2025-11-14T09:13:39-06:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 4334 MUNSON STREET SUITE 200 CANTON OH 44718 990 2024-01-01 042510563 D'YOUVILLE SENIOR CARE INC DYOU 9785691000 981 VARNUM AVENUE LOWELL MA 01854 MICHAEL FERRICK CEO 9785691000 2025-11-08 1 1 JENNIFER COLEMAN P00743188 3304972000 2024 2025-03-06 01:10:19Z MICHAEL FERRICK 981 VARNUM AVENUE LOWELL MA 01854 28609763 0 X WWW.DYOUVILLE.ORG X 1960 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. 16 15 0 31 0 0 119808 576491 24412523 25663341 357314 472169 212460 459668 25102105 27171669 0 0 0 0 15784387 16280941 0 0 1221 11050698 10215861 26835085 26496802 -1732980 674867 21566945 20499541 16250436 14037226 5316509 6462315 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 24201183 26123009 SENIOR CARE - THE ORGANIZATION FURTHERS THE HEALING MINISTRY OF JESUS CHRIST BY EXTENDING PROFESSIONAL AND COMPASSIONATE CARE TO SENIORS IN NEED THROUGH THE OPERATION OF A 208-BED SKILLED NURSING FACILITY. THE FACILITY'S CLINICIANS ARE PROFESSIONALS WHO ARE DEDICATED TO THE WELL-BEING AND HEALTH OF THEIR RESIDENTS. 24201183 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 1 36 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 16 15 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 MA X CORRINNE SCHINDLER 5185377500 646 WOODS ROAD GERMANTOWN NY 12526 X STEVEN LAROCHELLE CHAIR 1.00 3.00 X X 0 0 0 SR THERESA MARIE PFEFFER PRESIDENT 1.00 14.00 X X 0 0 0 MOTHER MARY ROSE HEERY VICE PRESIDENT 1.00 10.00 X X 0 0 0 CAROL HOWARD VICE CHAIRPERSON 1.00 5.00 X X 0 0 0 JERRY FRECHETTE TREASURER 1.00 3.00 X X 0 0 0 SR JEANNE ARCHAMBAULT SCO CLERK 1.00 3.00 X X 0 0 0 THOMAS J BROWN DIRECTOR 1.00 3.00 X 0 0 0 JOSEPH CLERMONT ESQ DIRECTOR 1.00 3.00 X 0 0 0 SR M JEANNE FRANCIS HALEY DIRECTOR 1.00 15.00 X 0 0 0 REVERAND PETER G GORI OSA JCD DIRECTOR 1.00 3.00 X 0 0 0 AMY J HOEY DIRECTOR 1.00 3.00 X 0 0 0 JAMES LINNEHAN JR ESQ DIRECTOR 1.00 3.00 X 0 0 0 SR PRESCILLE MALO SCO DIRECTOR 1.00 3.00 X 0 0 0 WILLIAM F MARTIN JR ESQ DIRECTOR 1.00 3.00 X 0 0 0 MARK COCHRAN DIRECTOR 1.00 3.00 X 0 0 0 SR MARK LOUIS ANNE RANDALL SPONSOR EXECUTIVE 1.00 5.00 X 0 0 0 PATRICIA GATHERS PRESIDENT/ CEO CARMELITE 1.00 39.00 X 0 740589 27080 MICHAEL FERRICK CEO 1.00 39.00 X 0 250507 0 0 991096 27080 0 0 1 0 FIRESIDE STAFFING INC 17 GAUDET LANE PELHAM NH 03076 NURSING CONTRACT LABOR 2293449 EDGESTONE STAFFING INC 35 SUMMER ST SUITE 103 TAUNTON MA 02780 CONTRACT LABOR 224280 FULLY MANAGED INC 1002 BEAVERBROOK RD UNIT 2 OTTAWA ONTARIO CA K2K 1L1 IT SERVICES / SUPPORT 187906 AMERICAN HEALTHCARE STAFFING 84 HIGHLAND AVENUE SUITE 312 SALEM MA 01970 NURSING CONTRACT LABOR 184266 4 528853 47638 576491 PATIENT REVENUE 623990 25663341 25663341 25663341 353515 353515 1556748 1438094 118654 118654 118654 OTHER OPERATING INCOME 623990 459668 459668 459668 27171669 26123009 0 472169 X 13213975 13016920 197055 114629 91195 23434 1653095 1651874 1221 1299242 936750 362492 514242 514242 19932 19932 93427 93427 3584286 3198808 385478 165016 113017 51999 43906 1934 41972 367727 367727 658946 658946 1015 1015 620311 558280 62031 916388 824749 91639 595826 536243 59583 SUPPLIES 946846 946846 FOOD 657810 657810 BED TAX/ASSESSMENT 544997 544997 REPAIRS AND MAINTENANCE 132264 132264 352922 330550 22372 26496802 24201183 2294398 1221 465036 136561 1920891 1866849 2389724 2541819 128097 92213 33266725 22206765 10743361 11059960 3368016 3739161 2551820 1062978 21566945 20499541 3020861 3386864 10133592 9923109 70449 82204 3025534 645049 16250436 14037226 X 5316509 6196566 265749 5316509 6462315 21566945 20499541 674867 470939 0 X X 1 X 1 X 1 1 1 X 1419773 4127436 1724656 119808 576491 7968164 21040579 23236112 23867420 24624983 26123009 118892103 22460352 27363548 25592076 24744791 26699500 126860267 0 0 0 126860267 81663 66660 88026 273070 353515 862934 81663 66660 88026 273070 353515 862934 22542015 27430208 25680102 25017861 27053015 127723201 0.99320 0.99520 0.00680 0.00480 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 820995 820995 26445903 17431565 9014338 4903661 4445011 458650 1096166 330189 765977 11059960 ASSETS LIMITED AS TO USE 82704 DUE FROM RELATED PARTIES 405369 ACCOUNTS RECEIVABLE, NON-RESIDENTS 1700 SWAP AGREEMENT 379232 OTHER ASSETS 193973 1062978 DUE TO RELATED PARTIES 598030 OTHER LIABILITIES 47019 645049 X PART X, LINE 2: D'YOUVILLE SENIOR CARE, INC. IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. 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, 2024 AND 2023. 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 PATRICIA GATHERS PRESIDENT/ CEO CARMELITE 0 569788 0 134277 0 36524 0 23000 0 4080 0 767669 0 0 MICHAEL FERRICK CEO 0 219808 0 25313 0 5386 0 0 0 0 0 250507 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 A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 2022-12-14 10357360 DEBT REFINANCING AND CONSTRUCTION 0 0 1 A 219840 10357360 10130743 226617 1500000 2024 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 SCHEDULE K SUPPLENTAL INFORMATION A TOTAL BOND ISSUANCE OF $24,660,380 WAS ISSUED BY THE MASSACHUSETTS DEVELOPMENT FINANCE AGENCY, REVENUE BONDS SERIES 2022 (D'YOUVILLE SENOR CARE, INC, D'YOUVILLE TRANSITIONAL CARE, INC., AND D'YOUVILLE LEADERSHIP SOLUTIONS, INC.). THE PORTION OF THE BOND ALLOCATED TO EACH ORGANIZATION WILL BE REPORTED ON THE SCHEDULE K OF THE APPLICABLE ORGANIZATION. STEVEN LAROCHELLE DIRECTOR 617400 DEBT SERVICE INTEREST - EBTC - DSC & DTC 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION'S MANAGEMENT DUTIES ARE PERFORMED BY A RELATED ORGANIZATION, D'YOUVILLE LEADERSHIP SOLUTIONS, INC. D'YOUVILLE LEADERSHIP SOLUTIONS, INC. PROVIDES MANAGEMENT AND ADMINISTRATIVE SUPPORT SERVICES AS FOLLOWS: MANAGEMENT OVERSIGHT, ALL BUSINESS OFFICE FUNCTIONS, HUMAN RESOURCES, MARKETING, INFORMATION TECHNOLOGY, ADMISSIONS, AND MAINTENANCE. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS D'YOUVILLE LIFE AND WELLNESS COMMUNITY, INC., ("DLWC") A MASSACHUSETTS NONPROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. FORM 990, PART VI, SECTION A, LINE 7A TWO OF THE CORPORATION'S DIRECTORS MUST BE MEMBERS OF THE GENERAL COUNCIL OF THE CARMELITE SISTERS OF THE AGED AND INFIRM, INC. (THE "CARMELITE SISTERS"), AND ARE SELECTED BY THE CARMELITE SISTERS. THE CORPORATION'S SOLE MEMBER, DLWC, ELECTS THE CORPORATION'S REMAINING DIRECTORS AND ITS PRESIDENT, WHO SERVES EX-OFFICIO AS A DIRECTOR. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER OF THE CORPORATION, DLWC HAS ALL POWERS RESERVED TO IT BY STATE LAW. IN ADDITION, DLWC HOLDS THE FOLLOWING RESERVED POWERS: (A) TO APPROVE ANY CHANGE TO THE PHILOSOPHY AND MISSION OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION, AND TO MONITOR COMPLIANCE WITH SAME; (B) TO AMEND THE ARTICLES OF ORGANIZATION AND BYLAWS OF THE CORPORATION, AND TO APPROVE THE ADOPTION OR AMENDMENT OF THE CHARTER AND THE BYLAWS (OR OTHER GOVERNING INSTRUMENTS) OF ANY SUBSIDIARY OF THE CORPORATION; (C) TO ELECT THE DIRECTORS OF THE CORPORATION (OTHER THAN THE DIRECTORS APPOINTED BY THE CARMELITE SISTERS OF THE AGED AND INFIRM, INC.) AND TO REMOVE THEM WITH OR WITHOUT CAUSE; (D) TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION IN CONSULTATION WITH THE BOARD OF DIRECTORS; (E) TO RATIFY THE BOARD OF DIRECTORS' ELECTION OF THE CHAIRPERSON OF THE BOARD OF DIRECTORS; (F) TO APPROVE ALL PLANS OF MERGER, CONSOLIDATION, REORGANIZATION OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION, OR THE SALE, LEASE, ASSIGNMENT OR TRANSFER OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION, OR THE PURCHASE OR ACQUISITION BY THE CORPORATION OR AN SUBSIDIARY OF THE CORPORATION OF AN INTEREST IN ANY CORPORATION, PARTNERSHIP, JOINT VENTURE OR OTHER ENTITY, WHETHER NEWLY CREATED OR PREVIOUSLY EXISTING, WHICH INTEREST, IN THE CASE OF A FOR PROFIT ENTITY, REPRESENTS TWENTY-FIVE PERCENT OR MORE OF THE VOTING POWER THEREOF OR EQUITY INTEREST THEREIN, OR, IN THE CASE OF A NON-PROFIT ENTITY, REPRESENTS TWENTY-FIVE PERCENT OR MORE OF THE VOTING POWER THEREOF OR MEMBERSHIP INTEREST THEREIN; (G) TO APPROVE THE ACQUISITION, SALE, TRANSFER OR ENCUMBRANCE OF ANY REAL ESTATE, OR THE CONSTRUCTION OR DESTRUCTION OF ANY IMPROVEMENTS THEREON, BY THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION VALUED IN EXCESS OF AN AMOUNT SET BY THE MEMBER FROM TIME TO TIME; (H) TO APPROVE ALL DEBT OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION FOR BORROWED MONEY IN EXCESS OF AN AMOUNT SET BY THE MEMBER FROM TIME TO TIME BEFORE SUCH DEBT IS INCURRED, AND TO APPROVE ALL CHANGES TO THE TERMS OF ANY SUCH DEBT; (I) TO APPROVE THE SALE, ASSIGNMENT OR TRANSFER BY THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION OF ANY EQUITY INTEREST OR MEMBERSHIP INTEREST IN ANY SUBSIDIARY OF THE CORPORATION, TO APPROVE ANY RECLASSIFICATION OR OTHER CHANGE OF ANY CAPITAL STOCK OR OTHER EQUITY SECURITY OF ANY SUBSIDIARY OF THE CORPORATION, OR ANY RECAPITALIZATION OF ANY SUBSIDIARY OF THE CORPORATION; AND TO APPROVE THE ISSUANCE OF, OR THE CREATION OF ANY OBLIGATION TO ISSUE, ANY EQUITY SECURITY OF ANY SUBSIDIARY OF THE CORPORATION, OR ANY INCREASE OR DECREASE IN THE TOTAL NUMBER OF SHARES OF AUTHORIZED CAPITAL STOCK OR OTHER EQUITY SECURITY OF ANY SUBSIDIARY OF THE CORPORATION; (J) TO APPROVE ALL LONG-RANGE STRATEGIC PLANS OF THE CORPORATION AND ANY SUBSIDIARY OF THE CORPORATION BEFORE THEIR IMPLEMENTATION; (K) TO APPROVE ALL CAPITAL AND OPERATING BUDGETS OF THE CORPORATION AND ANY SUBSIDIARY OF THE CORPORATION AND NON-BUDGETED EXPENDITURES BY THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION IN EXCESS OF AN AMOUNT SET BY THE MEMBER FROM TIME TO TIME; (L) TO APPOINT THE CORPORATION'S AUDITORS AND THE AUDITORS OF ANY SUBSIDIARY OF THE CORPORATION; (M) TO APPROVE THE ENGAGEMENT OF LEGAL COUNSEL FOR THE CORPORATION AND ANY SUBSIDIARY OF THE CORPORATION; (N) TO APPROVE THE ENGAGEMENT OF MONEY MANAGERS FOR THE CORPORATION AND ANY SUBSIDIARY OF THE CORPORATION; (O) TO APPROVE THE LENDING OF FUNDS OR THE MAKING OR RECEIPT OF GIFTS OR DONATIONS BY THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION IN EXCESS OF AN AMOUNT SET BY THE MEMBER FROM TIME TO TIME; (P) TO APPROVE CONTRACTS BY THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION WHICH ARE IN EXCESS OF AN AMOUNT SET BY THE MEMBER FROM TIME TO TIME; (Q) TO APPROVE ANY CHANGE IN LICENSURE, LEVEL OF CARE, BED CAPACITY AND TYPE OF SERVICE OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION IN CONFORMANCE WITH THE MISSION AND PHILOSOPHY OF THE CORPORATION OR SUCH SUBSIDIARY OF THE CORPORATION AND THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE FACILITIES; AND (R) TO (I) REQUIRE THE PARTICIPATION OF THE CORPORATION AND ANY SUBSIDIARY OF THE CORPORATION IN AN OBLIGATED GROUP INCLUDING AUTHORIZATION AND THE EXECUTION OF A MASTER TRUST INDENTURE PROVIDING FOR THE CROSS-COLLATERALIZATION OF THE ASSETS OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION THAT BECOMES A MEMBER OF THE OBLIGATED GROUP TO SECURE FINANCING FOR THE PROJECTS AND BUDGETS OF THE MEMBERS OF THE OBLIGATED GROUP, (II) REQUIRE THE EXECUTION BY THE CORPORATION AND ANY SUBSIDIARY OF THE CORPORATION THAT BECOMES A MEMBER OF THE OBLIGATED GROUP OF A SUPPLEMENTAL MASTER TRUST INDENTURE AND MASTER NOTE AS A MEMBER OF AN OBLIGATED GROUP, AND A MASTER TRUST INDENTURE MORTGAGE AS A MEMBER OF THE OBLIGATED GROUP GRANTING A MORTGAGE ON THE CORPORATION'S REAL PROPERTY TO SECURE THE ENTIRE MASTER TRUST INDENTURE DEBT, (III) REQUIRE AND SECURE THE OPINION OF COUNSEL FOR THE CORPORATION AND ANY SUBSIDIARY OF THE CORPORATION THAT BECOMES A MEMBER OF THE OBLIGATED GROUP THAT THE MASTER TRUST INDENTURE, SUPPLEMENTAL TRUST INDENTURE, MASTER NOTE AND MORTGAGE, AS DEEMED APPLICABLE ARE VALID, BINDING AND ENFORCEABLE OBLIGATIONS OF THE CORPORATION, (IV) SELECT THE MASTER TRUSTEE FOR AN OBLIGATED GROUP, (V) REQUIRE THE PLEDGE OF COLLATERAL OF THE CORPORATION AND ANY SUBSIDIARY OF THE CORPORATION THAT BECOMES A MEMBER OF THE OBLIGATED GROUP, INCLUDING THE ENTRY INTO ANY DOCUMENTATION RELATING TO PLEDGE OF SUCH COLLATERAL, (VI) TAKE ANY ACTION NECESSARY IN CONNECTION WITH THE INCURRENCE OF DEBT BY THE CORPORATION AND ANY SUBSIDIARY OF THE CORPORATION THAT BECOMES A MEMBER OF THE OBLIGATED GROUP IN CONNECTION WITH THE OBLIGATED GROUP OR THE SECURING OF ANY SUCH DEBT OF THE CORPORATION AND ANY SUBSIDIARY OF THE CORPORATION THAT BECOMES A MEMBER OF THE OBLIGATED GROUP; AND (VII) HAVE ANY AUTHORIZED OFFICER OF THE MEMBER EXECUTE ANY OF THE DOCUMENTS DESCRIBED OR RELATED TO THE POWERS SET FORTH IN THIS SUBSECTION (R). THE CARMELITE SISTERS IS THE "SPONSOR" OF THE CORPORATION'S SOLE MEMBER, DLWC. THE CARMELITE SYSTEM, INC. (THE "CARMELITE SYSTEM"), IS THE SOLE MEMBER OF DLWC. DLWC'S RESERVED POWERS AND RIGHTS WITH RESPECT TO THE CORPORATION ARE SUBJECT TO THE POWERS AND RIGHTS OF THE CARMELITE SISTERS AND THE CARMELITE SYSTEM WITH RESPECT TO DLWC. 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 B, LINE 15A THE DLWC COMPENSATION COMMITTEE CONSULTS WITH RAY ANSTISS, JR, CPA, PRINCIPAL OF ANSTISS AND COMPANY, PC, FOR INDUSTRY INFORMATION RELATING TO THE COMPENSATION OF THE DLWC PRESIDENT/CEO AND CFO POSITIONS. RAY ANSTISS ALSO MAINTAINS RECORDS OF THE COMPENSATION COMMITTEE DECISIONS FOR FUTURE REFERENCE 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 CARE, 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 CARE, INC. FORM 990, PART IX, LINE 11G PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 3,198,808. MANAGEMENT AND GENERAL EXPENSES 385,478. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,584,286. FORM 990, PART XII, LINE 2C: THE CARMELITE SYSTEM, INC. APPROVES THE ENGAGEMENT OF THE INDEPENDENT AUDITORS FOR THE CORPORATION. THE SYSTEM AUDIT COMMITTEE MEETS WITH THE SYSTEM'S MANAGEMENT AND THE INDEPENDENT AUDITORS TO REVIEW THE ENGAGEMENT PROPOSAL, RESULTS OF THE AUDIT, DRAFT AUDIT REPORT AND MANAGEMENT LETTERS. THE AUDIT COMMITTEE MAY MEET WITH THE INDEPENDENT AUDITORS IN AN EXECUTIVE SESSION BEFORE CONCLUDING ITS REVIEW AND ACCEPTANCE OF THE ANNUAL AUDIT REPORT. THE AUDIT COMMITTEE REPORTS ITS FINDINGS AND MAKES ITS RECOMMENDATION TO THE BOARD OF DIRECTORS. 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)(3) LINE 7 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 D'YOUVILLE SENIOR LIVING INC 979 VARNUM AVENUE LOWELL MA 01854 200837361 LOW-INCOME SENIOR HOUSING MA 501(C)(3) LINE 10 D'YOUVILLE SENIOR CARE INC 1 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 MARIAN WOODS INC 152 RIDGE RD HARTSDALE NY 10530 061512701 RELIGIOUS ORGANIZATION NY 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 CABRINI OF WESTCHESTER 115 BROADWAY DOBBS FERRY NY 10522 237063399 SKILLED NURSING FACILITY NY 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 0 0 1 1 1 0 0 0 1 0 1 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.