Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 234,113 | 233,085 | 213,550 | 202,530 | 197,194 | 1,080,472 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | 196,120 | 201,830 | 214,168 | 235,236 | 251,398 | 1,098,752 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | 430,233 | 434,915 | 427,718 | 437,766 | 448,592 | 2,179,224 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 2,179,224 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 430,233 | 434,915 | 427,718 | 437,766 | 448,592 | 2,179,224 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 952 | 538 | 569 | 280 | 2,122 | 4,461 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 952 | 538 | 569 | 280 | 2,122 | 4,461 |
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 6,639 | 12,506 | 8,540 | 7,130 | 8,420 | 43,235 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 437,824 | 447,959 | 436,827 | 445,176 | 459,134 | 2,226,920 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2024 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2024. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | LAUNDRY INCOME - 2020 AMOUNT: $ 6,151. 2021 AMOUNT: $ 5,954. 2022 AMOUNT: $ 5,907. 2023 AMOUNT: $ 3,582. 2024 AMOUNT: $ 6,335. OTHER INCOME - 2020 AMOUNT: $ 488. 2021 AMOUNT: $ 6,552. 2022 AMOUNT: $ 2,633. 2023 AMOUNT: $ 3,548. 2024 AMOUNT: $ 2,085. |
| Software ID: | |
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| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION'S MANAGEMENT DUTIES ARE PERFORMED BY A RELATED ORGANIZATION, D'YOUVILLE SENIOR CARE, INC. D'YOUVILLE SENIOR CARE, INC. PROVIDES MANAGEMENT AND ADMINISTRATIVE SUPPORT SERVICES WHICH INCLUDE MANAGEMENT OVERSIGHT, BUSINESS OFFICE FUNCTIONS, HUMAN RESOURCES, MARKETING, INFORMATION TECHNOLOGY, ADMISSIONS, AND MAINTENANCE FUNCTIONS. |
| 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 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 ELDERLY HOUSING CORPORATION 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 ELDERLY HOUSING CORPORATION. |
| 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. |
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