2012-11-15T15:05:33-06:00 2011-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2011-01-01 042510563 D'YOUVILLE SENIOR CARE INC DYOU 9785691000 981 VARNUM AVENUE LOWELL MA 01854 NAOMI PRENDERGAST 9785691000 2012-11-09 1 BARBARA MORRISON P00173340 6179848100 2012-10-22 2011 2016-02-24 21:20:13Z NAOMI PRENDERGAST 981 VARNUM AVENUE LOWELL MA 01854 25759439 0 X WWW.DYOUVILLE.ORG X 1960 MA D'YOUVILLE SENIOR CARE, INC. OPERATES A 208 BED SKILLED NURSING FACILITY. 17 16 513 76 0 0 124184 23382 20330165 20724529 522791 578097 0 0 20977140 21326008 0 0 0 0 13132352 13485740 0 0 83996 7283815 7219265 20416167 20705005 560973 621003 28626959 27737735 13016647 15990009 15610312 11747726 D'YOUVILLE SENIOR CARE FURTHERS THE HEALING MINISTRY OF JESUS CHRIST BY EXTENDING PROFESSIONAL AND COMPASSIONATE CARE TO SENIORS IN NEED. 0 0 18570328 20761553 OPERATION OF A 208 BED LONG-TERM NURSING CARE FACILITY. 427131 384763 OPERATION OF A 23 LICENSED ADULT DAY CENTER 18997459 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 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 0 1 26 0 1 513 1 0 0 0 0 0 0 0 0 0 0 X 17 16 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X MARK ALTENWEG 9785691000 DYOUVILLE SENIOR CARE INC 981 LOWELL MA 01854 DANIEL HANLEY 1.00 X 0 0 0 ROY JOHNSON 1.00 X 0 0 0 WILLIAM SOUCY 1.00 X 0 0 0 ROBERT YOUNG 2.00 X X 0 0 0 SR PRESCILLE MALO SCO 2.00 X X 0 0 0 NAOMI PRENDERGAST 40.00 X X 193193 0 30732 JOSEPH CLERMONT ESQUIRE 1.00 X 0 0 0 ANN MONTMINY 1.00 X 0 0 0 SR PAULA BRADLEY SCO 2.00 X X 0 0 0 KAREN DEVEREAUX MELILLO 1.00 X 0 0 0 JAMES M GEARY JR HON 1.00 X 0 0 0 MARK S COCHRAN 1.00 X X 0 0 0 JAMES LINNEHAN JR ESQ 1.00 X X 0 0 0 STEPHEN GUIMOND 1.00 X 0 0 0 THOMAS J BROWN 1.00 X 0 0 0 SR JEANE ARCHAMBAULT SCO 1.00 X 0 0 0 PHILIP J TAVANO MD 1.00 X 0 0 0 MARK ALTENWEG 40.00 X 138628 0 24982 ANDREA RATHBONE 40.00 X 129405 0 20809 CYNTHIA THORTON 40.00 X 110189 0 20530 571415 0 97053 4 0 1 0 CUTLER ASSOCIATES LTD 43 HARVARD ST PO BOX 15409 WORCESTER MA 01609 DESIGN BUILD 8317271 HPC FOODSERVICE INC DEPT 385 PO BOX 150473 HARTFORD CT 06115 FOOD DISTRIBUTOR 594914 BLUE CROSS BLUE SHIELD PO BOX 371318 PITTSBURGH PA 15250 HEALTH DENTAL INSURANCE 525817 PARTNER'S PHARMACY 181 CEDAR HILL RD MARLBOROUGH MA 01752 PHARMACY 458429 TRIMARK UNITED EAST INC PO BOX 3505 S ATTLEBORO MA 02703 FOODSERVICE EQUIP AND SUPPLIES 391679 10 23382 23382 PATIENT REVENUE 623990 20339766 20339766 ADULT DAY HEALTH 623990 384763 384763 20724529 156310 156310 4855218 4433431 421787 421787 421787 21326008 21146316 0 156310 387535 387535 10771410 9818112 884141 69157 146312 132475 12904 933 1244215 1126550 109730 7935 936268 847726 82571 5971 27509 27509 63245 63245 561213 505298 55915 69719 69719 165428 165428 43440 43440 1091113 1091113 25814 25814 1020007 1020007 412091 412091 USER FEES 1210789 1210789 DIETARY 650163 650163 ADULT DAY HEALTH 427131 427131 PHARMACY SUPPLIES 372034 372034 1079569 1079569 20705005 18997459 1623550 83996 1034789 1142829 2040008 2765092 1032681 1252799 239971 104244 26389517 11202900 15524658 15186617 5197147 5217164 3557705 2068990 28626959 27737735 2016647 3512681 11000000 12477328 13016647 15990009 X 15607363 11747726 2949 0 15610312 11747726 28626959 27737735 X 621003 -4483589 X X 0 1 1 X 0 X 73544 158770 91049 124184 15382 462929 19010107 19493132 19892082 20330165 20724531 99450017 19083651 19651902 19983131 20454349 20739913 99912946 0 0 0 99912946 465594 328378 192559 182689 164310 1333530 465594 328378 192559 182689 164310 1333530 19549245 19980280 20175690 20637038 20904223 101246476 0.98680 0.98430 0.01320 0.01570 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2949 2949 2949 2949 2949 2949 2949 2949 0.00000 0.00000 0.00000 820995 820995 21272900 7928791 13344109 4072153 3068282 1003871 223469 205827 17642 15186617 COST OF FINANCING 162336 SOFTWARE (NET) 56339 CONSTRUCTION IN PROGRESS 1676322 DUE FROM RELATED PARTIES 173993 2068990 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS WERE USED FOR THE FUNDING OF A LIBRARY. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS A NOT-FOR-PROFIT 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 FILES AS A TAX-EXEMPT ENTITY. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, THE ORGANIZATION'S 2008 THROUGH 2011 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. X X X X X 0 0 0 0 0 0 0 0 0 NAOMI PRENDERGAST 192177 0 0 0 1016 0 0 0 30732 0 223925 0 0 0 MARK ALTENWEG 136019 0 2500 0 109 0 0 0 24982 0 163610 0 0 0 ANDREA RATHBONE 129405 0 0 0 0 0 0 0 20809 0 150214 0 0 0 MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 2010-05-24 20500000 DEBT REFINANCING AND CONSTRUCTION 0 0 0 12500000 91520 1408480 11000000 2012 1 0 0 1 0 0 0 0 1 0 1 0 0 0 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'YOUVILE 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 TOTAL PROCEEDS OF ISSUE 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. MERRIMACK VALLEY INTERNAL MEDICINE ASSOCIATES PC (DR LOUIS BRESNICK) MEDICAL DIRECTOR AND BOD 36000 MEDICAL DIRECTOR 0 JEANNE DARC CREDIT UNION (MARK COCHRAN) BOD TREASURER 12500000 CEO OF PARTICIPATING BANK - NEW BONDS 0 FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING DIRECTOR'S HAD A BUSINESS RELATIONSHIP: 1) SR. PRESCILLE MALO, SCO, 2.) SR. PAULA BRADLEY, SCO, 3.) RAYMOND ANSTISS JR. (TERM EXPIRED IN 2011), 4.) WIN BROWN ( TERM EXPIRED IN 2011), 5.) DR. LOUIS BRESNICK ( TERM EXPIRED IN 2011), 6.) JAMES LINNEHAN JR., 7.) ANN MONTMINY, 8.) NAOMI PRENDERGAST, 9.) ROBERT YOUNG, 10.) MARK COCHRAN, 11.) WILLIAM SOUCY, 12.) CATHERINE SEELEY ( TERM EXPIRED IN 2011) 13.) KAREN MELILLO, 14.) STEPHEN GUIMOND. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SPONSORS ARE THE SISTERS OF CHARITY OF OTTAWA. FORM 990, PART VI, SECTION A, LINE 7A THE SISTERS OF CHARITY OF OTTAWA ELECT THE BOARD OF DIRECTORS FORM 990, PART VI, SECTION B, LINE 11 FULL REVIEW BY CFO, CEO AND BOARD TREASURER. THEN IT IS SENT TO ALL TRUSTEES FOR TOP-LEVEL REVIEW. FORM 990, PART VI, SECTION B, LINE 12C EACH EMPLOYEE, DIRECTOR, OFFICER, AND KEY EMPLOYEE IS GIVEN THE POLICY AT ORIENTATION. THIS IS REVIEWED ANNUALLY AT IN-SERVICE FAIR. TO PREVENT TRADE CONFLICT, ALL MATERIAL EXPENDITURES NEED A MINIMUM OF 3 BIDS FROM CONTRACTORS. FORM 990, PART VI, SECTION B, LINE 15 A COMPENSATION COMMITTEE WAS ESTABLISHED TO REVIEW CEO AND CFO COMPENSATION. OFFICER AND KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY IS AVAILABLE IN THE CORPORATE INTEGRITY PROGRAM HANDBOOK AND THE GOVERNING DOCUMENTS AND THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -483,588. TRANSFER TO AFFILIATE -4,000,000. ROUNDING -1. TOTAL TO FORM 990, PART XI, LINE 5: -4,483,589. FORM 990 PART XII LINE 2C THE ORGANIZATION HAS A COMMITTEE THAT IS RESPONSIBLE FOR THE OVERSIGHT OF THE FINANCIAL STATEMENTS AND THE SELECTION OF THE AUDITOR. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. D'YOUVILLE SENIOR CARE FOUNDATION INC 981 VARNUM AVE LOWELL MA 01854 912055004 FUNDRAISING MA 501(C)(3) LINE 11A, I N/A 0 D'YOUVILLE SENIOR LIVING INC 979 VARNUM AVE LOWELL MA 01854 200837361 LOW-INCOME SENIOR HOUSING MA 501(C)(3) LINE 9 N/A 0 D'YOUVILLE ELDERLY HOUSING INC 975 VARNUM AVE LOWELL MA 01854 043536564 LOW-INCOME SENIOR HOUSING MA 501(C)(3) LINE 7 N/A 0 D'YOUVILLE TRANSITIONAL CARE UNIT INC 1071 VARNUM AVE LOWELL MA 01854 271680453 SHORT-TERM REHAB MA 501(C)(3) LINE 1 N/A 0 D'YOUVILLE LEADERSHIP SOLUTIONS INC 981 VARNUM AVE LOWELL MA 01854 274675543 MANAGEMENT COMPANY MA 501(C)(3) LINE 11B, II N/A 0 D'YOUVILLE LIFE & WELLNESS COMMUNITY INC 981 VARNUM AVE LOWELL MA 01854 274675379 SENIOR CARE MA 501(C)(3) LINE 11B, II N/A 0 0 0 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 0