEMENTATION STRATEGY FOCUSES ON THESE TOP PRIORITIES, BUT INCLUDES COMMITMENTS RELATED TO THE REMAINING PRIORITIES WHERE THERE WAS DETERMINED TO BE A CLOSE RELATIONSHIP FOR EXAMPLE, THE IMPLEMENTATION STRATEGY CONTAINS COMMITMENTS RELATED TO HOUSING ON THE WORKFORCE AND WORKFORCE DEVELOPMENT, AS WELL AS COMMITMENTS RELATED TO COORDINATED HEALTH CARE THAT ARE GEARED TOWARD PROMOTING INCLUSIVITY IN HEALTH CARE. THE UVM MEDICAL CENTER'S STRATEGIES, INITIATIVES, AND FINANCIAL OUTLAYS TO PROMOTE THE PRIORITIES IDENTIFIED IN THE CHNA, AS WELL AS COMMUNITY HEALTH IN GENERAL, EXTEND BEYOND THE COMMITMENTS THAT ARE DISCUSSED IN THE IMPLEMENTATION STRATEGY. PRIORITIES AND INITIATIVES THAT WERE NOT IDENTIFIED AS TOP PRIORITIES BY COMMUNITY PARTICIPANTS CONTINUE TO GUIDE THE ACTIONS AND STRATEGIES OF FULL-TIME STAFF DEVOTED TO COMMUNITY BENEFIT. ADDITIONALLY, FINDINGS, DATA AND OTHER INFORMATION FROM THE CHNA CAN BE USED BY COMMUNITY PARTNERS TO DRIVE STRATEGY, GUIDE INVESTMENTS, AND INFORM DECISIONS.

UNIVERSITY OF VERMONT MEDICAL CENTER
PART V, SECTION B, LINE 16J: IN ADDITION TO POSTING OUR GUIDELINES AND PLAIN LANGUAGE SUMMARY ONLINE, AT THE TIME OF SERVICE, REGISTRATION AND CHECK-IN STAFF PROVIDE A COPY OF THE PLAIN LANGUAGE SUMMARY TO ALL PATIENTS WHO HAVE OR WILL HAVE A BALANCE AND TO THOSE WHO EXPRESS FINANCIAL HARDSHIP. ADDITIONALLY, PLAIN LANGUAGE SUMMARIES ALONG WITH RACK CARDS REFERENCING OUR ASSISTANCE PROGRAM ARE PLACED IN ALL REGISTRATION WAITING ROOMS. FROM REGISTRATION, PATIENTS ARE ROUTINELY REFERRED TO OUR FINANCIAL ADVOCACY DEPARTMENT OR COMMUNITY HEALTH IMPROVEMENT. BOTH AREAS PROVIDE KNOWLEDGE AND ASSISTANCE IN THE APPLICATION PROCESS FOR CHARITY AND OTHER APPLICABLE FUNDING SOURCES. ADVOCATES ACTIVELY EDUCATE ALL INPATIENT, OBSERVATION AND OUTPATIENT INVASIVE SERVICE PATIENTS OF OUR PROGRAM, PRIOR TO OR CONCURRENT WITH THE PATIENTS' STAY, SUBSEQUENTLY AIDING IN THE APPLICATION PROCESS FOR STATE AID AND UVM MEDICAL CENTER'S FINANCIAL PROGRAM.

UNIVERSITY OF VERMONT MEDICAL CENTER
PART V, SECTION B, LINE 20E: (ALSO APPLICABLE TO LINE 20A) THE UNIVERSITY OF VERMONT MEDICAL CENTER'S BAD DEBT POLICY PROVIDES THAT UVMMC SHALL NOT TAKE ANY EXTRAORDINARY COLLECTION ACTIONS.

PART V, SECTION B, LINES 7A AND 10A: HOSPITAL FACILITY'S WEBSITE
HTTPS://WWW.UVMHEALTH.ORG/MEDCENTER/ABOUT-UVM-MEDICAL-CENTER/THE-COMMUNITY/NEEDS-ASSESSMENT

PART V, SECTION B, LINE 15E
"WHILE THE ASSISTANCE POLICY DOES NOT PROVIDE A LIST OF ""EXTERNAL"" CONTACT INFORMATION FOR NON UVM MEDICAL CENTER PARTIES OR AGENCIES WHO MAY ASSIST PATIENTS IN THE APPLICATION PROCESS, APPLICATION COMPLETION AID IS WELL PUBLISHED WITH MULTIPLE INTERNAL, ORGANIZATIONAL AND UVM MEDICAL CENTER COMMUNITY HEALTH ASSISTANCE TEAM MEMBERS AVAILABLE TO ASSIST OUR PATIENTS. IT IS ALSO IMPORTANT TO NOTE, PATIENTS ARE REVIEWED IN ADVANCE OF SERVICE FOR POTENTIAL HARDSHIP; THE UNINSURED AND UNDERINSURED PATIENTS WHO ARE IDENTIFIED ARE ACTIVELY COUNSELED WITH HELP FOR GOVERNMENT AND EXCHANGE PROGRAMS AS WELL AS ASSISTANCE IN THE UVM MEDICAL CENTER FINANCIAL ASSISTANCE PROGRAM."

PART V, LINES 16A-16C: FINANCIAL ASSISTANCE POLICY RESOURCES
"THE FINANCIAL ASSISTANCE POLICY (""FAP""), THE FAP APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE UVMMC FINANCIAL ASSISTANCE WEBPAGE LOCATED AT: HTTPS://WWW.UVMHEALTH.ORG/MEDCENTER/PATIENTS-AND-VISITORS/BILLING-INSURANCE-AND-REGISTRATION/FINANCIAL-ASSISTANCE"

PART I, LINE 3C:
"ELIGIBILITY FOR FINANCIAL ASSISTANCE WILL BE CONSIDERED FOR THOSE INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR ANY GOVERNMENT HEALTH CARE BENEFIT PROGRAM. TO QUALIFY FOR FINANCIAL ASSISTANCE, AN ELIGIBLE PATIENT MUST PASS BOTH AN INCOME AND ASSETS TEST. INCOME IS SET AT A MAXIMUM OF 400% OF FEDERAL POVERTY LEVEL GUIDELINES (""FPLG"") AND THE ASSETS TEST IS SET AT $50,000 LIQUID ASSETS, AS FURTHER DEFINED AND DESCRIBED IN THE POLICY. ASSISTANCE IS GRANTED BASED UPON THE PATIENT'S INCOME FPLG. PATIENTS MUST RESIDE WITHIN THE UNIVERSITY OF VERMONT MEDICAL SERVICE AREA, UNLESS MEDICAL SERVICES WERE URGENT OR EMERGENT IN NATURE. FINANCIAL ASSISTANCE FOR RESIDENTS OUTSIDE OF THE UVMMC SERVICE AREA WILL BE GRANTED ONLY IN UNIQUE CIRCUMSTANCES AND WITH APPROPRIATE APPROVAL."

PART I, LN 7 COL(F):
THE PROVISION FOR BAD DEBT INCLUDED ON FORM 990, PART IX, LINE 25 BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE AMOUNT REPORTED ON LINE 7(F) IS $0. ALL PATIENT RELATED BAD DEBT IS SHOWN AS A DEDUCTION FROM PATIENT REVENUE. A VERY SMALL PORTION OF BAD DEBT ATTRIBUTABLE TO NON-PATIENTS IS INCLUDED IN LINE 24E OF THE STATEMENT OF FUNCTIONAL EXPENSES.

PART I, LINE 7
UVM MEDICAL CENTER UTILIZED ITS COST ACCOUNTING SYSTEM TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE ON LINE 7, AS WELL AS LYON SOFTWARE'S COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS, INCLUDING, BUT NOT LIMITED TO, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED AND SELF PAY. THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS ALSO UTILIZED FOR SOME OF THE FIGURES REPORTED IN THE TABLE ON LINE 7.THE UNIVERSITY OF VERMONT MEDICAL CENTER'S ANNUAL MEDICAID PROVIDER TAX IS ASSESSED ON VERMONT ACUTE CARE HOSPITALS BY THE STATE OF VERMONT. THE TAX ASSESSMENT IS CALCULATED AS 6% OF A HOSPITAL'S BASE YEAR NET PATIENT CARE REVENUE.

PART III, LINE 2:
UVM MEDICAL CENTER'S FINANCIAL STATEMENTS INCLUDE A FOOTNOTE DESCRIBING BAD DEBT EXPENSE. RECEIVABLES ARE REPORTED NET OF AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE PROVISION FOR PATIENT RELATED BAD DEBTS IS REPORTED AS A DEDUCTION FROM GROSS REVENUE. THIS EXPENSE IS DETERMINED AS A PERCENTAGE OF GROSS PATIENT SERVICE REVENUE BASED ON ACTUAL WRITE-OFF HISTORY, REVIEWED ON A QUARTERLY BASIS AND ADJUSTED ON A SEMI-ANNUAL BASIS.

PART III, LINE 3:
"DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE NETTED AGAINST THE TOTAL GROSS CHARGES WHEN DETERMINING BAD DEBT EXPENSE. THE $363,307 REFLECTS THE ADJUSTED BAD DEBT EXPENSE FOR ALL PATIENTS WHO SUBMITTED AN INITIAL APPLICATION, BUT UPON FOLLOW-UP, DID NOT RESPOND TO REQUESTS FOR ADDITIONAL INFORMATION OR SUPPORTING DOCUMENTATION. UVM MEDICAL CENTER HAS A DATABASE WHICH TRACKS ALL APPLICATIONS AND THEIR STATUS; A QUERY EXTRACTED ALL INCOMPLETE/NON RESPONSIVE ARCHIVED APPLICATIONS PROVIDING A LIST OF PATIENTS & DEPENDENTS. SUBSEQUENTLY, A QUERY OF ASSOCIATED PATIENT SERVICES FROM 10/1/21-9/30/22 FOR ""SELF-PAY AND COLLECTION ACCOUNTS WAS EXTRACTED FROM THE BILLING SYSTEM.UVM MEDICAL CENTER ATTEMPTS TO ENSURE THAT CONSPICUOUS DISPLAY OF OUR FINANCIAL ASSISTANCE POLICY APPEARS THROUGHOUT OUR FACILITY."

PART III, LINE 4:
THE ORGANIZATION'S BAD DEBT EXPENSE IS ADDRESSED ON PAGE 26 IN FOOTNOTE 4 OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS.

PART III, LINE 8:
THE AMOUNT REPORTED IN PART III, LINE 6, MEDICARE ALLOWABLE COSTS OF CARE, IS DERIVED FROM UVM MEDICAL CENTER'S FYE 9/30/22 MEDICARE COST REPORT, WORKSHEET D-1, COMPUTATION OF INPATIENT OPERATING COSTS, WORKSHEET E PART B, CALCULATION OF OUTPATIENT SETTLEMENT, AND WORKSHEET I-4, COMPUTATION OF AVERAGE COST PER TREATMENT FOR OUTPATIENT RENAL DIALYSIS. WHILE UVM MEDICAL CENTER HAS HISTORICALLY FOLLOWED THE CATHOLIC HOSPITAL ASSOCIATION'S GUIDANCE AND HAS NOT CONSIDERED ANY MEDICARE SHORTFALL (REPORTED IN PART III, LINE 7) AS A COMMUNITY BENEFIT, IT IS LIKELY THAT SOME PORTION OF MEDICARE PATIENTS WOULD HAVE QUALIFIED FOR CHARITY CARE UNDER OUR POLICIES IN THE ABSENCE OF MEDICARE COVERAGE, SUCH THAT SHORTFALLS ASSOCIATED WITH THOSE PATIENTS WOULD OTHERWISE HAVE BEEN INCLUDED IN OUR COMMUNITY BENEFITS.

PART III, LINE 9B:
THE UVM MEDICAL CENTER CREDIT AND COLLECTIONS POLICY IS DETACHED IN TERMS OF WHETHER PATIENTS QUALIFY FOR ASSISTANCE. INVOICES OF PATIENTS WHO DO QUALIFY OR ARE KNOWN TO QUALIFY WILL NOT AGE TO COLLECTIONS AND ARE NOT PURSUED. BALANCES THAT REMAIN UNPAID AFTER THE APPROPRIATE DISCOUNT HAS BEEN ADJUSTED WILL AGE TO COLLECTIONS.AN EXTENSION OF UP TO 120 DAYS CAN BE GRANTED IN THE COLLECTION AGENCY WINDOW WHEN PATIENTS APPLY AND ARE APPROVED FOR ASSISTANCE WITHIN THE APPLICATION WINDOW.THE COLLECTION PROCESS IN PLACE AT UVM MEDICAL CENTER INCLUDES GENERATION OF MONTHLY STATEMENTS, FOLLOWED BY A PRE-COLLECTION LETTER OVER THE COURSE OF 120 DAYS. IN THE CASE OF UNDELIVERABLE MAIL, EFFORTS WILL BE MADE TO REACH THE PATIENT BY TELEPHONE. IF A NEW BILLING ADDRESS IS OBTAINED, THE 120 DAY WINDOW WILL BEGIN AGAIN. IF NO CONTACT CAN BE MADE AND PAYMENT IS NOT RECEIVED WITHIN THE REVISED 120 DAY WINDOW, THE ACCOUNT WILL BE REFERRED TO A COLLECTION AGENCY. IF CONTACT IS MADE, THE PATIENT WILL BE OFFERED A BUDGET PLAN. ALL STATEMENTS, LETTERS AND CONTACT WILL INCLUDE THE FACT THAT FINANCIAL ASSISTANCE IS AVAILABLE.

SCHEDULE H PART V:
IN ADDITION TO THE FACILITIES OPERATED BY THE UNIVERSITY OF VERMONT MEDICAL CENTER, INC. (UVM MEDICAL CENTER) LISTED IN SECTION A AND SECTION D, UVM MEDICAL CENTER OPERATES 30 ADDITIONAL CLINIC SITES AROUND ITS SERVICE AREA. EACH OF THESE SITES IS COVERED UNDER THE UVM MEDICAL CENTER HOSPITAL LICENSE. ALL LISTED OR NON-LISTED FACILITIES OPERATED BY UVM MEDICAL CENTER OR ITS SUBSIDIARIES FOLLOW ALL OF THE SAME POLICIES AND PROCEDURES AS THE UVM MEDICAL CENTER.

PART VI, LINE 4:
COMMUNITY INFORMATION: UVM MEDICAL CENTER IS BOTH A COMMUNITY HOSPITALAND, IN PARTNERSHIP WITH THE UNIVERSITY OF VERMONT, THE STATE'S ONLYACADEMIC MEDICAL CENTER. IN ITS COMMUNITY HOSPITAL ROLE, UVM MEDICALCENTER SERVES 175,616 RESIDENTS IN CHITTENDEN AND GRANDISLE COUNTIES. THESE COUNTIES REPRESENT THE FASTEST AND THE THIRD FASTEST GROWING POPULATIONS IN THE STATE. CHITTENDEN COUNTY CONTINUES TO BE THE MOST RACIALLY AND ETHNICALLY DIVERSE COUNTY IN VERMONT.1 IN 8 RESIDENTS IN CHITTENDEN AND GRAND ISLE COUNTIES ARE BELOW THE FEDERAL POVERTY LEVEL. MEDIAN HOUSEHOLD INCOMES HAVE INCREASED ACROSS THE HEALTH SERVICE AREA, YET DISPARITIES REMAIN BY RACE AND ETHNICITY AND SEX. THE OVERALL HIGH SCHOOL GRADUATION RATE IS 94% YET DISPARITIES ARE EVIDENT BY RACE AND ETHNICITY.

PART VI, LINE 5:
"PROMOTION OF COMMUNITY HEALTH: UVM MEDICAL CENTER IS GOVERNED BY A BOARD OF COMMUNITY VOLUNTEERS FROM ITS SERVICE AREA, INCLUDING ITS PRIMARY, SECONDARY AND TERTIARY REFERRAL REGION. THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT AND NOT DIRECTLY AFFILIATED WITH THE ORGANIZATION. UVM MEDICAL CENTER'S MEDICAL STAFF IS AN ""OPEN STAFF"" MODEL WITH MEMBERSHIP GOVERNED BY THE MEDICAL STAFF'S BY-LAWS, AND INCLUDES APPROXIMATELY 720 EMPLOYED PHYSICIANS AND 170 COMMUNITY-BASED PHYSICIANS. AS A NON-PROFIT, ANY SURPLUS FUNDS GENERATED BY UVM MEDICAL CENTER ARE RE-INVESTED IN THE ORGANIZATION TO SUPPORT ITS MISSION. PLEASE SEE SCHEDULE O FOR A MORE DETAILED DESCRIPTION OF UVM MEDICAL CENTER'S ROLE IN ITS REGIONAL HEALTH CARE SYSTEM AND COMMUNITY BENEFIT ACTIVITIES."

PART VI, LINE 2:
UVM MEDICAL CENTER OFFERS FREE TO THE COMMUNITY A WIDE RANGE OF HEALTH, PREVENTION AND WELLNESS PROGRAMS, ALL OF WHICH ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITY AND LIMIT THE NEED FOR MORE EXPENSIVE ACUTE CARE. IN CONJUNCTION WITH THE UNIVERSITY OF VERMONT, THE ORGANIZATION OPERATES THE FRYMOYER COMMUNITY HEALTH RESOURCE CENTER, WHICH OFFERS FREE, PERSONALIZED ASSISTANCE TO HELP COMMUNITY MEMBERS FIND INFORMATION ABOUT MEDICAL CONDITIONS, HEALTHIER LIFESTYLE HABITS, AND MAKE INFORMED HEALTHCARE DECISIONS. ADDITIONALLY, THE UVM MEDICAL CENTER PARTNERS WITH A NUMBER OF COMMUNITY HEALTH RESOURCE GROUPS, INCLUDING THE UNITED WAY, THE VISITING NURSE ASSOCIATION, THE HOWARD CENTER AND THE COMMUNITY HEALTH CENTER TO ADDRES THE NEEDS OF VERMONT AND NORTHERN NEW YORK RESIDENTS. A MORE COMPREHENSIVE LIST OF HEALTH, WELLNESS AND SAFETY PROGRAMS CONDUCTED BY OR IN CONJUCTION WITH UVM MEDICAL CENTER IS AVAILABLE AT HTTPS://WWW.UVMHEALTH.ORG/MEDCENTER/DEPARTMENTS-AND-PROGRAMS/COMMUNITY-HEALTH-IMPROVEMENT.

PART VI, LINE 3:
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: UVM MEDICAL CENTERUTILIZES A VARIETY OF METHODS TO INFORM, EDUCATE AND ASSIST PATIENTS INIDENTIFYING PAYMENT SOURCES, INCLUDING STATE / FEDERAL PROGRAMS AS WELLAS OUR PATIENT ASSISTANCE PROGRAM.INFORM & EDUCATE:PATIENT EDUCATION IS PROVIDED ACROSS THE CONTINUUM OF CARE. PATIENTBENEFIT ADVISORS, FINANCIAL ADVOCATES, REGISTRARS, CASE MANAGERS, SOCIALWORKERS AND CUSTOMER SERVICE REPRESENTATIVES ACTIVELY INFORM AND EDUCATE PATIENTS ON THE PROGRAM, GUIDELINES, REQUIREMENTS FROM:- PRE-ARRIVAL SCREENING/REGISTRATION TO POINT OF SALE EDUCATION ATREGISTRATION- AT THE BEDSIDE OF AN INPATIENT OR OBSERVATION PATIENT- AFTER DISCHARGE WITH CONTINUED FOLLOW-UP BY FINANCIAL ADVOCATES AND- DURING THE SELF-PAY BILLING FOLLOW-UP PROCESS.PATIENTS ARE INFORMED OF THE PROGRAM, APPLICATIONS AND ASSISTANCE WITHCOMPLETION ARE PROVIDED WITH FINANCIAL ADVOCATES ALSO PROVIDING EDUCATIONAND ASSISTANCE FOR MEDICAID AND HEALTH INFORMATION EXCHANGE PROGRAMS,ALONG WITH ASSISTANCE IN APPLYING FOR THE UVM MEDICAL CENTER FINANCIALASSISTANCE PROGRAM. PATIENTS ARE ROUTINELY REFERRED TO ADVOCATES ANDADVISORS IN ADVANCE OF SERVICE WITH ADVOCATES ACTIVELY ASSISTING PATIENTSWHO ARE ADMITTED TO THE ORGANIZATION URGENTLY OR EMERGENTLY. POLICIES,SUMMARIES AND APPLICATIONS ARE AVAILABLE AT ALL REGISTRATION LOCATIONS,THEY ARE REFERENCED IN ALL INTERVIEW PROCESSES AND FURTHER AVAILABLE INTHE WAITING AREAS. OUR ORGANIZATIONAL WEBSITES PROVIDE EDUCATION, APPLICATIONS, POLICIES, SUMMARIES, FAQ DOCUMENTS ALONG WITH CONTACTINFORMATION AS A PASSIVE MEANS OF COMMUNICATION IN ADDITION TO THE ACTIVEEDUCATION REFERENCED PREVIOUSLY. OUR BILLING STATEMENTS REFLECTFINANCIAL ASSISTANCE HELP AND OUR COMMUNITY BENEFIT TEAM EDUCATE WITHINTHE COMMUNITY ON OUR PROGRAMS. APPLICATIONS AND INFORMATION AREADDITIONALLY AVAILABLE IN THE LOCAL COMMUNITY HEALTH CENTERS.ASSIST:- ALL INPATIENT AND OUTPATIENT PROCEDURES ARE FINANCIALLY SCREENED TOIDENTIFY THE UNDERINSURED OR UNINSURED PATIENT POPULATION. PRIOR TOSERVICE, CONCURRENT WITH SERVICE AND POST SERVICE, OUR PATIENT FINANCIALCOUNSELORS WILL CALL AND/OR MEET WITH PATIENTS AND FAMILIES TO EDUCATETHEM ON THE AVAILABLE PROGRAMS AND WHERE APPLICABLE, ASSIST IN THEAPPLICATION PROCESS. THIS INCLUDES STATE AND FEDERAL AID APPLICATIONS ANDTHE UVM MEDICAL CENTER CHARITY APPLICATION PROCESS.- OUR FINANCIAL COUNSELORS/ADVOCATES HAVE BEEN CERTIFIED AS ASSISTERS INTHE STATE OF VT AND WILL ADDITIONALLY AID PATIENTS IN THE APPLICATIONPROCESS FOR HEALTH EXCHANGE INSURANCE, MEDICAID AND THE FINANCIAL ASSISTANCE PROGRAMS. COUNSELORS WILL ADDITIONALLY MEET WITH PATIENTS ATTHE BEDSIDE TO HELP COMPLETE THE APPLICATIONS, PROVIDE DETAILS ONSUPPORTING DOCUMENTATION NEEDS AND FACILITATE AND EXPEDITE THE REVIEWPROCESS UNTIL A NOTICE OF DECISION HAS BEEN RECEIVED.- OUR COMMUNITY HEALTH IMPROVEMENT OFFICE PROVIDES EDUCATION AND APPLICATION ASSISTANCE FOR A VARIETY OF PROGRAMS, INCLUDING THE STATE AND FEDERAL MEDICAID APPLICATION PROCESS, THE PATIENT ASSISTANCE PROGRAM APPLICATION (CHARITY) AS WELL AS ASSIST WITH FINANCIAL ASSISTANCE TO PATIENTS FOR PHARMACEUTICALS. PROCESSES HAVE BEEN ESTABLISHED TO REFER URGENT CARE AND EMERGENCY DEPARTMENT PATIENTS TO THE PROGRAM, WHERE CASE MANAGERS ASSIST IN BOTH THE APPLICATION PROCESS AND COMMUNITY RESOURCE NEEDS IDENTIFICATION. ADDITIONALLY, THE CASE MANAGERS RECEIVE AND REVIEW REPORTS FOR THE UNINSURED EMERGENCY PATIENTS WHO HAVE FREQUENTED THE EMERGENCY DEPARTMENT MORE THAN 1 TIME PER MONTH. THE MANAGERS WILL THEN REACH OUT TO THE PATIENTS, SEEKING TO ASSIST PATIENTS IN IDENTIFYING FINANCIAL SPONSORSHIP.

PART VI, LINE 6:
AFFILIATED HEALTH CARE SYSTEM: AS OF OCTOBER 1, 2011, THE UNIVERSITY OF VERMONT MEDICAL CENTER, INC. (UVM MEDICAL CENTER) AND THE UNIVERSITY OF VERMONT HEALTH NETWORK-CENTRAL VERMONT MEDICAL CENTER, INC. (UVM HEALTH NETWORK-CENTRAL VERMONT MEDICAL CENTER), BECAME MEMBERS OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, (UVM HEALTH NETWORK), AN INTEGRATED SYSTEM OF CARE SERVING THE COMMUNITIES OF VERMONT AND NORTHERN NEW YORK. ON JANUARY 1, 2013 UVM HEALTH NETWORK BECAME THE SOLE MEMBER OF COMMUNITY PROVIDERS, INC. (CPI), THE SOLE MEMBER OF CHAMPLAIN VALLEY PHYSICIANS HOSPITAL (CVPH), ELIZABETHTOWN COMMUNITY HOSPITAL (ECH) AND ALICE HYDE MEDICAL CENTER (AHMC). ON APRIL 1, 2017, UVM HEALTH NETWORK BECAME THE SOLE MEMBER OF PORTER MEDICAL CENTER, INC. ON JANUARY 1, 2018 UVM HEALTH NETWORK ALSO BECAME THE SOLE MEMBER OF UVM HEALTH NETWORK HOME HEALTH & HOSPICE. UVM HEALTH NETWORK IS CARRYING OUT CENTRALIZED ACTIVITIES FOR THE BENEFIT OF PATIENTS OF ALL PARTNER ORGANIZATIONS, INCLUDING IMPROVING ACCESS TO LOCAL CARE, COST SAVINGS THROUGH GREATER JOINT PURCHASING POWER, ENHANCING INFORMATION TECHNOLOGY, INCREASING ACADEMIC OPPORTUNITIES FOR PHYSICIANS, ENGAGING IN REGIONAL STRATEGIC PLANNING, AND PARTICIPATING IN JOINT QUALITY AND CLINICAL INITIATIVES, AND COLLABORATIVE EFFORTS. UVM MEDICAL CENTER REGULARLY PARTNERS WITH OTHER ORGANIZATIONS AND PROVIDERS TO HELP MEET THE NEEDS OF ITS COMMUNITY. THIS INCLUDES WORKING WITH OTHER ORGANIZED SYSTEMS OF CARE (LIKE HOME HEALTH AGENCIES, OTHER VERMONT HOSPITALS, AND PHYSICIAN PRACTICES), AS WELL AS COMMUNITY-BASED ORGANIZATIONS WHOSE MISSIONS ARE SIMILAR TO OURS. FOR EXAMPLE, UVM MEDICAL CENTER COLLABORATES WITH COMMUNITY PARTNERS TO REGULARLY ASSESS COMMUNITY AND HEALTH CARE NEEDS, WHICH HELPS GUIDE OUR ORGANIZATION'S PRIORITIES. PLEASE READ FORM 990 PART III NARRATIVE IN SCHEDULE O FOR ADDITIONAL INFORMATION ON THE UVM MEDICAL CENTER'S INTERACTIONS IN AND WITH ITS COMMUNITY.

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THE UNIVERSITY OF VERMONT MEDICAL, INC. FILES A COMMUNITY BENEFIT REPORT WITH THE STATE OF VERMONT.