2022-05-15T13:26:21-05:00 2021-06-30 135565207 KPMG LLP 301 MAIN STREET SUITE 2150 BATON ROUGE LA 70801 990 2020-07-01 640714997 STCATHERINE'S VILLAGE INC STCA 6012006642 969 LAKELAND DRIVE JACKSON MS 392164699 SAM SCOTT TREASURER 6012006642 2022-05-13 1 SAM SCOTT 999009999 RYAN HOOKS P00746825 2253444000 2022-05-12 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z SAM SCOTT 969 LAKELAND DRIVE JACKSON MS 392164699 25778029 0 X WWW.STCATHERINESVILLAGE.COM X 1987 MS ST. CATHERINE'S VILLAGE OPERATES RETIREMENT FACILITIES, NURSING HOMES, HOSPICES AND HOME HEALTH AGENCIES FOR THE AGED. 9 8 456 19 0 0 0 2655144 23130123 22805906 131357 147579 0 169400 23261480 25778029 0 0 0 0 12843345 13777680 0 0 0 12064640 10494496 24907985 24272176 -1646505 1505853 74682360 74126052 59494862 57222995 15187498 16903057 X INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI 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 REVERENCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED TO 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. 0 0 20923048 22805906 THE VILLAGE IS MISSISSIPPI'S FIRST RETIREMENT COMMUNITY OFFERING THE SECURITY OF ALL-INCLUSIVE LIFE CARE. NESTLED ON 160 ACRES OF ROLLING GREEN HILLS AND TALL PINE TREES, THE VILLAGE OVERLOOKS A TRANQUIL 15 ACRE STOCKED LAKE. REMINISCENT OF A QUAINT EUROPEAN VILLAGE, THE VILLAGE IS CONVENIENTLY LOCATED IN MADISON, MISSISSIPPI 7 MILES NORTH OF JACKSON, THE STATE'S CAPITOL CITY. THE VILLAGE OFFERS A CONTINUUM OF CARE FEATURING:246 INDEPENDENT LIVING BEDS IN APARTMENTS AND GARDEN HOMES50 ASSISTED LIVING BEDS24 MEMORY SUPPORT BEDS120 SKILLED NURSING BEDSTHE VILLAGE IS THE FIRST RETIREMENT COMMUNITY IN MISSISSIPPI TO EARN ACCREDITATION BY CARF INTERNATIONAL. THIS "SEAL OF APPROVAL" SIGNIFIES THAT THE VILLAGE EXCEEDS THE STANDARDS OF EXCELLENCE AS ESTABLISHED BY CARF INTERNATIONAL. THE VILLAGE IS A FREE STANDING NOT-FOR-PROFIT, ALL INCLUSIVE CONTINUING CARE RETIREMENT COMMUNITY PROVIDING SERVICES TO INDIVIDUALS OVER 62 YEARS OF AGE, AND OPEN TO ALL FAITHS AND RACES. THE VILLAGE IS SPONSORED BY THE FRANCISCAN MISSIONARY OF OUR LADY SISTERS OF BATON ROUGE, LOUISIANA. THE DOMINICAN SISTERS OF SPRINGFIELD, ILLINOIS, WHO OWNED AND OPERATED ST. DOMINIC JACKSON MEMORIAL HOSPITAL FROM 1946 TO 2019, EXTENDED THEIR HEALING MINISTRY TO THE SPECIAL NEEDS OF OLDER ADULTS WITH THE CREATION OF THE VILLAGE. 20923048 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 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 1 0 0 0 1 41 0 1 456 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X SAM SCOTT 6012006642 969 LAKELAND DRIVE JACKSON MS 392164699 SONNY STONE CHAIRMAN 0.50 0.00 X X 0 0 0 JAMES E WOOD VICE CHAIR 0.50 0.00 X X 0 0 0 LIONEL FRASIER MD DIRECTOR 0.50 0.00 X 0 0 0 PATSY TOLLESON DIRECTOR 0.50 0.00 X 0 0 0 RANDALL DAY DIRECTOR 0.50 0.00 X 0 0 0 BARNEY DALY DIRECTOR 0.50 0.00 X 0 0 0 WILLIAM E LOPER MD DIRECTOR 0.50 0.00 X 0 0 0 LESTER DIAMOND PRESIDENT 0.50 41.50 X X 0 1135918 113444 SISTER MARY TRINITA EDDINGTON SECRETARY 0.50 40.50 X X 0 0 0 SAM SCOTT TREASURER 0.50 41.50 X 0 594049 26582 LISA WILBURN EXECUTIVE DIRECTOR 40.00 0.00 X 219875 0 22189 FELICHIA FIELDS VP SENIOR SERVICES 40.00 0.00 X 121518 0 12478 SCOTT KERSH MANAGER FINANCE SCV 40.00 0.00 X 151153 0 28689 SHEILA SIMPSON SR DIRECTOR ADMIN 40.00 0.00 X 108405 0 12037 600951 1729967 215419 4 0 1 0 CURA HOSPITALITY LLC PO BOX 743676 ATLANTA GA 303743676 FOOD SVC. MANAGEMENT 3530390 DAVID B TURNER BUILDERS LLC 213 PALMERS COURT MADISON MS 39110 VARIOUS CONSTRUCTION 396765 PRO LAWN CARE INC PO BOX 1098 MADISON MS 39130 LANDSCAPING SVCS 254265 D & L FLOORING AND DESIGN LLC 806 MONDRO ST JACKSON MS 39202 FLOORING SVCS 181501 COOKE DOUGLAS FARR LEMONS PO BOX 55909 JACKSON MS 39293 ARCHITECTURE SVCS 112870 6 2655144 2655144 RESIDENT SERVICES 623000 22805906 22805906 22805906 147579 147579 PENSION RELATED ADJUSTMENTS 900099 169400 169400 169400 25778029 22975306 0 147579 X 219875 106329 113546 11453006 10341600 1111406 1287797 1152656 135141 817002 731266 85736 355236 281827 73409 99318 88896 10422 350 313 37 3934270 3557538 376732 85235 76290 8945 460044 411767 48277 827741 740878 86863 505 452 53 3120 2793 327 597816 597816 2356027 2294191 61836 414675 414675 REPAIRS & MAINTENANCE 954774 797601 157173 SUPPLIES 339818 283878 55940 ALL OTHER EXPENSES 65567 54773 10794 24272176 20923048 3349128 0 3020763 3196388 45010 0 90725 63236 10000 10000 81190 280137 68977737 4597582 65737791 64380155 5696881 6196136 74682360 74126052 4928380 2961231 29194675 28522290 19383990 17913911 5987817 7825563 59494862 57222995 X 9621507 10556023 5565991 6347034 15187498 16903057 74682360 74126052 1505853 220499 -10793 0 X 0 1 X 1 0 X 160386 243222 162667 0 2655144 3221419 21575355 22699690 12159915 23130123 22805906 102370989 21735741 22942912 12322582 23130123 25461050 105592408 0 0 0 105592408 158323 141011 62141 131357 147579 640411 158323 141011 62141 131357 147579 640411 13975 15443 7921 169400 206739 21908039 23099366 12392644 23261480 25778029 106439558 0.99200 0.98180 0.00600 0.00590 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5565991 28462 913772 161191 6347034 5465758 68397 39311 7475 5565991 5429426 263163 226831 5465758 5568523 107563 246660 5429426 5005152 723757 160386 5568523 1.00000 0 1 1 5600000 5600000 61146784 3995493 57151291 356649 81625 275024 1874304 520464 1353840 64380155 DUE FROM AFFILIATES 766880 INTEREST IN SDHS FOUNDATION 5429256 6196136 SELF INSURANCE LIABILITY - LT 186945 DUE TO/FROM AFFILIATES 5082987 RETIREMENT PAYABLE LONG TERM 2025068 OTHER LIABILITIES 530563 7825563 X PART X, LINE 2: FMOLHS 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 JUDGMENT OCCURS. NO RESERVES FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED. PART V, LINE 4 RESTRICTED NET ASSETS ARE CLASSIFIED AS SUCH BASED ON DONOR STIPULATIONS THAT THEY BE USED IN A LATER PERIOD, FOR A SPECIFIC PURPOSE OR BOTH. AT JUNE 30, 2021 AND JUNE 30, 2020, THE VILLAGE HAD TEMPORARILY RESTRICTED NET ASSETS OF $6,347,034 AND $5,565,991 RESPECTIVELY, RELATED TO THE INTEREST IN NET ASSETS OF THE FOUNDATION. 0 1 0 0 0 0 0 0 0 LESTER DIAMOND PRESIDENT 0 691308 0 0 0 444610 0 84758 0 28686 0 1249362 0 346858 SAM SCOTT TREASURER 0 516351 0 0 0 77698 0 7762 0 18820 0 620631 0 35767 LISA WILBURN EXECUTIVE DIRECTOR 213335 0 0 0 6540 0 7028 0 15161 0 242064 0 0 0 SCOTT KERSH MANAGER FINANCE SCV 151153 0 0 0 0 0 5239 0 23450 0 179842 0 0 0 PART I, LINE 4B EFFECTIVE FOR THE PLAN YEAR BEGINNING 1/1/2013, THE EXECTIVE COMPENSATION COMMITTEE ADOPTED A NON QUALIFIED RESTORATION PLAN THAT PROVIDES 5% OF PAY FOR SALARY IN EXCESS OF THE IRS LIMIT (CODE SECTION 401(A)(17)). PAYOUTS ARE INCLUDED IN FORM W-2 BOX 5 WAGES AND REFLECTED IN OTHER REPORTABLE COMPENSATION. IN THE CURRENT YEAR, PAYMENTS WERE MADE TO THE FOLLOWING INDIVIDUALS : LESTER DIAMOND - $31,327 AND SAMUEL SCOTT - $16,368. SDHS MAINTAINS ONE UNFUNDED DEFERRED COMPENSATION PLAN WHICH MEETS THE REQUIREMENTS OF IRC SECTION 457(F) AND IRC SECTION 409A. THE PLAN PROVIDES 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 PLAN IS LIMITED TO CERTAIN EXECUTIVES AND IS SUBJECT TO APPROVAL OF SDHS BOARD OF DIRECTORS OR A DESIGNATED COMMITTEE OF SUCH BOARD. THE FOLLOWING INDIVIDUALS RECEIVEDE PAYMENT FROM THE PLAN IN THE CURRENT YEAR: LESTER DIAMOND - $413,283 AND SAMUEL SCOTT - $61,330. FMOLHS 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. NO ONE LISTED ON PART VII, SECTION A, RECEIVED A PAYMENT FROM THE PLANS IN THE CURRENT YEAR. PART I, QUESTION 3 THE ST. DOMINIC HEALTH SERVICES, INC. BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE CEO'S 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 APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR MAKING SUCH DETERMINATION IS DOCUMENTED BY THE COMPENSATION COMMITTEE. PART I, LINE 4A ONE OFFICER IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION FOR EMPLOYMENT 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 12 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. FORM 990, PART VI, SECTION A, LINE 6 ST. DOMINIC HEALTH SERVICES, INC. IS THE SOLE MEMBER OF THE VILLAGE. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF THE ORGANIZATION'S SOLE MEMBER, ST. DOMINIC HEALTH SERVICES, INC., HAS THE AUTHORITY TO APPROVE THE ELECTION OF THE PRESIDENT/CEO, THE CHAIR OF THE BOARD AND THE VICE-CHAIR OF THE BOARD OF DIRECTORS OF THE VILLAGE AND ALL OTHER DIRECTORS AND OFFICERS OF THE VILLAGE. FORM 990, PART VI, SECTION A, LINE 7B THE RESERVED POWER TO THE MEMBER, ST. DOMINIC HEALTH SERVICES, INC., ARE AS FOLLOWS: I. TO CHANGE PHILOSOPHY, OBJECTIVES AND PURPOSES OF CORPORATION. II. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION. III. TO AMEND, ALTER, MODIFY OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION. IV. TO AUTHORIZE MERGER, CONSOLIDATION, OR AFFILIATION, OR PARTICIPATE IN JOINT VENTURES. V. TO DISSOLVE AND TO DISTRIBUTE ASSETS OF THE CORPORATION. VI. TO APPOINT AND/OR TERMINATE WITH OR WITHOUT CAUSE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION. VII. TO ACQUIRE, PURCHASE, SELL, LEASE, TRANSFER, OR ENCUMBER ANY IMMOVABLE PROPERTY ON BEHALF OF THE CORPORATION. VIII. TO ADD TO OR INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY THE CORPORATION. IX. TO APPOINT THE FISCAL AUDITOR FOR THE CORPORATION. X. TO APPROVE ANY INCREMENT OR ADDITION TO THE CAPITAL DEBT OR EFFORTS TO RENEGOTIATE, MODIFY OR CHARGE THE EXISTING CAPITAL DEBT OBLIGATIONS OF THE CORPORATION. XI. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION. XII. TO APPROVE A STRATEGIC BUSINESS PLAN OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B AFTER PREPARATION AND REVIEW OF FORM 990 BY KPMG LLP, THE TAXPAYER'S TAX ADVISORS, ONE OR MORE MEMBERS OF SENIOR MANAGEMENT REVIEWS THE RETURN. A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS AND OFFICERS RECEIVE A COPY OF THE POLICY AND FORM FOR REPORTING EACH YEAR AT THE FIRST MEETING. 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 15 OUR 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. CATHERINE'S VILLAGE IS SET BY THE COMPENSATION COMMITTEE OF ST. DOMINIC HEALTH SERVICES (A RELATED TAX-EXEMPT ORGANIZATION) ACCORDING TO THEIR PAY PRACTICES WHICH ARE SIMILAR TO THOSE DESCRIBED ABOVE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,557,538. MANAGEMENT AND GENERAL EXPENSES 376,732. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,934,270. SECTION 1.263(A) -3(N) - BOOK CONFORMITY ELECTION ST. CATHERINE'S VILLAGE, INC. IS MAKING THE ELECTION UNDER TREAS. REG. SECTION 1.263(A)-3(N) TO CAPITALIZE THE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL IMPROVEMENTS ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDED JUNE 30, 2021. SECTION 1.263(A)-1(F) - DE MINIMIS SAFE HARBOR ELECTION ST. CATHERINE'S VILLAGE, INC. HEREBY MAKES THE DE MINIMIS SAFE HARBOR ELECTION UNDER SECTION 1.263(A)-1(F) OF THE TREASURY REGULATIONS, EFFECTIVE ONLY FOR THE TAX YEAR ENDING JUNE 30, 2021. TAXPAYER HAS ANAPPLICABLE FINANCIAL STATEMENT FOR THE YEAR OF THE 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 AN ECONOMIC USEFUL LIFE OF TWELVE MONTHS OR LESS AS DESCRIBED IN SECTION 1.263(A)-1(F)(1)(I). 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