2017-08-10T14:28:51-05:00 2016-12-31 310905417 VONLEHMAN & COMPANY INC 810 WRIGHTS SUMMIT PARKWAY SUITE 300 FORT WRIGHT KY 410112993 990 2016-01-01 610523290 CARMEL MANOR CARM 8597815111 100 CARMEL MANOR ROAD FORT THOMAS KY 41075 SR DIANE MACK ADMINISTRATOR 8597815111 2017-08-07 1 KERRI L RICHARDSON P00636119 8593313300 69.61.206.123 2017-08-07 10:30:43 ED P AF89ED51A4A17D397C599AF7871C7C883557ED69 2D92DA20BECA3EFBCF5E102943AFE4BCDEB5550F 2016 2021-01-29 14:40:06Z SR DIANE MACK 100 CARMEL MANOR ROAD FORT THOMAS KY 41075 8307838 0 X WWW.CARMELITESYSTEM.ORG/FACILITES/CARMEL_MANOR.HT X 1949 KY THE MISSION OF THE HOME IS TO 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 15 262 48 0 0 430853 331329 7430018 6883724 204168 253610 161414 182826 8226453 7651489 0 0 0 0 5016521 5485895 0 0 0 2384004 2659136 7400525 8145031 825928 -493542 28304082 31536154 19208222 22749690 9095860 8786464 X CARMEL MANOR OPERATES A NURSING HOME AND A PERSONAL CARE HOME IN FORT THOMAS, KENTUCKY. THE HOME PROVIDES PROFESSIONAL AND PERSONAL SERVICES IN A COMPASSIONATE AND CARING MANNER TO MEMBERS OF THE FORT THOMAS AND SURROUNDING COMMUNITIES AND OTHER LOCATIONS THAT SEEK OUR SERVICES. DURING 2016 THE HOME SERVED HUNDREDS OF OUR NEIGHBORS AND THEIR FAMILIES WITHOUT REGARD TO THEIR ETHNIC BACKGROUND, RELIGION, OR FINANCIAL CIRCUMSTANCES. 0 0 3585934 4927050 CARMEL MANOR IS A SKILLED NURSING FACILITY WHICH SERVES THE NEEDS OF UP TO 145 INDIVIDUALS.NURSING SERVICES 2464902 1978274 GENERAL SERVICES 912576 DIETARY SERVICES 6963412 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 15 0 1 262 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X SR DIANE MACK 8597815111 100 CARMEL MANOR RD FT THOMAS KY 410755111 X SR ANN BROWN OCARM DIRECTOR 0.00 X 0 0 0 SR JEANNE HALEY OCARM VICE PRESIDENT 0.00 X X 0 0 0 SR ANN MCCARTNEY OCARM DIRECTOR 0.00 X 0 0 0 SR M TERESA KATHLEEN DOMINICK DIRECTOR 0.00 X 0 0 0 SR MARY LUANN BENDER SND DIRECTOR 0.00 X 0 0 0 MR D ANTHONY BRINKER DIRECTOR 0.00 X 0 0 0 MR MICHAEL DESMOND CHAIRMAN 0.00 X X 0 0 0 REV RONALD KETTELER DIRECTOR 0.00 X 0 0 0 SR CYRIL KASPER O CARM PRESIDENT 0.00 X X 0 0 0 MR THOMAS E SAALFELD DIRECTOR 0.00 X 0 0 0 MR JEFFREY BRAULEY DIRECTOR 0.00 X 0 0 0 MR BOB HOFFER DIRECTOR 0.00 X 0 0 0 DR PATRICK J MCCAULEY DMD DIRECTOR 0.00 X 0 0 0 SR LOIS BANIEWICZ O CARM DIRECTOR 0.00 X 0 0 0 MS CATHERINE MILLETTE MORRISON SECRETARY 0.00 X X 0 0 0 SR DIANE MACK ADMINISTRATOR/TREASURER 40.00 X 124480 0 8878 FRANK FESSLER FINANCE DIRECTOR 40.00 X 64761 0 0 189241 0 8878 1 0 0 0 TURNER CONSTRUCTION 250 WEST COURT STREET SUITE 300 CINCINNATI OH 45202 GENERAL CONSTRUCTION CONTRACTORS 3133190 REHAB CARE PO BOX 503534 ST LOUIS MO 63150 PHYSICAL, OCCUPATIONAL AND SPEECH THERAP 299316 GORDON FOODS PO BOX 88029 CHICAGO IL 60680 GROCERIES 292590 PRN SERVICES LLC 3126 DIXIE HWY 1ST FLOOR ERLANGER KY 41018 CONTRACT NURSING 284938 HILL-ROM PO BOX 643592 PITTSBURGH PA 15264 BED FURNITURE 178469 10 331329 331329 RESIDENTIAL CARE 623000 4927050 4927050 1956674 1956674 6883724 163944 163944 744171 654505 89666 89666 89666 20 1844 -1824 -1824 MISCELLANEOUS REVENUE 900099 78714 78714 CONVENT REVENUE 900099 46722 46722 SHOP REVENUE 453220 33342 33342 25872 21600 4272 184650 7651489 6905324 0 414836 4501254 3888516 612738 53269 45651 7618 491899 421553 70346 439473 376624 62849 53234 53234 57054 57054 24907 24907 12738 12738 318602 318602 109673 109673 ANCILLARY MEDICAL EXPEN 441453 441453 FOOD COST 358143 358143 PROVIDER TAX 311898 311898 UTILITIES 271141 271141 700293 476597 223696 8145031 6963412 1181619 0 1345659 456317 61314 23709 122566 48952 495475 557337 43121 40318 40926 69894 9054817 7717403 1423914 1337414 5729524 6002368 19041583 22999845 28304082 31536154 960865 921813 17287569 20989034 959788 838843 19208222 22749690 X 9095860 8786464 9095860 8786464 28304082 31536154 X -493542 122515 61631 X X 0 1 X 1 0 X 54159 105371 190998 430853 331329 1112710 7222960 7139402 7519196 7458218 6905324 36245100 2393 1370 20 3783 7277119 7244773 7712587 7890441 7236673 37361593 0 0 0 37361593 166986 181503 171760 164007 163944 848200 166986 181503 171760 164007 163944 848200 156075 128163 138046 142057 163050 727391 7600180 7554439 8022393 8196505 7563667 38937184 0.95950 0.95980 0.02180 0.02170 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 48462 48462 5736995 5462361 274634 1796760 1562097 234663 1393801 632884 760917 78799 60061 18738 1337414 OTHER SECURITES 6002368 F 6002368 CONSTRUCTION IN PROGRESS 22601546 DEFERRED FINANCE COST 398299 22999845 SECURITY DEPOSITS 65000 SWAP AGREEMENT 773843 838843 X 7835635 122515 61631 184146 7651489 0 7651489 8145031 0 8145031 0 8145031 PART X, LINE 2: THE ORGANIZATION HAS ADOPTED THE PROVISIONS OF THE ACCOUNTING PRONOUNCEMENT RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE ORGANIZATION RECOGNIZED NO INTEREST OR PENALTIES IN THE STATEMENT OF OPERATIONS FOR THE YEARS ENDED DECEMBER 31, 2016 AND 2015. IF THE SITUATION AROSE IN WHICH THE ORGANIZATION WOULD HAVE INTEREST TO RECOGNIZE, IT WOULD RECOGNIZE THIS AS INTEREST EXPENSE AND PENALTIES WOULD BE RECOGNIZED IN OTHER EXPENSES. TAX YEARS STILL OPEN UNDER FEDERAL AND STATE STATUTE OF LIMITATIONS REMAIN SUBJECT TO REVIEW AND CHANGE. BASED ON THE EVALUATION OF THE ORGANIZATION'S TAX POSITIONS, MANAGEMENT BELIEVES ALL POSITIONS TAKEN WOULD BE UPHELD UNDER AN EXAMINATION. THEREFORE, NO PROVISION FOR THE EFFECTS OF UNCERTAIN TAX POSITIONS HAS BEEN RECORDED FOR THE YEARS ENDED DECEMBER 31, 2016 AND 2015. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 61,631. A KY ECONOMIC DEVELOPMENT FINANCE AUTHORITY HEALTHCARE FACILITIES REVENUE 610600439 2015-04-13 13661970 TO FINANCE THE PROPOSED ADDITION AND IMPROVEMENTS TO THE PROPERTY. 0 1 0 A 13661970 13661970 2016 0 0 0 0 A 0 0 0 0 0 0 0 A 0 0 0 1 1 0 0 0 0 A 0 FORM 990, PART VI THE ORGANIZATION HAS A FORMAL RECORD RETENTION AND DESTRUCTION POLICY WHICH COMPLIES WITH FEDERAL AND STATE LAW AND WITH THE REQUIREMENTS OF VARIOUS REGULATORY AGENCIES. FORM 990, PART VI THE ORGANIZATION HAS A CORPORTE COMPLIANCE POLICY IN PLACE, WHICH INCLUDES A POLICY ON WHISTLEBLOWER PROTECTION. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS THE CARMELITE SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBERS RETAIN THE RIGHT TO APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW. THE FINANCE COMMITTEE REPORTS TO THE BOARD OF DIRECTORS REGARDING THE REVIEW, AND A COPY OF FORM 990 IS PROVIDED TO THE BOARD BEFORE IT IS FILED. 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 INDIVIDUAL IS REQUIRED TO DISCLOSE IN WRITING THE NATURE OF SUCH EXTERNAL INTERESTS. THE DISCLOSURE STATEMENT IS PROVIDED TO THE ADMINISTRATOR FOR REVIEW. CONFLICTS ARE RESOLVED BY MAKING A REQUIRED DISCLOSURE, AND MAY RESULT IN RESTRICTING THE OFFICER OR BOARD MEMBER IN ANY RELATED ACTIVITY OR PROCESS AS DETERMINED APPROPRIATE TO THE CIRCUMSTANCES OF THE CONFLICT. FAILURE TO DISCLOSE A CONFLICT OF INTEREST IS IN VIOLATION OF THE ADOPTED POLICY AND CAN RESULT IN DISCIPLINARY ACTION OR REMOVAL. FORM 990, PART VI, SECTION B, LINE 15 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 COVERED INDIVIDUALS BASED ON RELEVANT DATA INCLUDING COMPARABILITY COMPENSATION FOR SIMILARLY SITUATED ENTITIES AND INDEPENDENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS AS DEEMED NECESSARY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS; CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND TAX FILINGS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION ALSO FILES REPORTS WITH VARIOUS GOVERNMENTAL AGENCIES AS A REQUIREMENT FOR PARTICIPATION IN GOVERNMENT PROGRAMS, WHICH THE AGENCIES MAY MAKE AVAILABLE TO THE PUBLIC. THE ORGANIZATIONS FORM 990 IS AVAILABLE TO THE PUBLIC ON GUIDESTAR'S WEBSITE. PART VII, SECTION A SR. DIANE MACK AS A MEMBER OF THE CARMELITE SISTERS FOR THE AGED AND INFIRM, INC. HAS TAKEN A VOW OF POVERTY. THE COMPENSATION ESTABLISHED FOR THE SISTER ON BEHALF OF SERVICES PROVIDED TO THE FACILITY FOR SR. DIANE MACK IS PAID DIRECTLY TO THE CARMELITE SISTERS FOR THE AGED AND INFIRM, INC. RATHER THAN TO THE INDIVIDUAL SISTER. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 61,631. 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 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 125265639 141369151 TO SPONSOR NURSING HOMES FOR THE AGED AND INFIRM NY 501(C)(3) LINE 10 N/A 0 THE CARMELITE SYSTEM INC 646 WOODS ROAD GERMANTOWN NY 125265639 141810368 MANAGEMENT OF AFFILIATED FACILITIES NY 501(C)(3) LINE 10 N/A 0 CARMEL TERRACE INC 933 CENTRAL ST FRAMINGHAM MA 01701 043210051 ASSISTED LIVING FACILITY MA 501(C)(3) LINE 10 N/A 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 N/A 0 LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE INC 315 SOUTH FLAGLER DR WEST PALM BEACH FL 33401 590879342 SKILLED, ASSISTED AND INDEPENDENT LIVING FACILITY FL 501(C)(3) LINE 10 N/A 0 MARIAN MANOR FOR THE AGED AND INFIRM INC 130 DORCHESTER ST BOSTON MA 02127 042173054 SKILLED NURSING FACILITY MA 501(C)(3) LINE 10 N/A 0 MOTHER ANGELINE MCCRORY MANOR INC 5199 EAST BROAD ST COLUMBUS OH 43213 912134683 SKILLED NURSING FACILITY OH 501(C)(3) LINE 10 N/A 0 MOUNT CARMEL CARE CENTER INC 320 PITTSFIELD ROAD LENOX MA 01240 383902709 SKILLED NURSING FACILITY MA 501(C)(3) LINE 10 N/A 0 ST MARGARET HALL 1960 MADISON ROAD CINCINNATI OH 45206 310655031 SKILLED NURSING AND ASSISTED LIVING FACILITY OH 501(C)(3) LINE 10 N/A 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 N/A 0 ST PATRICK'S MANOR 863 CENTRAL ST FRAMINGHAM MA 01701 042157057 SKILLED NURSING FACILITY MA 501(C)(3) LINE 10 N/A 0 ST PATRICK'S RESIDENCE 1400 BROOKDALE ROAD NAPERVILLE IL 60563 362527011 SKILLED NURSING FACILITY IL 501(C)(3) LINE 10 N/A 0 VILLAS AT SAINT THERESE INC 5253 EAST BROAD STREET COLUMBUS OH 43213 472021696 INDEPENDENT LIVING FACILITY OH 501(C)(3) LINE 10 N/A 0 OZANAM HALL 4241 201ST STREET BAYSIDE NY 11361 112167809 SKILLED NURSING FACILITY NY 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 CARMELITE SISTERS FOR THE AGED AND INFIRM INC Q 46722 CARMELITE SISTERS FOR THE AGED AND INFIRM INC O 247849