2018-11-14T12:34:59-06:00 2017-12-31 410746749 CLIFTONLARSONALLEN LLP 610 W GERMANTOWN PIKE STE 400 PLYMOUTH MEETING PA 19462 990 2017-01-01 420760833 KAHL HOME FOR THE AGED AND INFIRM KAHL 5633241621 6701 JERSEY RIDGE ROAD DAVENPORT IA 52807 KIMBERLY HUFSEY ADMINISTRATOR 5633241621 2018-11-12 1 BERNADETTE O'TOOLE CPA P00229258 2156433900 67.137.57.251 2018-11-12 12:01:38 ES P 49D45E06031322FC5F433B8196F1C5D2180A31DD 9EB2786B3EC6AF35018D7997716D9ABE495A2698 2017 2019-02-21 02:37:17Z KIMBERLY HUFSEY 6701 JERSEY RIDGE ROAD DAVENPORT IA 52807 11946178 0 0928 X WWW.KAHLHOMEDAV.COM X 1957 IA PROVIDE CARE AND SERVICES TO THE COMMUNITY IN CONFORMANCE WITH THE THEOLOGY; PHILOSOPHY; TEACHINGS AND DOCTRINES OF THE ROMAN CATHOLIC CHURCH, RESPECTING AND BUILDING ON THE MISSION, PHILOSOPHY AND VALUES OF THE CARMELITE SISTERS FOR THE AGED AND INFIRM. 15 15 157 120 0 0 170555 94411 12462460 11430430 202643 254298 0 167039 12835658 11946178 0 0 0 0 8503774 6123918 0 0 0 5173095 8690268 13676869 14814186 -841211 -2868008 55318184 52442074 26220637 24284998 29097547 28157076 PROVIDE CARE AND SERVICES TO THE COMMUNITY IN CONFORMANCE WITH THETHEOLOGY, PHILOSOPHY, TEACHINGS AND DOCTRINES OF THE ROMAN CATHOLICCHURCH. RESPECTING AND BUILDING ON THE MISSION, PHILOSOPHY AND VALUESOF THE CARMELITE SISTERS FOR THE AGED AND INFIRM. 0 0 11957480 11597469 THE HOME PROVIDES PROFESSIONAL AND PERSONAL SERVICES IN A COMPASSIONATE AND CARING MANNER TO SERVE MEMBERS OF THE DAVENPORT AND SURROUNDING COMMUNITIES. DURING THE YEAR, THE HOME PROVIDED APPROXIMATELY 40,000 PATIENT DAYS OF CARE TO OUR NEIGHBORS AND THEIR FAMILIES WITHOUT REGARD TO THEIR ETHNIC BACKGROUND, RELIGION, AND FINANCIAL CIRCUMSTANCES. 11957480 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 2 0 157 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X RACHEL KING 5633241621 6701 JERSEY RIDGE ROAD DAVENPORT IA 52807 SR MARY ROSE HEERY PRESIDENT 1.00 10.00 X X 0 0 0 SR PATRICIA MARGARET RAWDON VICE PRESIDENT 1.00 7.00 X X 0 0 0 SHAWNA GRAHAM SECRETARY 1.00 0.00 X X 0 0 0 MICHAEL MCCARTHY CHAIRMAN 1.00 0.00 X X 0 0 0 SR ANTHONY DE LOURDES VEILLE DIRECTOR 1.00 1.00 X 0 0 0 SR ALICE WEBSTER DIRECTOR 1.00 2.00 X 0 0 0 SR LEDA VERONICA DOMINO DIRECTOR 1.00 1.00 X 0 0 0 DR JOSEPH LOHMULLER MD DIRECTOR 1.00 0.00 X 0 0 0 JUDITH K PRANGER DIRECTOR 1.00 0.00 X 0 0 0 THOMAS SUNDERBRUCH DIRECTOR 1.00 0.00 X 0 0 0 SR ANN ELIZABETH BROWN DIRECTOR 1.00 3.00 X 0 0 0 SR JEANNE FRANCIS HALEY DIRECTOR 1.00 9.00 X 0 0 0 ROBERT MCCABE DIRECTOR 1.00 0.00 X 0 0 0 JOSEPH POLASCHEK DIRECTOR 1.00 0.00 X 0 0 0 MARY REHMANN DIRECTOR 1.00 0.00 X 0 0 0 ROSALIE THOMAS ADMINISTRATOR 45.00 0.00 X 106901 0 0 KIMBERLY HUFSEY TREASURER 1.00 0.00 X 50719 0 55 157620 0 55 1 0 0 0 MEDICAL STAFFING NETWORK PO BOX 840292 DALLAS TX 75284 NURSE STAFFING 812158 GRAPETREE MEDICAL STAFFING INC 1003 23RD STREET MILFORD IA 51351 NURSE STAFFING 802122 CONSONUS REHAB PO BOX 4800 UNIT 12 PORTLAND OR 97208 THERAPY 578999 HEALTHCARE SERVICES GROUP INC 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 HOUSEKEEPING & LAUNDRY SERVICE 526440 A-1 CAREERS 7050 W 107TH ST SUITE 120 OVERLAND PARK KS 66212 NURSE STAFFING 395269 5 94411 54170 94411 RESIDENT SERVICES REVENUE 623000 11430430 11430430 11430430 226798 226798 27500 0 27500 27500 27500 OTHER OPERATING INCOME 623000 167039 167039 167039 11946178 11597469 0 254298 X 157675 157675 4574967 4029514 545453 23812 20292 3520 953836 816289 137547 413628 352478 61150 129157 129157 29249 29249 26075 26075 4073440 4022455 50985 54167 7391 46776 605124 414843 190281 99850 99850 284551 284551 13042 13042 915989 915989 1199478 1173796 25682 130874 14184 116690 FOOD 427837 427837 REPAIRS AND MAINTENANCE 204029 204029 BAD DEBTS 181348 181348 PHARMACY 145087 145087 170971 44734 126237 14814186 11957480 2856706 0 4029781 2771270 93004 1217263 1543397 48432 54795 36455999 6593659 31038571 29862340 16777079 18118191 2114054 92081 55318184 52442074 2102925 1650943 23395000 22210087 722712 423968 26220637 24284998 X 29004543 28156481 93004 595 29097547 28157076 55318184 52442074 X -2868008 1608319 319218 X X 0 1 X 1 0 X 313632 410837 175979 170555 94411 1165414 10859156 12418595 12672455 12462460 11597469 60010135 11172788 12829432 12848434 12633015 11691880 61175549 17984 17012 34996 0 17984 17012 34996 61140553 174360 189710 196388 205112 226798 992368 174360 189710 196388 205112 226798 992368 11347148 13019142 13044822 12838127 11918678 62167917 0.98350 0.98330 0.01600 0.01610 X 2553016 2553016 31255996 5724806 25531190 2646987 868853 1778134 29862340 PROFESSIONALLY MANAGED POOLED INVESTMENT FUNDS 18118191 F 18118191 DUE TO RELATED PARTY 171467 SWAP AGREEMENT 226023 OTHER CURRENT LIABILITIES 12750 DUE TO THIRD PARTY PAYORS 13728 423968 A IOWA FINANCE AUTHORITY 521699886 2014-11-12 24895000 TO REFINANCE SERIES 2011 REVENUE BONDS 0 0 0 A 2684913 24895000 569854 24325146 2011 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 FORM 990, SCHEDULE K, PART I: THE BONDS WERE ISSUED AT THE SAME TIME AS THE $14,430,000 COUNTY OF FRANKLIN, OHIO REVENUE REFUNDING BONDS, SERIES 2014 (MOTHER ANGELINE MCCRORY MANOR, INC. PROJECT), THE $7,040,000 COUNTY OF FRANKLIN OHIO REVENUE BONDS, SERIES 2014 (THE VILLAS AT SAINT THERESE PROJECT), AND THE $17,300,000 PALM BEACH COUNTY REVENUE REFUNDING BONDS, SERIES 2014 (LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE, INC. PROJECT), (COLLECTIVELY THE "OBLIGATED GROUP BONDS"). THE BONDS AND THE OBLIGATED GROUP BONDS CONSTITUTE A SINGLE ISSUE FOR PURPOSES OF TREASURY REGULATIONS SECTION 1 150-1(C). EACH SERIES OF THE OBLIGATED GROUP BONDS WILL BE REPORTED ON THE SCHEDULE K OF THE APPLICABLE MEMBER OF THE OBLIGATED GROUP. X EQUIMENT 1 54170 FMV 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THERE SHALL BE AN "EXECUTIVE COMMITTEE," WHICH SHALL BE A COMMITTEE OF THE CORPORATION AND SHALL CONSIST OF THE CHAIRPERSON OF THE BOARD, THE PRESIDENT, THE VICE-PRESIDENT, THE SECRETARY, THE TREASURER, AND SUCH OFFICERS OF THE CORPORATION AS MAY BE APPOINTED BY THE MEMBER. THE EXECUTIVE COMMITTEE SHALL MEET AS NEEDED AND SHALL HAVE AUTHORITY TO TRANSACT REGULAR BUSINESS OF THE CORPORATION BETWEEN MEETINGS OF THE BOARD. HOWEVER, THE EXECUTIVE COMMITTEE IS NOT EMPOWERED TO ACT WITH RESPECT TO ANY RESERVE POWERS DESCRIBED IN THE BY-LAWS, SHALL NOT TAKE ANY ACTION BEYOND THE AUTHORITY OF THE BOARD OR IN CONFLICT WITH THE EXPRESSED POLICIES OF THE BOARD. A MAJORITY OF THE COMMITTEE SHALL CONSTITUTE A QUORUM FOR THE TRANSACTION OF BUSINESS FOR ANY MEETING. ANY ACTION TAKEN BY THE EXECUTIVE COMMITTEE SHALL BE REPORTED TO THE BOARD AT THE NEXT MEETING OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS THE CARMELITE SYSTEM, INC. THE MEMBERS OF THE CARMELITE SYSTEM, INC.'S INCLUDE FIVE MEMBERS CONSISTING OF THE PRIORESS GENERAL AND FOUR MEMBERS OF THE GENERAL COUNCIL OF THE CARMELITE SISTERS FOR THE AGED AND INFIRM, INC. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE CORPORATE MEMBER, THE CARMELITE SYSTEM, INC., RETAINS THE RIGHT TO APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS OF THE ORGANIZATION RESERVE THE FOLLOWING MANAGEMENT POWERS: A) TO APPROVE AND INTERPRET THE CORPORATION'S PURPOSES, MISSION, PHILOSOPHY AND VALUES AND TO REQUIRE THAT THE CORPORATION OPERATES IN CONFORMANCE WITH SAME; B) TO APPROVE AND AMEND THE CERTIFICATE OF INCORPORATION AND BY-LAWS OF THE CORPORATION C) TO APPROVE ANY PLAN OF MERGER, CONSOLIDATION, OR REORGANIZATION OF THE CORPORATION; D) TO APPROVE ANY PLAN OF DISSOLUTION OF THE CORPORATION AND THE DISTRIBUTION OF THE ASSETS OF THE CORPORATION UPON DISSOLUTION; E) TO APPROVE THE ESTABLISHMENT, MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF ANY ORGANIZATIONAL RELATIONSHIP OF THE CORPORATION, INCLUDING SUBSIDIARY CORPORATIONS, PARTNERSHIPS, JOIN VENTURES, AND LIKE RELATIONSHIPS; F) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION; G) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION; H) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE VICE-PRESIDENT OF MISSION OF THE CORPORATION; I) TO RATIFY ANY DEBT OF THE CORPORATION IN EXCESS OF AN AMOUNT TO BE FIXED FROM TIME TO TIME BY THE MEMBERS, EXCEPT FOR ANY DEBT NECESSARY TO FINANCE THE COST OF COMPLIANCE THE OPERATION OR PHYSICAL PLANT STANDARDS REQUIRED BY APPLICABLE LAW; J) TO RATIFY THE SALE, ACQUISITION, LEASE, TRANSFER, MORTGAGE, PLEDGE OR OTHER ALIENATION OF REAL OR PERSONAL PROPERTY OF THE CORPORATION IN EXCESS OF AN AMOUNT TO BE FIXED FROM TIME TO TIME BY THE MEMBERS; K) TO RATIFY SETTLEMENTS OF CLAIMS AND LITIGATION WHEN SUCH CLAIMS OR SETTLEMENTS EXCEEDS APPLICABLE INSURANCE COVERAGE OR THE AMOUNT OF ANY APPLICABLE SELF-INSURANCE FUND; L) TO APPOINT FISCAL AUDITORS, UPON THE RECOMMENDATION OF THE AUDIT COMMITTEE; AND M) TO APPOINT LEGAL COUNSEL 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 THE CONFLICT OF INTEREST DISCLOSURE POLICY REQUIRES ALL OFFICERS AND BOARD MEMBERS TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT. IN ADDITION, SHOULD AN OFFICER OR BOARD MEMBER ASSUME NEW EXTERNAL INTERESTS THAT POTENTIALLY CONFLICT WITH HIS/HER ROLE WITH THE ORGANIZATION SUCH INDIVIDUALS IS REQUIRED TO DISCLOSE IN WRITING THE NATURE OF SUCH EXTERNAL INTERESTS. THE DISCLOSURE STATEMENT IS PROVIDED TO THE CHAIR OF THE BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 15A A COMPENSATION POLICY WAS DEVELOPED BY THE BOARD TO GOVERN COMPENSATION ARRANGEMENTS BETWEEN THE ORGANIZATION AND COVERED INDIVIDUALS, DEFINED AS THOSE IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. THE COMPENSATION COMMITTEE CONSISTS OF AT LEAST THREE INDEPENDENT INDIVIDUALS APPOINTED BY THE BOARD, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE RECOMMENDS TO THE BOARD THE COMPENSATION FOR A COVERED INDIVIDUAL BASED ON RELEVANT DATA INCLUDING COMPARABILITY OF COMPENSATION FOR SIMILARLY SITUATE ENTITIES AND COMPENSATION SURVEYS COMPLIED BY INDEPENDENT FIRMS AS REQUIRED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FORM 990 IS ALSO AVAILABLE TO THE PUBLIC ON GUIDESTAR'S WEBSITE. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,022,455. MANAGEMENT AND GENERAL EXPENSES 50,985. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,073,440. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 319,218. 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. 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 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 121740033 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 0 0 0 0 1 0 0 0 0 0 1 0 1 0 1 1 0 0 0