2022-11-15T13:35:30-06:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 501 GRANT STREET SUITE 425 PITTSBURGH PA 15219 990 2021-01-01 042510563 D'YOUVILLE SENIOR CARE INC DYOU 9785691000 981 VARNUM AVENUE LOWELL MA 01854 NAOMI PRENDERGAST PRESIDENT & CEO 9785691000 2022-11-13 1 NAOMI PRENDERGAST 999009999 RYAN SANTARELLA P02069285 4124856700 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z NAOMI PRENDERGAST 981 VARNUM AVENUE LOWELL MA 01854 31917560 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. 19 17 0 17 0 0 2267720 4127436 19852385 22691555 242716 88204 340247 544557 22703068 27451752 0 0 0 0 16849207 15304305 0 0 37066 7072537 8783573 23921744 24087878 -1218676 3363874 27932918 28122716 15240413 11962538 12692505 16160178 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 19397069 0 23236112 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. 19397069 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 19 17 0 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 MA X JUDITH NADERHOFF 5185377500 646 WOODS ROAD GERMANTOWN NY 12526 X NAOMI PRENDERGAST PRESIDENT/ CEO 1.00 40.00 X X 0 267853 13235 MARK ALTENWEG CFO 1.00 40.00 X X 0 171949 11210 CAROL HOWARD TREASURER 1.00 3.00 X X 0 0 0 ARTHUR SUTCLIFFE SECRETARY 1.00 3.00 X X 0 0 0 JOSEPH CLERMONT ESQ CHAIRPERSON 1.00 4.00 X X 0 0 0 STEVEN LAROCHELLE VICE CHAIRPERSON 1.00 4.00 X X 0 0 0 SR JEANNE ARCHAMBAULT SCO CLERK 1.00 3.00 X X 0 0 0 LOUIS BRESNICK MD MEMBER 1.00 3.00 X 0 0 0 THOMAS J BROWN MEMBER 1.00 3.00 X 0 0 0 MARK S COCHRAN MEMBER 1.00 3.00 X 0 0 0 JERRY FRECHETTE MEMBER 1.00 3.00 X 0 0 0 REVERAND PETER G GORI OSA JCD MEMBER 1.00 3.00 X 0 0 0 MOTHER MARY ROSE HEERY OCARM MEMBER 1.00 5.00 X 0 0 0 AMY J HOEY MEMBER 1.00 3.00 X 0 0 0 MARGARET KNIGHT MEMBER 1.00 3.00 X 0 0 0 SR PAULINE LEBLANC SCO MEMBER 1.00 3.00 X 0 0 0 JAMES LINNEHAN JR ESQ MEMBER 1.00 3.00 X 0 0 0 SR PRESCILLE MALO SCO MEMBER 1.00 3.00 X 0 0 0 WILLIAM F MARTIN JR ESQ MEMBER 1.00 3.00 X 0 0 0 SR CYRIL METHODIUS OCARM MEMBER 1.00 3.00 X 0 0 0 JUDITH RAMIREZ MEMBER 1.00 3.00 X 0 0 0 SR MARK LOUIS RANDALL OCARM MEMBER 1.00 4.00 X 0 0 0 MICHAEL FERRICK ADMINISTRATOR 41.00 0.00 X 0 175298 4282 0 615100 28727 0 0 1 0 INTELYCARE INC 1250 HANCOCK STREET SUITE 501N QUINCY MA 02169 NURSING CONTRACT LABOR 999700 PRO EMS SOLUTIONS INC 31 SMITH PLACE CAMBRIDGE MA 02138 LAB SERVICES 990135 FIRESIDE STAFFING INC 17 GAUDET LANE PELHAM NH 03076 NURSING CONTRACT LABOR 822686 PARAMOUNT HEALTHCARE SERVICES INC 3 COURTHOUSE LANE UNIT 2 CHELMSFORD MA 01824 NURSING CONTRACT LABOR 458517 4 4087436 40000 4127436 PATIENT REVENUE 623990 22691555 22691555 22691555 66660 66660 4487352 4465808 21544 21544 21544 OTHER OPERATING INCOME 623990 544557 544557 544557 27451752 23236112 0 88204 X 12311704 11282740 991898 37066 156095 153457 2638 1640079 749052 891027 1196427 361160 835267 7146 7146 79448 79448 22829 22829 3829615 2542231 1287384 45274 23497 21777 66763 2997 63766 193408 193408 410663 410449 214 2439 604 1835 383697 345327 38370 1013562 912206 101356 277536 249782 27754 SUPPLIES 1129055 1124502 4553 FOOD 859768 859768 BED TAX/ASSESSMENT 147928 147928 REPAIRS AND MAINTENANCE 125711 124275 1436 188731 107094 81637 24087878 19397069 4653743 37066 4372798 2433915 40764 372084 1030078 1827504 148606 13724 31834367 20065739 12637161 11768628 3714090 3549951 5989421 8156910 27932918 28122716 2279672 2117524 270769 10059694 9742674 67884 90214 2561200 1194 12126 15240413 11962538 X 12692505 16160178 12692505 16160178 27932918 28122716 3363874 103799 0 X 0 1 X 1 1 1 X 14972 13873 67731 1419773 4127436 5643785 20573719 22307720 22308697 21040579 23236112 109466827 20588691 22321593 22376428 22460352 27363548 115110612 0 0 0 115110612 64709 68501 80317 81663 66660 361850 64709 68501 80317 81663 66660 361850 819371 819371 21472771 22390094 22456745 22542015 27430208 116291833 0.98980 0.98950 0.00310 0.00310 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 820995 820995 26091770 15833061 10258709 4479629 3899532 580097 441973 333146 108827 11768628 ASSETS LIMITED AS TO USE 90714 DUE FROM RELATED PARTIES 7862948 ACCOUNTS RECEIVABLE, NON-RESIDENTS 203248 8156910 DUE TO RELATED PARTIES 12126 12126 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, 2021 AND 2020. 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 267853 0 0 0 0 0 6544 0 6691 0 281088 0 0 MARK ALTENWEG CFO 0 171949 0 0 0 0 0 4551 0 6659 0 183159 0 0 MICHAEL FERRICK ADMINISTRATOR 0 175298 0 0 0 0 0 4282 0 0 0 179580 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 2010-05-24 20500000 DEBT REFINANCING AND CONSTRUCTION 0 0 0 A 2675534 12500000 91520 1408480 11000000 2012 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 1 0 0 0 0 A 0 SCHEDULE K SUPPLENTAL INFORMATION THE BOND ISSUANCE OF $20,500,000 WAS PARTIALLY USED FOR THE PAYOFF OF AN EXISTING DEBT OF $11,000,000 AND $1,500,000 OF CONSTRUCTION FOR D'YOUVILLE SENIOR CARE, INC., IN ADDITION THE REMAINING $8,000,000 WAS USED FOR CONSTRUCTION OF A RELATED ORGANIZATION, D'YOUVILLE TRANSITIONAL CARE, INC. FORM K, PART II, LINE 3: THE GROSS PROCEEDS FROM THE BOND ISSUANCE TOTAL $20,500,000, THE PROCEEDS USED BY D'YOUVILLE SENIOR CARE, INC. TOTAL $12,500,000. THE REMAINING PROCEEDS OF $8,000,000 HAVE BEEN USED BY A RELATED TAX EXEMPT PARTY CONSISTENT WITH THE TERMS OF THE BOND ISSUANCE. STEVEN LAROCHELLE DIRECTOR 213481 DEBT SERVICE INTEREST - EBTC - DSC & DTC 0 MARK S COCHRAN DIRECTOR 167075 DEBT SERVICE INTEREST- CEO OF JEANNE D'ARC CREDIT UNION - DEBT SERVICE PROVIDER 0 KERI ALTENWEG CFO'S SPOUSE 120170 EMPLOYEE 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 4 THE ORGANIZATION'S BY-LAWS WERE AMENDED DUE TO A CHANGE IN SPONSORSHIP. THE RIGHTS OF THE SPONSOR FOR APPOINTMENT TO THE BOARD OF DIRECTORS AND ADDITIONAL RIGHTS OF THE SPONSOR HAVE BEEN UPDATED ON SCHEDULE O OF THIS 990 FILING. 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 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 2,542,231. MANAGEMENT AND GENERAL EXPENSES 1,287,384. TOTAL EXPENSES 3,829,615. 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 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.