ST DOMINIC-JACKSON MEMORIAL HOSPITAL: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: ST DOMINIC-JACKSON MEMORIAL HOSPITAL (EIN 64-0303091)
Tax period: 2021-07-01 to 2022-06-30
Filed: 2023-05-15
IRS object ID: 202311359349315756
Schema version: 2021v4.2
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-05-15T16:05:09-05:00	ReturnTs
Tax Period End	2022-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	135565207	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	301 MAIN STREET SUITE 2150	AddressLine1Txt
City	BATON ROUGE	CityNm
State Abbreviation	LA	StateAbbreviationCd
ZIP	70801	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	640303091	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ST DOMINIC - JACKSON MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	STDO	BusinessNameControlTxt
Phone	6012006570	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	969 LAKELAND DRIVE	AddressLine1Txt
City	JACKSON	CityNm
State Abbreviation	MS	StateAbbreviationCd
ZIP	392164699	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	SAM SCOTT	PersonNm
Person Title	REGIONAL CFO	PersonTitleTxt
Phone	6012006570	PhoneNum
Signature	2023-05-15	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	SAM	PersonFirstNm
Person Last	SCOTT	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	RYAN HOOKS	PreparerPersonNm
PTIN	P00746825	PTIN
Phone	2253444000	PhoneNum
Preparation	2023-05-10	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	SAMUEL T SCOTT	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	969 LAKELAND DRIVE	AddressLine1Txt
City	JACKSON	CityNm
State Abbreviation	MS	StateAbbreviationCd
ZIP	392164699	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$557,322,632	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.STDOM.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1946	FormationYr
Legal Domicile State	MS	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE FOR THE CARE OF THE ILL, INJURED, OR DISABLED PERSONS, AND TO PROVIDE FOR RESEARCH, EDUCATION, AND FOR THE ENHANCEMENT OF HEALTH OF THOSE IN THE COMMUNITY.	ActivityOrMissionDesc
Voting Members Governing Body	16	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	4352	TotalEmployeeCnt
Total Volunteers	265	TotalVolunteersCnt
Total Gross UBI	$627,827	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$49,243,178	PYContributionsGrantsAmt
CY Contributions Grants	$11,779,404	CYContributionsGrantsAmt
PY Program Service Revenue	$525,283,460	PYProgramServiceRevenueAmt
CY Program Service Revenue	$530,365,163	CYProgramServiceRevenueAmt
PY Investment Income	$8,870,762	PYInvestmentIncomeAmt
CY Investment Income	-$2,121,726	CYInvestmentIncomeAmt
PY Other Revenue	$8,633,917	PYOtherRevenueAmt
CY Other Revenue	$9,747,841	CYOtherRevenueAmt
PY Total Revenue	$592,031,317	PYTotalRevenueAmt
CY Total Revenue	$549,770,682	CYTotalRevenueAmt
PY Grants And Similar Paid	$2,523,206	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$2,381,455	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$247,519,837	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$284,102,007	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$269,299,712	PYOtherExpensesAmt
CY Other Expenses	$310,240,020	CYOtherExpensesAmt
PY Total Expenses	$519,342,755	PYTotalExpensesAmt
CY Total Expenses	$596,723,482	CYTotalExpensesAmt
PY Revenues Less Expenses	$72,688,562	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$46,952,800	CYRevenuesLessExpensesAmt
Total Assets BOY	$502,151,354	TotalAssetsBOYAmt
Total Assets EOY	$457,480,771	TotalAssetsEOYAmt
Total Liabilities BOY	$213,774,579	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$230,428,767	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$288,376,775	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$227,052,004	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	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.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$455,157,867	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$533,041,592	RevenueAmt
Desc	THE ST. DOMINIC - JACKSON MEMORIAL HOSPITAL PROVIDES QUALITY HOSPITAL AND MEDICAL SERVICES TO ITS PATIENTS. IN THE CURRENT YEAR, SERVICES WERE PROVIDED FOR 119,976 PATIENT DAYS, 44,888 EMERGENCY ROOM VISITS AND 19,932 INPATIENT DISCHARGES. THE MEDICAL CENTER IS AN ACTIVE, CARING MEMBER OF THE COMMUNITIES IT SERVES. IN CARRYING OUT ITS MISSION, THE MEDICAL CENTER HAS ESTABLISHED A POLICY UNDER WHICH IT PROVIDES CARE TO NEEDY MEMBERS OF ITS COMMUNITIES. ADDITIONAL COSTS WERE INCURRED FOR PARTICIPATION IN PROGRAMS WHICH, IN SOME CASES, PAY AMOUNTS LESS THAN THE COST OF PROVIDING SERVICES.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$2,381,455	ExpenseAmt
Grant	$2,381,455	GrantAmt
Revenue	$0	RevenueAmt
Desc	THE HOSPITAL SERVES THE COMMUNITY IN NUMEROUS WAYS. SOME EXAMPLES INCLUDE ASSISTING IN EDUCATING THE COMMUNITY REGARDING HEALTH-RELATED ISSUES.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$457,539,322	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	225	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	4352	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	16	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	0	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SAM SCOTT	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6012006570	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	969 LAKELAND DRIVE	AddressLine1Txt
City	JACKSON	CityNm
State Abbreviation	MS	StateAbbreviationCd
ZIP	392164699	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JOHNNY DONALDSON
VICE CHAIR	0.75	0.00	Yes (X)	Yes (X)	$0	$0	$0
SISTER M TRINITA EDDINGTON OP
SECRETARY	0.75	40.50	Yes (X)	Yes (X)	$0	$0	$0
JEFF FLETCHER
CHAIR	0.75	0.00	Yes (X)	Yes (X)	$0	$0	$0
RICK GUYNES MD
BOARD MEMBER	40.00	0.00	Yes (X)		$40,079	$0	$0
REGINALD MARTIN MD
BOARD MEMBER/PHYSICIAN	40.00	0.00	Yes (X)		$351,041	$0	$25,571
REBEKAH MOULDER MD
BOARD MEMBER/PHYSICIAN	40.00	0.00	Yes (X)		$614,401	$0	$2,676
SISTER ROSE MIRIAM SCHULTE OP
BOARD MEMBER	0.75	1.00	Yes (X)		$0	$0	$0
D PAUL SEAGO MD
BOARD MEMBER/PHYSICIAN	40.00	0.50	Yes (X)		$973,306	$0	$20,028
SISTER KARINA DICKEY OP
BOARD MEMBER	0.75	0.00	Yes (X)		$0	$0	$0
SISTER DOROTHEA SONDGEROTH OP
BOARD MEMBER	0.75	41.50	Yes (X)		$0	$0	$0
MONSIGNOR ELVIN SUNDS
BOARD MEMBER	0.75	0.00	Yes (X)		$0	$0	$0
SISTER KATHLEEN ANNE TAIT OP
BOARD MEMBER	0.75	0.00	Yes (X)		$0	$0	$0
STEVEN GREMILLION MD
BOARD MEMBER	0.75	42.00	Yes (X)		$0	$992,768	$39,628
THOMAS K HUDSON
BOARD MEMBER	0.75	0.00	Yes (X)		$0	$0	$0
SCOTT KASHMAN
PRESIDENT - SD & JACKSON MARKET	0.75	42.00	Yes (X)	Yes (X)	$0	$187,062	$2,298
GENE LOPER MD
BOARD MEMBER	0.75	0.00	Yes (X)		$0	$0	$0
SAMUEL SCOTT
SVP, CFO	0.75	41.00		Yes (X)	$0	$508,382	$33,276
ROBERT NELSON
VP CHIEF NURSING OFFICER	40.00	0.00			$352,493	$0	$40,405	Yes (X)
JOHN LANCON
PHYSICIAN	40.00	0.00			$1,201,707	$0	$28,310		Yes (X)
BRYAN A GASPARD
PHYSICIAN	40.00	0.00			$933,692	$0	$25,610		Yes (X)
PB KERR
PHYSICIAN	40.00	0.00			$955,798	$0	$25,610		Yes (X)
DAVID THEODORO
PHYSICIAN	40.00	0.00			$1,083,208	$0	$19,532		Yes (X)
RONALD KENNEDY
PHYSICIAN	40.00	0.00			$815,869	$0	$12,472		Yes (X)
LESTER DIAMOND
PRESIDENT (THRU 03/2021)	0.00	0.00			$0	$714,339	$6,751			Yes (X)
DAVID C HENRY
VP OPERATIONS - THRU 5/2021	0.00	0.00			$231,083	$0	$9,892			Yes (X)
WILLIAM MORGAN
COO - THRU 5/2021	0.00	0.00			$420,124	$0	$11,020			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$7,972,801	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,402,551	TotReportableCompRltdOrgAmt
Total Other Compensation	$303,079	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	386	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
TRIMEDX
PO BOX 636129	CINCINNATI	OH	452636129	EQUIPMENT MAINTENANCE	$8,898,714
ALLIED EMERGENCY SERVICES PC
PO BOX 2120	RIDGELAND	MS	39158	EMERGENCY ROOM SERVICES	$6,487,553
PHYSICIANS ANESTHESIA GROUP PA
971 LAKELAND DRIVE	JACKSON	MS	39207	ANESTHESIA SERVICE	$5,623,344
CERNER CORPORATION
PO BOX 959156	ST LOUIS	MO	63195	INFORMATION TECHNOLOGY	$5,082,737
NTHRIVE INC
PO BOX 676188	DALLAS	TX	752676188	PATIENT FINANCIAL SVCS	$4,376,229

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	61	CntrctRcvdGreaterThan100KCnt
Related Organizations	$1,882,386	RelatedOrganizationsAmt
Government Grants	$8,537,371	GovernmentGrantsAmt
All Other Contributions	$1,359,647	AllOtherContributionsAmt
Total Contributions	$11,779,404	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
PATIENT SERVICE REV	621990	$512,777,660	$512,777,660
OTHER PROGRAM SERVICE	621990	$14,525,983	$13,898,156	$627,827
CAFETERIA SALES	722514	$2,366,528			$2,366,528
RETAIL SALES	453000	$598,320			$598,320
LAB	621990	$84,190	$84,190

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,482	TotalRevenueColumnAmt
Exclusion	$12,482	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$530,365,163	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$3,633,160	TotalRevenueColumnAmt
Exclusion	-$3,633,160	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$3,466,255	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$3,466,255	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,466,255	TotalRevenueColumnAmt
Exclusion	$3,466,255	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$9,053,634	SecuritiesAmt
Other	$9,750	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$7,551,950	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$1,501,684	SecuritiesAmt
Other	$9,750	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,511,434	TotalRevenueColumnAmt
Exclusion	$1,511,434	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	PENSION RELATED CHANGE	Desc
Business	900099	BusinessCd
Total Revenue Column	$6,281,586	TotalRevenueColumnAmt
Related Or Exempt Func Income	$6,281,586	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$6,281,586	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$549,770,682	TotalRevenueColumnAmt
Related Or Exempt Func Income	$533,041,592	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$627,827	UnrelatedBusinessRevenueAmt
Exclusion	$4,321,859	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$2,381,455	TotalAmt
Program Services	$2,381,455	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,262,471	TotalAmt
Program Services	$2,034,315	ProgramServicesAmt
Management And General	$228,156	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$228,490,930	TotalAmt
Program Services	$205,449,037	ProgramServicesAmt
Management And General	$23,041,893	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$16,117,341	TotalAmt
Program Services	$14,492,007	ProgramServicesAmt
Management And General	$1,625,334	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$22,493,380	TotalAmt
Program Services	$20,225,062	ProgramServicesAmt
Management And General	$2,268,318	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$14,737,885	TotalAmt
Program Services	$13,251,661	ProgramServicesAmt
Management And General	$1,486,224	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$57,559,396	TotalAmt
Program Services	$37,847,806	ProgramServicesAmt
Management And General	$19,711,590	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$239,193	TotalAmt
Program Services	$14,703	ProgramServicesAmt
Management And General	$224,490	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$50,400	TotalAmt
Program Services	$3,098	ProgramServicesAmt
Management And General	$47,302	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$33,893	TotalAmt
Program Services	$9,726	ProgramServicesAmt
Management And General	$24,167	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$38,231,563	TotalAmt
Program Services	$13,485,799	ProgramServicesAmt
Management And General	$24,745,764	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,141,638	TotalAmt
Program Services	$327,604	ProgramServicesAmt
Management And General	$814,034	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$36,609,716	TotalAmt
Program Services	$17,024,924	ProgramServicesAmt
Management And General	$19,584,792	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,109,751	TotalAmt
Program Services	$318,454	ProgramServicesAmt
Management And General	$791,297	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$14,584,963	TotalAmt
Program Services	$145,850	ProgramServicesAmt
Management And General	$14,439,113	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$272,486	TotalAmt
Program Services	$78,193	ProgramServicesAmt
Management And General	$194,293	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$23,545	TotalAmt
Program Services	$6,756	ProgramServicesAmt
Management And General	$16,789	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$3,291,256	TotalAmt
Program Services	$20,904	ProgramServicesAmt
Management And General	$3,270,352	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$17,289,571	TotalAmt
Program Services	$163,215	ProgramServicesAmt
Management And General	$17,126,356	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$7,412,298	TotalAmt
Program Services	$3,675,413	ProgramServicesAmt
Management And General	$3,736,885	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL & OTHER SUPPLIE	$126,119,075	$126,119,075
REPAIRS & MAINTENANCE	$4,845,483	$314,884	$4,530,599
MISCELLANEOUS EXPENSES	$1,425,793	$149,381	$1,276,412

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$596,723,482	TotalAmt
Program Services	$457,539,322	ProgramServicesAmt
Management And General	$139,184,160	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$117,018,469	BOYAmt
EOY	$79,747,387	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$75,326,090	BOYAmt
EOY	$56,209,733	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$15,422,662	BOYAmt
EOY	$16,612,202	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$22,543,161	BOYAmt
EOY	$13,159,253	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$273,560,957	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$43,644,263	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$214,761,603	BOYAmt
EOY	$229,916,694	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$31,561,936	BOYAmt
EOY	$30,314,640	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$7,846,405	BOYAmt
EOY	$9,260,054	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,361,321	BOYAmt
EOY	$17,257,645	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$10,309,707	BOYAmt
EOY	$5,003,163	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$502,151,354	BOYAmt
EOY	$457,480,771	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$58,236,879	BOYAmt
EOY	$60,671,979	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$12,548,941	BOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$142,988,759	BOYAmt
EOY	$169,756,788	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$213,774,579	BOYAmt
EOY	$230,428,767	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$288,376,775	BOYAmt
EOY	$227,052,004	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$288,376,775	BOYAmt
EOY	$227,052,004	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$502,151,354	BOYAmt
EOY	$457,480,771	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$46,952,800	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$4,542,917	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$9,829,054	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (1)	GrantsOtherOrganizationsInd
Grants Other Organizations	$23,602	GrantsOtherOrganizationsAmt
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	0	OtherActivitiesInd
Total Lobbying Expenditures	$23,602	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	ST. DOMINIC-JACKSON MEMORIAL HOSPITAL PAID DUES TO THE MISSISSIPPI HOSPITAL ASSOCIATION. THE MISSISSIPPI HOSPITAL ASSOCIATION REPORTS THAT 13.37% OF THE $176,533 OF DUES PAID WERE RELATED TO LOBBYING ACTIVITIES.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Incl Escrow Custodial Acct Liab	0	InclEscrowCustodialAcctLiabInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$15,142,699	OtherCostOrOtherBasisAmt
Book Value	$15,142,699	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$204,024,892	OtherCostOrOtherBasisAmt
Depreciation	$20,628,363	DepreciationAmt
Book Value	$183,396,529	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$54,351,775	OtherCostOrOtherBasisAmt
Depreciation	$23,008,987	DepreciationAmt
Book Value	$31,342,788	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$41,591	OtherCostOrOtherBasisAmt
Depreciation	$6,913	DepreciationAmt
Book Value	$34,678	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$229,916,694	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	FND DEPR - FMOL PORTFOLIO	Desc
Book Value	$30,314,640	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$30,314,640	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
CAPITAL LEASES	$12,765,910
OTHER LONG TERM LIABILITIES	$3,121,390
RETIREMENT PAYABLE LONG TERM	$67,369,447
NET DUE TO/FROM AFFILIATES	$69,889,389
CURR PORTION OF LT DEBT	$12,557,908
SELF INSURANCE LIABILITY LT	$4,053,703
MEDICARE ACCELERATED PAYMENTS	-$959

Field	Value	IRS element (for citing)
Total Liability	$169,756,788	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	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 RESERVE FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	250.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	0	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$13,926,615	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,405,889	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,520,726	NetCommunityBenefitExpnsAmt
Total Expense	0.01260	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$64,293,631	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$63,111,767	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,181,864	NetCommunityBenefitExpnsAmt
Total Expense	0.00200	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$120,365	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$73,129	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$47,236	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$78,340,611	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$69,590,785	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,749,826	NetCommunityBenefitExpnsAmt
Total Expense	0.01470	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,056,337	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,056,337	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$161,280	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$161,280	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$17,282,386	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$14,267,255	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,015,131	NetCommunityBenefitExpnsAmt
Total Expense	0.00510	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,789,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,789,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00300	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,289,003	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$14,267,255	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,021,748	NetCommunityBenefitExpnsAmt
Total Expense	0.01020	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$98,629,614	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$83,858,040	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$14,771,574	NetCommunityBenefitExpnsAmt
Total Expense	0.02490	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$601,795	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$601,795	NetCommunityBenefitExpnsAmt
Total Expense	0.00100	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$601,795	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$601,795	NetCommunityBenefitExpnsAmt
Total Expense	0.00100	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$35,128,648	BadDebtExpenseAmt
Bad Debt Expense Attributable	$10,614,667	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$136,625,297	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$139,256,937	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$2,631,640	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	1 ST DOMINIC ASC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	OUTPATIENT SURGERY CENTER	PrimaryActivitiesTxt
Org Profit Or Ownership	0.46300	OrgProfitOrOwnershipPct
Physicians Profit Or Ownership	0.53700	PhysiciansProfitOrOwnershipPct

Field	Value	IRS element (for citing)
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ST DOMINIC-JACKSON MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	969 LAKELAND DRIVE	AddressLine1Txt
City	JACKSON	CityNm
State Abbreviation	MS	StateAbbreviationCd
ZIP	392164699	ZIPCd

Field	Value	IRS element (for citing)
Website Address	HTTP://WWW.STDOM.COM/	WebsiteAddressTxt
State License	14-031	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ST DOMINIC-JACKSON MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	21	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	21	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	250.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	0.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
ST. DOMINIC-JACKSON MEMORIAL HOSPITAL	PART V, SECTION B, LINE 5: AS PART OF THE COMMUNITY NEEDS ASSESSMENT, ST. DOMINIC HOSPITAL REACHED OUT TO AN EXPANSIVE AND HIGHLY DIVERSE GROUP OF INDIVIDUALS TO PARTICIPATE IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) LEADERSHIP TEAM AND TO CONTRIBUTE INSIGHT FROM COMMUNITY SERVICE ORGANIZATIONS. EACH MEMBER PROVIDED PROJECT INSIGHT, FEEDBACK REGARDING PERCEPTIONS OF AREA HEALTH NEEDS, DATA EVALUATION, AND OTHER GUIDANCE DURING THE CHNA DEVELOPMENT PROCESS. THESE INDIVIDUALS OFFERED A BREADTH OF COMMUNITY HEALTH VISION, KNOWLEDGE, AND POWER TO IMPACT THE WELL-BEING OF THE SERVICE AREA. INFORMATION WAS GATHERED ABOUT THE LARGER COMMUNITY USING SECONDARY RESEARCH, DISCUSSION GROUPS AND COMMUNITY SURVEYS.
ST. DOMINIC-JACKSON MEMORIAL HOSPITAL	PART V, SECTION B, LINE 11: ST. DOMINIC'S BUILT UPON WHAT IT LEARNED IN ITS PRECEDING CHNA'S AND USED THAT INFORMATION TO CONDUCT A NEW AND MORE EXTENSIVE NEEDS ASSESSMENTS. THE RESULTS OF THE NEW ASSESSMENT WERE LATER PUBLISHED WITHIN THE 2021-2024 COMMUNITY HEALTH NEEDS ASSESSMENT AND CAN BE FOUND ONLINE AT HTTPS://WWW.STDOM.COM/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.THE OVERARCHING GOAL OF THE ASSESSMENT WAS TO IDENTIFY AND RESPOND TO COMMUNITY HEALTH NEEDS, IMPROVE ACCESS AND IMPROVE HEALTH STATUS ESPECIALLY FOR THE MOST VULNERABLE AND UNDERSERVED IN THE COMMUNITY. IT IS INTEGRAL TO ST. DOMINIC'S FOCUS 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 THE 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 FEEDBACK AND THE RESULTS OF COMMUNITY SURVEYS. THOSE IDENTIFIED PRESSING ISSUES FOR 2021-2024 ARE:- HOMELESSNESS;- CRISIS CARE FOR MENTAL HEALTH; - AFFORDABLE HEALTHCARE SERVICES FOR PEOPLE OR FAMILIES WITH LOW INCOME;- DOMESTIC VIOLENCE RESOURCES; - HOUSING FOR ALL INCOMES/AGES; - COUNSELING SERVICES FOR DEPRESSION OR ANXIETY; - JOB READINESS; - POST-ADDICTIONS TREATMENT SUPPORT PROGRAMS; - COUNSELING SERVICES FOR ADOLESCENTS/CHILDREN AND - PRESCRIPTION ASSISTANCE.THE HOSPITAL IS CURRENTLY ADDRESSING THE COMMUNITY NEEDS OF AFFORDABLE HEALTHCARE SERVICES FOR PEOPLE OR FAMILIES WITH LOW INCOME, DOMESTIC VIOLENCE RESOURCES, AND PRESCRIPTION ASSISTANCE AND IS PLANNING ON CONTINUING TO ADDRESS SUCH NEEDS. THE HOSPITAL HAS DECIDED THAT IT WILL ADDRESS CRISIS CARE FOR MENTAL HEALTH, COUNSELING SERVICES FOR DEPRESSION OR ANXIETY, AND POST-ADDICTIONS TREATMENT SUPPORT PROGRAMS WITHIN THE NEXT 2-3 YEARS. THE HOSPITAL WILL NOT ADDRESS HOMELESSNESS, HOUSING FOR ALL INCOMES/AGES, OR COUNSELING SERVICES FOR ADOLESCENTS/CHILDREN AS THOSE COMMUNITY NEEDS ARE OUTSIDE OF ITS SCOPE. IN 2022, AS IT DID IN PRIOR YEARS, ST. DOMINIC'S INTEGRATED ITS COMMITMENT TO COMMUNITY SERVICE INTO ITS MANAGEMENT AND GOVERNANCE STRUCTURES AS WELL AS ITS STRATEGIC AND OPERATIONAL PLANS. THE HOSPITAL'S STRATEGIC PLAN CONTAINED A GOAL AND STRATEGIES SPECIFICALLY DIRECTED AT ALLOCATING RESOURCES TO MEET THE NEEDS OF THE COMMUNITY IN RESPONSE TO THE IDENTIFIED FOCUS AREAS IN THE NEEDS ASSESSMENT. THE HOSPITAL ADDRESSED THE COMMUITY HEALTH NEEDS IDENTIFIED IN ITS PRIOR CHNA OF ACCESS TO AFFORDABLE HEALTH CARE AND MENTAL HEALTH AND SUBSTANCE ABUSE. IT DID NOT ADDRESS LIFESTYLE RELATED CONDITIONS AS THAT NEED IT OUTSIDE OF ITS SCOPE. ACCESS TO AFFORDABLE HEALTH CARE - SERVED VULNERABLE CHILDREN AND MATURE ADULTS THROUGHOUT THE STATE FROM JULY 2021 - JUNE 2022 THROUGH THE CARE-A-VAN PROGRAM. THE PROGRAM TAKES HEALTH SCREENING TO THE MOST VULNERABLE POPULATIONS SUCH AS SENIOR CENTERS, DAYCARE CENTERS, ELEMENTARY SCHOOLS, AS WELL AS COMMUNITY-WIDE WELLNESS FAIRS IN RURAL AND UNDERSERVED AREAS OF THE METRO JACKSON AREA. CARE-A-VAN PERFORMED 634 HEALTH SCREENINGS AND ADMINISTERED 1,269 COVID-19 VACCINATIONS.BEHAVIORAL OR MENTAL HEALTH - FOCUS ON ACCESS, EARLY DETECTION AND INTERVENTION AS EVIDENCED BY STEERED SCREENING OR EDUCATION ACTIONS IN COMMUNITIES THROUGHOUT THE STATE, COMPLETED IN-PERSON AND THROUGH VIRTUAL MEANS. THE NUMBER OF REFERRAL DEVELOPMENT CONTACTS RECORDED FROM JULY 2021 TO JUNE 2022 WAS APPROXIMATELY 3072, OR AN AVERAGE OF 256 PER MONTH. THIS NUMBER REFLECTS THE OUTREACH OF BEHAVIORAL HEALTH IN THE COMMUNITY TO PROMOTE ACCESS AND INTERVENTION. EARLY DETECTION WAS A FOCUS IN PROVIDING DEPRESSION SCREENING TOOLS TO SDMA AND MEA CLINICS, AS WELL AS OTHER CLINIC LOCATIONS FOR PATIENTS SEEN IN THE PHP SETTING. ST. DOMINIC'S ALSO CONTINUED THE TELEMEDICINE OFFERINGS TO ENCOMPASS BEHAVIORAL HEALTH AND ASSIST OUTLYING COMMUNITIES WITH LIMITED PERSONNEL AND RESOURCES TO CONDUCT PROPER ASSESSMENTS. ST. DOMINIC'S BEHAVIORAL HEALTH PARTNERED WITH OTHER SENIOR CARE AGENCIES TO PROMOTE SENIOR CARE SERVICES ACROSS THE STATE AND PARTICIPATED IN COMMUNITY OUTREACH PROGRAMS WHERE BHS CLINICAL STAFF SPOKE TO SMALLER AUDIENCES IN AGENCIES AND COMMUNITY SETTINGS, SOMETIMES VIRTUALLY TO ADHERE TO COVID GUIDELINES. BEHAVIORAL HEALTH IS THE SINGLE POINT OF ENTRY FOR THE HINDS COUNTY CRISIS INTERVENTION TEAM (CIT) AND IS PART OF THE COMMITTEE AND THE OFFICER TRAINING ASSOCIATED WITH THE CIT.
ST. DOMINIC-JACKSON MEMORIAL HOSPITAL	PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:1. THE PATIENT RECEIVING FREE CARE FROM A COMMUNITY CLINIC AND ISREFERRED TO THE HOSPITAL;2. STATE-FUNDED PRESCRIPTION PROGRAMS;3. HOMELESS, INDIGENT, OR HOMELESS CLINIC PATIENT;4. PATIENTS' CHILDREN WHO QUALIFY FOR OTHER FINANCIAL ASSISTANCEPROGRAMS;5. PATIENT ELIGIBLE FOR FOOD STAMPS;6. MEDICAID ELIGIBLE PATIENT;7. PATIENT IS DECEASED WITH NO KNOWN RESPONSIBLE PARTY;8. PATIENT IS INCARCERATED AND HAS NO OTHER RESPONSIBLE PARTY
ST. DOMINIC-JACKSON MEMORIAL HOSPITAL	PART V, SECTION B, LINE 16J: REGISTRATION PERSONNEL REFER UNINSURED AND/OR LOW-INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY.
PART V, SECTION A, LINES 7A &10:	HTTPS://WWW.STDOM.COM/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART V, SECTION B, LINE 16 A, B, C:	THE FAP, FAP APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT:HTTPS://WWW.STDOM.COM/PATIENTS-AND-VISITORS/PATIENT-GUIDE/FINANCIAL-ASSISTANCE

Field	Value	IRS element (for citing)
Facility	35	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (35 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - ST DOMINIC'S HOSPITAL MEDICINE
971 LAKELAND DRIVE SUITE 1453	JACKSON	MS	39216	HOSPITALIST CLINIC
2 - ST DOMINIC'S NEUROSURGERY ASSOCIATES
971 LAKELAND DRIVE SUITE 657	JACKSON	MS	39216	PHYSICIAN CLINIC
3 - ST DOMINIC'S NEUROCARE
971 LAKELAND DRIVE SUITE 557	JACKSON	MS	39216	PHYSICIAN CLINIC
4 - ST DOMINIC'S VASCULAR AND ENDOVASCULAR
971 LAKELAND DRIVE SUITE 1250	JACKSON	MS	39216	PHYSICIAN CLINIC
5 - ST DOMINIC'S EAR NOSE & THROAT SURGICA
970 LAKELAND DRIVE SUITE 40	JACKSON	MS	39216	PHYSICIAN CLINIC
6 - ST DOMINIC'S INTERNAL MEDICINE GROUP
971 LAKELAND DRIVE SUITE 250	JACKSON	MS	39216	PHYSICIAN CLINIC
7 - STDOMINIC'S FAMILY MEDICINE OF MADISON
106 HIGHLAND WAY 103	MADISON	MS	39110	PHYSICIAN CLINIC
8 - ST DOMINIC'S INTERNAL MEDICINE MADISON
106 HIGHLAND WAY 200	MADISON	MS	39110	PHYSICIAN CLINIC
9 - ST DOMINIC'S CARDIOVASCULAR SURGERY
971 LAKELAND DRIVE SUITE 657	JACKSON	MS	39216	PHYSICIAN CLINIC
10 - ST DOMINIC'S PAIN MANAGEMENT CENTER
971 LAKELAND DRIVE SUITE 1159	JACKSON	MS	39216	PHYSICIAN CLINIC
11 - ST DOMINIC'S GYNECOLOGIC ONCOLOGY
971 LAKELAND DRIVE SUITE 750	JACKSON	MS	39216	PHYSICIAN CLINIC
12 - ST DOMINIC'S UROLOGY
971 LAKELAND DRIVE SUITE 360	JACKSON	MS	39216	PHYSICIAN CLINIC
13 - ST DOMINIC'S INFECTIOUS DISEASE
971 LAKELAND DRIVE SUITE 954	JACKSON	MS	39216	PHYSICIAN CLINIC
14 - ST DOMINIC'S PSYCHIATRIC ASSOCIATES
890 LAKELAND DRIVE	JACKSON	MS	39216	PHYSICIAN CLINIC
15 - ST DOMINIC'S RHEUMATOLOGY
106 HIGHLAND WAY SUITE 200	MADISON	MS	39110	PHYSICIAN CLINIC
16 - ST DOMINIC'S FAMILY MEDICINE OF BRANDON
1297 WEST GOVERNMENT STREET	BRANDON	MS	39042	PHYSICIAN CLINIC
17 - ST DOMINIC'S FAMILY MEDICINE OF CLINTON
728 CLINTON PARKWAY SUITE B	CLINTON	MS	39056	PHYSICIAN CLINIC
18 - ST DOMINIC'S FAMILY MEDICINE OF FLOWOOD
1050 RIVER OAKS DRIVE	FLOWOOD	MS	39232	PHYSICIAN CLINIC
19 - ST DOMINIC'S FAMILY MEDICINE OF DOGWOOD
205A BELLE MEADE POINTE	FLOWOOD	MS	39232	PHYSICIAN CLINIC
20 - ST DOMINIC'S FAMILY MEDICINE OF MAGEE
360 SIMPSON HWY 149 SUITE 220	MAGEE	MS	39111	PHYSICIAN CLINIC
21 - ST DOMINIC'S FAMILY MEDICINE OF JACKSON
890 LAKELAND DRIVE	JACKSON	MS	39056	PHYSICIAN CLINIC
22 - ST DOMINIC'S MARTIN SURGICAL ASSOCIATES
971 LAKELAND DRIVE SUITE 211	JACKSON	MS	39216	PHYSICIAN CLINIC
23 - ST DOMINIC'S FAMILY MED OF PELAHATCHIE
610 2ND STREET	PELAHATCHIE	MS	39145	PHYSICIAN CLINIC
24 - ST DOMINIC'S FAMILY MEDICINE OF RALEIGH
342 MAGNOLIA DRIVE	RALEIGH	MS	39153	PHYSICIAN CLINIC
25 - ST DOMINIC'S FAMILY MEDICINE GLUCKSTADT
286 CALHOUN STATION PARKWAY	MADISON	MS	39110	PHYSICIAN CLINIC
26 - ST DOMINIC'S COUMADIN CLINIC
890 LAKELAND DRIVE	JACKSON	MS	39056	PHYSICIAN CLINIC
27 - ST DOMINIC'S CHRONIC CARE CLINIC
969 LAKELAND DRIVE	JACKSON	MS	39216	PHYSICIAN CLINIC
28 - ST DOMINIC'S OUTREACH PROGRAM-TELEMEDIC
969 LAKELAND DRIVE	JACKSON	MS	39216	PHYSICIAN CLINIC
29 - ST DOMINIC'S OUTREACH PROGRAM-MAGEE
360 SIMPSON HWY 149 SUITE 370	MAGEE	MS	39111	PHYSICIAN CLINIC
30 - ST DOMINIC'S OUTREACH PROGRAM-CLEVELAND
810 E SUNFLOWER ROAD	CLEVELAND	MS	38732	PHYSICIAN CLINIC
31 - ST DOMINIC'S OUTREACH PROGRAM-KOSCIUSKO
332 HIGHWAY 12 WEST	KOSCIUSKO	MS	39090	PHYSICIAN CLINIC
32 - ST DOMINIC'S OUTREACH PROGRAM-PELAHATCH
610 2ND STREET	PELAHATCHIE	MS	39145	PHYSICIAN CLINIC
33 - ST DOMINIC'S OUTREACH PROGRAM-VICKSBURG
4204 CLAY STREET	VICKSBURG	MS	39180	PHYSICIAN CLINIC
34 - ST DOMINIC'S OUTREACH PROGRAM-BROOKHAVE
427 HWY 51 N	BROOKHAVEN	MS	39601	PHYSICIAN CLINIC
35 - ST DOMINIC'S INTERNAL MEDICINE CLINIC
112 SOUTH LAKE CIRCLE	CANTON	MS	39046	PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	FINANCIAL ASSISTANCE IS AVAILABLE FOR INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR ANY GOVERNMENT HEALTH CARE BENEFIT PROGRAM, AND WHO ARE UNABLE TO PAY FOR THEIR CARE. FULLY-DISCOUNTED CARE IS AVAILABLE IF INCOME AND ASSETS MEET CERTAIN FEDERAL POVERTY GUIDELINE LEVELS. FULLY-DISCOUNTED CARE IS ALSO AVAILABLE FOR THOSE PATIENTS WITH CATASTROPHIC MEDICAL BILLS IF MEDICAL BILLS EXCEED A CERTAIN PERCENTAGE OF INCOME AND ASSETS. FULLY DISCOUNTED CARE IS ALSOAVAILABLE WHERE THE PATIENT OR OTHER SOURCES CAN PROVIDE SUFFICIENT EVIDENCE OF PRESUMPTIVE ELIGIBILITY. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:1) PATIENT RECEIVING FREE CARE FROM A COMMUNITY CLINIC AND IS REFERREDTO THE HOPSITAL;2) STATE-FUNDED PRESCRIPTION PROGRAMS;3) HOMELESS, INDIGENT, OR HOMELESS CLINIC PATIENT;4) PATIENT'S CHILDREN WHO QUALIFY FOR OTHER FINANCIAL ASSISTANCEPROGRAMS;5) PATIENT ELIGIBLE FOR FOOD STAMPS;6) MEDICAID ELIGIBLE PATIENT;7) PATIENT IS DECEASED WITH NO KNOWN RESPONSIBLE PARTY;8) PATIENT IS INCARCERATED AND HAS NO OTHER RESPONSIBLE PARTY.
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 HTTPS://WWW.STDOM.COM/ABOUT-US/COMMUNITY-BENEFIT-AND-NEEDS/.
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 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. EXAMPLES OF THESE SERVICES INCLUDE BUT ARE NOT LIMITED TO THE EMERGENCY DEPARTMENT AND BEHAVIORAL HEALTH SERVICES.
PART II, COMMUNITY BUILDING ACTIVITIES:	ST. DOMINIC 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 INTERNAL FINANCIAL STATEMENTS.
PART III, LINE 3:	ST. DOMINIC HOSPITAL FREQUENTLY HAS PATIENT ACCOUNTS THAT ARE INTITIALLY 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 44 PERCENT. THE PERCENTAGE IS DETERMINED UTILIZING AN INTERNAL REPORT OF ACCOUNTS WRITTEN OFF AS A BAD DEBT EXPENSE IN ONE YEAR AND 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 COLLECTABILITY 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 UNCOLLECTABLE 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.
PART III, LINE 8:	THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTSREPORTED IN THE MEDICARE COST REPORT IS BASED ON REGULATORY REQUIREMENTSAND GUIDELINES.
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 HOSPITAL'S FINANCIAL AID POLICY AND ASSIST IN EDUCATING ITS PATIENTS. THEY ROUTINELY SEND FINANCIAL AID APPLICATIONS TO PATIENTS AND REFER THOSE PATIENTS BACK TO THE HOSPITAL'S FINANCIAL COUNSELORS WHEN APPROPRIATE.
PART VI, LINE 2:	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; AND4) PUBLIC HEALTH INFORMATION.
PART VI, LINE 3:	ST. DOMINIC HOSPITAL WORKS TO EDUCATE ITS PATIENTS AND COMMUNITY OF 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 HOSPITAL'S 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 HOSPITAL'S 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) EDUCATION THE EARLY-OUT AND BAD DEBT COLLECTION AGENCIES ON THE HOSPITAL'S FINANCIAL ASSISTANCE POLICIES SO THEY CAN ASSIST PATIENTS WHOM THEY FIND MIGHT HAVE FINANCIAL NEED.
PART VI, LINE 4:	THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING GEOGRAPHIC AND DEMOGRAPHIC AREAS, IS ADDRESSED IN THE 2021-2024 COMMUNITY HEALTH NEEDS ASSESSMENT. THE CHNA CAN BE ACCESSED AT: HTTPS://WWW.STDOM.COM/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART VI, LINE 5:	INSPIRED BY THE TEACHINGS OF JESUS CHRIST AND THE WITNESS OF OUR FOUNDING DOMINICAN SISTERS, WE PROVIDE COMPASSIONATE CARE AND HOPE AS A HEALING MINISTRY OF THE CATHOLIC CHURCH. ST. DOMINIC APPLIES THIS MISSION BY CONDUCTING NEEDS ASSESSMENTS, PUBLISHING THE RESULTS, ESTABLISHING GOALS AND STRATEGIES TO HELP RESOLVE IDENTIFIED ISSUES AND SEEKING OPPORTUNITIES TO WORK WITH THE COMMUNITY. THE HOSPITAL INVOLVES MEMBERS OF ITS COMMUNITY IN ITS GOVERNANCE SO THAT IT MAINTAINS THE FOCUS ON THE NEEDS OF ITS COMMUNITY. THE HOSPITAL HAS AN OPEN MEDICAL STAFF.
PART VI, LINE 6:	ST. DOMINIC HEALTH SERVICES, INC. IS THE PARENT ORGANIZATION OF A SYSTEM THAT INCLUDES ST. DOMINIC - JACKSON MEMORIAL HOSPITAL (A 571-BED ACUTE CARE FACILITY), ST. CATHERINE'S VILLAGE (A CONTINUING CARE RETIREMENT COMMUNITY), ST. DOMINIC HEALTH SERVICES FOUNDATION (A FUNDRAISING/GRANT FOCUSED ENTITY) 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 GIVE TIME, TALENTS, AND RESOURCES TO MAKE THE COMMUNITIES SERVED BY THE ORGANIZATION 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 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. ADDITIONALLY ON JULY 1, 2019, ST. DOMINIC HEALTH SERVICES BECAME PART OF THE FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM (FMOLHS). AS SUCH, IT IS AFFILIATED WITH TAX-EXEMPT HOSPITALS THROUGHOUT THE STATE OF LOUISIANA INCLUDING:OUR LADY OF LOURDES REGIONAL MEDICAL CENTERST. FRANCIS MEDICAL CENTEROUR LADY OF THE LAKE ASSUMPTION HOSPITALOUR LADY OF THE ANGELS HOSPITALOUR LADY OF THE LAKE HOSPITAL
PART VI, LINE 7:	STATE FILING OF COMMUNITY BENEFIT REPORTST. 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

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (27 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt
100 BLACK MEN OF JACKSON
5360 HIGHLAND DRIVE	JACKSON	MS	39286	640817928	501 (C)(3)	$22,000	$0	GENERAL SUPPORT
AMERICAN CANCER SOCIETY
250 WILLIAMS STREET	ATLANTA	GA	30303	131788491	501 (C)(3)	$10,000	$0	GENERAL SUPPORT
AMERICAN HEART ASSOCIATION
4830 MCWILLIE CIRCLE	JACKSON	MS	39206	135613797	501 (C)(3)	$50,000	$0	GENERAL SUPPORT
BB KING MUSEUM
400 SECOND STREET	INDIANOLA	MS	38751	460501512	501 (C)(3)	$15,000	$0	GENERAL SUPPORT
CANOPY CHILDREN'S SOLUTION
1465 LAKELAND DRIVE	JACKSON	MS	39216	640303085	501 (C)(3)	$25,000	$0	GENERAL SUPPORT
CATHOLIC CHARITIES
850 EAST RIVER PLACE	JACKSON	MS	39201	640466850	501 (C)(3)	$135,000	$0	GENERAL SUPPORT
CATHOLIC DIOCESE OF JACKSON
PO BOX 2248	JACKSON	MS	392252248	640303073	501 (C)(3)	$15,000	$0	GENERAL SUPPORT
CENTER FOR VIOLENCE PREVENTION
PO BOX 6279	PEARL	MS	39288	581959108	501 (C)(3)	$47,500	$0	GENERAL SUPPORT
COMMUNITY HEALTH SERVICES
970 LAKELAND DR	JACKSON	MS	39216	640884870	501 (C)(3)	$100,000	$0	GENERAL SUPPORT
DEVOTED DREAMERS
454 OAK LAWN DRIVE	PEARL	MS	39208	276601178	501 (C)(3)	$15,000	$0	GENERAL SUPPORT
HOPE HOUSE OF HOSPITALITY
786 EAST NORTHSIDE DRIVE	JACKSON	MS	39206	640622022	501 (C)(3)	$15,000	$0	GENERAL SUPPORT
HOSPICE MINISTRIES
45 TOWNE CENTER BLVD	RIDGELAND	MS	39157	640789919	501 (C)(3)	$50,000	$0	GENERAL SUPPORT
JACKSON HEART FOUNDATION
PO BOX 5021	JACKSON	MS	39296	270723542	501 (C)(3)	$20,000	$0	GENERAL SUPPORT
LEXINGTON MEDICAL CLINIC
22741 HIGHWAY 12	LEXINGTON	MS	39095	200378262	501 (C)(3)	$18,000	$0	GENERAL SUPPORT
MISSION FIRST INC
PO BOX 250	JACKSON	MS	39205	640797107	501 (C)(3)	$15,000	$0	GENERAL SUPPORT
MISSION MISSISSIPPI
PO BOX 22655	JACKSON	MS	39225	640824240	501 (C)(3)	$37,500	$0	GENERAL SUPPORT
MISSISSIPPI CHILDREN'S MUSEUM
PO BOX 55409	JACKSON	MS	392965409	640850010	501 (C)(3)	$10,000	$0	GENERAL SUPPORT
MISSISSIPPI SYMPHONY ORCHESTRA
PO BOX 2052	JACKSON	MS	39225	640273405	501 (C)(3)	$20,800	$0	GENERAL SUPPORT
NATIONAL COALITION OF 100 BLACK WOMEN
PO BOX 68412	JACKSON	MS	39286	582063167	501 (C)(3)	$15,000	$0	GENERAL SUPPORT
NEWKS CARES
814 NORTH CONGRESS STREET	JACKSON	MS	39202	640765336	501 (C)(3)	$50,000	$0	GENERAL SUPPORT
OPERATION SHOESTRING
1711 BAILEY AVENUE	JACKSON	MS	39283	640471554	501 (C)(3)	$20,000	$0	GENERAL SUPPORT
REAL CHRISTIAN FOUNDATION
PO BOX 180059	RICHLAND	MS	39218	640885750	501 (C)(3)	$42,500	$0	GENERAL SUPPORT
REFILL CAFE
136 SOUTH ADAMS STREET	JACKSON	MS	39203	832814994	501 (C)(3)	$10,000	$0	GENERAL SUPPORT
SISTERS IN BIRTH
5839 PEAR ORCHARD RD	JACKSON	MS	39211	812072883	501 (C)(3)	$10,000	$0	GENERAL SUPPORT
ST JOSEPH CATHOLIC SCHOOL
PO BOX 2027	MADISON	MS	391302027	640339825	501 (C)(3)	$40,000	$0	GENERAL SUPPORT
TUTWILER COMMUNITY EDUCATION CENTER INC
PO BOX 448	TUTWILER	MS	38963	581887449	501 (C)(3)	$10,000	$0	GENERAL SUPPORT
ST DOMINIC HEALTH SERVICES INC
969 LAKELAND DRIVE	JACKSON	MS	39216	640714999	501 (C)(3)	$1,500,000	$0	GENERAL SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	30	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	THE HOSPITAL HAS A CONTRIBUTIONS COMMITTEE, WHICH IS A SUB-COMMITTEE OF THE BOARD, THAT OVERSEES THE HOSPITAL'S GIVING. THEY MONITOR THE REQUESTS AND OVERSEE ALL GIFTS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JOHN LANCON
PHYSICIAN	$1,201,707	$0	$0	$0	$0	$0	$0	$0	$28,310	$0	$1,230,017	$0	$0	$0
DAVID THEODORO
PHYSICIAN	$1,083,208	$0	$0	$0	$0	$0	$0	$0	$19,532	$0	$1,102,740	$0	$0	$0
STEVEN GREMILLION MD
BOARD MEMBER	$0	$599,955	$0	$385,164	$0	$7,649	$0	$14,500	$0	$25,128	$0	$1,032,396	$0	$0
D PAUL SEAGO MD
BOARD MEMBER/PHYSICIAN	$956,412	$0	$16,894	$0	$0	$0	$0	$0	$20,028	$0	$993,334	$0	$0	$0
PB KERR
PHYSICIAN	$955,798	$0	$0	$0	$0	$0	$0	$0	$25,610	$0	$981,408	$0	$0	$0
BRYAN A GASPARD
PHYSICIAN	$933,692	$0	$0	$0	$0	$0	$0	$0	$25,610	$0	$959,302	$0	$0	$0
RONALD KENNEDY
PHYSICIAN	$815,869	$0	$0	$0	$0	$0	$0	$0	$12,472	$0	$828,341	$0	$0	$0
LESTER DIAMOND
PRESIDENT (THRU 03/2021)	$0	$116,032	$0	$79,177	$0	$519,130	$0	$0	$0	$6,751	$0	$721,090	$0	$75,873
REBEKAH MOULDER MD
BOARD MEMBER/PHYSICIAN	$614,401	$0	$0	$0	$0	$0	$0	$0	$2,676	$0	$617,077	$0	$0	$0
SAMUEL SCOTT
SVP, CFO	$0	$334,237	$0	$174,145	$0	$0	$0	$14,500	$0	$18,776	$0	$541,658	$0	$0
WILLIAM MORGAN
COO - THRU 5/2021	$145,478	$0	$0	$0	$274,646	$0	$0	$0	$11,020	$0	$431,144	$0	$0	$0
ROBERT NELSON
VP CHIEF NURSING OFFICER	$263,998	$0	$88,495	$0	$0	$0	$14,500	$0	$25,905	$0	$392,898	$0	$0	$0
REGINALD MARTIN MD
BOARD MEMBER/PHYSICIAN	$351,041	$0	$0	$0	$0	$0	$0	$0	$25,571	$0	$376,612	$0	$0	$0
DAVID C HENRY
VP OPERATIONS - THRU 5/2021	$78,468	$0	$0	$0	$152,615	$0	$0	$0	$9,892	$0	$240,975	$0	$0	$0
SCOTT KASHMAN
PRESIDENT - SD & JACKSON MARKET	$0	$95,448	$0	$75,000	$0	$16,614	$0	$0	$0	$2,298	$0	$189,360	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3	THE FMOL HEALTH SYSTEM BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE REIVEWS COMPENSATION PACKAGES AND APPRROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR MAKING SUCH DETERMINATION IS DOCUMENTED BY THE COMPENSATION COMMITTEE.
PART I, LINES 4A-B	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. LESTER DIAMOND RECEIVED A PAYMENT IN THE CURRENT YEAR OF $78,347.
PART I, QUESTION 4A:	ONE DIRECTOR AND ONE OFFICER ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF 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 18 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. AN OFFICER IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF 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. THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS THIS YEAR - LESTER DIAMOND $519,130 DAVID HENRY $152,615 WILLIAM MORGAN $274,646

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 HOSPITAL'S SOLE MEMBER, ST. DOMINIC HEALTH SERVICES, INC., HAS THE AUTHORITY TO APPROVE THE ELECTION OF THE PRESIDENT/CEO, THE CHAIR OF THE BOARD OF DIRECTORS AND THE VICE-CHAIR OF THE BOARD OF DIRECTORS OF THE HOSPITAL AND ALL OTHER DIRECTORS AND OFFICERS OF THE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B	THE RESERVED POWER TO THE MEMBER, ST. DOMINIC HEALHT 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, LEAASE, 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 CHANGE 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	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.
FORM 990, PART VI, SECTION B, LINE 12C	ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND SIGN A CONFLICT OF INTEREST FORM ANNUALLY. THE PRESIDENT REVIEWS THE FORMS, AND ANY CONFLICTS ARE DISCLOSED TO THE OTHER MEMBERS OF THE BOARD AND MADE A MATTER OF RECORD. PERSONS WITH CONFLICTS OF INTERESTS DO NOT VOTE OR USE HIS OR HER INFLUENCE ON THE MATTER AND ARE EXCLUDED FROM THE COUNT IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHERE PERMITTED BY LAW.
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. DOMINIC JACKSON MEMORIAL HOSPITAL 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. SECTION 1.263(A)-3(N) - BOOK CONFORMITY ELECTION: ST. DOMINIC JACKSON MEMORIAL HOSPITAL IS MAKING THE ELECTION UNDER TREAS. REG. 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, 2022. SECTION 1.263(A)-1(F) - DE MINIMIS SAFE HARBOR ELECTION: ST. DOMINIC JACKSON MEMORIAL HOSPITAL 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 ENDED JUNE 30, 2022. TAXPAYER HAS AN APPLICABLE 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).
FORM 990, PART XI, LINE 9:	PRIOR PERIOD ADJUSTMENTS -4,052,816. CAPITAL TRANSFERS -5,776,238.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
ST DOMINIC MEDICAL ASSOCIATES
969 LAKELAND DRIVE	JACKSON	MS	39216	261969846	HEALTHCARE	MS	$43,642,815	$1,372,954	SDJMH
ST DOMINIC HOSPITAL MEDICINE LLC
969 LAKELAND DRIVE	JACKSON	MS	39216	814908606	HEALTHCARE	MS	$6,078,774	$6,067,563	SDJMH
CENTRAL MISSISSIPPI IMAGING LLC DBA SOUTHERN DIAGNOSTIC IMAGING
1037 NORTH FLOWOOD DRIVE	FLOWOOD	MS	39232	640928442	HEALTHCARE	MS	$2,454,462	$2,997,074	SDJMH
MEA PRIMARY CARE PLUS LLC
308 CORPORATE DRIVE	RIDGELAND	MS	39211	814502721	HEALTHCARE	MS		$248	SDJMH

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
HEALTH CARE CENTERS IN SCHOOLS
5000 HENNESSY BLVD	BATON ROUGE	LA	70808	721443935	HEALTHCARE	LA	501(C)(3)	LINE 10 - A	OLOL	0
ST DOMINIC HEALTH SERVICES INC
969 LAKELAND DRIVE	JACKSON	MS	39216	640714999	HOLDING CO	MS	501(C)(3)	LINE 12C, III - FI	FMOLHS	0
COMMUNITY HEALTH SERVICES - ST DOMINIC
969 LAKELAND DRIVE	JACKSON	MS	39216	640884870	HEALTH PROGRAM	MS	501(C)(3)	LINE 10 - A	SDHS	0
ST DOMINIC - HEALTH SERVICES FOUNDATION
969 LAKELAND DRIVE	JACKSON	MS	39216	431992975	FUNDRAISING	MS	501(C)(3)	LINE 7 - AN	SDHS	0
ST CATHERINE'S VILLAGE INC
969 LAKELAND AND DRIVE	JACKSON	MS	39216	640714997	RET HOME	MS	501(C)(3)	LINE 10 - A	SDHS	0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (23 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Predominant Income TypePredominantIncomeTypeTxt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
LOURDES IMAGING DEVELOPMENT LLC
4801 AMBASSADOR CAFFERY PKWY	LAFAYETTE	LA	70508	208326287	REAL ESTATE	LA	N/A	N/A	0	0
PARK PLACE SURGERY CENTER LLC
4811 AMBASSADOR CAFFERY PKWY	LAFAYETTE	LA	70508	721404092	HEALTHCARE	LA	N/A	N/A	0	0
BRPT LAKE REHABILITATION CENTERS LLC
175 S ENGLISH STATION RD STE 218	LOUISVILLE	KY	40245	721506100	HEALTHCARE	LA	N/A	N/A	0	0
CONVENIENT CARE LLC
10319 JEFFERSON HIGHWAY	BATON ROUGE	LA	70809	721439481	HEALTHCARE	LA	N/A	N/A	0	0
CONVENIENT CARE LLC
10319 JEFFERSON HIGHWAY	BATON ROUGE	LA	70809	721439481	HEALTHCARE	LA	N/A	N/A	0	0
PERKINS PLAZA AMBULATORY SURGERY CENTER LLC
7145 PERKINS ROAD	BATON ROUGE	LA	70808	481264699	HEALTHCARE	LA	N/A	N/A	0	0
SURGICAL SPECIALTY CENTER OF BATON ROUGE LLC
8080 BLUEBONNET BLVD	BATON ROUGE	LA	70810	263120962	HEALTHCARE	LA	N/A	N/A	0	0
ST ELIZABETH-MARY BIRD PERKINS CANCER CENTER LLC
4950 ESSEN LANE	BATON ROUGE	LA	70809	260628752	HEALTHCARE	LA	N/A	N/A	0	0
NORTHEAST LA CANCER INSTITUTE LLC
411 CALYPSO STREET	MONROE	LA	71201	721329499	HEALTHCARE	LA	N/A	N/A	0	0
LHCG-XIII LLC DBA LOURDES HOME HEALTH
901 S HUGH WALLIS ROAD	LAFAYETTE	LA	70508	208068308	HEALTHCARE	LA	N/A	N/A	0	0
LOURDES AFTER HOURS LLC
7777 HENNESSY BLVD SUITE 1004-202	BATON ROUGE	LA	70809	201367299	HEALTHCARE	LA	N/A	N/A	0	0
LAKE URGENT CARE ASCENSION LLC
10319 JEFFERSON HIGHWAY	BATON ROUGE	LA	70809	352463092	HEALTHCARE	LA	N/A	N/A	0	0
ST FRANCIS URGENT CARE LLC
10319 JEFFERSON HIGHWAY	BATON ROUGE	LA	70809	474013731	HEALTHCARE	LA	N/A	N/A	0	0
GAMMA KNIFE OF LOUISIANA LLC
4950 ESSEN LANE	BATON ROUGE	LA	70809	811827194	HEALTHCARE	LA	N/A	N/A	0	0
LHCG LXVII LLC
901 S HUGH WALLIS ROAD	LAFAYETTE	LA	70508	474283509	HEALTHCARE	LA	N/A	N/A	0	0
PINNACLE CARE HOLDINGS LLC
5627 S SHERWOOD FOREST BLVD	BATON ROUGE	LA	70816	821637627	HEALTHCARE	LA	N/A	N/A	0	0
LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIP
4801 AMBASSADOR CAFFERY PKWY	LAFAYETTE	LA	70508	943419282	HEALTHCARE	LA	N/A	N/A	0	0
FREMAUX OFFICE MM LLC
3500 NORTH CAUSEWAY BOULEVARD STE 6	METAIRIE	LA	70002	843084552	HEALTHCARE	LA	N/A	N/A	0	0
FREMAUX MOB LLC
3500 NORTH CAUSEWAY BOULEVARD STE 6	METAIRIE	LA	70002		MED BLDG	LA	N/A	N/A	0	0
OLOL PONTCHARTRAIN SURGERY CENTER LLC
4200 ESSEN LANE	BATON ROUGE	LA	70809	461379031	HEALTHCARE	LA	N/A	N/A	0	0
LAKE SURGICAL HOSPITAL (SLIDELL) LLC
1700 LINDBERG DR	SLIDELL	LA	70458	474228147	HEALTHCARE	LA	N/A	N/A	0	0
PREMIER HEALTH HOLDINGS LLC
10319 JEFFERSON HIGHWAY	BATON ROUGE	LA	70809	472665226	HEALTHCARE	LA	N/A	N/A	0	0
PREMIER HEALTH HOLDINGS LLC
10319 JEFFERSON HIGHWAY	BATON ROUGE	LA	70809	472665226	HEALTHCARE	LA	N/A	N/A	0	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1ForeignAddress/AddressLine1Txt	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Legal Domicile StateLegalDomicileStateCd	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct
LOUISE INSURANCE COMPANY
PO BOX 1051	CJ	KY1-1102	INSURANCE	CJ	FMOL	C	Yes (1)
FRANCISICAN HEALTH & WELLNESS SERVICES INC
			HEALTHCARE		FMOL	C	Yes (1)	4200 ESSEN LANE	BATON ROUGE	LA	70809	455492379	LA
FMOL HEALTH SYSTEM HOLDINGS INC
			INVESTMENT		FMOL	C	Yes (1)	4200 ESSEN LANE	BATON ROUGE	LA	70809	454405024	LA
ST DOMINIC MADISON HEALTH SERVICES INC
			HEALTHCARE		SDHS	C	Yes (1)	969 LAKELAND DRIVE	JACKSON	MS	39216	202870254	MS
FIRST INTERMED CORPORATION
			MEDICAL SERVICES		SDHS	C	Yes (1)	308 CORPORATE DRIVE	RIDGELAND	MS	39157	640824796	MS
ST DOMINIC INTEGRATED SERVICES INC
			INVESTMENTS		SDJMH	C	Yes (1)	969 LAKELAND DRIVE	JACKSON	MS	39216	271493623	MS	$434,993	$5,925,961	1.00000
LAFAYETTE SURGICARE INC
			HEALTHCARE		LOURDES	C	Yes (1)	C/O C T CORP SYSTEM 3867 PLAZA TOWE	BATON ROUGE	LA	70816	943419282	LA

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd