ST DOMINIC-JACKSON MEMORIAL HOSPITAL: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
ST DOMINIC-JACKSON MEMORIAL HOSPITAL (EIN 64-0303091)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-13
IRS object ID
201513179349302276
Schema version
2014v5.0
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)
Return2015-11-13T09:06:22-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1190 E Capitol Street Ste 500AddressLine1Txt
CityJacksonCityNm
State AbbreviationMSStateAbbreviationCd
ZIP392012190ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN640303091EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1St Dominic - Jackson Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JENNIFER SINCLAIRInCareOfNm
Business Name ControlSTDOBusinessNameControlTxt
Phone6012002000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1969 Lakeland DriveAddressLine1Txt
CityJacksonCityNm
State AbbreviationMSStateAbbreviationCd
ZIP392164699ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLESTER K DIAMONDPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone6012002000PhoneNum
Signature2015-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonPenny Wood CPAPreparerPersonNm
PTINP00328157PTIN
Phone6019486700PhoneNum
Preparation2015-11-15PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLESTER K DIAMONDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1969 LAKELAND DRIVEAddressLine1Txt
CityJACKSONCityNm
State AbbreviationMSStateAbbreviationCd
ZIP392164699ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$451,343,419GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.STDOM.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1946FormationYr
Legal Domicile StateMSLegalDomicileStateCd
Activity Or MissionST. DOMINIC-JACKSON MEMORIAL HOSPITAL OPERATES A 535 BED PATIENT FACILITY FOR THE CITIZENS OF THE JACKSON, MS METROPOLITAN AREA THAT EXPRESSES A MISSION OF CHRISTIAN HEALING.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee4150TotalEmployeeCnt
Total Volunteers499TotalVolunteersCnt
Total Gross UBI$2,037,371TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$746,404NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$77,932PYContributionsGrantsAmt
CY Contributions Grants$1,755,263CYContributionsGrantsAmt
PY Program Service Revenue$392,940,325PYProgramServiceRevenueAmt
CY Program Service Revenue$433,530,647CYProgramServiceRevenueAmt
PY Investment Income$1,824,107PYInvestmentIncomeAmt
CY Investment Income$2,385,465CYInvestmentIncomeAmt
PY Other Revenue$9,125,698PYOtherRevenueAmt
CY Other Revenue$13,612,063CYOtherRevenueAmt
PY Total Revenue$403,968,062PYTotalRevenueAmt
CY Total Revenue$451,283,438CYTotalRevenueAmt
PY Grants And Similar Paid$2,080,061PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,347,028CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$194,282,287PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$197,108,203CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$197,592,305PYOtherExpensesAmt
CY Other Expenses$235,206,697CYOtherExpensesAmt
PY Total Expenses$393,954,653PYTotalExpensesAmt
CY Total Expenses$434,661,928CYTotalExpensesAmt
PY Revenues Less Expenses$10,013,409PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$16,621,510CYRevenuesLessExpensesAmt
Total Assets BOY$348,502,285TotalAssetsBOYAmt
Total Assets EOY$356,046,225TotalAssetsEOYAmt
Total Liabilities BOY$47,830,507TotalLiabilitiesBOYAmt
Total Liabilities EOY$90,989,951TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$300,671,778NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$265,056,274NetAssetsOrFundBalancesEOYAmt
MissionST. DOMINIC-JACKSON MEMORIAL HOSPITAL (THE HOSPITAL) RECOGNIZES ITS BASIC PARTICIPATION IN THE MISSION OF THE CHURCH WHICH INVOLVES TWO MAIN MINISTRIES: EDUCATION AND HEALTH CARE. THREE ACTIVITIES-COMMUNICATING A CHRISTIAN MESSAGE, ESTABLISHING COMMUNITY, AND PERFORMING SERVICE-EXPRESS ITS MISSION OF CHRISTIAN HEALING.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$403,151,430ExpenseAmt
Revenue$435,221,510RevenueAmt
DescST. DOMINIC HOSPITAL IS A 535-BED ACUTE CARE FACILITY IN JACKSON, MS. AS PART OF ITS HEALING MINISTRY, ST. DOMINIC'S IS ONE OF THE LARGEST EMPLOYERS IN THE AREA, AND THOSE EMPLOYEES, AS WELL AS THE HOSPITAL OPERATIONS, SIGNIFICANTLY HELP TO SUPPORT THE LOCAL ECONOMY. IN 2014, ST. DOMINIC HOSPITAL PROVIDED OVER $1 BILLION (CHARGES) IN HOSPITAL SERVICES TO PATIENTS THROUGHOUT THE CENTRAL REGION OF MISSISSIPPI, AND EMPLOYED NEARLY 2,800 PEOPLE. ST. DOMINIC HOSPITAL'S MEDICAL STAFF OF NEARLY 500 LEADING PHYSICIANS AND SPECIALISTS MAKES ST. DOMINIC'S ONE OF THE MOST COMPREHENSIVE HOSPITALS IN MISSISSIPPI. THESE PHYSICIANS AND STAFF MEMBERS HAVE PLAYED AN INTEGRAL ROLE IN DEVELOPING HIGHLY REGARDED CLINICAL PROGRAMS AND SERVICES. SOME OF THOSE KEY SERVICES INCLUDE THE MISSISSIPPI HEART AND VASCULAR INSTITUTE, THE CANCER CENTER (AND CANCER SERVICES AS A WHOLE), AND INNOVATIVE AND VARIED SURGICAL SERVICES. MISSISSIPPI HEART AND VASCULAR INSTITUTE- In 2014, St. Dominic's celebrated 40 years of excellence in providing cardiac and vascular services to the community through the Mississippi Heart and Vascular Institute (MHVI). Due to the dedication of the Institute's physicians and staff, St. Dominic's is one of the leading providers of cardiac, vascular and venous services in Central Mississippi. St. Dominic's participated in American Heart Month by holding educational and screening events throughout the month of February. Later, in October, St. Dominic's partnered with the Metro Jackson American Heart Association to hold a Go Red for Women Premier Party. An estimated 120 women attended the event to hear from a panel of St. Dominic's specialists and physicians and receive answers to questions about women's heart health. The call to action for the Premier Party and all the events held in February was for participants to schedule a personal healthy heart screening. The community events, in conjunction with advertising and an increased focus on community outreach, led the Healthy Heart program to achieve an increase from 480 individuals served in 2013 to 908 receiving screenings in 2014. In turn, that increase led many individuals to early detection of potentially life threatening ailments. St. Dominic's also created and hosted a Strike Out Stroke Night at a Mississippi Braves baseball game. Throughout the game, St. Dominic's staff, in conjunction with representatives from the American Stroke Association, raised awareness of the signs and symptoms of stroke by handing out educational materials. In addition, a stroke awareness commercial and information were played on the big screen during breaks between innings. In addition, in 2014 St. Dominic's was selected by Blue Cross & Blue Shield of Mississippi as a Blue Distinction Center of Excellence for Cardiac Care. This distinction recognizes hospitals and their physicians that demonstrate high levels of performance in delivering quality specialty care to their patients safely, efficiently, and cost-effectively. CANCER CENTER AND CANCER SERVICES- St. Dominic's Cancer Program is a leader in community outreach and education about cancer. Throughout September and October, St. Dominic's held several free community events raising awareness of cancer and communicating the importance of women's health. In September, a women's health event called "Be Inspired" was held at Highland Village Shopping Center. The event featured representatives from various St. Dominic's departments who provided educational information and answered questions from attendees on women's health topics. This year's annual Drive to Inspire campaign featured a pink Honda Pilot driven around the metro area to spread awareness about breast health and the importance of early detection and mammograms. Throughout the entire month of October, the pink car traveled to various locations, and community members were encouraged to sign the car in support of breast cancer awareness. In October, St. Dominic's partnered with the Outlets of Mississippi located in Pearl for a month long fundraiser called "Shop Pink." Through this fundraiser, $10,000 was raised to benefit the many women's programs and services at St. Dominic's. Over 1,000 "Shop Pink" $10 discount cards were sold that entitled the purchaser to a discount of up to 25 percent in each of the 30 participating outlet stores. The discount cards were sold by St. Dominic's and St. Catherine's Village employees as a community service project. St. Dominic's also sponsored a "Shop Pink" Health Fair at the Outlets. The Care-A-Van and approximately 20 St. Dominic's wellness, screening and outreach program representatives were set up to offer educational information and health screenings to participants. Also in October, St. Dominic's Cancer Boutique held its first breast cancer awareness luncheon called "A Touch of Pink." The luncheon featured guest speakers who shared their own personal survivor stories and the struggles and triumphs they have endured along the way. SURGICAL SERVICES- St. Dominic's offers a comprehensive array of traditional surgical services and is a minimally invasive robotic surgery center of excellence. During December 2014, St. Dominic's participated in Operation Walk USA, for the second year in a row, by giving seven deserving patients free total joint replacements. Five patients received knee replacements, and two received hip replacements. St. Dominic's partnered with other healthcare providers to deliver all aspects of care - surgery, hospitalization, and pre- and post-operative care-at no cost to participating patients who may not qualify for government assistance, have insurance or cannot afford surgery on their own. Nationwide an estimated 120 patients received free joint replacements from 85 volunteer orthopaedic surgeons through Operation Walk USA 2014. This is the fifth year for Operation Walk USA, which has provided free total joint replacements to nearly 500 patients at a value of $13.2 million.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$21,729,288ExpenseAmt
DescTHE HOSPITAL IS AN ACTIVE, CARING MEMBER OF THE COMMUNITY IT SERVES. IN CARRYING OUT ITS TEACHING AND HEALING MINISTRIES, THE BOARD OF DIRECTORS HAS ESTABLISHED A POLICY UNDER WHICH THE HOSPITAL PROVIDES CARE TO THE NEEDY MEMBERS OF ITS COMMUNITY. FOLLOWING THAT POLICY, THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THEIR CHARITY CARE POLICIES. THE DIRECT AND INDIRECT COSTS ASSOCIATED WITH THESE SERVICES CANNOT BE IDENTIFIED TO SPECIFIC CHARITY CARE PATIENTS. THEREFORE, MANAGEMENT ESTIMATED THE COSTS OF THESE SERVICES BY CALCULATING A COST TO GROSS CHARGE RATIO AND MULTIPLYING IT BY THE CHARGES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS MEETING THE HOSPITAL'S CHARITY CARE GUIDELINES. THE ESTIMATED COST OF CHARGES FOREGONE, BASED ON THE COST TO CHARGE RATIO, WAS APPROXIMATELY $13,870,000. THE FOREGONE CHARGES ARE NETTED AGAINST PATIENT SERVICE REVENUE TO ARRIVE AT NET PATIENT SERVICE REVENUE AS REFLECTED AS PROGRAM SERVICE REVENUE ON PART VIII OF FORM 990 IN ORDER TO BE CONSISTENT WITH FINANCIAL STATEMENT REPORTING AND ARE NOT REPORTED AS FUNCTIONAL EXPENSES ON THE FORM 990. THE HOSPITAL ALSO PROVIDES HEALTH CARE SERVICES TO A SIGNIFICANT PORTION OF THE UNINSURED POPULATION IN THE SURROUNDING COMMUNITY. WHILE A PORTION OF THESE PATIENTS MAY ULTIMATELY QUALIFY FOR COVERAGE UNDER THE MEDICAID PROGRAM OR THE CHARITY CARE POLICY DISCUSSED ABOVE, THE HOSPITAL IS UNABLE TO COLLECT A SIGNIFICANT PORTION OF THESE ACCOUNTS. CHARGES DEEMED UNCOLLECTIBLE DURING 2014 WERE APPROXIMATELY $ 21,730,000.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$2,347,028ExpenseAmt
Grant$2,347,028GrantAmt
DescTHE HOSPITAL SERVES THE COMMUNITY IN NUMEROUS WAYS. SOME EXAMPLES INCLUDE ASSISTING IN EDUCATING THE COMMUNITY REGARDING HEALTH-RELATED ISSUES. THE HOSPITAL PARTICIPATES IN NUMEROUS HEALTH FAIRS AND GIVES PRESENTATIONS TO VARIOUS SCHOOLS AND INDUSTRY REGARDING SUCH ISSUES AS DRUG ABUSE, SAFETY IN THE WORKPLACE, ETC. THE HOSPITAL HAS SPONSORED ANNUAL CHOLESTEROL AND CANCER SCREENINGS UPON WHICH THE TEST IS MADE AVAILABLE TO THE PUBLIC FOR A NOMINAL FEE AND THE MAJORITY OF THE COSTS INCURRED ARE ABSORBED BY THE HOSPITAL. THE HOSPITAL ALSO ORGANIZES EMPLOYEE PARTICIPATION IN FUNDRAISING FOR ORGANIZATIONS, SUCH AS THE UNITED WAY, STEWPOT MINISTRIES AND JUNIOR ACHIEVEMENT, AMONG OTHERS. IN ADDITION, THE HOSPITAL GAVE APPROXIMATELY $684,000 DURING 2014 IN CHARITABLE CORPORATE DONATIONS TO VARIOUS AREA COMMUNITY SERVICE ORGANIZATIONS. ALTHOUGH THE HOSPITAL HAS ESTIMATED THE COST OF EACH OF THESE EFFORTS TO SERVE THE JACKSON, MISSISSIPPI, METROPOLITAN AREA, MANAGEMENT AND THE BOARD OF DIRECTORS BELIEVE THAT SUCH COSTS REPRESENT ONLY ONE FACET OF THE MANY WAYS THE HOSPITAL SERVES THE GREATER JACKSON COMMUNITY. THE ABOVE EXAMPLES RELATE ONLY TO CERTAIN MEASUREABLE BENEFITS THAT THE HOSPITAL PROVIDES TO ITS SERVICE AREA. THIS PRESENTATION IS NOT INTENDED TO MEASURE ALL SUCH COMMUNITY BENEFITS, MANY OF WHICH ARE INTANGIBLE IN NATURE OR OTHERWISE NOT QUANTIFIABLE.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$427,227,746TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document406IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee4150EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJENNIFER SINCLAIRPersonNm
Phone6012006955PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JEFF FLETCHER MD
CHAIRMAN0.750.0Yes (X)Yes (X)$0$0$0
DAN GRAFTON
VICE CHAIRMAN0.750.0Yes (X)Yes (X)$0$0$0
SISTER MARY TRINITA OP
SECRETARY0.7540.5Yes (X)Yes (X)$0$0$0
SISTER THECLA KUHNLINE OP
DIRECTOR0.750.0Yes (X)$0$0$0
SISTER CELESTINE RONDELLI OP
DIRECTOR0.750.0Yes (X)$0$0$0
SISTER KATHLEEN GALLAGHER OP
DIRECTOR0.751.0Yes (X)$0$0$0
SISTER KRISTIN REVER OP
DIRECTOR0.750.0Yes (X)$0$0$0
SISTER CORDE LENN OP
DIRECTOR0.750.0Yes (X)$0$0$0
DONNA SIMS
DIRECTOR0.750.0Yes (X)$0$0$0
TOD ETHEREDGE
DIRECTOR0.750.0Yes (X)$0$0$0
EDDIE MALONEY
DIRECTOR0.750.0Yes (X)$0$0$0
JIMMY JONES MD
DIRECTOR0.750.0Yes (X)$0$0$0
BILL TEW MD
DIRECTOR0.750.0Yes (X)$0$0$0
CLAUDE W HARBARGER
DIRECTOR0.7542.0Yes (X)$0$776,624$97,015
LESTER K DIAMOND
PRESIDENT40.00.0Yes (X)Yes (X)$555,148$0$73,870
JENNIFER SINCLAIR
EXECUTIVE VP - OPERATIONS40.00.0Yes (X)$370,308$0$31,861
MATTHEW FISHER
VP - FINANCE40.00.0Yes (X)$261,707$0$27,021
KEITH VAN CAMP
VP - INFORMATION TECH40.00.0$297,386$0$29,016Yes (X)
REBECCA LOWE
VP - ANCILLARY SERVICES40.00.0$237,597$0$15,963Yes (X)
RAYMOND SWARTZFAGER
VP - ANCILLARY SERVICES40.00.0$230,464$0$32,174Yes (X)
LAWRENCE M RIDDLES
EXEC VP - MEDICAL AFFAIRS40.00.0$403,092$0$21,169Yes (X)
THERESA A HORNE
VP - PATIENT CARE SERVICES40.00.0$234,911$0$14,795Yes (X)
LORRAINE WASHINGTON
VP - HUMAN RESOURCES24.016.0$0$247,389$34,712Yes (X)
JOHN LANCON
PHYSICIAN40.00.0$1,310,971$0$12,353Yes (X)
D P SEAGO
PHYSICIAN40.00.5$1,196,937$0$8,716Yes (X)
RONALD KENNEDY
PHYSICIAN40.00.0$962,651$0$12,353Yes (X)
VERN A KELLER
PHYSICIAN40.00.0$957,197$0$11,324Yes (X)
PB KERR
PHYSICIAN40.00.0$872,235$0$11,808Yes (X)
STEPHEN BOMGARDNER
FORMER KEY EMPLOYEE40.00.0$146,519$0$19,916Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$8,037,123TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,024,013TotReportableCompRltdOrgAmt
Total Other Compensation$454,066TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K161IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ALLIED EMERGENCY SERVICES PC
PO BOX 2120RIDGELANDMS39158E.R. PHYSICIANS$7,659,375
PHYSICIANS ANESTHESIA GROUP PA
PO BOX 4608JACKSONMS39296ANESTHESIA SERVICE$2,802,383
MEDICAL MANAGEMENT SERVICES
308 CORPORATE DRIVERIDGELANDMS39157CLINIC MANAGEMENT$2,524,928
JACKSON HEART CLINIC PA
970 LAKELAND DRIVEJACKSONMS39216CO-MANAGEMENT$1,303,292
M MODAL SERVICES LTD
PO BOX 538504ATLANTAGA30353TRANSCRIPTION$798,189
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K38CntrctRcvdGreaterThan100KCnt
Related Organizations$1,355,172RelatedOrganizationsAmt
All Other Contributions$400,091AllOtherContributionsAmt
Noncash Contributions$6,046NoncashContributionsAmt
Total Contributions$1,755,263TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Service Revenue621990$427,853,345$427,853,345
Pharmaceutical Sales446110$4,914,528$3,523,716$1,390,812
Spa Sales812900$762,774$116,215$646,559
FieldValueIRS element (for citing)
Total Program Service Revenue$433,530,647TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,338,588TotalRevenueColumnAmt
Exclusion$2,338,588ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$5,204,775RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$5,204,775RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,204,775TotalRevenueColumnAmt
Exclusion$5,204,775ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$106,858OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$59,981OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$46,877OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$46,877TotalRevenueColumnAmt
Exclusion$46,877ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
WEIGHT LOSS CENTER812900$1,184,608$1,184,608
CAFETERIA & FOOD SALES722514$3,209,611$3,209,611
Day Care Center624410$750,632$750,632

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,262,437TotalRevenueColumnAmt
Related Or Exempt Func Income$2,543,626RelatedOrExemptFuncIncomeAmt
Exclusion$718,811ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$8,407,288OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$451,283,438TotalRevenueColumnAmt
Related Or Exempt Func Income$435,221,510RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$2,037,371UnrelatedBusinessRevenueAmt
Exclusion$12,269,294ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,262,322TotalAmt
Program Services$2,262,322ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$84,706TotalAmt
Program Services$84,706ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,836,482TotalAmt
Management And General$2,836,482ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$74,599TotalAmt
Program Services$74,599ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$166,949,420TotalAmt
Program Services$164,124,057ProgramServicesAmt
Management And General$2,825,363ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total-$834,542TotalAmt
Program Services-$622,298ProgramServicesAmt
Management And General-$212,244ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$16,845,675TotalAmt
Program Services$16,360,197ProgramServicesAmt
Management And General$485,478ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$11,236,569TotalAmt
Program Services$10,877,773ProgramServicesAmt
Management And General$358,796ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$353,104TotalAmt
Program Services$353,104ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$839,982TotalAmt
Management And General$839,982ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$300,325TotalAmt
Management And General$300,325ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$34,975TotalAmt
Program Services$34,975ProgramServicesAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$23,710,731TotalAmt
Program Services$23,710,731ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,604,362TotalAmt
Program Services$1,604,362ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,825,411TotalAmt
Program Services$1,825,411ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$11,011,434TotalAmt
Program Services$11,011,434ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$902,850TotalAmt
Program Services$902,850ProgramServicesAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$107,553TotalAmt
Program Services$107,553ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$14,090TotalAmt
Program Services$14,090ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$21,685,954TotalAmt
Program Services$21,685,954ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,398,010TotalAmt
Program Services$2,398,010ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL & OTHER SUPPLIES$76,262,050$76,262,050
Pharmaceutical Drugs$23,366,286$23,366,286
BAD DEBT EXPENSE$21,729,288$21,729,288
Repairs & Maintenance$18,130,568$18,130,568

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$30,929,724TotalAmt
Program Services$30,929,724ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$434,661,928TotalAmt
Program Services$427,227,746ProgramServicesAmt
Management And General$7,434,182ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$823,704BOYAmt
EOY$766,345EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$67,048,897BOYAmt
EOY$65,893,253EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$48,224,751BOYAmt
EOY$49,919,401EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$7,535,504BOYAmt
EOY$7,782,525EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$8,035,294BOYAmt
EOY$8,037,112EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$443,704,487LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$264,537,054LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$177,582,942BOYAmt
EOY$179,167,433EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$39,251,193BOYAmt
EOY$44,480,156EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$348,502,285BOYAmt
EOY$356,046,225EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$33,408,374BOYAmt
EOY$31,804,386EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,955,659BOYAmt
EOY$1,285,310EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,466,474BOYAmt
EOY$57,900,255EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$47,830,507BOYAmt
EOY$90,989,951EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$300,671,778BOYAmt
EOY$265,056,274EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$300,671,778BOYAmt
EOY$265,056,274EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$348,502,285BOYAmt
EOY$356,046,225EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$16,621,510ReconcilationRevenueExpnssAmt
Prior Period Adjustments$282,385PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$52,519,399OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$34,975OtherActivitiesAmt
Total Lobbying Expenditures$34,975TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1I:FormAndLineReferenceDesc
ExplanationST. DOMINIC-JACKSON MEMORIAL HOSPITAL PAID DUES TO THE MISSISSIPPI HOSPITAL ASSOCIATION. THE MISSISSIPPI HOSPITAL ASSOCIATION REPORTS THAT 24.63% OF THE $142,000 OF DUES PAID WERE RELATED TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,272,580OtherCostOrOtherBasisAmt
Book Value$9,272,580BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$212,681,743OtherCostOrOtherBasisAmt
Depreciation$102,002,204DepreciationAmt
Book Value$110,679,539BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,024,965OtherCostOrOtherBasisAmt
Depreciation$5,271,213DepreciationAmt
Book Value$3,753,752BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$199,026,731OtherCostOrOtherBasisAmt
Depreciation$151,126,488DepreciationAmt
Book Value$47,900,243BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,698,468OtherCostOrOtherBasisAmt
Depreciation$6,137,149DepreciationAmt
Book Value$7,561,319BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$179,167,433TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
OTHER RECEIVABLES$1,533,958
DUE FROM AFFILIATES$33,967,986
DUE FROM THIRD PARTY PAYORS$3,442,384
INVESTMENT IN AFFILIATES$4,027,163
INVESTMENT-SPIVA TRUST$1,508,665
FieldValueIRS element (for citing)
Total Book Value Other Assets$44,480,156TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLIABILITY FOR PENSION BENEFITSDesc
Amt$57,900,255Amt
FieldValueIRS element (for citing)
Total Liability$57,900,255TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationMANAGEMENT HAS EVALUATED THE COMPANY'S INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent350Yes (X)Percent350Ind
Free Care Medically IndigentfalseFreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,812,664TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,649,483DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,163,181NetCommunityBenefitExpnsAmt
Total Expense0.02460TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$53,850,336TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$57,606,403DirectOffsettingRevenueAmt
Net Community Benefit Expns-$3,756,067NetCommunityBenefitExpnsAmt

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$197,424TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$221,175DirectOffsettingRevenueAmt
Net Community Benefit Expns-$23,751NetCommunityBenefitExpnsAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$67,860,424TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$61,477,061DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,383,363NetCommunityBenefitExpnsAmt
Total Expense0.02460TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,149,979TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,149,979NetCommunityBenefitExpnsAmt
Total Expense0.00280TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$103,418TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$103,418NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,581,176TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,683,551DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,897,625NetCommunityBenefitExpnsAmt
Total Expense0.00700TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,762,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,762,500NetCommunityBenefitExpnsAmt
Total Expense0.00430TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,597,073TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,683,551DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,913,522NetCommunityBenefitExpnsAmt
Total Expense0.01440TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$84,457,497TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$72,160,612DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,296,885NetCommunityBenefitExpnsAmt
Total Expense0.03900TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$431,236TotalCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$431,236TotalCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$21,729,288BadDebtExpenseAmt
Bad Debt Expense Attributable$10,430,058BadDebtExpenseAttributableAmt
Reimbursed By Medicare$126,133,328ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$137,107,990CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$10,974,662MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line1St Dominic ASCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesOutpatient surgery centerPrimaryActivitiesTxt
Org Profit Or Ownership0.51316OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership0.00000OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership0.48684PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST DOMINIC-JACKSON MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1969 LAKELAND DRIVEAddressLine1Txt
CityJACKSONCityNm
State AbbreviationMSStateAbbreviationCd
ZIP392164699ZIPCd
FieldValueIRS element (for citing)
Website Addresshttp://www.stdom.com/WebsiteAddressTxt
State License14-031StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST DOMINIC-JACKSON MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://www.stdom.com/why/benefit/OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt12ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttp://www.stdom.com/why/benefit/StrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care350.FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLXFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLXFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLXFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Average Negotiated RatesYes (X)AverageNegotiatedRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, SECTION B, LINE 5:AS PART OF THE COMMUNITY NEEDS ASSESSMENT,SDHS SPONSORED SIX FOCUS GROUPS. THOSE SIX FOCUS GROUPS INCLUDED INTERNAL COMMUNITY LEADERS, SENIORS AT ST. CATHERINES VILLAGE, A CONTINUING CARE FACILTY THAT IS PART OF SDHS, SENIORS FROM THE COMMUNITY, ST. DOMINIC EMPLOYEES AND EXTERNAL COMMUNITY LEADERS.
PART V, SECTION B, LINE 11:In 2014 St. Dominic's continued its focus on fulfilling community needs in areas identified in the 2013-2015 Community Health Needs Assessment. The overarching goal of the assessment was to respond to identified community health needs, improve access and improve health status - especially for the most vulnerable and underserved in our community. It is integral to St. Dominic's mission to establish community and provide service, setting an example to others in community service. St. Dominic Hospital's overall approach to community benefit is to target the intersection of documented unmet community health needs and our organization's key strengths and mission commitments. Specifically, members of the task force that led the development of the assessment identified priority health issues in St. Dominic's service area based on its review of demographic information, focus group summaries and results of a community survey. Those identified pressing issues are: O OBESITY, O HEART DISEASE, AND O MENTAL HEALTH NEEDS. St. Dominic's integrates its commitment to community service into its management and governance structures as well as its strategic and operational plans, and monitors and evaluates progress. In 2014 the strategic plan contained a strategy specifically directed at allocating resources to meet the needs of the community in response to the identified focus areas in the needs assessment. The overarching strategy indicated, "Use the 2012 Community Needs Assessment to ensure the hospital is appropriately allocating resources to meet the needs of our community." Following are ways in which the strategy was implemented in 2014. DISPARITY OR COMMUNITY NEED: OBESITY AND HEART DISEASE; Celebrated the 40th anniversary of the Mississippi Heart and Vascular Institute by holding heart educational events throughout the month of February. DISPARITY OR COMMUNITY NEED: OBESITY AND HEART DISEASE; Added Southwest Mississippi Regional Medical Center in McComb as an additional hospital to the telestroke program (making four hospitals in total). DISPARITY OR COMMUNITY NEED: OBESITY AND HEART DISEASE; Increased the number of participants in the Healthy Heart screening program from 480 in 2013 to 908 in 2014. DISPARITY AND COMMUNITY NEED: OBESITY, HEART DISEASE AND ACCESS TO CARE; Hosted a Go Red for Women Premier Party in partnership with the American Heart Association. The event provided a casual Q&A with a panel of experts and registrations increased by over 50 percent compared to 2013. In addition, St. Dominic's sponsored the main Go Red for Women event. In total, nearly 600 women were instructed on the dangers and signs of heart disease in women. DISPARITY AND COMMUNITY NEED: MENTAL HEALTH NEEDS; Continued to support the operations of the Community Health Clinic which provides primary care and a referral access point to services, including mental health, for the medically uninsured, homeless or working poor of Jackson.
PART V, SECTION B, LINE 20E:THE HOSPITAL PROACTIVELY SCREENS PATIENTS FOR FINANCIAL ASSISTANCE ELIGIBILITY IF THERE IS AN INDICATION THAT THE PATIENT MAY QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY.
FieldValueIRS element (for citing)
Facility24FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (24 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
ST DOMINIC'S EAR NOSE & THROAT
970 LAKELAND DRIVE SUITE 40JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S GYNECOLOGIC ONCOLOGY
971 LAKELAND DRIVE SUITE 750JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S HOSPITAL MEDICINE
971 LAKELAND DRIVE SUITE 1453JACKSONMS39216HOSPITALIST CLINIC
ST DOMINIC'S INTERNAL MEDICINE GROUP
971 LAKELAND DRIVE SUITE 250JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S CARDIOVASCULAR SURGERY
971 LAKELAND DRIVE SUITE 657JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S NEUROSURGERY ASSOCIATES
971 LAKELAND DRIVE SUITE 657JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S INFECTIOUS DISEASE
971 LAKELAND DRIVE SUITE 954JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF MADISON
106 HIGHLAND WAY SUITE 103MADISONMS39110PHYSICIAN CLINIC
ST DOMINIC'S PAIN MANAGEMENT CENTER
971 LAKELAND DRIVE SUITE 1159JACKSONMS39216PHYSICIAN CLINIC
STDOMINIC'S PSYCHIATRIC ASSOCIATES
890 LAKELAND DRIVEJACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S SURGICAL ONCOLOGY
106 HIGHLAND WAY SUITE 200MADISONMS39110PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF CLINTON
728 CLINTON PARKWAY SUITE BCLINTONMS39056PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF FLOWOOD
1050 RIVER OAKS DRIVEFLOWOODMS39232PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF BRANDON
1297 WEST GOVERNMENT STREETBRANDONMS39042PHYSICIAN CLINIC
ST DOMINIC'S INTERNAL MEDICINE GROUP
971 LAKELAND DRIVE SUITE 950JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S NEUROCARE
971 LAKELAND DRIVE SUITE 557JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S MARTIN SURGICAL ASSOCIATES
971 LAKELAND DRIVE SUITE 211JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S CHRONIC CARE CLINIC
890 LAKELAND DRIVEJACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF RALEIGH
342 MAGNOLIA DRIVERALEIGHMS39153PHYSICIAN CLINIC
ST DOMINIC'S INTERNAL MEDICINE GROUP
112 SOUTH LAKE CIRCLECANTONMS39046PHYSICIAN CLINIC
ST DOMINIC'S EMPLOYEE HEALTH CLINIC
969 LAKELAND DRIVEJACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S OUTREACH PROGRAM-BROOKHAVE
427 HWY 51 NBROOKHAVENMS39601PHYSICIAN CLINIC
ST DOMINIC'S OUTREACH PROGRAM-MORTON
321 HWY 13 SOUTHMORTONMS39117PHYSICIAN CLINIC
ST DOMINIC'S OUTREACH PROGRAM-CLEVELAND
810 E SUNFLOWER ROADCLEVELANDMS38732PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:ST. DOMINIC HOSPITAL HAS A DISCOUNT POLICY THAT IS BASED ON FEDERAL POVERTY GUIDELINES WITH A SLIDING SCALE THAT OFFERS DISCOUNTS RANGING FROM 20% TO 100%. IN ADDITION, ST. DOMINIC OFFERS A 60% DISCOUNT OFF GROSS CHARGES TO ALL UNINSURED PATIENTS.
PART I, LINE 6A:THE COMMUNITY BENEFIT REPORT FOR ST. DOMINIC HOSPITAL IS CONSOLIDATED WITH THE PARENT ORGANIZATION, ST. DOMINIC HEALTH SERVICES, INC. THE REPORT IS AVAILABLE AT HTTP://WWW.STDOM.COM/WHY/BENEFIT/.
PART I, LINE 7:ST. DOMINIC HOSPITAL USED A COST-TO-CHARGE RATIO BASED ON WORKSHEET 2 PROVIDED IN THE FORM 990, SCHEDULE H INSTRUCTIONS.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A) BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $21,729,288.
PART I, LINE 7G:ST. DOMINIC HOSPITAL DID NOT INCLUDE LOSSES ON ITS OWNED PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES. IN ORDER TO MEET THE NEEDS OF THE COMMUNITY IT SERVES, ST. DOMINIC CONTINUES ITS MINISTRY IN VARIOUS SERVICE LINES THAT ARE NOT PROFITABLE TO THE ORGANIZATION. AN EXAMPLE OF THESE SERVICES INCLUDES BUT IS NOT LIMITED TO THE EMERGENCY DEPARTMENT.
PART II:ST. DOMINIC HOSPITAL PROVIDES SIGNIFICANT SUPPORT TO ITS COMMUNITY THROUGH A VARIETY OF WAYS INCLUDING FREE HEALTH SCREENINGS AT LOCAL SCHOOLS, PARTICIPATION IN VARIOUS NON- PROFIT BOARDS AS WELL AS FINANCIAL SUPPORT THROUGH CASH DONATIONS. PART III, LINE 2: THE AMOUNT REPORTED IN PART III, LINE 2 AS BAD DEBT EXPENSE MATCHES THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS. PART III, LINE 3: St. Dominic Hospital frequently has patient accounts that are initially written off as a bad debt expense, but later (through a screening process) it is determined that the patient does qualify for financial assistance under the Hospital's financial assistance policy. The percentage of accounts is estimated to be 48 percent. The percentage is determined utilizing an internal report of accounts written off as a bad debt expense in one year and subsequently classified as charity in a subsequent year. PART III, LINE 4: Patient accounts receivable are reduced by an allowance for doubtful accounts and reported at net realizable value. In evaluating the collectibility of accounts receivable, the Hospital analyzes its historical experience and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a provision for uncollectible accounts in the period of service on the basis of their past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Hospitals allowance for doubtful accounts for self-pay patients increased from 67.4% of self-pay accounts receivable at December 31, 2013, to 69.2% of self-pay accounts receivable at December 31, 2014. In addition, the Hospitals self-pay bad debt write-offs increased from approximately $11,718,000 in 2013 to $19,726,000 in 2014. PART III, LINE 8: THE SHORTFALL SHOULD NOT BE INCLUDED IN THE COMMUNITY BENEFIT TOTAL.
PART III, LINE 9B:ST. DOMINIC HOSPITAL HAS A BOARD APPROVED COLLECTION POLICY AND HAS WRITTEN CONTRACTS IN PLACE WITH ITS COLLECTION AGENCIES SO THE APPROPRIATE COLLECTION ACTIVITIES ARE FOLLOWED. THE COLLECTION AGENCIES THAT ST. DOMINIC USES ARE FULLY INFORMED ABOUT THE HOSPITALS FINANCIAL AID POLICY AND ASSIST IN EDUCATING ITS PATIENTS. THEY ROUTINELY SEND FINANCIAL AID APPLICATIONS TO PATIENTS AND REFER THOSE PATIENTS BACK TO THE HOSPITALS FINANCIAL COUNSELORS WHEN APPROPRIATE.
PART VI, LINE 2:NEEDS ASSESSMENT St. Dominic Hospital assesses the community it serves through various sources which include: 1)analysis of the payor source and disease categories of patients treated at St. Dominic Hospital with particular analysis done on patients presenting to its Emergency Department; 2) feedback from the Board members who represent the community it serves; 3) requests made from the community; and 4) public health information.
PART VI, LINE 3:PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ST. DOMINIC HOSPITAL WORKS TO EDUCATE ITS PATIENTS AND COMMUNITY ON ASSISTANCE OPTIONS BY: 1-POSTING SIGNAGE IN THE EMERGENCY ROOM AND OTHER REGISTRATION AREAS INFORMING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. 2-PROVIDING BROCHURES IN THE WAITING ROOMS AND AT THE REGISTRATION DESKS THAT EXPLAIN THE BILLING AND COLLECTION PROCESS AS WELL AS INFORMATION ABOUT THE HOSPITALS FINANCIAL ASSISTANCE POLICY AND PHONE NUMBERS TO CALL FOR ASSISTANCE. 3-CONTRACTING AND PAYING AN AGENCY TO MEET WITH ALL UNINSURED PATIENTS TO ASSIST THEM IN APPLYING FOR FEDERAL AND STATE ASSISTANCE (I.E. MEDICAID, DISABILITY, ETC.). 4-PROVIDING FINANCIAL COUNSELORS TO MEET WITH PATIENTS. THESE COUNSELORS FULLY UNDERSTAND THE HOSPITALS CHARITY POLICY AND ARE AVAILABLE TO ASSIST WITH THE APPLICATIONS, SET UP INTEREST FREE PAYMENT PLANS AND OFFER ADVICE ON PUBLIC ASSISTANCE THAT MAY BE AVAILABLE. 5-STAFFING PATIENT REPRESENTATIVES TO ANSWER QUESTIONS AND ASSIST PATIENTS AS NEEDED. 6-EDUCATING THE EARLY-OUT AND BAD DEBT COLLECTION AGENCIES ON THE HOSPITALS FINANCIAL ASSISTANCE POLICIES SO THEY CAN ASSIST PATIENTS WHOM THEY FIND MIGHT HAVE FINANCIAL NEED.
PART VI, LINE 4:COMMUNITY INFORMATION THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING GEOGRAPHIC AND DEMOGRAPHIC AREAS, IS ADDRESSED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED DURING 2012. THE CHNA CAN BE ACCESSED AT: HTTP://WWW.STDOM.COM/WHY/BENEFIT/
PART VI, LINE 5:PROMOTION OF COMMUNITY HEALTH ST. DOMINIC RECOGNIZES ITS BASIC PARTICIPATION IN THE MISSION OF THE CHURCH WHICH INVOLVES TWO MAIN MINISTRIES: EDUCATION AND HEALTH CARE. THREE ACTIVITIES - COMMUNICATING A CHRISTIAN MESSAGE, ESTABLISHING COMMUNITY AND PERFORMING SERVICE - EXPRESS OUR MISSION OF CHRISTIAN HEALING. WE INVOLVE MEMBERS OF OUR COMMUNITY IN OUR GOVERNANCE SO THAT WE MAINTAIN THE FOCUS ON THE NEEDS OF OUR COMMUNITY. WE HAVE AN OPEN MEDICAL STAFF.
PART VI, LINE 6:AFFILIATED HEALTH CARE SYSTEM ST. DOMINIC HEALTH SERVICES, INC. IS THE PARENT ORGANIZATION OF A SYSTEM THAT INCLUDES ST. DOMINIC - JACKSON MEMORIAL HOSPITAL (A 535-BED ACUTE CARE FACILITY), ST. CATHERINE'S VILLAGE (A CONTINUING CARE RETIREMENT COMMUNITY), ST. DOMINIC HEALTH SERVICES FOUNDATION (A FUNDRAISING/GRANT FOCUSED ENTITY), FIRST INTERMED CORPORATION (PHYSICIAN CLINICS) AND ST. DOMINIC MADISON HEALTH SERVICES, INC. (A MEDICAL OFFICE BUILDING AND FITNESS CENTER). IN ADDITION, ST. DOMINIC HEALTH SERVICES OPERATES COMMUNITY HEALTH SERVICES -ST. DOMINIC, INC., WHICH INCORPORATES THE OUTREACH SERVICES OF THE CLUB AT ST. DOMINIC'S, NEW DIRECTIONS FOR OVER 55, ST. DOMINIC COMMUNITY HEALTH CLINIC, MADISON SCHOOL NURSE PROGRAM AND THE CARE-A-VAN SCREENING PROGRAM. AS A WHOLE, ALL OF THE SERVICES, ENTITIES AND HOSPITAL ARE COLLECTIVELY REFERRED TO AS ST. DOMINIC'S. ST. DOMINIC'S SEEKS TO FULFILL ITS CHRISTIAN HEALING MINISTRY BY ESTABLISHING COMMUNITY AND PERFORMING SERVICE. THAT MEANS GIVING OF TIME, TALENTS, AND RESOURCES TO MAKE THE COMMUNITIES SERVED BY ST. DOMINIC'S BETTER PLACES TO LIVE. THE ST. DOMINIC'S FAMILY OF CAREGIVERS NOT ONLY SERVES PATIENTS, BUT ALSO CONTRIBUTES TO AN ATMOSPHERE OF CARE AND COMPASSION FOR THOSE OUTSIDE THE HOSPITAL'S WALLS. ST. DOMINIC'S STRIVES TO NOT ONLY PROVIDE CARE FOR THE SICK BUT ALSO TO OFFER EDUCATION AND WELLNESS SERVICES TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY AND HELP ELIMINATE RISK FACTORS FOR MORE SERIOUS HEALTH PROBLEMS.
PART VI, LINE 7:STATE FILING OF COMMUNITY BENEFIT REPORT ST. DOMINIC HOSPITAL (CONSOLIDATED WITH ST. DOMINIC HEALTH SERVICES, INC.) PREPARES ANNUALLY A COMMUNITY BENEFIT REPORT WHICH IS DISTRIBUTED TO KEY MEMBERS OF THE LOCAL COMMUNITY AND STATE GOVERNMENT. HOWEVER, THERE ARE CURRENTLY NO REQUIREMENTS TO DO SO IN THE STATE OF MISSISSIPPI.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
100 BLACK MEN OF JACKSON
5360 HIGHLAND DRIVEJACKSONMS39286640817928501(C)(3)$20,000GENERAL SUPPORT
BEGINNING AGAIN IN CHRIST
PO BOX 26BRANDONMS39042640592123501(C)(3)$15,000GENERAL SUPPORT
BOY SCOUTS OF AMERICA
855 RIVERSIDE DRJACKSONMS39202640303071501(C)(3)$32,000GENERAL SUPPORT
CATHOLIC CHARITIES
200 NORTH CONGRESS ST SUITE 100JACKSONMS39201640468850501(C)(3)$155,000GENERAL SUPPORT
CENTER FOR THE PREVENTION OF VIOLENCE
PO BOX 6279PEARLMS39288581959108501(C)(3)$36,000GENERAL SUPPORT
COMMUNITY HEALTH SERVICES
970 LAKELAND DRJACKSONMS39216640714997501(C)(3)$200,000AFFILIATE SUPPORT
HOSPICE MINISTRIES
45 TOWNE CENTER BLVDRIDGELANDMS39157640789919501(C)(3)$62,500GENERAL SUPPORT
MISSION MISSISSIPPI
PO BOX 22655JACKSONMS39225640824240501(C)(3)$30,000GENERAL SUPPORT
NEIGHBORHOOD CHRISTIAN CENTER
417 WEST ASH STJACKSONMS39203640800919501(C)(3)$18,000GENERAL SUPPORT
OPERATION SHOESTRING
1711 BAILEY AVENUEJACKSONMN39283640471554501(C)(3)$25,000GENERAL SUPPORT
REAL CHRISTIAN FOUNDATION
PO BOX 180059RICHLANDMS39218640885750501(C)(3)$40,000GENERAL SUPPORT
SOUTHERN CHRISTIAN SERVICES
860 EAST RIVER PLACE SUITE 104JACKSONMS39202640758344501(C)(3)$25,000GENERAL SUPPORT
TUTWILER COMMUNITY EDUCATION CENTER INC
PO BOX 448TUTWILERMS38963581887449501(C)(3)$15,000GENERAL SUPPORT
VOICE OF CALVARY
531 W CAPITOL STREETJACKSONMS39203640564343501(C)(3)$10,000GENERAL SUPPORT
ST DOMINIC HEALTH SERVICES INC
969 LAKELAND DRIVEJACKSONMS39216640714999501(c)(3)$1,500,000AFFILIATE SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org15Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPS/TUITION REIMBURSEMENTGrantTypeTxt
Recipient38RecipientCnt
Cash Grant$84,706CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE HOSPITAL HAS A CONTRIBUTIONS COMMITTEE, WHICH IS A SUB-COMMITTEE OF THE BOARD, THAT OVERSEES THE HOSPITALS GIVING. THEY MONITOR THE REQUESTS AND OVERSEE ALL GIFTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
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 (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 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
CLAUDE W HARBARGER
DIRECTOR$0$741,572$0$0$0$35,052$0$86,854$0$10,161$0$873,639$0$0
LESTER K DIAMOND
PRESIDENT$535,435$0$0$0$19,713$0$61,514$0$12,356$0$629,018$0$0$0
JENNIFER SINCLAIR
EXECUTIVE VP - OPERATIONS$363,415$0$0$0$6,893$0$31,185$0$676$0$402,169$0$0$0
MATTHEW FISHER
VP - FINANCE$236,579$0$0$0$25,128$0$14,953$0$12,068$0$288,728$0$0$0
KEITH VAN CAMP
VP - INFORMATION TECH$295,527$0$0$0$1,859$0$28,669$0$347$0$326,402$0$0$0
REBECCA LOWE
VP - ANCILLARY SERVICES$237,597$0$0$0$0$0$15,784$0$179$0$253,560$0$0$0
RAYMOND SWARTZFAGER
VP - ANCILLARY SERVICES$230,464$0$0$0$0$0$23,718$0$8,456$0$262,638$0$0$0
LAWRENCE M RIDDLES
EXEC VP - MEDICAL AFFAIRS$394,092$0$0$0$9,000$0$9,540$0$11,629$0$424,261$0$0$0
THERESA A HORNE
VP - PATIENT CARE SERVICES$219,911$0$0$0$15,000$0$6,355$0$8,440$0$249,706$0$0$0
JOHN LANCON
PHYSICIAN$1,190,544$0$58,000$0$62,427$0$0$0$12,353$0$1,323,324$0$0$0
D P SEAGO
PHYSICIAN$1,139,940$0$0$0$56,997$0$0$0$8,716$0$1,205,653$0$0$0
RONALD KENNEDY
PHYSICIAN$916,810$0$0$0$45,841$0$0$0$12,353$0$975,004$0$0$0
VERN A KELLER
PHYSICIAN$911,616$0$0$0$45,581$0$0$0$11,324$0$968,521$0$0$0
PB KERR
PHYSICIAN$791,700$0$39,000$0$41,535$0$0$0$11,808$0$884,043$0$0$0
LORRAINE WASHINGTON
VP - HUMAN RESOURCES$0$247,389$0$0$0$0$0$26,235$0$8,477$0$282,101$0
STEPHEN BOMGARDNER
FORMER KEY EMPLOYEE$146,519$0$0$0$0$0$10,262$0$9,654$0$166,435$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1A:THE HOSPITAL PROVIDED A HOUSING ALLOWANCE THAT COVERS A 90 DAY PERIOD OF TIME DURING RELOCATION FOR RECRUITING PHYSICIANS. TWO OF THE PHYSICIANS LISTED IN PART VII OF FORM 990 RECEIVED A HOUSING ALLOWANCE, WHICH IS TREATED AS TAXABLE COMPENSATION AND INCLUDED IN THE PHYSICIANS' W-2S. PART I, LINE 4A: OFFICER, MATTHEW FISHER, RECEIVED $25,128 IN SEVERANCE PAYMENTS DURING CALENDAR YEAR 2014.
PART I, LINE 4B:EFFECTIVE FOR THE PLAN YEAR BEGINNING 1/1/2013, THE EXECUTIVE 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)). THE PAYOUTS BEGAN IN FIRST QUARTER 2014, WHICH ARE INCLUDED IN THE FORM W-2 BOX 5 WAGES AND REFLECTED IN OTHER REPORTABLE COMPENSATION ON SCHEDULE J. THESE AMOUNTS ARE: LESTER K. DIAMOND - 19,713 JENNIFER SINCLAIR - 6,893 KEITH VAN CAMP - 1,859 CLAUDE HARBARGER- 35,032 DEFERRED AMOUNTS UNDER THE 457(F) PLAN REFLECTED IN RETIREMENT AND OTHER DEFERRED COMPENSATION ON SCHEDULE J INCLUDE: LESTER K. DIAMOND- 50,142 JENNIFER SINCLAIR - 13,646 CLAUDE HARBARGER- 69,315 MATTHEW FISHER- 8,013 KEITH VAN CAMP- 11,130 RAYMOND SWARTZFAGER- 8,688 LAWRENCE RIDDLES- 3,177 THERESA HORNE- 2,547 LORRAINE WASHINGTON- 9,364

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonMELANIE GRAFTONPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionSEE PART VRelationshipDescriptionTxt
Transaction$74,599TransactionAmt
TransactionSEE PART VTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART VI, COLUMNS B & D:FormAndLineReferenceDesc
ExplanationMELANIE GRAFTON RELATIONSHIP: DAUGHTER OF DIRECTOR, DAN GRAFTON TRANSACTION: EMPLOYEE OF ST. DOMINIC - JACKSON MEMORIAL HOSPITALExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, PRIOR YEAR REVENUE:CERTAIN RECLASSIFICATIONS HAVE BEEN MADE TO 2013 TO BE CONSISTENT WITH CURRENT YEAR FINANCIAL STATEMENT PRESENTATION. THESE RECLASSIFICATIONS HAD NO EFFECT ON THE CHANGE IN NET ASSETS. FORM 990, PART VI, SECTION A, LINE 6: ST. DOMINIC HEALTH SERVICES, INC. IS THE SOLE MEMBER OF ST. DOMINIC- JACKSON MEMORIAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A:THE BOARD OF DIRECTORS OF ST. DOMINIC- JACKSON MEMORIAL HOSPITALS SOLE MEMBER, ST. DOMINIC HEALTH SERVICES, INC., HAS THE AUTHORITY TO ELECT THE PRESIDENT/CEO, THE CHAIR OF THE BOARD OF DIRECTORS AND THE VICE-CHAIR OF THE BOARD OF DIRECTORS OF THE HOSPITAL AND TO APPROVE THE ELECTION OF ALL OTHER OFFICERS OF THE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B:THE BOARD OF DIRECTORS OF THE SOLE MEMBER OF ST. DOMINIC-JACKSON MEMORIAL HOSPITAL, ST. DOMINIC HEALTH SERVICES, INC., HAS THE RIGHT TO APPROVE THE FORMATION OF, OR PARTICIPATION IN, ANY JOINT VENTURE OR PARTNERSHIP OF THE HOSPITAL. ST. DOMINIC HEALTH SERVICES, INC.S BOARD OF DIRECTORS ALSO HAS THE RIGHT TO APPROVE ANY DISSOLUTION OR MERGER ENACTED BY THE HOSPITAL. IF THE HOSPITALS BOARD OF DIRECTORS HAS A STALEMATE IN ANY VOTE, THE FINAL DECISION RESTS WITH THE BOARD OF DIRECTORS OF ITS SOLE MEMBER, ST. DOMINIC HEALTH SERVICES, INC. THE GOVERNING COUNCIL OF THE DOMINICAN SISTERS OF SPRINGFIELD ILLINOIS 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 11:THE BOARD HAS DELEGATED REVIEW OF THE FORM 990 TO THE FINANCE COMMITTEE OF THE BOARD PRIOR TO FILING. A FULL COPY, AS APPROVED BY THE FINANCE COMMITTEE, IS PROVIDED TO THE BOARD AND RATIFIED PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C:ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND SIGN A CONFLICT FORM ANNUALLY. FORMS ARE REVIEWED BY THE PRESIDENT AND ANY CONFLICTS SHARED WITH THE BOARD CHAIR. PERSONS WITH CONFLICTS OF INTERESTS ARE EXCLUDED FROM BOARD DELIBERATION AND ABSTAIN FROM ANY DECISIONS WHERE THE CONFLICT EXISTS.
FORM 990, PART VI, SECTION B, LINE 15:THE ORGANIZATIONS EXECUTIVE COMPENSATION PROGRAM IS ADMINISTERED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. THE EXECUTIVE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ESTABLISHING AND MAINTAINING A COMPETITIVE COMPENSATION PROGRAM FOR THE KEY EXECUTIVES OF THE ORGANIZATION. THE EXECUTIVE COMPENSATION COMMITTEE MEETS AS NEEDED TO REVIEW THE COMPENSATION PROGRAM AND MAKE RECOMMENDATIONS FOR ANY CHANGES AS APPROPRIATE. THE EXECUTIVE COMPENSATION COMMITTEE COMMISSIONS AN ANNUAL REVIEW BY AN INDEPENDENT CONSULTING FIRM TO EVALUATE THE ORGANIZATIONS EXECUTIVE COMPENSATION PROGRAM AGAINST THE COMPETITIVE MARKET. THE EVALUATION IS REVIEWED IN THE FIRST QUARTER OF EACH YEAR AND IS INTENDED TO ENSURE THAT THE COMPENSATION PROGRAM FALLS WITHIN A REASONABLE RANGE OF COMPETITIVE PRACTICES FOR COMPARABLE POSITIONS AMONG SIMILARLY SITUATED ORGANIZATIONS AS DESCRIBED IN SECTION 4958. FOLLOWING THIS REVIEW, THE COMMITTEE REVIEWS AND APPROVES, FOR SELECTED KEY EXECUTIVES, BASE SALARY AND TOTAL COMPENSATION RANGE FOR THE UPCOMING YEAR. THE EXECUTIVE COMPENSATION COMMITTEE MAINTAINS MINUTES AND RECORDS TO ENSURE THAT IT CAN CLAIM THE REBUTTABLE PRESUMPTION OF REASONABLE COMPENSATION FOR PURPOSES OF SECTION 4958. THE CHIEF EXECUTIVE OFFICER FOR THE HOSPITAL ASSIGNS PAY CHANGES FOR THE UPCOMING YEAR FOR EACH OF THE HOSPITAL EXECUTIVES WITHIN THE LIMITS ESTABLISHED BY THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT OF ST. DOMINIC HEALTH SERVICES, INC. IN CONJUNCTION WITH THE CHAIR OF ST. DOMINIC-JACKSON MEMORIAL HOSPITAL BOARD OF DIRECTORS SHALL ASSIGN THE PAY CHANGE FOR THE PRESIDENT (CHIEF EXECUTIVE OFFICER) OF ST. DOMINIC-JACKSON MEMORIAL HOSPITAL WITHIN THE LIMITS ESTABLISHED BY THE EXECUTIVE COMPENSATION COMMITTEE. KEY EXECUTIVES OF THE ORGANIZATION MAY ATTEND THE COMMITTEE MEETING OF THE EXECUTIVE COMPENSATION COMMITTEE TO PROVIDE THE INFORMATION NEEDED BY SUCH COMMITTEE. THESE EXECUTIVES ARE EXCUSED AND THE EXECUTIVE COMPENSATION COMMITTEE MEETS IN EXECUTIVE SESSION TO RENDER ITS RECOMMENDATIONS. 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 X, BEGINNING OF YEAR:CERTAIN ASSETS AND LIABILITIES FOR 2013 HAVE BEEN RECLASSED TO BE CONSISTENT WITH CURRENT YEAR REPORTING. FORM 990, PART XI, LINE 9: Pension Related Changes- (53,287,996) Intercompany Transactions- (6,933) Net Asset Reclass to match financial reporting- 775,530 Other Changes in Net Assets: (52,519,399)

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1ST DOMINIC MEDICAL ASSOCIATESBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1969 LAKELAND DRIVEAddressLine1Txt
CityJACKSONCityNm
State AbbreviationMSStateAbbreviationCd
ZIP392164699ZIPCd
FieldValueIRS element (for citing)
EIN261969846EIN
Primary ActivitiesHEALTHCAREPrimaryActivitiesTxt
Legal Domicile StateMSLegalDomicileStateCd
Total Income$51,906,054TotalIncomeAmt
End Of Year Assets$8,113,990EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SDJMHBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
ST DOMINIC HEALTH SERVICES FOUNDATION
969 LAKELAND DRIVEJACKSONMS392164699431992975FUNDRAISINGMS501(C)(3)7SDHSfalse
ST DOMINIC HEALTH SERVICES INC
969 LAKELAND DRIVEJACKSONMS392164699640714999HOLDING CO.MS501(C)(3)11-INAfalse
ST CATHERINE'S VILLAGE INC
969 LAKELAND DRIVEJACKSONMS392164699640714997RET HOMEMS501(C)(3)9SDHSfalse
COMMUNITY HEALTH SERVICES - ST DOMINIC
969 LAKELAND DRIVEJACKSONMS392164699640884870HLTH PROGRAMMS501(C)(3)9SDHSfalse
CONGREGATION OF THE DOMINICAN SISTERS
1237 WEST MONROE STSPRINGFIELDIL62704370968955CONGREGATIONIL501(C)(3)1NAfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
ST DOMINIC AMBULATORY SURGERY CENTER
971 LAKELAND DRIVE SUITE 200JACKSONMS39216640908713HEALTHCAREMSNAN/Afalsefalse
HIGHLAND MEDICAL ARTS LLC
PO BOX 55769JACKSONMS39296743073171MEDICAL BLDGMSNAN/Afalsefalse
D1 SPORTS TRAINING OF MS LLC
7115 SOUTH SPRINGS DRIVEFRANKLINTN37067275277568ATHLETIC TRAININGMSNAN/Afalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPct
ST DOMINIC MADISON HEALTH SERVICES INC
969 LAKELAND DRIVEJACKSONMS392164699202870254HEALTHCAREMSSDHSC CORPfalse
FIRST INTERMED CORPORATION
308 CORPORATE DRIVERIDGELANDMS39157640824796MEDICAL SERVICESMSSDHSC CORPfalse
ST DOMINIC INTEGRATED SERVICES INC
969 LAKELAND DRIVEJACKSONMS392164699271493623INVESTMENTSMSSDJMHC CORPYes (true)$536,851$2,932,1001.00000
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangeYes (true)AssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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