2023-11-13T14:00:34-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 4334 MUNSON STREET SUITE 200 CANTON OH 44718 990 2022-01-01 200837361 D'YOUVILLE SENIOR LIVING INC DYOU 9785691000 979 VARNUM AVENUE LOWELL MA 01854 MICHAEL FERRICK CEO 9785691000 2023-11-12 1 MICHAEL FERRICK 999009999 0 JENNIFER COLEMAN P00743188 3304972000 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z MICHAEL FERRICK 979 VARNUM AVENUE LOWELL MA 01854 238871 0 X WWW.DYOUVILLE.ORG X 2002 MA FOUNDED BY THE SISTERS OF CHARITY OF OTTAWA AND SPONSORED BY THE CARMELITE SISTERS FOR THE AGED AND INFIRM, D'YOUVILLE LIFE AND WELLNESS COMMUNITY CONTINUES THE HEALING MINISTRY OF JESUS CHRIST BY IDENTIFYING AND RESPONDING TO THE NEEDS OF THE COMMUNITY WITH PROFESSIONAL AND COMPASSIONATE CARE IN A HOME LIKE SETTING. 6 5 0 5 0 0 109474 103998 124643 130987 7 8 5200 3878 239324 238871 0 0 0 0 83067 114437 0 0 0 248668 229235 331735 343672 -92411 -104801 2390482 2287940 3574309 3576568 -1183827 -1288628 X FOUNDED BY THE SISTERS OF CHARITY OF OTTAWA AND SPONSORED BY THE CARMELITE SISTERS FOR THE AGED AND INFIRM, D'YOUVILLE LIFE AND WELLNESS COMMUNITY CONTINUES THE HEALING MINISTRY OF JESUS CHRIST BY IDENTIFYING AND RESPONDING TO THE NEEDS OF THE COMMUNITY WITH PROFESSIONAL AND COMPASSIONATE CARE IN A HOME LIKE SETTING. 0 0 280024 134865 THE ORGANIZATION FURTHERS THE HEALING MINISTRY OF JESUS CHRIST BY EXTENDING PROFESSIONAL AND COMPASSIONATE CARE TO SENIORS IN NEED THROUGH PROVIDING AFFORDABLE HOUSING TO QUALIFIED PERSONS. THIS THOUGHTFULLY AND BEAUTIFULLY DESIGNED FACILITY CONTAINS A 22-UNIT APARTMENT BUILDING THAT ALLOW RESIDENTS TO ENJOY THE PRIVACY OF THEIR OWN HOME WITHIN A CARING, COMPASSIONATE, AND SERVICE-RICH SETTING. 280024 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 5 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MA X CORRINNE SCHINDLER 5185377500 646 WOODS ROAD GERMANTOWN NY 12526 X NAOMI PRENDERGAST PRESIDENT/ CEO 1.00 39.00 X X 0 323081 13481 JOSEPH CLERMONT ESQ MEMBER 1.00 4.00 X 0 0 0 WILLIAM GROGAN CLERK 1.00 1.00 X X 0 0 0 MOTHER MARY ROSE HEERY OCARM MEMBER 1.00 11.00 X 0 0 0 MIKE MCCAFFREY MEMBER 1.00 1.00 X 0 0 0 SISTER MARK LOUIS RANDALL MEMBER 1.00 12.00 X 0 0 0 STEVE LAROCHELLE CHAIRPERSON 1.00 1.00 X X 0 0 0 0 323081 13481 0 0 1 0 0 103998 103998 RESIDENT SERVICES REVENUE 623000 130987 130987 130987 8 8 LAUNDRY INCOME 623990 3488 3488 OTHER INCOME 623990 390 390 3878 238871 134865 0 8 90707 87656 3051 542 232 310 22233 21485 748 955 923 32 18191 18191 19167 8840 10327 176 176 2420 2420 5292 4741 551 26526 26526 823 741 82 102677 92409 10268 16709 15038 1671 REPAIRS AND MAINTENANCE 15456 13934 1522 SUPPLIES 2934 2934 DUES AND SUBSCRIPTIONS 905 905 17959 2145 15814 343672 280024 63648 0 62923 22484 72640 85358 4042130 1885630 2244623 2156500 10296 23598 2390482 2287940 10828 24712 3481311 3482134 82170 69722 3574309 3576568 X -1183827 -1288628 -1183827 -1288628 2390482 2287940 -104801 0 X 1 X 1 X 1 1 1 X 120853 115259 111894 109474 103998 561478 106602 106700 113590 124643 130987 582522 227455 221959 225484 234117 234985 1144000 0 0 0 1144000 14 11 10 7 8 50 14 11 10 7 8 50 3605 3363 2951 5200 3878 18997 231074 225333 228445 239324 238871 1163047 0.98360 0.98390 0.00000 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3648978 1506796 2142182 393152 378834 14318 2156500 TENANT SECURITY DEPOSITS 10297 DUE TO RELATED PARTIES 59425 69722 X 238871 0 238871 0 238871 343672 0 343672 0 343672 PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION FOLLOWS THE PROVISIONS OF THE INCOME TAX ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. IT IS THE ORGANIZATION'S POLICY TO ACCOUNT FOR ANY INTEREST OR PENALTIES ASSESSED RELATING TO UNCERTAIN TAX POSITIONS, IF ANY, AS ADMINISTRATIVE EXPENSES. THE ORGANIZATION DID NOT INCUR ANY INTEREST OR PENALTIES FOR THE YEARS ENDED DECEMBER 31, 2022 OR 2021. THE APPLICATION OF THESE PROVISIONS HAS NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. 0 0 0 0 0 0 0 0 0 NAOMI PRENDERGAST PRESIDENT/ CEO 0 323081 0 0 0 0 0 6632 0 6849 0 336562 0 0 PART I, LINE 3 THE ORGANIZATION'S COMPENSATION IS ESTABLISHED BY D'YOUVILLE LIFE AND WELLNESS COMMUNITY, INC. A RELATED PARTY. COMPENSATION IS DETERMINED BY THE FOLLOWING: 1. COMPENSATION COMMITTEE 2. FORM 990 OF OTHER ORGANIZATIONS 3. COMPENSATION SURVEY/STUDY 4. APPROVAL BY THE BOARD OF DIRECTORS/COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION'S MANAGEMENT DUTIES ARE PERFORMED BY A RELATED ORGANIZATION, D'YOUVILLE SENIOR CARE, INC. D'YOUVILLE SENIOR CARE, INC. PROVIDES MANAGEMENT AND ADMINISTRATIVE SUPPORT SERVICES WHICH INCLUDE MANAGEMENT OVERSIGHT, BUSINESS OFFICE FUNCTIONS, HUMAN RESOURCES, MARKETING, INFORMATION TECHNOLOGY, ADMISSIONS, AND MAINTENANCE FUNCTIONS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION SHALL BE THE CARMELITE SYSTEM, INC., A NEW YORK NOT-FOR-PROFIT CORPORATION (THE "MEMBER"). THE SPONSOR OF THE CORPORATION IS THE CARMELITE SISTERS FOR THE AGED AND INFIRM, INC. (THE "SPONSOR"). THE PRIORESS GENERAL AND FOUR MEMBERS OF THE GENERAL COUNCIL OF THE SPONSOR SHALL EXERCISE THE PREROGATIVES OF THE SPONSOR, AS THE MEMBERS OF THE CARMELITE SYSTEM, INC. WITH SPECIFIED RESERVED POWERS REGARDING THE CARMELITE SYSTEM, INC. AND THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A TWO DIRECTORS SHALL BE MEMBERS OF THE GENERAL COUNCIL OF THE SPONSOR AND SHALL BE APPOINTED BY THE CHAIR OF THE SPONSOR. IN ADDITION, THE SPONSOR SHALL APPOINT A CARMELITE SISTER TO SERVE AS A "SPONSOR'S REPRESENTATIVE" WHO WILL ALSO SERVE AS A DIRECTOR. THE PRESIDENT/CEO SHALL SERVICE AS A DIRECTOR, EX OFFICIO. ALL REMAINING DIRECTORS SHALL BE ELECTED BY THE MEMBER AT THE MEMBER'S ANNUAL MEETING. UNTIL THE TRANSITION DATE, THE MEMBER SHALL NAME ONE OR MORE MEMBERS OF THE SISTERS OF CHARITY WHO ARE RECOMMENDED BY THE BOARD TO SERVE AS DIRECTORS. NOTHWITHSTANDING ANYTHING HEREIN TO THE CONTRARY, AT LEAST A MAJORITY OF THE DIRECTORS OF THE CORPORATION SHALL BE PERSONS WHO ALSO SERVE AS DIRECTORS OF D'YOUVILLE SENIOR CARE, INC. OR D'YOUVILLE TRANSITIONAL CARE, INC. FORM 990, PART VI, SECTION A, LINE 7B THE SPONSOR HAS THE FOLLOWING POWERS AND RIGHTS REGARDING THE CORPORATION AND, WHERE INDICATED, THE SUBSIDIARY CORPORATIONS: (A) APPROVE ANY AMENDMENTS OF THE ARTICLES OF INCORPORATION OF THE BY-LAWS OF THE CORPORATION AND ANY AMENDMENT OF THE ARTICLES OF INCORPORATION OR BY-LAWS OF ANY SUBSIDIARY CORPORATION; (B) APPROVE NEW ENTITIES OF WHICH THE CORPORATION AND ANY SUBSIDIARY CORPORATION IS A MEMBER, STOCKHOLDER, PARTNER, JOINT VENTURE OR TRUSTEE, OR IN WHICH IT OTHERWISE HAS AN EQUITY INTEREST; (C) REQUIRE THE CORPORATION AND ANY SUBSIDIARY CORPORATION TO ENTER INTO A CONTRACT TO MANAGE ALL OR PART OF ANY OTHER ENTITY, OR TO BE MANAGED, IN WHOLE OR IN PART, BY ANY OTHER ENTITY, EXCEPT THAT THE SPONSORSHALL REQUIRE SUCH ACTION ONLY WHEN NECESSARY TO ENSURE COMPLIANCE WITH THE MISSION AND PHILOSOPHY OF THE CORPORATION; (D) APPROVE THE ACQUISITION, SALE, LEASE, PLEDGE, MORTGAGE OR OTHER ENCUMBRANCE OR DISPOSITION OF ASSETS OF THE CORPORATION AND ANY SUBSIDIARY CORPORATION THAT EXCEEDS IN VALUE A LIMIT SET BY THE MEMBER; (E) APPROVE AMEND ANY PLAN OF MERGER, CONSOLIDATION OR REORGANIZATION OF THE CORPORATION STRUCTURE, CORPORATION, ORGANIZATION OR PROGRAM, OF THE DISSOLUTION OF THE CORPORATION AND ANY SUBSIDIARY CORPORATION; (F) APPROVE ANY CHANGE THE FUNDAMENTAL NATURE OF THE CORPORATION AND ANY SUBSIDIARY CORPORATION AFFECTING ITS MISSION AND PHILOSOPHY; (G) APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION, PROVIDED THAT ANY TERMINATION OR CHANGE IN THE CORPORATION'S CHIEF EXECUTIVE OFFICER SHALL NOT BE EFFECTED WITHOUT PRIOR GOOD FAITH CONSULTATION WITH THE BOARD OF DIRECTORS OF THE CORPORATION AND FURTHER PROVIDED THAT THE BOARD OF DIRECTORS SHALL ALSO HAVE A MEANINGFUL ROLE IN THE RECRUITMENT AND EVALUATION OF CANDIDATES FOR THE CHIEF EXECUTIVE OFFICER; (H) APPROVE ANY CHANGE IN LICENSURE, LEVEL OF CARE, BED CAPACITY AND TYPES OF SERVICE OF THE CORPORATION AND ANY SUBSIDIARY CORPORATION IN CONFORMANCE WITH THE MISSION AND PHILOSOPHY OF THE CORPORATION AND ANY SUBSIDIARY CORPORATIONS AND THE DIRECTIVES; AND (I) SELECT A MEMBER OF THE GENERAL COUNCIL OF THE SPONSOR TO SERVE AS ONE OF THE DIRECTORS ELECTED BY THE CORPORATION TO SERVE AS A DIRECTOR OF D'YOUVILLE ELDERLY HOUSING CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE COMMITTEE REPORTS TO THE BOARD OF DIRECTORS REGARDING THE REVIEW OF THE FORM 990. A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH EMPLOYEE IS GIVEN THE CONFLICT OF INTEREST POLICY AT ORIENTATION AND IS REQUIRED TO REVIEW THIS POLICY ON AN ON-GOING BASIS. DIRECTORS ARE GIVEN THE POLICY AT ORIENTATION AND REVIEW CHANGES AS THEY OCCUR. THE POLICY COVERS ALL EMPLOYEES AND BOARD MEMBERS AND POTENTIAL CONFLICTS ARE REVIEWED BY MANAGEMENT ON AN ON-GOING BASIS TO ASSURE COMPLIANCE. IDENTIFIED ISSUES ARE DISCUSSED AT THE BOARD LEVEL AND AN APPROPRIATE COURSE OF ACTION IS TAKEN BASED ON THE VIOLATION. TO PREVENT TRADE CONFLICT, ALL MATERIAL EXPENDITURES NEED A MINIMUM OF THREE BIDS FROM CONTRACTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII: D'YOUVILLE SENIOR LIVING, INC. EMPLOYEES ARE PAID BY A RELATED ENTITY, D'YOUVILLE LEADERSHIP SOLUTIONS, INC. (EIN 27-4675543). THE SALARIES AND RELATED EXPENSES FOR THESE EMPLOYEES ARE ALLOCATED BACK TO D'YOUVILLE SENIOR LIVING, INC.. D'YOUVILLE ELDERLY HOUSING CORPORATION 975 VARNUM AVENUE LOWELL MA 01854 043536564 LOW-INCOME SENIOR HOUSING MA 501(C)(3) LINE 10 PLANNING OFFICE FOR URBAN AFFAIRS INC 0 D'YOUVILLE LEADERSHIP SOLUTIONS INC 981 VARNUM AVENUE LOWELL MA 01854 274675543 MANAGEMENT COMPANY MA 501(C)(3) LINE 12B, II CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 D'YOUVILLE LIFE & WELLNESS COMMUNITY INC 981 VARNUM AVENUE LOWELL MA 01854 274675379 SUPPORT SERVICES MA 501(C)(3) LINE 12B, II CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 D'YOUVILLE SENIOR CARE FOUNDATION INC 981 VARNUM AVENUE LOWELL MA 01854 912055004 FUNDRAISING MA 501(C)(7) LINE 12B, II CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 D'YOUVILLE SENIOR CARE INC 981 VARNUM AVENUE LOWELL MA 01854 042510563 SENIOR CARE MA 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 D'YOUVILLE TRANSITIONAL CARE INC 1071 VARNUM AVENUE LOWELL MA 01854 271680453 SHORT-TERM REHAB MA 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 SISTERS OF CHARITY OF OTTAWA 245 UNIVERSITY AVENUE LOWELL MA 01854 042127030 SCHOOL - GRADES K-8 MA 501(C)(3) LINE 1 N/A 0 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 600 WOODS ROAD GERMANTOWN NY 12526 141369151 LONG TERM HEALTHCARE MINISTRY NY 501(C)(3) LINE 10 N/A 0 CARMEL MANOR INC 100 CARMEL MANOR ROAD FT THOMAS KY 41075 610523290 SKILLED NURSING FACILITY KY 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 CARMEL TERRACE INC 933 CENTRAL STREET FRAMINGHAM MA 01701 043210051 ASSISTED LIVING FACILITY MA 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 KAHL HOME FOR THE AGED AND INFIRM 6701 JERSEY RIDGE ROAD DAVENPORT IA 52807 420760833 SKILLED NURSING FACILITY IA 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 LOURDES FOUNDATION INC 315 SOUTH FLAGLER DRIVE WEST PALM BEACH FL 33401 592632080 FUNDRAISING FL 501(C)(3) LINE 12A, I CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE INC 315 SOUTH FLAGLER DRIVE WEST PALM BEACH FL 33401 590879342 SKILLED, ASSISTED AND INDEPENDENT LIVING FACILITY FL 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 MARIAN MANOR FOR THE AGED AND INFIRM INC 130 DORCHESTER STREET BOSTON MA 02127 042173054 SKILLED NURSING FACILITY MA 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 MOTHER ANGELINE MCCRORY MANOR INC 5199 EAST BROAD STREET COLUMBUS OH 43213 912134683 SKILLED NURSING FACILITY OH 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 MOUNT CARMEL CARE CENTER INC 320 PITTSFIELD ROAD LENOX MA 01240 383902709 SKILLED NURSING FACILITY MA 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 OZANAM HALL OF QUEENS NURSING HOME INC 42-41 201ST STREET BAYSIDE NY 11361 112167809 SKILLED NURSING FACILITY NY 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 ST MARGARET HALL INC 1960 MADISON ROAD CINCINNATI OH 45206 310655031 SKILLED AND ASSISTED LIVING FACILITY OH 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 ST PATRICK'S HOME FOR THE AGED AND INFIRM INC 66 VAN CORTLAND PARK SOUTH BRONX NY 10463 131740033 SKILLED NURSING FACILITY NY 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 ST PATRICK'S MANOR INC 863 CENTRAL STREET FRAMINGHAM MA 01701 042157057 SKILLED NURSING FACILITY MA 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 ST PATRICK'S RESIDENCE 1400 BROOKDALE ROAD NAPERVILLE IL 60563 362527011 SKILLED NURSING FACILITY IL 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 THE CARMELITE SYSTEM INC 646 WOODS ROAD GERMANTOWN NY 12526 141810368 MANAGEMENT NY 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 VILLAS AT ST THERESE INC 5253 EAST BROAD STREET COLUMBUS OH 43213 472021696 INDEPENDENT LIVING & ASSISTED LIVING FACILITY OH 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 TCIG INC 159 BANK STREET FOURTH FLOOR BURLINGTON VT 05401 872580182 INSURANCE COMPANY VT 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 0 0 0 1 1 0 0 0 0 0 0 0 1 1 1 1 1 0 0 SCHEDULE R, PART II: D'YOUVILLE SENIOR CARE FOUNDATION, INC. IS RECOGNIZED AS EXEMPT AS BEING A SUBORDINATE UNDER A GROUP EXEMPTION, AND ORIGINALLY QUALIFIED AS A PUBLIC CHARITY BY REASON OF BEING A SUPPORTING ORGANIZATION. D'YOUVILLE SENIOR CARE FOUNDATION, INC. BELIEVES THAT IT HAS QUALIFIED AS A PUBLICLY SUPPORTED ORGANIZATION UNDER SECTIONS 509(A)(1) AND 170(B)(1)(A)(VI) SINCE ITS FORMATION, AND INTENDS TO CORRECT INTERNAL REVENUE SERVICE RECORDS, INCLUDING BY THE FILING OF A FORM 8940 REQUESTING RECLASSIFICATION ACCORDINGLY.