ST DOMINIC HEALTH SERVICES INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- ST DOMINIC HEALTH SERVICES INC (EIN 64-0714999)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-17
- IRS object ID
- 202111379349309786
- Schema version
- 2019v5.1
- 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 F
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-17T17:43:28-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
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 | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 640714999 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST DOMINIC HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % SAM SCOTT | InCareOfNm |
| 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 | CFO | PersonTitleTxt |
| Phone | 6012006844 | PhoneNum |
| Signature | 2021-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRITTANY ELLISER | PreparerPersonNm |
| PTIN | P01284594 | PTIN |
| Phone | 2253444000 | PhoneNum |
| Preparation | 2021-05-17 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SAM 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 | $7,160,865 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.stdom.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1985 | FormationYr |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Activity Or Mission | SDHS MANAGES AN INTEGRATED HEALTH SYSTEM TO MAKE A DIFFERENCE IN OUR COMMUNITIES THROUGH CATHOLIC HEALTH SERVICES BY CALLING FORTH ALL WHO SERVE IN THE HEALTHCARE MINISTRY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 47 | TotalEmployeeCnt |
| Total Volunteers | 8 | TotalVolunteersCnt |
| Total Gross UBI | $12,352 | TotalGrossUBIAmt |
| PY Contributions Grants | $750,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,500,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,375,748 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,848,686 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,109,169 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,566,227 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $4,234,917 | PYTotalRevenueAmt |
| CY Total Revenue | $6,914,913 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,287,360 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $323,950 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,325,245 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,433,174 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,944,541 | PYOtherExpensesAmt |
| CY Other Expenses | $4,750,319 | CYOtherExpensesAmt |
| PY Total Expenses | $6,557,146 | PYTotalExpensesAmt |
| CY Total Expenses | $8,507,443 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,322,229 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,592,530 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $225,193,912 | TotalAssetsBOYAmt |
| Total Assets EOY | $180,262,649 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $83,111,730 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $32,824,699 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $142,082,182 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $147,437,950 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | INSPIRED BY THE VISION OF ST. FRANCIS AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH ALL WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING- WITH REVERANCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED IN OUR CARE. WE ARE, WITH GOD'S HELP, A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,198,177 | ExpenseAmt |
| Revenue | $2,848,686 | RevenueAmt |
| Desc | The St. Dominic Health Services (SDHS) is the parent company of a multi-dimensional provider of health care services with coporate headquarters in Jackson, MS. SDHS provides management services to its affiliated companies including the following entities: St. Dominic - Jackson Memorial Hospital I. 571-Bed Adult Tertiary Referral Center II. Serves a broad area encompassing Jackson and most of Central Mississippi III. Includes primary and specialty physician services. St. Catherine's Village, Inc. I. Consist of 246 Independent living units-multiple individuals in each unit including 54 garden homes. II. 120 Skilled nursing beds located in three different areas of skilled nursing. Three locations-Siena, Tuscany and Hughes Center. Licensed nursing home with 120 beds. III. 50 basic assisted living beds in Marian Hall IV. 24 Alzheimer's assisted living beds in Campbell Cove. Community Health Services - St. Dominic, Inc. I. The Club (St. Dominic's Community Wellness Program) offers a comprehensive selection of personalized, medically integrated health education and fitness programs available to employees, members and the community. II. New directions for over 55 (Senior Adult Program) provides education and services to help keep senior adults active and engaged. III. Care-A-Van Mobile Health Screening Unit provides health screenings across Central Mississippi with focus on underserved populations. IV. Community Health Clinic provides primary care to the uninsured in an underserved area of Jackson. V. School Nurse Program provides registered nurses to the Madison County Middle and Elementary Schools. Limited services are also provided to a high school located in an underserved area of the district. St. Dominic Health Services Foundation, Inc. I. Fundraising and Giving Initiatives that support the mission and vision of SDHS and its subsidiaries. First Intermed Corporation I. Operates 16 ambulatory/ industrial Medicare or primary care clinics to make these services more accessible in the state. St. Dominic Madison Health Services, Inc. I. Supports the SDHS mission through operation of a medical office building that increases access to health services. II. Partners in the operation of a health and wellness center in Madison County that offers family-oriented health and fitness services. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $323,950 | ExpenseAmt |
| Grant | $323,950 | GrantAmt |
| Desc | GRANTS ARE MADE TO CHARITABLE ORGANIZATIONS IN ORDER TO SUPPORT THE CHARITABLE MISSION OF FRANCISCAN MISSIONAIRES OF OUR LADY HEALTH SYSTEM, INC. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $1,522,127 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (true) | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | Yes (true) | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 30 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 47 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SAM SCOTT | PersonNm |
| Phone | 6012006642 | 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 (18 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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Richard Vath MD | |||||||||
| PRESIDENT/CEO, FMOLHS | 1.0 | 40.0 | Yes (X) | Yes (X) | $0 | $1,434,367 | $14,151 | ||
| Claude Harbarger | |||||||||
| PRESIDENT SDHS | 40.0 | 0.0 | $1,134,014 | $0 | $16,085 | Yes (X) | |||
| Lester K Diamond | |||||||||
| PRESIDENT SDHS | 0.5 | 40.0 | Yes (X) | Yes (X) | $0 | $688,471 | $88,512 | ||
| Rene J Ragas | |||||||||
| DIRECTOR | 1.0 | 40.0 | Yes (X) | $0 | $446,018 | $97,074 | |||
| Sam Scott | |||||||||
| TREASURER & CFO | 40.0 | 2.0 | Yes (X) | $485,760 | $0 | $34,724 | |||
| Jonathan Werne | |||||||||
| VP GENERAL COUNSEL | 40.0 | 0.0 | $370,061 | $0 | $47,550 | Yes (X) | |||
| Frank Lenoir | |||||||||
| VP HUMAN RESOURCES | 40.0 | 0.0 | $335,748 | $0 | $30,088 | Yes (X) | |||
| Kay Mcree | |||||||||
| SR. DIRECTOR FND | 40.0 | 0.0 | $216,450 | $0 | $58,046 | Yes (X) | |||
| Deidra Bell | |||||||||
| SDHS CFO | 40.0 | 0.0 | $239,427 | $0 | $29 | Yes (X) | |||
| Sister M Dorothea Sondgeroth | |||||||||
| VICE CHAIR | 40.0 | 0.5 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Sister M Trinita Eddington | |||||||||
| SECRETARY | 4.0 | 37.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Richard Hickson | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| E B ROBINSON | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| MARCELO J RUVINSKY MD | |||||||||
| CHAIR | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Sister Rose Miriam Schulte OP | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Bishop Joseph Kopacz | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Sister Beth Murphy | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Steward Gentry | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,781,460 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,568,856 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $386,259 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| UNUM Life Insurance Co | |||||
| 1 FOUNTAIN SQUARE | CHATTANOOGA | TN | 374021330 | ADMINISTRATIVE | $1,246,585 |
| AETNA Life Insurance Co | |||||
| PO BOX 88863 | CHICAGO | IL | 60695 | ADMINISTRATIVE | $1,240,482 |
| Ameritas Life Insurance Co | |||||
| 5900 O STREET | LINCOLN | NE | 68510 | ADMINISTRATIVE | $1,182,029 |
| Ironshort Insurance Services | |||||
| 605 RENAISSANCE WAY | RIDGELAND | MS | 39157 | ADMINISTRATIVE | $837,942 |
| BRUNINI GRANTHAM GROWER HEWES | |||||
| PO BOX 119 | JACKSON | MS | 39205 | LEGAL SERVICES | $727,088 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 22 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,500,000 | RelatedOrganizationsAmt |
| All Other Contributions | $0 | AllOtherContributionsAmt |
| Total Contributions | $1,500,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MANAGEMENT REVENUE | 561000 | $1,364,700 | $1,364,700 |
| HEALTH SERVICE REVENUE | 561499 | $821,096 | $821,096 |
| RELATED RENTAL INCOME | 531120 | $662,890 | $662,890 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,848,686 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $304,114 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $12,352 | UnrelatedBusinessRevenueAmt |
| Exclusion | $291,762 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,508,065 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $245,952 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,262,113 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,262,113 | TotalRevenueColumnAmt |
| Exclusion | $2,262,113 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,914,913 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,848,686 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $12,352 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,553,875 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $323,950 | TotalAmt |
| Program Services | $323,950 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,401,861 | TotalAmt |
| Program Services | $467,277 | ProgramServicesAmt |
| Management And General | $1,934,584 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,031,313 | TotalAmt |
| Program Services | $88,606 | ProgramServicesAmt |
| Management And General | $942,707 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $900,927 | TotalAmt |
| Program Services | $401,762 | ProgramServicesAmt |
| Management And General | $499,165 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,424 | TotalAmt |
| Program Services | $4,649 | ProgramServicesAmt |
| Management And General | $5,775 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,132 | TotalAmt |
| Program Services | $6,748 | ProgramServicesAmt |
| Management And General | $8,384 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,500 | TotalAmt |
| Management And General | $25,500 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,508 | TotalAmt |
| Program Services | $3,348 | ProgramServicesAmt |
| Management And General | $4,160 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,896,795 | TotalAmt |
| Program Services | $123,040 | ProgramServicesAmt |
| Management And General | $1,773,755 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,079 | TotalAmt |
| Program Services | $3,573 | ProgramServicesAmt |
| Management And General | $51,506 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,139 | TotalAmt |
| Program Services | $15,837 | ProgramServicesAmt |
| Management And General | $228,302 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,203 | TotalAmt |
| Management And General | $273,203 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $221,676 | TotalAmt |
| Management And General | $221,676 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,326 | TotalAmt |
| Program Services | $4,582 | ProgramServicesAmt |
| Management And General | $48,744 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| OTHER EXPENSES | $141,539 | $9,181 | $132,358 | $0 |
| REPAIRS AND MAINTENANCE | $388,895 | $25,227 | $363,668 | |
| PENSION RELATED CHANGES | $516,176 | $44,347 | $471,829 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,507,443 | TotalAmt |
| Program Services | $1,522,127 | ProgramServicesAmt |
| Management And General | $6,985,316 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,859,024 | BOYAmt |
| EOY | $998,768 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,113,653 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,000 | BOYAmt |
| EOY | $101,570 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $25,869,414 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $221,676 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,351,714 | BOYAmt |
| EOY | $25,647,738 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,040,461 | BOYAmt |
| EOY | $135,615,000 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $15,771,227 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,906,713 | BOYAmt |
| EOY | $14,693 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $225,193,912 | BOYAmt |
| EOY | $180,262,649 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,573,835 | BOYAmt |
| EOY | $5,113,452 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,537,895 | BOYAmt |
| EOY | $27,711,247 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,111,730 | BOYAmt |
| EOY | $32,824,699 | 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 | $142,082,182 | BOYAmt |
| EOY | $147,437,950 | 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 | $142,082,182 | BOYAmt |
| EOY | $147,437,950 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $225,193,912 | BOYAmt |
| EOY | $180,262,649 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,592,530 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,761,902 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $6,454,906 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$1,268,510 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (4 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| ST DOMINIC JACKSON MEMORIAL HOSPITAL | ||||
| 640303091 | 3 | false | $7,640,951 | $0 |
| COMMUNITY HEALTH SERVICES - ST DOMINIC | ||||
| 640884870 | 10 | false | $10,389 | $0 |
| ST CATHERINE'S VILLAGE | ||||
| 640714997 | 10 | false | $90,613 | $0 |
| ST DOMINIC HEALTH SERVICES FOUNDATION | ||||
| 431992975 | 7 | false | $765,490 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 4 | SupportedOrganizationsTotalCnt |
| Support Sum | $8,507,443 | SupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | false | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (true) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (true) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | Yes (true) | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Parent Supported Org | Yes (X) | ParentSupportedOrgInd |
| Appoint Elect Majority Officer | Yes (true) | AppointElectMajorityOfficerInd |
| Exercise Direction Policies | Yes (true) | ExerciseDirectionPoliciesInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Sch A, Part IV, Section A, Question 1 | ST. DOMINIC HEALTH SERVICES ("SDHS") SUPPORTS THE FOLLOWING ENTITIES: ST. DOMINIC JACKSON MEMORIAL HOSPITAL ("HOSPITAL") COMMUNITY HEALTH SERVICES - ST. DOMINIC ("CHS") ST. CATHERINE'S VILLAGE ("SCV") ST. DOMINIC HEALTH SERVICES FOUNDATION ("FOUNDATION") SDHS HAS A HISTORIC AND CONTINUING RELATIONSHIP WITH EACH OF THE ABOVE ENTITIES (COLLECTIVELY AFFILIATES) WHICH SPANS MANY DECADES. SDHS IS THE PARENT COMPANY OF THE AFFILIATES AND WORKS WITH EACH ON A DAILY BASIS TO PROVIDE CRITICAL HEALTHCARE, ELDERLY HOUSING AND ASSISTED LIVING, HEALTH EDUCATION AND OTHER COMMUNITY BENEFITS FOR THE SURROUNDING COMMUNITY AND ITS SCHOOLS. SDHS WAS FORMED IN 1985 FOR THE PURPOSE OF SUPPORTING THE HOSPITAL AND OTHER AFFILIATES. SDHS AND THE AFFILIATES ALSO HAVE SEVERAL OF THE SAME BOARD MEMBERS AND OFFICERS WHICH SERVE TO ENSURE A CLOSE AND CONTINUING RELATIONSHIP. DURING THIS FISCAL YEAR, THE HOSPITAL HAS THREE OF ITS BOARD MEMBERS WHO ALSO SERVED AS BOARD MEMBERS OF SDHS. BOTH THE PRESIDENT AND CFO OF SDHS ARE ALSO OFFICERS OF THE HOSPITAL. SDHS, CHS, AND SCV ALL HAVE TWO SIMILAR OFFICERS (PRESIDENT AND CFO) AND ONE SIMILAR BOARD MEMBER. SDHS AND FOUNDATION HAVE TWO SIMILAR BOARD MEMBERS AND ONE SIMILAR OFFICER (PRESIDENT). THE ENTITIES' INTERWOVEN HISTORY ALONG WITH ITS OVERLAPPING DIRECTORS/OFFICERS AND DAY-TO-DAY COLLABORATION SUPPORT A HISTORIC AND CONTINUING RELATIONSHIP BETWEEN SDHS AND THE ABOVE-LISTED AFFILIATES. |
| Sch A, Part IV, Section D, Question 3 | THE SUPPORTED ORGANIZATIONS (THE HOSPITAL, CHS, SCV, AND FOUNDATION) ALL HAD A SIGNIFICANT VOICE IN THE SDHS'S INVESTMENT POLICIES AND IN DIRECTING THE USE OF THE SDHS'S INCOME OR ASSETS AT ALL TIMES DURING THE YEAR SINCE THEY HAD MANY OF THE SAME OFFICERS AND BOARD MEMBERS AS SDHS. SDHS PROVIDES STRATEGIC PLANNING, LEADERSHIP SERVICES, AND BUSINESS SUPPORT SERVICES TO ITS SUPPORTED ORGANIZATIONS. THESE SERVICES ARE INFLUENCED BY AND RESULT FROM THE EXPRESSED NEEDS OF THE SUPPORTED ORGANIZATIONS. |
| Sch A, Part IV, Section E, Question 3a | WITH REGARDS TO EACH OF THE SUPPORTED ENTITIES, SDHS HAS THE POWER TO APPROVE THE ELECTION OF ALL OFFICERS AND BOARD MEMBERS INCLUDING THE CHAIR OF THE BOARD, THE VICE-CHAIR OF THE BOARD, AND THE PRESIDENT OF THE FOUNDATION. |
| Sch A, Part IV, Section E, Question 3b | SDHS PROVIDES MANAGEMENT AND OTHER SUPPORT SERVICES TO EACH OF ITS SUPPORTED ORGANIZATIONS ON A DAILY BASIS. SUCH SERVICES INCLUDE STRATEGIC PLANNING, LEADERSHIP SERVICES, PROJECT PLANNING, AND BUSINESS SUPPORT FUNCTIONS INCLUDING FINANCE LEADERSHIP, LEGAL, MISSION INTEGRATION, AND HUMAN RESOURCES LEADERSHIP. THE NATURE OF THESE SERVICES PROVIDED TO THE SUPPORTED ORGANIZATIONS NECESSITATE THE REQUISITE DEGREE OF DIRECTION OVER THE POLICIES, PROGRAMS, AND ACTIVITIES OF EACH SUPPORTED ORGANIZATION. THE SUPPORTED ORGANIZATIONS WOULD NOT BE ABLE TO ACCOMPLISH THE CRITICAL HEALTHCARE AND COMMUNITY SERVICES THEY PROVIDE WITHOUT THE GUIDANCE AND DIRECTION GAINED FROM SDHS. |
Schedule 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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (true) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $25,500 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $25,500 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1G: | FormAndLineReferenceDesc |
| Explanation | St. Dominic Health Services, Inc. paid a lobbying consultant who had direct contact with legislators to discuss various public policy issues and legislative matters. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,140,000 | OtherCostOrOtherBasisAmt |
| Book Value | $20,140,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,580,184 | OtherCostOrOtherBasisAmt |
| Depreciation | $186,006 | DepreciationAmt |
| Book Value | $5,394,178 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $149,230 | OtherCostOrOtherBasisAmt |
| Depreciation | $35,670 | DepreciationAmt |
| Book Value | $113,560 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $25,647,738 | TotalBookValueLandBuildingsAmt |
| Financial Derivatives | FinancialDerivativesGrp | |
| Closely Held Equity Interests | CloselyHeldEquityInterestsGrp |
Other Securities OtherSecuritiesGrp (4 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| IMP TRUST FUNDS | $63,359,163 | F |
| RESERVE FOR SCV | $30,138,559 | F |
| EMPLOYEE BENEFIT TRUST | $18,476,822 | F |
| SELF INSURED TRUST | $23,640,456 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $135,615,000 | TotalBookValueSecuritiesAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| INVESTMENT IN FIC | $7,760,975 | C |
| INVESTMENT N SDMHS | $7,610,252 | C |
| INVESTMENT IN MS TRUE | $400,000 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $15,771,227 | TotalBookValueProgramRltdAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| RETIREMENT PAYABLE LONG TERM | $822,194 |
| DUE TO AFFILIATES | $1,067,637 |
| SELF INSURANCE LIABILITY - LT | $20,725,013 |
| EMPLOYEE BENEFIT TRUST | $5,096,403 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $27,711,247 | 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 | ST. DOMINIC HEALTH SERVICES RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. NO RESERVES FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED. | ExplanationTxt |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Central America and the Caribbean | RegionTxt |
| Type Of Activities Conducted | INVESTMENTS | TypeOfActivitiesConductedTxt |
| Region Total Expenditures | $19,882,069 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Spent | $19,882,069 | SubtotalSpentAmt |
| Total Spent | $19,882,069 | TotalSpentAmt |
| Transfer To Foreign Corp | false | TransferToForeignCorpInd |
| Interest In Foreign Trust | false | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (true) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | Yes (true) | PassiveForeignInvestmestCoInd |
| Foreign Partnership | false | ForeignPartnershipInd |
| Boycott Countries | false | BoycottCountriesInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3: | St. Dominic Health Services, Inc. owns an interest Oz Overseas Fund II, LTD, a hedge fund domiciled in the Cayman Islands. The book value of this investment as of 6/30/2020 was $19,882,069. |
| PART IV, LINE 3: | St. Dominic Health Services Inc. (SDHS) was not required to file form 5471 during the fiscal year ended 6/30/2020 for its ownership in a foreign corporation. Therefore, form 5471 was not filed by SDHS. |
| PART IV, LINE 4: | St. Dominic Health Services, Inc. (SDHS) was not required to file form 8621 during the fiscal year ended 6/30/2020 for its ownership of a passive foreign investment company (PFIC) since it is a tax-exempt organization under 501(a) and income from the PFIC was non-taxable. Therefore, form 8621 was not filed by SDHS. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| American Cancer Society | |||||||
| 1380 LIVINGSTON LANE | JACKSON | MS | 39213 | 131788491 | 501(C)(3) | $27,000 | GENERAL SUPPORT |
| Mississippi Children's Museum | |||||||
| 2660 RIDGEWOOD RD | JACKSON | MS | 39216 | 640850010 | 501(C)(3) | $25,000 | GENERAL SUPPORT |
| BB King Museum | |||||||
| 400 2ND ST | INDIANOLA | MS | 38751 | 460501512 | 501(C)(3) | $15,000 | GENERAL SUPPORT |
| Jackson Heart Foundation | |||||||
| PO BOX 5021 | JACKSON | MS | 39216 | 270723542 | 501(C)(3) | $20,000 | GENERAL SUPPORT |
| Catholic Diocese of Jackson | |||||||
| PO BOX 2248 | JACKSON | MS | 39225 | 640303073 | 501(C)(3) | $28,500 | GENERAL SUPPORT |
| Catholic Charities | |||||||
| PO BOX 2248 | JACKSON | MS | 39225 | 640466850 | 501(C)(3) | $13,000 | GENERAL SUPPORT |
| Mississippi Blood Services | |||||||
| 115 TREE ST | FLOWOOD | MS | 39232 | 237447676 | 501(C)(3) | $10,000 | GENERAL SUPPORT |
| American Heart Association | |||||||
| 4830 MCWILLIE CIRCLE | JACKSON | MS | 39206 | 135613797 | 501(C)(3) | $50,000 | GENERAL SUPPORT |
| Epilepsy Foundation | |||||||
| 5 OLD RIVER PL 105 | JACKSON | MS | 39202 | 640605780 | 501(C)(3) | $10,000 | GENERAL SUPPORT |
| Junior League of Jackson | |||||||
| PO BOX 4709 | JACKSON | MS | 39296 | 646011106 | 501(C)(3) | $10,000 | GENERAL SUPPORT |
| Foundation for MS History | |||||||
| PO BOX 571 | JACKSON | MS | 392050571 | 202649529 | 501(C)(3) | $20,000 | GENERAL SUPPORT |
| United Way of the Capital Area | |||||||
| 843 N PRESIDENT | JACKSON | MS | 39202 | 640303075 | 501(C)(3) | $7,500 | GENERAL SUPPORT |
| Hope House of Hospitality | |||||||
| 786 E NORTHSIDE DR | JACKSON | MS | 39206 | 640622022 | 501(C)(3) | $15,000 | GENERAL SUPPORT |
| Refill Cafe - Jackson Initiative | |||||||
| 136 S ADAMS ST | JACKSON | MS | 39203 | 832814994 | 501(C)(3) | $15,000 | GENERAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 14 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2 | FormAndLineReferenceDesc |
| Explanation | St. Dominic Health Service's (SDHS) contributions committee stays in contact with the organization receiving funds and receives follow-up reports on the outcome of projects. Most organizations are annual recipients, so SDHS receives the follow-up report for the previous year along with the request for the current year. In addition to providing financial support, many of the organizations have board members or volunteers that are employees of one of the St. Dominic affiliates. The committee also receives feedback from these individuals on the activities of the grantee organization. | 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 | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sam Scott | ||||||||||||
| TREASURER & CFO | $481,056 | $4,704 | $21,583 | $13,141 | $520,484 | |||||||
| Lester K Diamond | ||||||||||||
| PRESIDENT SDHS | $662,371 | $26,100 | $61,375 | $27,137 | $776,983 | |||||||
| Richard Vath MD | ||||||||||||
| PRESIDENT/CEO, FMOLHS | $847,395 | $9,097 | $349 | $13,802 | $1,448,518 | $577,875 | ||||||
| Rene J Ragas | ||||||||||||
| DIRECTOR | $328,740 | $1,301 | $44,232 | $52,842 | $543,092 | $115,977 | ||||||
| Kay Mcree | ||||||||||||
| SR. DIRECTOR FND | $172,244 | $44,206 | $47,907 | $10,139 | $274,496 | |||||||
| Deidra Bell | ||||||||||||
| SDHS CFO | $188,816 | $50,611 | $29 | $239,456 | $0 | |||||||
| Frank Lenoir | ||||||||||||
| VP HUMAN RESOURCES | $335,409 | $339 | $19,906 | $10,182 | $365,836 | |||||||
| Jonathan Werne | ||||||||||||
| VP GENERAL COUNSEL | $367,578 | $2,483 | $21,127 | $26,423 | $417,611 | |||||||
| Claude Harbarger | ||||||||||||
| PRESIDENT SDHS | $591,214 | $542,800 | $6,130 | $9,955 | $1,150,099 | $271,348 | ||||||
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART 1, QUESTION 3 | THE FMOLHS BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE REIVEWS COMPENSATION PACKAGES AND APPRROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR MAKING SUCH DETERMINATION IS DOCUMENTATED BY THE COMPENSATION COMMITTEE. |
| PART 1, QUESTION 4A | A BOARD MEMBER IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR TERMINATION OF EMPLOYMENT WITHOUT CAUSE FOR GOOD REASON AND FOR A CHANGE OF CONTROL. IF TRIGGERED, THE EXECUTIVE WOULD BE PAID HIS/HER BASE SALARY AND AN ANNUAL INCENTIVE AT TARGET AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 24 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. A BOARD MEMBER IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION OF EMPLOYEMENT WITHOUT CAUSE, FOR GOOD REASON OR DUE TO CHANGE OF CONTROL. IF TRIGGERED, THE EMPLOYEE WOULD BE PAID HIS/HER BASE SALARY AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS GENERALLY 12 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. |
| 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)). Payouts are included in form W-2 box 5 wages and reflected in other reportable compensation. In the current year, payments were made to the following individuals: Deidra Bell - 13,551 Lester Diamond - 26,100 Sam Scott - 4,704 Frank Lenior - 339 Jonathan Werne - 2,483 Claude Harbarger - 67,355 SDHS maintains one unfunded deferred compensation plan which meets the requirements of IRC Section 457(F) and IRC Section 409A. The plan provides for compensation to be deferred and paid upon the occurrence of certain events such as termination without cause, disability, death or attainment of a specific payment date. Participation in the plan is limited to certain executives and is subject to approval of SDHS board of directors or a designated committee of such board. The following individuals received payment from the plan in the current year: Claude Harbarger - 475,445 Deidra Bell - 37,060 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. None of the individuals on Part VII received payments in the current year. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6: | FMOL HEALTH SYSTEM (AN IRC SECTION 501(C)(3) ORGANIZATION) IS THE SOLE MEMBER OF ST. DOMINIC HEALTH SERVICES, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A: | FMOL HEALTH SYSTEM, AS THE SOLE MEMBER OF ST. DOMINIC HEALTH SERVICES, INC. RETAINS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF ST. DOMINIC HEALTH SERVICES, INC. |
| FORM 990, PART VI, SECTION A, 7B: | THE RESERVED POWERS TO FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM, INC. ARE AS FOLLOWS: 1. TO CHANGE PHILOSOPHY, OBJECTIVES AND PURPOSES OF THE CORPORATION AND ANY CORPORATION IN WHICH SDHS RETAINS VOTING RIGHTS 2. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF ST. DOMINIC HEALTH SERVICES, INC. 3. ALTER ARTICLES OF INCORPORATION AND BYLAWS OF SDHS AND ANY CORPORATION IN WHICH SDHS RETAINS VOTING RIGHTS 4. TO AUTHORIZE MERGER, CONSOLIDATION, OR AFFILIATION, OR PARTICIPATE IN JOINT VENTURES 5. TO DISSOLVE AND TO DISTRIBUTE ASSETS OF SDHS OR ANY CORPORATION IN WHICH SDHS RETAINS VOTING RIGHTS 6. TO APPOINT AND TERMINATE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION OR ANY CORPORATION IN WHICH SDHS RETAINS VOTING RIGHTS 7. TO ACQUIRE, LEASE, ENCUMBER, REAL ESTATE ON BEHALF OF SDHS OR ANY CORPORATION IN WHICH SDHS RETAINS VOTING RIGHTS 8. TO ADD OR TO INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY SDHS OR ANY CORPORATION IN WHICH SDHS RETAINS VOTING RIGHTS 9. TO APPOINT THE FISCAL AUDITOR FOR THE CORPORATION |
| FORM 990, PART VI, SECTION B, LINE 12C: | DIRECTORS AND OFFICERS RECEIVE A COPY OF THE POLICY AND FORM FOR REPORTING EACH YEAR AT THE FIRST MEETING OF THE YEAR. FORMS ARE REVIEWED BY THE PRESIDENT AND ANY CONFLICTS SHARED WITH THE BOARD CHAIR. PERSONS WITH CONFLICTS OF INTERESTS ABSTAIN FROM ANY DECISIONS WHERE THE CONFLICT EXISTS. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B: | 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 Health Services, Inc. is set by the compensation committee of FMOL Health System (a related tax-exempt organization) according to their pay practices which are similar to those described above. |
| FORM 990, PART VI, SECTION C, LINE 19: | The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. |
| FORM 990, PART VI, SECTION B, LINE 11 | After preparation of the Form 990 by KPMG LLP, management reviewed the Form 990. A copy of the Form 990 was provided to the organization's governing board before it was filed with the IRS. |
| FORM 990, PART XI, LINE 9 | Capital gain from capital reserve $(93,460) Intercompany contribution $(1,500,000) Book/tax differences $324,950 |
| SECTION 1.263(A)-1(F)- DE MINIMIS SAFE HARBOR ELECTION | ST. DOMINIC HEALTH SERVICES, INC. DOES HAVE APPLICABLE FINANCIAL STATEMENTS FOR THE YEAR OF THE ELECTION, AND INTEND TO APPLY THE DE MINIMIS SAFE HARBOR ELECTION. THIS ELECTION PERMITS THE TAXPAYER TO DEDUCT FOR TAX PURPOSES ANY ITEM DEDUCTED UNDER ITS BOOK POLICY THAT DOES NOT EXCEED $5,000 PER INVOICE (OR PER ITEM AS SUBSTANTIATED BY THE INVOICE) OR ITEMS HAVING ECONOMIC USEFUL LIFE OF TWELVE MONTHS OR LESS AS DESCRIBTED IN SECTION 1.263(A)-1(F)(1)(II). |
| SECTION 1.263(A)-3(N) ELECTION- BOOK CONFORMITY ELECTION | ST. DOMINIC HEALTH SERVICES, INC. IS MAKING THE ELECTION UNDER TREAS. REG. 1.263()-3(n) TO CAPITALIZE THOSE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL IMPROVEMENTS ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDED JUNE 30, 2020. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:1896795 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST DOMINIC HEALTH & WELLNESS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 969 LAKELAND DRIVE | AddressLine1Txt |
| City | JACKSON | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39216 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 823234006 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Total Income | $808,744 | TotalIncomeAmt |
| End Of Year Assets | $126,521 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SDHS | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| ST BERNARD HEALTH FUND | ||||||||||
| 4200 ESSEN LANE | BATON ROUGE | LA | 70809 | 204685614 | HEALTHCARE | LA | 501(C)(3) | 12 TYPE 1 | FMOL | false |
| HEALTH CARE CENTERS IN SCHOOLS | ||||||||||
| 4200 ESSEN LANE | BATON ROUGE | LA | 70809 | 721443935 | HEALTHCARE | LA | 501(C)(3) | 10 | OLOL | false |
| COMMUNITY HEALTH SERVICES - ST DOMINIC | ||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 640884870 | HEALTH PROGRA | MS | 501(C)(3) | 10 | SDHS | Yes (true) |
| ST DOMINIC - JACKSON MEMORIAL HOSPITAL | ||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 640303091 | HOSPITAL | MS | 501(C)(3) | 3 | SDHS | Yes (true) |
| ST DOMINIC - HEALTH SERVICES FOUNDATION | ||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 431992975 | FUNDRAISING | MS | 501(C)(3) | 7 | SDHS | Yes (true) |
| ST CATHERINE'S VILLAGE INC | ||||||||||
| 969 LAKELAND AND DRIVE | JACKSON | MS | 39216 | 640714997 | RET HOME | MS | 501(C)(3) | 10 | SDHS | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (24 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | UBI Code VUBICodeVAmt | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HEART HOSPITAL OF ACADIANA LLC | ||||||||||||||
| 1105 KALISTE SALOOM ROAD | LAFAYETTE | LA | 70508 | 300442368 | HEALTHCARE | LA | LOURDES | N/A | ||||||
| LOURDES IMAGING DEVELOPMENT LLC | ||||||||||||||
| 4801 AMBASSADOR CAFFERY PKWY | LAFAYETTE | LA | 70508 | 208326287 | REAL ESTATE | LA | LOURDES | N/A | ||||||
| PARK PLACE SURGERY CENTER LLC | ||||||||||||||
| 4811 AMBASSADOR CAFFERY PKWY | LAFAYETTE | LA | 70508 | 721404092 | HEALTHCARE | LA | LOURDES | N/A | ||||||
| BRPT LAKE REHABILITATION CENTERS LLC | ||||||||||||||
| 175 S ENGLISH STATION RD STE 218 | LOUISVILLE | KY | 40245 | 721506100 | HEALTHCARE | LA | OLOL | N/A | ||||||
| CONVENIENT CARE LLC | ||||||||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 721439481 | HEALTHCARE | LA | OLOL | N/A | ||||||
| SURGICAL SPECIALTY CENTER OF BATON ROUGE | ||||||||||||||
| 8080 BLUEBONNET BLVD | BATON ROUGE | LA | 70810 | 263120962 | HEALTHCARE | LA | OLOL | N/A | ||||||
| ST ELIZABETH-MARY BIRD PERKINS CANCER C | ||||||||||||||
| 4950 ESSEN LANE | BATON ROUGE | LA | 70809 | 260628752 | HEALTHCARE | LA | OLOL | N/A | ||||||
| NORTHEAST LA CANCER INSTITUTE LLC | ||||||||||||||
| 411 CALYPSO STREET | MONROE | LA | 71201 | 721329499 | HEALTHCARE | LA | SFMC | N/A | ||||||
| LHCG-XIII LLC dba Lourdes Home Health | ||||||||||||||
| 901 S HUGH WALLIS ROAD | LAFAYETTE | LA | 70508 | 208068308 | HEALTHCARE | LA | LOURDES | N/A | ||||||
| LOURDES AFTER HOURS LLC | ||||||||||||||
| 7777 HENNESSY BLVD SUITE 1004-202 | BATON ROUGE | LA | 70809 | 201367299 | HEALTHCARE | LA | LOURDES | N/A | ||||||
| LAKE URGENT CARE ASCENSION LLC | ||||||||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 352463092 | HEALTHCARE | LA | OLOL | N/A | ||||||
| OLOLUSP SURGERY CENTER LLC | ||||||||||||||
| 15305 DALLAS PKWY STE 1600 LB 28 | ADDISON | TX | 75001 | 352457810 | HEALTHCARE | TX | OLOL | N/A | ||||||
| ST FRANCIS URGENT CARE LLC | ||||||||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 474013731 | HEALTHCARE | LA | SFMC | N/A | ||||||
| GAMMA KNIFE OF LOUISIANA LLC | ||||||||||||||
| 4950 ESSEN LANE | BATON ROUGE | LA | 70809 | 811827194 | HEALTHCARE | LA | OLOL | N/A | ||||||
| LHCG LXVII LLC | ||||||||||||||
| 901 S HUGH WALLIS ROAD | LAFAYETTE | LA | 70508 | 474283509 | HEALTHCARE | LA | LOURDES | N/A | ||||||
| PREMIER HEALTH HOLDINGS LLC | ||||||||||||||
| 10319 JEFFERSON HIGHWAY | BATON ROUGE | LA | 70809 | 472665226 | HEALTHCARE | LA | OLOL | N/A | ||||||
| PINNACLE CARE HOLDINGS LLC | ||||||||||||||
| 5627 S SHERWOOD FOREST BLVD | BATON ROUGE | LA | 70816 | 821637627 | HEALTHCARE | LA | OLOL | N/A | ||||||
| LAFAYETTE SURGERY CENTER LIMITED PARTNER | ||||||||||||||
| C/O C T CORPORATION SYSTEM 3867 PL | BATON ROUGE | LA | 70816 | HEALTHCARE | LA | LOURDES | N/A | |||||||
| HIGHLAND MEDICAL ARTS LLC | ||||||||||||||
| PO BOX 55769 | JACKSON | MS | 39296 | 743073171 | MED BUILDING | MS | SDHS | RELATED | $377,745 | $8,503,516 | false | $0 | false | 0.74468 |
| D1 SPORTS TRAINING OF MISSISSIPPI LLC | ||||||||||||||
| 7715 SOUTH SPRINGS DRIVE | FRANKLIN | TN | 37067 | 275277568 | ATHLETIC CENTER | MS | SDMHS | N/A | ||||||
| MEA PRIMARY CARE PLUS LLC | ||||||||||||||
| 308 CORPORATE DRIVE | RIDGELAND | MS | 39157 | HEALTHCARE | MS | FIC | N/A | |||||||
| FREMAUX OFFICE MM LLC | ||||||||||||||
| 3500 NORTH CAUSEWAY BOULEVARD STE | METAIRIE | LA | 70002 | HEALTHCARE | LA | FMOLHS | N/A | |||||||
| FREMAUX MOB LLC | ||||||||||||||
| 3500 NORTH CAUSEWAY BOULEVARD STE | METAIRIE | LA | 70002 | MED BLDG | LA | FMOLHS | N/A | |||||||
| SHP Managing Member LLC | ||||||||||||||
| 7015 HIGHWAY 190 E SERVICE ROAD ST | COVINGTON | LA | 70433 | 832168844 | HEALTHCARE | LA | OLOL | N/A | ||||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HOSPITAL ASSISTANCE SERVICES | ||||||||||||||||
| 4200 ESSEN LANE | BATON ROUGE | LA | 70809 | 721073486 | HEALTHCARE | LA | LOURDES | C CORP | false | |||||||
| LOUISE INSURANCE COMPANY | ||||||||||||||||
| INSURANCE | FMOL | C CORP | false | PO BOX 1051 KY1-1102 | CAYMAN ISLANDS | CJ | CJ | |||||||||
| FRANCISICAN HEALTH & WELLNESS SERVICES I | ||||||||||||||||
| 4200 ESSEN LANE | BATON ROUGE | LA | 70809 | 455492379 | HEALTHCARE | LA | FMOL | C CORP | false | |||||||
| FMOL HEALTH SYSTEM HOLDINGS INC | ||||||||||||||||
| 4200 ESSEN LANE | BATON ROUGE | LA | 70809 | 454405024 | INVESTMENT | LA | FMOL | C CORP | false | |||||||
| ST DOMINIC MADISON HEALTH SERVICES INC | ||||||||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 202870254 | HEALTHCARE | MS | SDHS | C CORP | Yes (true) | $2,340,736 | $18,388,134 | 1.00000 | ||||
| FIRST INTERMED CORPORATION | ||||||||||||||||
| 308 CORPORATE DRIVE | RIDGELAND | MS | 39157 | 640824796 | MEDICAL SERVICES | MS | SDHS | C CORP | Yes (true) | $26,790,500 | $3,928,038 | 1.00000 | ||||
| ST DOMINIC INTEGRATED SERVICES INC | ||||||||||||||||
| 969 LAKELAND DRIVE | JACKSON | MS | 39216 | 271493623 | INVESTMENTS | MS | SDJMH | C CORP | false | |||||||
| LAFAYETTE SURGICARE INC | ||||||||||||||||
| C/O C T CORPORATION SYSTEM 3867 PL | BATON ROUGE | LA | 70816 | 943419282 | HEALTHCARE | LA | LOURDES | C CORP | false | |||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ST DOMINIC JACKSON MEMORIAL HOPSITAL | ||
| C | $1,500,000 | FMV |
| ST DOMINIC JACKSON MEMORIAL HOSPITAL | ||
| S | $542,589 | FMV |
| St Dominic Jackson Memorial Hospital | ||
| J | $639,507 | FMV |
| St Dominic Jackson Memorial Hospital | ||
| L | $1,364,700 | FMV |
| St Dominic Jackson Memorial Hospital | ||
| R | $258,885 | FMV |
| St Dominic Health System Foundation | ||
| C | $747,193 | FMV |