ST DOMINIC HEALTH SERVICES INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
ST DOMINIC HEALTH SERVICES INC (EIN 64-0714999)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-13
IRS object ID
202301339349302410
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-05-13T18:28:34-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135565207PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1301 MAIN STREET SUITE 2150AddressLine1Txt
CityBATON ROUGECityNm
State AbbreviationLAStateAbbreviationCd
ZIP70801ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN640714999EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST DOMINIC HEALTH SERVICES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSTDOBusinessNameControlTxt
Phone6012006951PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1969 LAKELAND DRIVEAddressLine1Txt
CityJACKSONCityNm
State AbbreviationMSStateAbbreviationCd
ZIP392164699ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSAM SCOTTPersonNm
Person TitleCFO/TREASURERPersonTitleTxt
Phone6012006951PhoneNum
Signature2023-05-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSAMPersonFirstNm
Person LastSCOTTPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRYAN HOOKSPreparerPersonNm
PTINP00746825PTIN
Phone2253444000PhoneNum
Preparation2023-05-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSAM SCOTTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1969 LAKELAND DRIVEAddressLine1Txt
CityJACKSONCityNm
State AbbreviationMSStateAbbreviationCd
ZIP392164699ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$34,815,574GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.STDOM.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1985FormationYr
Legal Domicile StateMSLegalDomicileStateCd
Activity Or MissionSDHS MANAGES AN INTEGRATED HEALTH SYSTEM TO MAKE A DIFFERENCE IN OUR COMMUNITIES THROUGH CATHOLIC HEALTH SERVICES BY CALLING FORTH ALL WHO SERVE IN THE HEALTHCARE MINISTRY.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee51TotalEmployeeCnt
Total Volunteers8TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$9,332,353PYProgramServiceRevenueAmt
CY Program Service Revenue$8,938,966CYProgramServiceRevenueAmt
PY Investment Income$4,960,026PYInvestmentIncomeAmt
CY Investment Income$6,476,612CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$14,292,379PYTotalRevenueAmt
CY Total Revenue$15,415,578CYTotalRevenueAmt
PY Grants And Similar Paid$2,975,117PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,017,211CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$4,534,631PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,312,884CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,701,188PYOtherExpensesAmt
CY Other Expenses$5,766,549CYOtherExpensesAmt
PY Total Expenses$12,210,936PYTotalExpensesAmt
CY Total Expenses$9,096,644CYTotalExpensesAmt
PY Revenues Less Expenses$2,081,443PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,318,934CYRevenuesLessExpensesAmt
Total Assets BOY$213,543,945TotalAssetsBOYAmt
Total Assets EOY$188,916,017TotalAssetsEOYAmt
Total Liabilities BOY$44,387,612TotalLiabilitiesBOYAmt
Total Liabilities EOY$26,659,463TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$169,156,333NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$162,256,554NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionINSPIRED BY THE VISION OF ST. FRANCIS AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH ALL WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING- WITH REVERANCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED IN OUR CARE. WE ARE, WITH GOD'S HELP, A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILEGED TO SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$533,912ExpenseAmt
Revenue$8,938,966RevenueAmt
DescST. DOMINIC HEALTH SERVICES (SDHS) IS THE PARENT COMPANY OF A MULTI-DIMENSIONAL PROVIDER OF HEALTH CARE SERVICES WITH CORPORATE HEADQUARTERS IN JACKSON, MS. SDHS PROVIDES MANAGEMENT SERVICES TO ITS AFFILIATED COMPANIES INCLUDING THE FOLLOWING ENTITIES:ST. DOMINIC - JACKSON MEMORIAL HOSPITALI. 571-BED ADULT TERTIARY REFERRAL CENTERII. SERVES A BROAD AREA ENCOMPASSING JACKSON AND MOST OF CENTRAL MISSISSIPPI III. INCLUDES PRIMARY AND SPECIALTY PHYSICIAN SERVICESST. CATHERINE'S VILLAGE, INC. I. CONSIST OF 246 INDEPENDENT LIVING UNITS-MULTIPLE INDIVIDUALS IN EACH UNIT INCLUDING 54 GARDEN HOMESII. 120 SKILLED NURSING BEDS LOCATED IN THREE DIFFERENT AREAS OF SKILLED NURSING. THREE LOCATIONS-SIENA, TUSCANY AND HUGHES CENTER LICENSED NURSING HOME WITH 120 BEDS III. 53 BASIC ASSISTED LIVING BEDS IN MARIAN HALLIV. 24 ALZHEIMER'S ASSISTED LIVING BEDS IN CAMPBELL COVECOMMUNITY HEALTH SERVICES - ST. DOMINIC, INC. I. THE CLUB (ST. DOMINIC'S COMMUNITY WELLNESS PROGRAM) OFFERS A COMPREHENSIVE SELECTION OF PERSONALIZED, MEDICALLY INTEGRATED HEALTH EDUCATION AND FITNESS PROGRAMS AVAILABLE TO EMPLOYEES, MEMBERS AND THE COMMUNITY. II. NEW DIRECTIONS FOR OVER 55 (SENIOR ADULT PROGRAM) PROVIDES EDUCATION AND SERVICES TO HELP KEEP SENIOR ADULTS ACTIVE AND ENGAGED. III. CARE-A-VAN MOBILE HEALTH SCREENING UNIT PROVIDES HEALTH SCREENINGS AND VACCINATIONS ACROSS MISSISSIPPI WITH FOCUS ON UNDERSERVED POPULATIONS. IV. COMMUNITY HEALTH CLINIC PROVIDES PRIMARY CARE TO THE UNINSURED IN AN UNDERSERVED AREA OF JACKSON. V. SCHOOL NURSE PROGRAM PROVIDES REGISTERED NURSES TO THE MADISON COUNTY MIDDLE AND ELEMENTARY SCHOOLS. ST. DOMINIC HEALTH SERVICES FOUNDATION, INC. I. THE ST. DOMINIC HEALTH SERVICES FOUNDATION SUPPORTS THE MISSION AND VISION OF ST. DOMINIC HEALTH SERVICES AND ITS SUBSIDIARIES THROUGH MULTIPLE FUNDRAISING AND GIVING INITIATIVES THAT CONVEY A CHRISTIAN MESSAGE. ST. DOMINIC MADISON HEALTH SERVICES, INC. I. SUPPORTS THE SDHS MISSION THROUGH OPERATION OF A MEDICAL OFFICE BUILDING THAT INCREASES ACCESS TO HEALTH SERVICES II. PARTNERS IN THE OPERATION OF A HEALTH AND WELLNESS CENTER IN MADISON COUNTY THAT OFFERS FAMILY - ORIENTED HEALTH AND FITNESS SERVICES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,017,211ExpenseAmt
Grant$1,017,211GrantAmt
DescGRANTS ARE MADE TO CHARITABLE ORGANIZATIONS IN ORDER TO SUPPORT THE CHARITABLE MISSION OF FRANCISCAN MISSIONAIRES OF OUR LADY HEALTH SYSTEM, INC.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$1,551,123TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document23IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee51EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SAM SCOTTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6012006642PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1969 LAKELAND DRIVEAddressLine1Txt
CityJACKSONCityNm
State AbbreviationMSStateAbbreviationCd
ZIP392164699ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
SISTER M DOROTHEA SONDGEROTH
VICE CHAIR40.000.50Yes (X)Yes (X)$0$0$0
SISTER M TRINITA EDDINGTON
SECRETARY4.0037.00Yes (X)Yes (X)$0$0$0
E B ROBINSON JR
BOARD MEMBER1.000.00Yes (X)$0$0$0
MARCELO J RUVINSKY MD
CHAIR1.000.00Yes (X)Yes (X)$0$0$0
SISTER ROSE MIRIAM SCHULTE OP
BOARD MEMBER1.000.00Yes (X)$0$0$0
BISHOP JOSEPH KOPACZ
BOARD MEMBER1.000.00Yes (X)$0$0$0
SISTER BETH MURPHY
BOARD MEMBER1.000.00Yes (X)$0$0$0
RICHARD VATH MD
BOARD MEMBER/CEO FMOLHS1.0040.00Yes (X)$0$2,415,659$46,605
STEWARD GENTRY
BOARD MEMBER1.000.00Yes (X)$0$0$0
RENE J RAGAS
BOARD MEMBER/CEO OF ANGELS1.000.00Yes (X)$0$642,468$109,874
SCOTT KASHMAN
MARKET PRESIDENT - 20220.5042.00Yes (X)Yes (X)$0$187,062$2,298
SAMUEL SCOTT
SVP, CFO, TREASURER41.250.50Yes (X)$508,382$0$33,276
JONATHAN WERNE
VP REG GENERAL COUNSEL40.000.00$388,902$0$43,174Yes (X)
FRANK LENIOR
VP HUMAN RESOURCES SDHS40.000.00$358,084$0$11,002Yes (X)
KAY MCREE
SDHS FOUNDATION EXECUTIVE DIRECTOR40.000.00$254,345$0$25,042Yes (X)
LESTER DIAMOND
FORMER PRESIDENT0.500.00$714,339$0$6,751Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,224,052TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,245,189TotReportableCompRltdOrgAmt
Total Other Compensation$278,022TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
BRUNINI GRANTHAM GROWER & HEWES
PO BOX 119JACKSONMS39205LEGAL SERVICES$590,999
BE SMITH LLC
PO BOX 74007636CHICAGOIL606747636EXECUTIVE PLACEMENT SVCS$507,206
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MANAGEMENT FEES561000$8,007,336$8,007,336
RENTAL INCOME531120$647,151$647,151
HEALTH SERVICE REVENUE561499$284,463$284,463
PURCHASED DISCOUNT561499$16$16
FieldValueIRS element (for citing)
Total Program Service Revenue$8,938,966TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$998,138TotalRevenueColumnAmt
Exclusion$998,138ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$24,878,470SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$19,399,996SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$5,478,474SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,478,474TotalRevenueColumnAmt
Exclusion$5,478,474ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,415,578TotalRevenueColumnAmt
Related Or Exempt Func Income$8,938,966RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$6,476,612ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,017,211TotalAmt
Program Services$1,017,211ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$489,052TotalAmt
Program Services$58,963ProgramServicesAmt
Management And General$430,089ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,000,094TotalAmt
Program Services$120,577ProgramServicesAmt
Management And General$879,517ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$143,239TotalAmt
Program Services$9,184ProgramServicesAmt
Management And General$134,055ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$626,894TotalAmt
Program Services$40,225ProgramServicesAmt
Management And General$586,669ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$53,605TotalAmt
Program Services$3,437ProgramServicesAmt
Management And General$50,168ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$3,141,971TotalAmt
Program Services$197,345ProgramServicesAmt
Management And General$2,944,626ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$45,849TotalAmt
Program Services$12,895ProgramServicesAmt
Management And General$32,954ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$124,071TotalAmt
Program Services$576ProgramServicesAmt
Management And General$123,495ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$251,780TotalAmt
Program Services$25,433ProgramServicesAmt
Management And General$226,347ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$18,027TotalAmt
Program Services$84ProgramServicesAmt
Management And General$17,943ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,282,702TotalAmt
Program Services$41,080ProgramServicesAmt
Management And General$1,241,622ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,964TotalAmt
Program Services$18ProgramServicesAmt
Management And General$3,946ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$122,708TotalAmt
Program Services$17,586ProgramServicesAmt
Management And General$105,122ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$41,430TotalAmt
Program Services$193ProgramServicesAmt
Management And General$41,237ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$824TotalAmt
Program Services$4ProgramServicesAmt
Management And General$820ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$15,373TotalAmt
Program Services$38ProgramServicesAmt
Management And General$15,335ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$303,117TotalAmt
Management And General$303,117ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$159,787TotalAmt
Program Services$2,594ProgramServicesAmt
Management And General$157,193ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
REPAIRS AND MAINTENANCE$226,144$3,354$222,790
MEDICAL SUPPLIES$21,564$320$21,244
OTHER EXPENSES$7,238$6$7,232

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$9,096,644TotalAmt
Program Services$1,551,123ProgramServicesAmt
Management And General$7,545,521ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,438,384BOYAmt
EOY$1,908,345EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,037,725BOYAmt
EOY$6,321EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$6,119BOYAmt
EOY$36,749EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$31,040,824LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$776,088LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$27,961,036BOYAmt
EOY$30,264,736EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$164,891,670BOYAmt
EOY$134,968,604EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$8,185,252BOYAmt
EOY$8,210,252EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$23,759BOYAmt
EOY$13,521,010EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$213,543,945BOYAmt
EOY$188,916,017EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,501,221BOYAmt
EOY$2,947,491EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$41,886,391BOYAmt
EOY$23,711,972EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$44,387,612BOYAmt
EOY$26,659,463EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$169,156,333BOYAmt
EOY$162,256,554EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$169,156,333BOYAmt
EOY$162,256,554EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$213,543,945BOYAmt
EOY$188,916,017EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$6,318,934ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$15,813,985NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$2,595,272OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type3 Func IntYes (X)SupportingOrgType3FuncIntInd
Supported Organizations4SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (4 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
ST DOMINIC JACKSON MEMORIAL HOSPITAL
64030309130$0$7,625,503
COMMUNITY HEALTH SERVICES - ST DOMINIC
640884870100$0$32,292
ST CATHERINE'S VILLAGE
640714997100$212,175$334,261
ST DOMINIC HEALTH SERVICES FOUNDATION
43199297570$120,000$0
FieldValueIRS element (for citing)
Supported Organizations Total4SupportedOrganizationsTotalCnt
Support Sum$332,175SupportSumAmt
Other Support Sum$7,992,056OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing Doc0ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

FieldValueIRS element (for citing)
Timely Provided DocumentsYes (1)TimelyProvidedDocumentsInd
Officers Close RelationshipYes (1)OfficersCloseRelationshipInd
Supported Org Voice InvestmentYes (1)SupportedOrgVoiceInvestmentInd

Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp

FieldValueIRS element (for citing)
Parent Supported OrgYes (X)ParentSupportedOrgInd
Appoint Elect Majority OfficerYes (1)AppointElectMajorityOfficerInd
Exercise Direction PoliciesYes (1)ExerciseDirectionPoliciesInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, SECTION A, LINE 1:ST. DOMINIC HEALTH SERVICES ("SDHS") SUPPORTS THE FOLLOWING ENTITIES: - ST. DOMINIC JACKSON MEMORIAL HOSPITAL ("HOSPITAL") - COMMUNITY HEALTH SERVICES - ST. DOMINIC ("CHS") - ST. CATHERINE'S VILLAGE ("SCV") - ST. DOMINIC HEALTH SERVICES FOUNDATION ("FOUNDATION") SDHS HAS A HISTORIC AND CONTINUING RELATIONSHIP WITH EACH OF THE ABOVE ENTITIES (COLLECTIVELY AFFILIATES) WHICH SPANS MANY DECADES. SDHS IS THE PARENT COMPANY OF THE AFFILIATES AND WORKS WITH EACH ON A DAILY BASIS TO PROVIDE CRITICAL HEALTHCARE, ELDERLY HOUSING AND ASSISTED LIVING, HEALTH EDUCATION AND OTHER COMMUNITY BENEFITS FOR THE SURROUNDING COMMUNITY AND ITS SCHOOLS. SDHS WAS FORMED IN 1985 FOR THE PURPOSE OF SUPPORTING THE HOSPITAL AND OTHER AFFILIATES. SDHS AND THE AFFILIATES ALSO HAVE SEVERAL OF THE SAME BOARD MEMBERS AND OFFICERS WHICH SERVE TO ENSURE A CLOSE AND CONTINUING RELATIONSHIP. DURING THIS FISCAL YEAR, THE HOSPITAL HAS THREE OF ITS BOARD MEMBERS WHO ALSO SERVED AS BOARD MEMBERS OF SDHS. BOTH THE MARKET PRESIDENT AND CFO OF SDHS ARE ALSO OFFICERS OF SDHS, THE HOSPITAL, SDHS FOUNDATION, CHS, AND SCV. SDHS, HOSPITAL AND SDHS FOUNDATION HAVE ONE SIMILAR BOARD MEMBER. SDHS, HOSPITAL, CHS AND SCV HAVE ONE SIMILAR BOARD MEMBER. HOSPITAL AND SDHS FOUNDATION HAVE A SIMILAR BOARD MEMBER. THE ENTITIES' INTERWOVEN HISTORY ALONG WITH ITS OVERLAPPING DIRECTORS/OFFICERS AND DAY-TO-DAY COLLABORATION SUPPORT A HISTORIC AND CONTINUING RELATIONSHIP BETWEEN SDHS AND THE ABOVE-LISTED AFFILIATES.
PART IV, SECTION D, LINE 3:THE SUPPORTED ORGANIZATIONS (THE HOSPITAL, CHS, SCV, AND FOUNDATION) ALL HAD A SIGNIFICANT VOICE IN THE SDHS'S INVESTMENT POLICIES AND IN DIRECTING THE USE OF THE SDHS'S INCOME OR ASSETS AT ALL TIMES DURING THE YEAR SINCE THEY HAD MANY OF THE SAME OFFICERS AND BOARD MEMBERS AS SDHS. SDHS PROVIDES STRATEGIC PLANNING, LEADERSHIP SERVICES, AND BUSINESS SUPPORT SERVICES TO ITS SUPPORTED ORGANIZATIONS. THESE SERVICES ARE INFLUENCED BY AND RESULT FROM THE EXPRESSED NEEDS OF THE SUPPORTED ORGANIZATIONS.
PART IV, SECTION E, LINE 3A:WITH REGARDS TO EACH OF THE SUPPORTED ENTITIES, SDHS HAS THE POWER TO APPROVE THE ELECTION OF ALL OFFICERS AND BOARD MEMBERS INCLUDING THE CHAIR OF THE BOARD, THE VICE-CHAIR OF THE BOARD, AND THE PRESIDENT OF THE FOUNDATION.
PART IV, SECTION E, LINE 3B:SDHS PROVIDES MANAGEMENT AND OTHER SUPPORT SERVICES TO EACH OF ITS SUPPORTED ORGANIZATIONS ON A DAILY BASIS. SUCH SERVICES INCLUDE STRATEGIC PLANNING, LEADERSHIP SERVICES, PROJECT PLANNING, AND BUSINESS SUPPORT FUNCTIONS INCLUDING FINANCE LEADERSHIP, LEGAL, MISSION INTEGRATION, AND HUMAN RESOURCES LEADERSHIP. THE NATURE OF THESE SERVICES PROVIDED TO THE SUPPORTED ORGANIZATIONS NECESSITATE THE REQUISITE DEGREE OF DIRECTION OVER THE POLICIES, PROGRAMS, AND ACTIVITIES OF EACH SUPPORTED ORGANIZATION. THE SUPPORTED ORGANIZATIONS WOULD NOT BE ABLE TO ACCOMPLISH THE CRITICAL HEALTHCARE AND COMMUNITY SERVICES THEY PROVIDE WITHOUT THE GUIDANCE AND DIRECTION GAINED FROM SDHS.

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$30,000DirectContactLegislatorsAmt
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$30,000TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1G:FormAndLineReferenceDesc
ExplanationST. DOMINIC HEALTH SERVICES, INC. PAID A LOBBYING CONSULTANT WHO HAD DIRECT CONTACT WITH LEGISLATORS TO DISCUSS VARIOUS PUBLIC POLICY ISSUES AND LEGISLATIVE MATTERS.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,140,000OtherCostOrOtherBasisAmt
Book Value$20,140,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,751,594OtherCostOrOtherBasisAmt
Depreciation$670,885DepreciationAmt
Book Value$10,080,709BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$149,230OtherCostOrOtherBasisAmt
Depreciation$105,203DepreciationAmt
Book Value$44,027BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$30,264,736TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (3 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
FND DEPR FMOL PORTFOLIO$105,289,506F
FND DEPR ST DOMINIC PORTFOLIO$4,872,899F
SELF INSURED TRUST$24,806,199F
FieldValueIRS element (for citing)
Total Book Value Securities$134,968,604TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
EMPLOYEE BENEFIT TRUST$13,509,923
OTHER CURRENT ASSETS$11,087
FieldValueIRS element (for citing)
Total Book Value Other Assets$13,521,010TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
SELF INSURANCE LIABILITY - LT$21,749,942
NET DUE TO/FROM AFFILIATES$1,195,257
RETIREMENT PAYABLE LONG TERM$763,634
INTERCOMPANY AP$3,139
FieldValueIRS element (for citing)
Total Liability$23,711,972TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationFIN 48 (ASC 740) FOOTNOTE: ST. DOMINIC HEALTH SERVICES RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. NO RESERVES FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1ST DOMINIC HEALTH SYSTEM FOUNDATION INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1969 LAKELAND DRAddressLine1Txt
CityJACKSONCityNm
State AbbreviationMSStateAbbreviationCd
ZIP391264699ZIPCd
FieldValueIRS element (for citing)
Recipient EIN431992975RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$394,305CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantGENERAL SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationST. DOMINIC HEALTH SERVICES (SDHS) MONITORS THE USE OF GRANTS FUNDS BY ONLY GIVING TO ITS AFFILIATES.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RICHARD VATH MD
BOARD MEMBER/CEO FMOLHS$0$1,278,765$0$1,127,625$0$9,269$0$26,100$0$20,505$0$2,462,264$0$0
RENE J RAGAS
BOARD MEMBER/CEO OF ANGELS$0$376,418$0$264,215$0$1,835$0$83,688$0$26,186$0$752,342$0$0
LESTER DIAMOND
FORMER PRESIDENT$116,032$0$79,177$0$519,130$0$0$0$6,751$0$721,090$0$75,873$0
SAMUEL SCOTT
SVP, CFO, TREASURER$334,237$0$174,145$0$0$0$14,500$0$18,776$0$541,658$0$0$0
JONATHAN WERNE
VP REG GENERAL COUNSEL$278,047$0$110,855$0$0$0$14,500$0$28,674$0$432,076$0$0$0
FRANK LENIOR
VP HUMAN RESOURCES SDHS$257,037$0$101,047$0$0$0$0$0$11,002$0$369,086$0$0$0
KAY MCREE
SDHS FOUNDATION EXECUTIVE DIRECTOR$201,496$0$52,849$0$0$0$13,021$0$12,021$0$279,387$0$0$0
SCOTT KASHMAN
MARKET PRESIDENT - 2022$0$95,448$0$75,000$0$16,614$0$0$0$2,298$0$189,360$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE FMOLHS BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPRROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR MAKING SUCH DETERMINATION IS DOCUMENTATED BY THE COMPENSATION COMMITTEE.
PART I, LINES 4A-BFMOLHS MAINTAINS THREE UNFUNDED DEFERRED COMPENSATION PLANS WHICH MEET THE REQUIREMENTS OF IRC SECTION 457(F) AND IRC SECTION 409A. THE PLANS PROVIDE FOR COMPENSATION TO BE DEFERRED AND PAID UPON THE OCCURRENCE OF CERTAIN EVENTS SUCH AS TERMINATION WITHOUT CAUSE, DISABILITY, DEATH OR ATTAINMENT OF A SPECIFIC PAYMENT DATE. PARTICIPATION IN THE PLANS IS LIMITED TO CERTAIN EXECUTIVES AND IS SUBJECT TO APPROVAL OF FMOLHS BOARD OF DIRECTORS OR A DESIGNATED COMMITTEE OF SUCH BOARD. LESTER DIAMOND RECEIVED A PAYMENT OF 78,347 IN THE CURRENT YEAR.
PART 1, QUESTION 4A:A BOARD MEMBER IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR TERMINATION OF EMPLOYMENT WITHOUT CAUSE FOR GOOD REASON AND FOR A CHANGE OF CONTROL. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID HIS/HER BASE SALARY AND AN ANNUAL INCENTIVE AT TARGET AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 24 MONTHS. TWO BOARD MEMBERS ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYEMENT WITHOUT CAUSE, FOR GOOD REASON OR DUE TO CHANGE OF CONTROL. IF TRIGGERED, THE EMPLOYEE WOULD BE PAID HIS/HER BASE SALARY AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS GENERALLY 18 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. AN OFFICER AND TWO HIGHEST COMPENSATED INDIVIDUALS ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYEMENT WITHOUT CAUSE, FOR GOOD REASON OR DUE TO CHANGE OF CONTROL. IF TRIGGERED, THE EMPLOYEE WOULD BE PAID HIS/HER BASE SALARY AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS GENERALLY 12 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6FMOL HEALTH SYSTEM (AN IRC SECTION 501(C)(3) ORGANIZATION) IS THE SOLE MEMBER OF ST. DOMINIC HEALTH SERVICES, INC.
FORM 990, PART VI, SECTION A, LINE 7AFMOL HEALTH SYSTEM, AS THE SOLE MEMBER OF ST. DOMINIC HEALTH SERVICES, INC. RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF ST. DOMINIC HEALTH SERVICES, INC.
FORM 990, PART VI, SECTION A, LINE 7BFRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC. (FMOLHS) HAS THE RIGHT TO APPROVE ANY DISSOLUTION OR MERGER ENACTED BY ST. DOMINIC HEALTH SERVICES, INC. FMOLHS HAS THE AUTHORITY TO BREAK ANY TIE VOTE OF THE BOARD OF DIRECTORS OF ST. DOMINIC HEALTH SERVICES, INC.
FORM 990, PART VI, SECTION B, LINE 11BAFTER PREPARATION OF THE FORM 990 BY KPMG LLP, MANAGEMENT REVIEWED THE FORM 990. A COPY OF THE FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BOARD BEFORE IT WAS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CDIRECTORS AND OFFICERS RECEIVE A COPY OF THE POLICY AND FORM FOR REPORTING EACH YEAR AT THE FIRST MEETING OF THE YEAR. FORMS ARE REVIEWED BY THE PRESIDENT AND ANY CONFLICTS SHARED WITH THE BOARD CHAIR. PERSONS WITH CONFLICTS OF INTERESTS ABSTAIN FROM ANY DECISIONS WHERE THE CONFLICT EXISTS.
FORM 990, PART VI, SECTION B, LINE 15OUR BOARD OF DIRECTORS DESIGNATES AN EXECUTIVE COMMITTEE MADE UP OF INDEPENDENT BOARD MEMBERS TO REVIEW AND SET THE COMPENSATION ANNUALLY OF OUR OFFICERS AND KEY EMPLOYEES. THE EXECUTIVE COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING INDUSTRY-WIDE COMPENSATION INFORMATION PROVIDED BY AN OUTSIDE CONSULTING FIRM. THE EXECUTIVE COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR DETERMINATION IS THEN DOCUMENTED BY THE EXECUTIVE COMMITTEE. THE COMPENSATION FOR THE CEO OF ST. DOMINIC HEALTH SERVICES, INC. IS SET BY THE COMPENSATION COMMITTEE OF FMOL HEALTH SYSTEM (A RELATED TAX-EXEMPT ORGANIZATION) ACCORDING TO THEIR PAY PRACTICES WHICH ARE SIMILAR TO THOSE DESCRIBED ABOVE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:PRIOR PERIOD ADJUSTMENTS 2,282,834. CAPITAL TRANSFERS 312,438.
SECTION 1.263(A)-1(F)- DE MINIMIS SAFE HARBOR ELECTION:ST. DOMINIC HEALTH SERVICES, INC. DOES HAVE APPLICABLE FINANCIAL STATEMENTS FOR THE YEAR OF THE ELECTION, AND INTEND TO APPLY THE DE MINIMIS SAFE HARBOR ELECTION. THIS ELECTION PERMITS THE TAXPAYER TO DEDUCT FOR TAX PURPOSES ANY ITEM DEDUCTED UNDER ITS BOOK POLICY THAT DOES NOT EXCEED $5,000 PER INVOICE (OR PER ITEM AS SUBSTANTIATED BY THE INVOICE) OR ITEMS HAVING ECONOMIC USEFUL LIFE OF TWELVE MONTHS OR LESS AS DESCRIBTED IN SECTION 1.263(A)-1(F)(1)(II) FOR THE TAX YEAR ENDING JUNE 30, 2022.
SECTION 1.263(A)-3(N) ELECTION- BOOK CONFORMITY ELECTION:ST. DOMINIC HEALTH SERVICES, INC. IS MAKING THE ELECTION UNDER TREAS. REG. 1.263()-3(N) TO CAPITALIZE THOSE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL IMPROVEMENTS ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDING JUNE 30, 2022.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1ST DOMINIC HEALTH & WELLNESS LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1969 LAKELAND DRIVEAddressLine1Txt
CityJACKSONCityNm
State AbbreviationMSStateAbbreviationCd
ZIP39216ZIPCd
FieldValueIRS element (for citing)
EIN823234006EIN
Primary ActivitiesHEALTHCAREPrimaryActivitiesTxt
Legal Domicile StateMSLegalDomicileStateCd
Total Income$284,463TotalIncomeAmt
End Of Year Assets$86,593EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SDHSBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
HEALTH CARE CENTERS IN SCHOOLS
5000 HENNESSY BLVDBATON ROUGELA70808721443935HEALTHCARELA501(C)(3)LINE 10OLOL0
ST DOMINIC HEALTH SERVICES INC
969 LAKELAND DRIVEJACKSONMS39216640714999HOLDING COMS501(C)(3)LINE 12C, III-FIFMOLHS0
COMMUNITY HEALTH SERVICES - ST DOMINIC
969 LAKELAND DRIVEJACKSONMS39216640884870HEALTH PROGRAMMS501(C)(3)LINE 10SDHSYes (1)
ST DOMINIC - JACKSON MEMORIAL HOSPITAL
969 LAKELAND DRIVEJACKSONMS39216640303091HOSPITALMS501(C)(3)LINE 3SDHSYes (1)
ST DOMINIC - HEALTH SERVICES FOUNDATION
969 LAKELAND DRIVEJACKSONMS39216431992975FUNDRAISINGMS501(C)(3)LINE 7SDHSYes (1)
ST CATHERINE'S VILLAGE INC
969 LAKELAND DRIVEJACKSONMS39216640714997RET HOMEMS501(C)(3)LINE 10SDHSYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (23 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
LOURDES IMAGING DEVELOPMENT LLC
4801 AMBASSADOR CAFFERY PKWYLAFAYETTELA70508208326287REAL ESTATELA00
PARK PLACE SURGERY CENTER LLC
4811 AMBASSADOR CAFFERY PKWYLAFAYETTELA70508721404092HEALTHCARELA00
BRPT LAKE REHABILITATION CENTERS LLC
175 S ENGLISH STATION RD STE 218LOUISVILLEKY40245721506100HEALTHCARELA00
CONVENIENT CARE LLC
10319 JEFFERSON HIGHWAYBATON ROUGELA70809721439481HEALTHCARELA00
CONVENIENT CARE LLC
10319 JEFFERSON HIGHWAYBATON ROUGELA70809721439481HEALTHCARELA00
PERKINS PLAZA AMBULATORY SURGERY CENTER LLC
7145 PERKINS ROADBATON ROUGELA70808481264699HEALTHCARELA00
SURGICAL SPECIALTY CENTER OF BATON ROUGE LLC
8080 BLUEBONNET BLVDBATON ROUGELA70810263120962HEALTHCARELA00
ST ELIZABETH-MARY BIRD PERKINS CANCER CENTER LLC
4950 ESSEN LANEBATON ROUGELA70809260628752HEALTHCARELA00
NORTHEAST LA CANCER INSTITUTE LLC
411 CALYPSO STREETMONROELA71201721329499HEALTHCARELA00
LHCG-XIII LLC DBA LOURDES HOME HEALTH
901 S HUGH WALLIS ROADLAFAYETTELA70508208068308HEALTHCARELA00
LOURDES AFTER HOURS LLC
7777 HENNESSY BLVD SUITE 1004-202BATON ROUGELA70809201367299HEALTHCARELA00
LAKE URGENT CARE ASCENSION LLC
10319 JEFFERSON HIGHWAYBATON ROUGELA70809352463092HEALTHCARELA00
ST FRANCIS URGENT CARE LLC
10319 JEFFERSON HIGHWAYBATON ROUGELA70809474013731HEALTHCARELA00
GAMMA KNIFE OF LOUISIANA LLC
4950 ESSEN LANEBATON ROUGELA70809811827194HEALTHCARELA00
LHCG LXVII LLC
901 S HUGH WALLIS ROADLAFAYETTELA70508474283509HEALTHCARELA00
PINNACLE CARE HOLDINGS LLC
5627 S SHERWOOD FOREST BLVDBATON ROUGELA70816821637627HEALTHCARELA00
LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIP
4801 AMBASSADOR CAFFERY PKWYLAFAYETTELA70508943419282HEALTHCARELA00
FREMAUX OFFICE MM LLC
3500 NORTH CAUSEWAY BOULEVARD STE 6METAIRIELA70002843084552HEALTHCARELA00
FREMAUX MOB LLC
3500 NORTH CAUSEWAY BOULEVARD STE 6METAIRIELA70002MED BLDGLA00
OLOL PONTCHARTRAIN SURGERY CENTER LLC
4200 ESSEN LANEBATON ROUGELA70809461379031HEALTHCARELA00
LAKE SURGICAL HOSPITAL (SLIDELL) LLC
1700 LINDBERG DRSLIDELLLA70458474228147HEALTHCARELA00
PREMIER HEALTH HOLDINGS LLC
10319 JEFFERSON HIGHWAYBATON ROUGELA70809472665226HEALTHCARELA00
PREMIER HEALTH HOLDINGS LLC
10319 JEFFERSON HIGHWAYBATON ROUGELA70809472665226HEALTHCARELA00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPct
LOUISE INSURANCE COMPANY
PO BOX 1051CAYMAN ISLANDSCJKY1-1102INSURANCECJC0
FRANCISICAN HEALTH & WELLNESS SERVICES INC
HEALTHCAREC04200 ESSEN LANEBATON ROUGELA70809455492379LA
FMOL HEALTH SYSTEM HOLDINGS INC
INVESTMENTC04200 ESSEN LANEBATON ROUGELA70809454405024LA
ST DOMINIC MADISON HEALTH SERVICES INC
HEALTHCARECYes (1)969 LAKELAND DRIVEJACKSONMS39216202870254MSSDHS$296,869$7,631,8861.00000
FIRST INTERMED CORPORATION
MEDICAL SERVICESCYes (1)308 CORPORATE DRIVERIDGELANDMS39157640824796MSSDHS1.00000
ST DOMINIC INTEGRATED SERVICES INC
INVESTMENTSC0969 LAKELAND DRIVEJACKSONMS39216271493623MS
LAFAYETTE SURGICARE INC
HEALTHCAREC0C/O C T CORPORATION SYSTEM 3867 PLABATON ROUGELA70816943419282LA
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
ST DOMINIC JACKSON MEMORIAL HOSPITAL
L$7,625,503
ST DOMINIC JACKSON MEMORIAL HOSPITAL
J$319,752
HIGHLAND MEDICAL ARTS
K$457,520
ST CATHERINE'S VILLAGE
L$334,261
COMMUNITY HEALTH SERVICES
B$212,175
ST DOMINIC HEALTH SYSTEM FOUNDATION
C$394,305

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