2016-11-03T20:46:54-05:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2015-01-01 271680453 D'YOUVILLE TRANSITIONAL CARE INC DYOU 9785691000 1071 VARNUM AVENUE LOWELL MA 01854 NAOMI PRENDERGAST PRESIDENT & CEO 9785691000 2016-10-24 1 JUDY DALEY P01294075 6179848100 2016-10-17 2015 2017-02-10 21:41:12Z NAOMI PRENDERGAST 981 VARNUM AVENUE LOWELL MA 01854 5280062 0 X WWW.DYOUVILLE.ORG X 2007 MA IN THE SPIRIT OF THE SISTERS OF CHARITY OF OTTAWA, GREY NUNS OF THE CROSS, FOUNDED BY ELISABETH BRUYERE, AND CONTINUING THE HEALING MINISTRY OF JESUS CHRIST, D'YOUVILLE LIFE & WELLNESS COMMUNITY IDENTIFIES AND RESPONDS TO THE NEEDS OF THE COMMUNITY WITH PROFESSIONAL AND COMPASSIONATE CARE. 21 20 88 19 0 0 0 0 4752917 4922224 197 448 347681 357390 5100795 5280062 0 0 0 0 2061557 2119005 0 0 0 3402219 3340489 5463776 5459494 -362981 -179432 12548797 12091097 10006256 9727988 2542541 2363109 X IN THE SPIRIT OF THE SISTERS OF CHARITY OF OTTAWA, GREY NUNS OF THE CROSS, FOUNDED BY ELISABETH BRUYERE, AND CONTINUING THE HEALING MINISTRY OF JESUS CHRIST, D'YOUVILLE LIFE & WELLNESS COMMUNITY IDENTIFIES AND RESPONDS TO THE NEEDS OF THE COMMUNITY WITH PROFESSIONAL AND COMPASSIONATE CARE. 0 0 5037197 4933928 THE ORGANIZATION FURTHERS THE HEALING MINISTRY OF JESUS CHRIST BY EXTENDING PROFESSIONAL AND COMPASSIONATE CARE TO SENIORS IN NEED THROUGH THE OPERATION OF A 33-BED SHORT-TERM REHABILITATION FACILITY. 5037197 1 0 0 0 0 0 0 0 0 0 1 0 0 0 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 1 0 0 0 0 0 1 0 0 0 1 5 0 1 88 1 0 0 0 0 0 0 0 0 0 0 X 21 20 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X MARK ALTENWEG 9785691000 981 VARNUM AVENUE LOWELL MA 01854 NAOMI PRENDERGAST PRESIDENT & CEO 1.50 41.00 X X 0 225051 39161 JOSEPH CLERMONT ESQ CHAIRPERSON 1.00 4.00 X X 0 0 0 THOMAS J BROWN VICE CHAIRPERSON 1.00 4.00 X X 0 0 0 SR PRESCILLE MALO SCO EX-OFFICIO 1.00 4.00 X X 0 0 0 MARK S COCHRAN TREASURER 1.00 4.00 X X 0 0 0 SR PAULA BRADLEY SCO CLERK 1.00 4.00 X X 0 0 0 RAYMOND ANSTISS JR DIRECTOR 1.00 4.00 X 0 0 0 SR JEANNE ARCHAMBAULT SCO DIRECTOR 1.00 4.00 X 0 0 0 KAREN DEVEREAUX MELILLO DIRECTOR 1.00 4.00 X 0 0 0 CAROL DUNCAN DIRECTOR 1.00 4.00 X 0 0 0 JERRY FRECHETTE DIRECTOR 1.00 4.00 X 0 0 0 JAMES M GEARY JR HON DIRECTOR 1.00 4.00 X 0 0 0 REV PETER G GORI OSA JCD DIRECTOR 1.00 4.00 X 0 0 0 AMY J HOEY DIRECTOR 1.00 4.00 X 0 0 0 CAROL HOWARD DIRECTOR 1.00 4.00 X 0 0 0 STEVEN LAROCHELLE DIRECTOR 1.00 4.00 X 0 0 0 SR PAULINE LEBLANC SCO DIRECTOR 1.00 4.00 X 0 0 0 JAMES LINNEHAN JR ESQ DIRECTOR 1.00 4.00 X 0 0 0 JUDITH RAMIREZ DIRECTOR 1.00 4.00 X 0 0 0 ARTHUR SUTCLIFFE DIRECTOR 1.00 4.00 X 0 0 0 PHILIP J TAVANO MD DIRECTOR 1.00 4.00 X 0 0 0 CYNTHIA THORNTON DIRECTOR OF NURSING 40.00 0.00 X 111627 0 22116 MARK ALTENEWG CFO 1.50 41.00 X 0 150593 23170 111627 375644 84447 1 0 1 0 PARTNERS PHARMACY 181 CEDAR HILL STREET 4 MARLBOROUGH MA 01752 PHARMACY 456223 1 PATIENT SERVICE REVENUE 623000 4922224 4922224 4922224 448 448 345686 0 345686 345686 345686 OTHER INCOME 623390 11704 11704 11704 5280062 4933928 0 346134 133743 57705 76038 1712709 1712709 7040 6839 201 136242 131805 4437 129271 125577 3694 140639 140639 795 795 14162 14162 154125 118230 35895 11341 11341 22994 22994 13265 13265 497040 497040 345 345 383816 383816 60911 60911 ANCILLARY SUPPLIES 1539748 1539748 DIETARY 236976 236976 BAD DEBTS 78386 78386 NURSING SUPPLIES & EXPE 77279 77279 108667 101873 6794 5459494 5037197 422297 0 180151 129396 678561 651466 4084 1802 12473188 1257159 11575296 11216029 110705 92404 12548797 12091097 213271 205194 9907 25999 7601853 7436524 2181225 2060271 10006256 9727988 X 2542541 2363109 2542541 2363109 12548797 12091097 -179432 0 X 0 1 X 1 0 X 2641445 4561680 4747917 4922224 16873266 2641445 4561680 4747917 4922224 16873266 0 0 0 16873266 226592 338423 343552 346134 1254701 226592 338423 343552 346134 1254701 8677 4326 11704 24707 2868037 4908780 5095795 5280062 18152674 0.92950 0.06910 X 11527621 1024190 10503431 945567 232969 712598 11216029 DUE TO RELATED PARTIES 2060271 2060271 X PART X, LINE 2: THE ORGANIZATION FOLLOWS THE POLICY FOR UNCERTAINTY IN INCOME TAXES TO BE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE POLICY PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. NO UNCERTAIN INCOME TAX POSITIONS WERE IDENTIFIED FOR THE YEARS ENDING DECEMBER 31, 2015 AND 2014. THE ORGANIZATION'S 2012 THROUGH 2015 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL, STATE, AND LOCAL TAXING AUTHORITIES. 0 0 0 0 0 0 0 0 0 NAOMI PRENDERGAST PRESIDENT & CEO 0 223777 0 0 0 1274 0 5775 0 33386 0 264212 0 0 MARK ALTENEWG CFO 0 150465 0 0 0 128 0 3901 0 19269 0 173763 0 0 PART I, LINE 3 THE ORGANIZATION'S COMPENSATION IS ESTABLISHED BY D'YOUVILLE LEADERSHIP SOLUTIONS, 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 MASSACHUSSETTS DEVELOPMENT FINANCE AGENCY 043431814 2010-05-24 20500000 DEBT REFINANCING AND CONSTRUCTION 0 0 0 A 398147 8000000 18415 7981585 2012 0 0 0 1 A 0 0 0 0 0 0 0 A 0 0 1 0 1 0 0 0 0 A 0 SCHEDULE K SUPPLENTAL INFORMATION THE BOND ISSUANCE OF $20,500,000 WAS USED PARTIALLY FOR THE PAYOFF OF AN EXISTING DEBT OF $11,000,000 AND $1,500,000 OF CONSTRUCTION FOR A RELATED PARTY D'YOUVILE SENIOR CARE INC, THE REMAINING $8,000,000 WAS USED FOR CONSTRUCTION BY 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 A D'YOUVILLE TRANSITIONAL CARE, INC. TOTAL $8,000,000. THE REMAINING PROCEEDS OF $12,500,000 HAVE BEEN USED BY A RELATED TAX EXEMPT PARTY CONSISTENT WITH THE TERMS OF THE BOND ISSUANCE. PHILIP TAVANO DIRECTOR 36000 MEDICAL DIRECTOR AT MERRIMACK VALLEY MEDICINE ASSOCIATES - MEDICAL SERVICES PROVIDER 0 MARK COCHRAN TREASURER 104751 CEO OF JEANE D'ARC CREDIT UNION - DEBT SERVICE PROVIDER 0 STEVEN LAROCHELLE DIRECTOR 182638 EBTC BOND, LINE OF CREDIT & BANK FEES 0 FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING BOARD MEMBERS HAD A BUSINESS RELATIONSHIP: 1. NAOMI PRENDERGAST, PRESIDENT & CEO 2. SR. PAULA BRADLEY, S.C.O., CLERK 3. SR. PRESCILLE MALO, S.C.O., EX-OFFICIO 4. SR. JEANNE ARCHAMBAULT, S.C.O., DIRECTOR 5. JERRY FRECHETTE, DIRECTOR 6. AMY J. HOEY, DIRECTOR 7. STEVEN LAROCHELLE, DIRECTOR 8. JAMES LINNEHAN, JR., ESQUIRE, DIRECTOR 9. PHILIP J. TAVANO, M.D., DIRECTOR 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 ORGANIZATION HAS ONE CLASS OF MEMBERSHIP CONSISTING SOLELY OF THE SISTERS OF CHARITY OF OTTAWA. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS HAVE THE FOLLOWING POWERS AND RIGHTS AS THEY PERTAIN TO ELECTIONS: 1. TO ELECT THE DIRECTORS OF THE ORGANIZATION (OTHER THAN DIRECTORS SERVING EX-OFFICIO) AND TO REMOVE THEM WITH OR WITHOUT CAUSE. 2. TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION IN CONSULTATION WITH THE BOARD OF DIRECTORS. 3. TO RATIFY THE BOARD OF DIRECTORS' ELECTION OF THE CHAIRPERSON OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS HAVE THE FOLLOWING ADDITIONAL POWERS AND RIGHTS: 1. TO APPROVE ANY CHANGE TO THE PHILOSOPHY AND MISSION OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION, AND TO MONITOR COMPLIANCE WITH SAME. 2. TO AMEND AND TO REPEAL THE ARTICLES OF ORGANIZATION AND THE BYLAWS OF THE CORPORATION, AND TO APPROVE THE ADOPTION, AMENDMENT OR REPEAL OF THE CHARTER AND THE BYLAWS (OR OTHER GOVERNING INSTRUMENTS) OF ANY SUBSIDIARY OF THE CORPORATION. 3. 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 ANY 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. 4. TO APPROVE THE ACQUISITION, SALE, TRANSFER OR ENCUMBRANCE OF ANY REAL ESTATE, OR THE CONSTRUCTION OR DESTRUCTION OF ANY IMPROVEMENTS THEREON, BY THECORPORATION OR ANY SUBSIDIARY OF THE CORPORATION VALUED IN EXCESS OF $250,000 (OR SUCH OTHER AMOUNT AS IS SET BY THE MEMBERS IN WRITING FROM TIME TO TIME). 5. TO APPROVE ALL DEBT OF THE CORPORATION FOR BORROWED MONEY IN EXCESS OF $250,000 (OR SUCH OTHER AMOUNT AS IS SET BY THE MEMBERS IN WRITING FROM TIME TO TIME) BEFORE SUCH DEBT IS INCURRED, AND TO APPROVE ALL CHANGES TO THE TERMS OF ANY SUCH DEBT. 6. 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. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS FULLY REVIEWED BY THE CEO, CFO, AND THE BOARD TREASURER. THE COMPLETE FORM 990 IS THEN SENT TO ALL DIRECTORS FOR TOP-LEVEL REVIEW PRIOR TO FILLING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH EMPLOYEE, OFFICER AND KEY EMPLOYEE IS GIVEN THE CONFLICT OF INTEREST POLICY AT ORIENTATION AND IS REQUIRED TO REVIEW THIS POLICY ON AN ON-GOING BASIS USING AN ONLINE EDUCATIONAL SOFTWARE. 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 15 A COMPENSATION COMMITTEE WAS ESTABLISHED TO REVIEW AND APPROVE THE CEO AND CFO COMPENSATION ANNUALLY. THE ANNUAL REVIEW INCLUDES (BUT IS NOT LIMITED TO) A REVIEW OF MARKET WAGES BY USE OF INDEPENDENT SURVEY OR BY COMPARISON TO INDUSTRY DATA. THE COMPENSATION REVIEW IS DOCUMENTED BY USE OF MINUTES AND IS LOCATED WITHIN THE EMPLOYEES FILE. OFFICERS WITH VOTING RIGHTS ABSTAIN FROM THE REVIEW PROCESS IF A CONFLICT EXISTS. MANAGEMENT AND KEY EMPLOYEE COMPENSATION IS REVIEWED BY THE CEO ON AN ANNUAL BASIS USING THE SAME METHODOLOGY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. D'YOUVILLE SENIOR CARE INC 981 VARNUM AVENUE LOWELL MA 01854 042510563 SENIOR CARE MA 501(C)(3) LINE 9 SISTERS OF CHARITY OF OTTAWA 0 D'YOUVILLE SENIOR CARE FOUNDATION INC 981 VARNUM AVENUE LOWELL MA 01854 912055004 FUNDRAISING MA 501(C)(3) LINE 11A, I SISTERS OF CHARITY OF OTTAWA 0 D'YOUVILLE SENIOR LIVING INC 979 VARNUM AVENUE LOWELL MA 01854 200837361 LOW-INCOME SENIOR HOUSING MA 501(C)(3) LINE 9 D'YOUVILLE SENIOR CARE INC 0 D'YOUVILLE LEADERSHIP SOLUTIONS INC 981 VARNUM AVENUE LOWELL MA 01854 274675543 MANAGEMENT COMPANY MA 501(C)(3) LINE 11B, II SISTERS OF CHARITY OF OTTAWA 0 D'YOUVILLE LIFE & WELLNESS COMMUNITY INC 981 VARNUM AVENUE LOWELL MA 01854 274675379 SENIOR CARE MA 501(C)(3) LINE 11B, II SISTERS OF CHARITY OF OTTAWA 0 SISTERS OF CHARITY OF OTTAWA 245 UNIVERSITY AVENUE LOWELL MA 01854 042127030 SCHOOL - GRADES K-8 MA 501(C)(1) N/A 0 D'YOUVILLE ELDERLY HOUSING CORPORATION 975 VARNUM AVENUE LOWELL MA 01854 043536564 LOW-INCOME SENIOR HOUSING MA 501(C)(3) LINE 9 PLANNING OFFICE FOR URBAN AFFAIRS INC 0 0 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 1 0 0