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ST DOMINIC-JACKSON MEMORIAL HOSPITAL: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
ST DOMINIC-JACKSON MEMORIAL HOSPITAL (EIN 64-0303091)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-13
IRS object ID
201803179349301305
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-11-13T07:59:47-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1190 E Capitol Street Ste 500AddressLine1Txt
CityJacksonCityNm
State AbbreviationMSStateAbbreviationCd
ZIP392012190ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN640303091EIN

Business Name BusinessName

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLESTER K DIAMONDPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone6012006955PhoneNum
Signature2018-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonFatima Chase CPAPreparerPersonNm
PTINP01677201PTIN
Phone6019486700PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id64248120183175000004FederalOriginalSubmissionId
Federal Original Submission Id2018-11-13FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdD1C40A0FB9ED889897236B17A1DE3D5FB0A8D9DCAtSubmissionCreationDeviceId
At Submission Filing Device Id468D4A6F67C914A138C9D1D024C98E150145FE59AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLESTER K DIAMONDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1969 LAKELAND DRIVEAddressLine1Txt
CityJACKSONCityNm
State AbbreviationMSStateAbbreviationCd
ZIP392164699ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$510,847,513GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.STDOM.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1946FormationYr
Legal Domicile StateMSLegalDomicileStateCd
Activity Or MissionST. DOMINIC-JACKSON MEMORIAL HOSPITAL OPERATES A 571 BED PATIENT FACILITY FOR THE CITIZENS OF THE JACKSON, MS METROPOLITAN AREA THAT EXPRESSES A MISSION OF CHRISTIAN HEALING.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee4604TotalEmployeeCnt
Total Volunteers355TotalVolunteersCnt
Total Gross UBI$626,050TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$70,955NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$58,015PYContributionsGrantsAmt
CY Contributions Grants$87,035CYContributionsGrantsAmt
PY Program Service Revenue$480,814,294PYProgramServiceRevenueAmt
CY Program Service Revenue$490,335,664CYProgramServiceRevenueAmt
PY Investment Income$3,617,598PYInvestmentIncomeAmt
CY Investment Income$9,793,505CYInvestmentIncomeAmt
PY Other Revenue$10,686,561PYOtherRevenueAmt
CY Other Revenue$10,607,849CYOtherRevenueAmt
PY Total Revenue$495,176,468PYTotalRevenueAmt
CY Total Revenue$510,824,053CYTotalRevenueAmt
PY Grants And Similar Paid$2,556,085PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,347,714CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$239,030,446PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$239,065,738CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$257,521,438PYOtherExpensesAmt
CY Other Expenses$273,828,541CYOtherExpensesAmt
PY Total Expenses$499,107,969PYTotalExpensesAmt
CY Total Expenses$515,241,993CYTotalExpensesAmt
PY Revenues Less Expenses-$3,931,501PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$4,417,940CYRevenuesLessExpensesAmt
Total Assets BOY$347,022,982TotalAssetsBOYAmt
Total Assets EOY$369,248,286TotalAssetsEOYAmt
Total Liabilities BOY$103,121,538TotalLiabilitiesBOYAmt
Total Liabilities EOY$102,276,893TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$243,901,444NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$266,971,393NetAssetsOrFundBalancesEOYAmt
MissionST. DOMINIC-JACKSON MEMORIAL HOSPITALS (THE HOSPITAL OR ST. DOMINIC'S) MISSION: 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.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$476,842,827ExpenseAmt
Revenue$493,002,743RevenueAmt
DescSt. Dominic Hospital is a 571-bed acute care facility in Jackson, MS. As part of its healing ministry, St. Dominic's is one of the largest employers in the area, and those employees, as well as hospital operations, significantly help to support the local economy. In 2017 St. Dominic Hospital provided over $1 Billion (charges) in hospital services to patients throughout the central region of Mississippi, and employed over 3,200 people. St. Dominic Hospital's medical staff of nearly 500 leading physicians and specialists makes St. Dominic's one of the most comprehensive hospitals in Mississippi. These physicians and staff members have played an integral role in developing highly regarded clinical programs and services. Some of those key services include the Mississippi Heart and Vascular Institute, stroke services, women's services, behavioral health services, and the cancer center (and cancer services as a whole). MISSISSIPPI HEART AND VASCULAR INSTITUTE - In 1974, St. Dominic's established a center for comprehensive cardiac care. Then known as the Mississippi Heart Institute the name has since been revised to Mississippi Heart and Vascular Institute (MHVI) to show St. Dominic's ongoing commitment to expertise and care of the entire circulatory system. Many of St. Dominic's heart and vascular physicians are nationally known for using the most advanced technology and procedures and for their clinical excellence in delivering patient care. Services offered range from minimally invasive cardiac treatments to traditional open-heart surgery to complicated and very specialized valve repairs. In 2017 heart and vascular service volumes continued to climb compared to prior years. Much of these increases can be attributed to St. Dominic's efforts to offer outreach services to the broader community. St. Dominic's Clinical Outreach, first established in 2013, provides screenings, specialty clinic hubs and other health services to individuals in both the Jackson area and in outlying communities. The program is made up of two parts: screenings, which encompasses the Healthy Heart screening program and community screening events, and outreach, which includes telemedicine and specialty clinics in rural areas. Patients who schedule an appointment with the Healthy Heart program receive a (hospital subsidized) heart risk assessment for $99. Up to 18 patients a day can be seen at two locations. The Healthy Heart program staff conducted a total of 2,209 screenings in 2017 an increase of over 176 participants compared to the previous year. The Healthy Heart staff also participated in 20 health fairs and events throughout the year and came into contact with 1,923 people in the community through those events. Clinical outreach also aims to spread its ministry further by providing services to communities across the state to augment existing medical resources. In 2017, the program added one new specialty clinic hub site in Kosciusko in addition to its already existing sites located in Magee, Pelahatchie, Greenville, Cleveland, Brookhaven and Vicksburg. At these locations, neurology, cardiology and ear, nose and throat physicians see patients via face-to-face encounters once or twice each month, allowing patients to receive medical services without the need to travel to see a specialist. Three locations Vicksburg, Brookhaven and Cleveland also offer tele-medicine clinics where physicians remain at St. Dominics and the patients remain in their local community to receive consultations and care. COMPRESHENSIVE STROKE CENTER- St. Dominics Comprehensive Stroke Center offers rapid diagnosis, high-tech intervention, expert care and intensive rehabilitation in a caring, compassionate setting. St. Dominics is capable of delivering the full spectrum of care to seriously ill patients with stroke and cerebrovascular disease. The chief component of the program is a highly collaborative, expertly-skilled team of clinical professionals who direct and provide evidence-based care for every stroke patient. The program provides care to the adult population of central Mississippi and outlying rural areas. In 2016 St. Dominics earned The Joint Commissions Gold Seal of Approval and the American Heart Association/American Stroke Associations Heart-Check mark for Advanced Certification for Comprehensive Stroke Centers. The Gold Seal of Approval and the Heart-Check mark represent symbols of quality from their respective organizations. To be eligible for this distinction, hospitals must demonstrate compliance with stroke-related standards as a Primary Stroke Center and meet additional requirements, including those related to advanced imaging capabilities, 24/7 availability of specialized treatments, and providing staff with the unique education and competencies to care for complex stroke patients. St. Dominics has worked to extend this expertise to areas outside of the Jackson area. St. Dominics tele-stroke network links seven hospitals in rural areas with stroke neurologists at St. Dominics who can provide specialized, urgent care for those suspected of having a stroke. In 2017 St. Dominics treated 1,515 stroke patients, 2/3 of whom were transferred in from outlying, rural hospitals. WOMEN'S SERVICES- St. Dominic's maternal and newborn care center emphasizes a team approach to care with physicians, nurses and educators working together to meet the total needs of the patient and the entire family. St. Dominic's offers services and programs not only during a patient's hospital stay, but also classes and resources to assist with the family transition long before and long after the birth of a baby. Services include prenatal care, labor and delivery, newborn care, digital mammography, wellness checks, lactation consultations, gynecological surgeries and a wide array of classes. In 2017, St. Dominic's women's services worked with families to deliver 1,429 babies. Of those only a small fraction were low birth weight, which can be partially attributed to prenatal care efforts. BEHAVIORAL HEALTH SERVICES- For St. Dominics, the treatment of behavioral health conditions has been a priority since the inception of its behavioral health program. St. Dominics Behavioral Health Services provides quality and compassionate treatment to adult individuals and their families suffering from mental illness. Board certified psychiatrists, social workers and other therapists work together within a multi-disciplinary team to meet the individualized needs of each patient. One of the specialty psychiatric units at St. Dominic's, The Oakes, is a geriatric psychiatric unit that provides compassionate care for senior adult patients in a secure and therapeutic environment. The Oakes uses proven methods to help patients, such as social group interaction, reality orientation, sensory stimulation, recreation and self-expression. St. Dominic's behavioral health services facility completed in 2013 can accommodate patients in need of psychiatric inpatient services in the metro area. The two-story, state-of-the-art facility contains 78,000 square feet and 77 private rooms. Separate units within the facility have individual group meeting and dining areas. St. Dominics Behavioral Health Services frequently reaches out to the community to help individuals identify disorders and find help. In 2017 Behavioral Health Services provided screening materials to more than 1,000 people for anxiety and depression disorders throughout multiple community events. Also, more collaborative efforts and partnerships are being established within the community to develop a coordinated approach to addressing issues surrounding mental health in the community. Efforts to reduce the stigmas associated with mental health were also a focus in marketing and social media coverage during 2017. Participation in many community events in the Jackson and the surrounding area were completed to educate the public on mental illness. CANCER CENTER AND CANCER SERVICES- St. Dominics cancer services are a leader in community outreach and cancer education. The comprehensive program was recognized in 2015 with an Outstanding Achievement Award by the Commission on Cancer (CoC) of the American College of Surgeons. St. Dominics was the only hospital in the state of Mississippi to receive this award twice, and since then no other Mississippi has received this designation. In 2017 St. Dominics was recognized by Beckers Hospital Review as one of 100 hospitals and health systems in the nation with great oncology programs. According to Beckers Hospital Review, "Hospitals selected for this list lead the way in oncology expertise, outcomes, research and treatment options." An integral part of St. Dominics cancer services is the freestanding Cancer Center, which provides easy access to a large variety of services as well as convenient parking. Treatments at the center include medical cancer therapy, radiation therapy and lymphedema treatment. In 2017 alone, 25,613 radiatioDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$26,565,658ExpenseAmt
DescThe Hospital is an active, caring member of the community it serves. In carrying out its healing ministry, the Board of Directors has established a policy under which the Hospital provides care to the needy members of its community. Following that policy, the Hospital maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policies. The direct and indirect costs associated with these services cannot be identified to specific charity care patients. Therefore, management estimated the costs of these services by calculating a cost to gross charge ratio and multiplying it by the charges associated with services provided to patients meeting the Hospital's charity care guidelines. The estimated cost of charges foregone, based on the cost to charge ratio, was approximately $15,752,000. The foregone charges are netted against patient service revenue to arrive at net patient service revenue as reflected as program service revenue on part viii of form 990 in order to be consistent with financial statement reporting and are not reported as functional expenses on the form 990. The Hospital also provides health care services to a significant portion of the uninsured population in the surrounding community. While a portion of these patients may ultimately qualify for coverage under the Medicaid program or the charity care policy discussed above, the Hospital is unable to collect a significant portion of these accounts. Charges deemed uncollectible during 2017 were approximately $26,567,000.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$2,347,714ExpenseAmt
Grant$2,347,714GrantAmt
DescThe Hospital serves the community in numerous ways. Some examples include assisting in educating the community regarding health-related issues. The Hospital participates in numerous health fairs and gives presentations to various schools and industries regarding such issues as drug abuse and safety in the workplace. The Hospital has sponsored annual cholesterol and cancer screenings upon which the tests are made available to the public for a nominal fee and the majority of the costs incurred are absorbed by the hospital. The Hospital also organizes employee participation in fundraising for organizations, such as the United Way, Stewpot Ministries and Junior Achievement, among others. In addition, the Hospital gave approximately $718,000 during 2017 in charitable corporate donations to various area community service organizations. Although the Hospital has estimated the cost of each of these efforts to serve the Jackson, Mississippi metropolitan area, management and the Board of Directors believe that such costs represent only one facet of the many ways the Hospital serves the greater Jackson community. The above examples relate only to certain measureable benefits that the Hospital provides to its service area and is not intended to measure all such community benefits, many of which are intangible in nature or otherwise not quantifiable.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$505,756,199TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document241IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee4604EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSAM SCOTTPersonNm
Phone6012006570PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JEFF FLETCHER MD
CHAIRMAN0.750.0Yes (X)Yes (X)$0$0$0
DAN GRAFTON
VICE CHAIRMAN0.750.0Yes (X)Yes (X)$0$0$0
SISTER MARY TRINITA OP
SECRETARY0.7540.5Yes (X)Yes (X)$0$0$0
SISTER THECLA KUHNLINE OP
DIRECTOR0.750.0Yes (X)$0$0$0
SISTER CELESTINE OP
DIRECTOR0.750.0Yes (X)$0$0$0
SISTER KATHLEEN GALLAGHER OP
DIRECTOR0.750.0Yes (X)$0$0$0
SISTER KRISTIN REVER OP
DIRECTOR0.750.0Yes (X)$0$0$0
SISTER CORDE LENN OP
DIRECTOR0.750.0Yes (X)$0$0$0
DONNA SIMS
DIRECTOR0.750.0Yes (X)$0$0$0
WILL MCCRANEY MD
DIRECTOR0.750.0Yes (X)$0$0$0
EDDIE MALONEY
DIRECTOR0.750.0Yes (X)$0$0$0
JIMMY JONES MD
DIRECTOR0.750.0Yes (X)$0$0$0
JOHNNY DONALDSON
DIRECTOR0.750.0Yes (X)$0$0$0
CLAUDE W HARBARGER
DIRECTOR0.7542.0Yes (X)$0$848,319$115,728
LESTER K DIAMOND
PRESIDENT40.00.0Yes (X)Yes (X)$622,129$0$89,788
JENNIFER SINCLAIR
EXECUTIVE VP - OPERATIONS40.00.0Yes (X)$398,747$0$56,263
KEITH VAN CAMP
VP - INFORMATION TECHNOLOGY40.00.0$334,405$0$33,045Yes (X)
RAYMOND SWARTZFAGER
VP - BUSINESS DEVELOPMENT40.00.0$276,857$0$38,396Yes (X)
THERESA A HORNE
VP - PATIENT CARE SERVICES40.00.0$259,775$0$26,499Yes (X)
FRANK LENOIR
VP - HUMAN RESOURCES0.00.0$0$272,068$34,935Yes (X)
MICHAEL L SANDERS
INTERIM VP - MEDICAL AFFAIRS40.00.0$316,746$0$30,160Yes (X)
SAMUEL T SCOTT
VP - FINANCE40.00.0$323,117$0$33,655Yes (X)
TANDRA R DAVISON
VP - QUALITY & PERFORMANCE40.00.0$224,760$0$23,274Yes (X)
DAVID C HENRY
VP - CLINICAL OPERATIONS40.00.0$216,015$0$27,215Yes (X)
DAVID W SINCLAIR
VP - NETWORK ADMINISTRATION40.00.0$283,698$0$27,616Yes (X)
ERIC A MCVEY
EXEC VP - MEDICAL AFFAIRS40.00.0$362,154$0$11,688Yes (X)
JOHN LANCON
PHYSICIAN40.00.0$1,265,695$0$15,607Yes (X)
D P SEAGO
PHYSICIAN40.00.0$944,277$0$8,511Yes (X)
PB KERR
PHYSICIAN40.00.0$986,822$0$14,527Yes (X)
VERN A KELLER
PHYSICIAN40.00.0$1,088,527$0$16,327Yes (X)
ZACHARY K BALDWIN
PHYSICIAN40.00.0$917,721$0$16,327Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$8,821,445TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,120,387TotReportableCompRltdOrgAmt
Total Other Compensation$619,561TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K209IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CERNER CORPORATION
PO BOX 959156ST LOUISMO63195IT SERVICES$8,611,212
ALLIED EMERGENCY SERVICES PC
PO BOX 2120RIDGELANDMS39158ER PHYSICIANS$8,502,234
TEKSYSTEMS INC
PO BOX 198568ATLANTAGA30381IT CONSULTING$6,335,569
JACKSON HEART CLINIC PA
970 LAKELAND DRIVEJACKSONMS39216CO-MGMT SERVICES$4,142,316
FOUNTAIN CONSTRUCTION CO INC
PO BOX 10506JACKSONMS39289CONSTRUCTION$3,674,321
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K68CntrctRcvdGreaterThan100KCnt
Related Organizations$53,892RelatedOrganizationsAmt
All Other Contributions$33,143AllOtherContributionsAmt
Total Contributions$87,035TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue621990$490,335,687$490,335,687
Pharmaceutical Sales446110-$682-$682
Spa Sales812900$659$659
FieldValueIRS element (for citing)
Total Program Service Revenue$490,335,664TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,804,648TotalRevenueColumnAmt
Exclusion$9,804,648ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$2,940,181RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$2,940,181RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,940,181TotalRevenueColumnAmt
Exclusion$2,940,181ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$12,317OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$23,460OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$11,143OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$11,143TotalRevenueColumnAmt
Exclusion-$11,143ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Cafeteria Sales722514$3,327,587$3,327,587
Day Care Center624410$1,120,347$494,297$626,050
WEIGHT LOSS CENTER812900$1,035,381$1,035,381

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,184,353TotalRevenueColumnAmt
Related Or Exempt Func Income$1,631,698RelatedOrExemptFuncIncomeAmt
Exclusion$552,655ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$7,667,668OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$510,824,053TotalRevenueColumnAmt
Related Or Exempt Func Income$493,002,743RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$626,050UnrelatedBusinessRevenueAmt
Exclusion$17,108,225ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,251,851TotalAmt
Program Services$2,251,851ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$95,863TotalAmt
Program Services$95,863ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$4,016,002TotalAmt
Management And General$4,016,002ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$82,324TotalAmt
Program Services$82,324ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$197,548,955TotalAmt
Program Services$193,927,166ProgramServicesAmt
Management And General$3,621,789ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$3,213,663TotalAmt
Program Services$3,213,663ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$21,187,331TotalAmt
Program Services$20,692,772ProgramServicesAmt
Management And General$494,559ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$13,017,463TotalAmt
Program Services$12,549,145ProgramServicesAmt
Management And General$468,318ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,375,725TotalAmt
Program Services$1,375,725ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$510,703TotalAmt
Management And General$510,703ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$374,423TotalAmt
Management And General$374,423ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$27,701TotalAmt
Program Services$27,701ProgramServicesAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$30,698,256TotalAmt
Program Services$30,698,256ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,416,231TotalAmt
Program Services$1,416,231ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,502,060TotalAmt
Program Services$3,502,060ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$8,643,076TotalAmt
Program Services$8,643,076ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$2,894,780TotalAmt
Program Services$2,894,780ProgramServicesAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$122,821TotalAmt
Program Services$122,821ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$215,720TotalAmt
Program Services$215,720ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$21,647,632TotalAmt
Program Services$21,647,632ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,783,530TotalAmt
Program Services$4,783,530ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Medical & Other Supplies$94,940,059$94,940,059
BAD DEBT EXPENSE$26,565,658$26,565,658
Repairs & Maintenance$21,709,365$21,709,365
LICENSES & TAXES$19,547,728$19,547,728

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$34,853,073TotalAmt
Program Services$34,853,073ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$515,241,993TotalAmt
Program Services$505,756,199ProgramServicesAmt
Management And General$9,485,794ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,020,381BOYAmt
EOY$757,865EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$47,497,284BOYAmt
EOY$44,416,336EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$49,902,303BOYAmt
EOY$60,186,773EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$10,653,570BOYAmt
EOY$11,593,821EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$8,519,035BOYAmt
EOY$4,832,169EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$481,105,608LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$293,472,964LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$188,509,824BOYAmt
EOY$187,632,644EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$8,863,631EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$40,920,585BOYAmt
EOY$50,965,047EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$347,022,982BOYAmt
EOY$369,248,286EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$30,226,109BOYAmt
EOY$40,285,278EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,068,417BOYAmt
EOY$20,864,189EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$69,827,012BOYAmt
EOY$41,127,426EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$103,121,538BOYAmt
EOY$102,276,893EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$243,901,444BOYAmt
EOY$266,971,393EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$243,901,444BOYAmt
EOY$266,971,393EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$347,022,982BOYAmt
EOY$369,248,286EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$4,417,940ReconcilationRevenueExpnssAmt
Prior Period Adjustments$915,219PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$26,572,670OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$27,701OtherActivitiesAmt
Total Lobbying Expenditures$27,701TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1I:FormAndLineReferenceDesc
ExplanationST. DOMINIC-JACKSON MEMORIAL HOSPITAL PAID DUES TO THE MISSISSIPPI HOSPITAL ASSOCIATION. THE MISSISSIPPI HOSPITAL ASSOCIATION REPORTS THAT 17.84% OF THE $155,275 OF DUES PAID WERE RELATED TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

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

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$215,628,151OtherCostOrOtherBasisAmt
Depreciation$108,744,822DepreciationAmt
Book Value$106,883,329BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,297,783OtherCostOrOtherBasisAmt
Depreciation$7,017,997DepreciationAmt
Book Value$2,279,786BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$228,096,545OtherCostOrOtherBasisAmt
Depreciation$170,497,225DepreciationAmt
Book Value$57,599,320BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$18,810,549OtherCostOrOtherBasisAmt
Depreciation$7,212,920DepreciationAmt
Book Value$11,597,629BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$187,632,644TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Investment in Affiliates$6,175,303
Other Receivables$3,137,484
Due from Affiliates$41,652,260
FieldValueIRS element (for citing)
Total Book Value Other Assets$50,965,047TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Liability for Pension Benefits$33,781,994
Due to Third Party Payors$7,345,432
FieldValueIRS element (for citing)
Total Liability$41,127,426TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule H IRS990ScheduleH

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,103,986TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$16,103,986NetCommunityBenefitExpnsAmt
Total Expense0.03300TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$61,442,829TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$63,113,738DirectOffsettingRevenueAmt
Net Community Benefit Expns-$1,670,909NetCommunityBenefitExpnsAmt

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$149,087TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$88,521DirectOffsettingRevenueAmt
Net Community Benefit Expns$60,566NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$77,695,902TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$63,202,259DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,493,643NetCommunityBenefitExpnsAmt
Total Expense0.03310TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,403,002TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,403,002NetCommunityBenefitExpnsAmt
Total Expense0.00290TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$80,640TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$80,640NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,278,562TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,025,893DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,252,669NetCommunityBenefitExpnsAmt
Total Expense0.00660TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,675,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,675,000NetCommunityBenefitExpnsAmt
Total Expense0.00340TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,437,204TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,025,893DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,411,311NetCommunityBenefitExpnsAmt
Total Expense0.01310TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$98,133,106TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$77,228,152DirectOffsettingRevenueAmt
Net Community Benefit Expns$20,904,954NetCommunityBenefitExpnsAmt
Total Expense0.04620TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$550,218TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$550,218NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$550,218TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$550,218NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$26,565,658BadDebtExpenseAmt
Bad Debt Expense Attributable$11,688,890BadDebtExpenseAttributableAmt
Reimbursed By Medicare$149,930,759ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$154,714,007CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,783,248MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line1ST DOMINIC ASCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesOUTPATIENT SURGERY CENERPrimaryActivitiesTxt
Org Profit Or Ownership0.46316OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership0.0OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership0.53684PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line1969 LAKELAND DRIVEAddressLine1Txt
CityJACKSONCityNm
State AbbreviationMSStateAbbreviationCd
ZIP392164699ZIPCd
FieldValueIRS element (for citing)
Website AddressHTTP://WWW.STDOM.COM/WebsiteAddressTxt
State License14-031StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Facility Reporting Group1FacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST DOMINIC-JACKSON MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLsee section COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLsee section CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care350.FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://www.stdom.com/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttp://www.stdom.com/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp://www.stdom.com/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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.
PART V, SECTION A, LINES 7A &10:https://www.stdom.com/about-us/community-benefit-and-needs/
PART V, SECTION B, LINE 11:In 2015 St. Dominics built upon what it learned in its prior CHNA and used that information to conduct a new and more extensive needs assessment. The results of the new assessment were later published in December of 2015 as the 20162018 Community Health Needs Assessment and can be found online at stdom.com/about-us/community-benefit-and-needs/. The overarching goal of both assessments 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. Dominics focus to establish community and provide service, setting an example to others in community service. St. Dominic Hospitals overall approach to community benefit is to target the intersection of documented unmet community health needs and the organizations key strengths and mission commitments. Specifically, members of the task force that led the development of the assessment identified priority health issues in St. Dominics service area based on its review of demographic information, focus group feedback and the results of community surveys. Those identified pressing issues for 20162018 are: - access to care; - behavioral health or mental health; - chronic disease care and screening (especially for heart disease, cancer, diabetes, stroke and obesity); - HIV prevention and treatment; and - managing the expected growth in senior health services. In 2017, as it did in prior years, St. Dominics integrated its commitment to community service into its management and governance structures as well as its strategic and operational plans. In 2017 the hospitals strategic plan contained a strategy specifically directed at allocating resources to meet the needs of the community in response to the identified focus areas in the needs assessment. The overarching strategy indicated, "Conduct a market analysis and create a long-term plan for addressing current and anticipated community needs in the primary service area." Following are ways in which that strategy was implemented as well as ways other identified needs were met in 2017. Access to Care - Added three care access points to the overall network, bringing the total up to 58 by the end of 2017. Early in the year St. Dominics tele-stroke services were launched at Delta Regional Medical Center in Greenville. Later clinical outreach began operating in Kosciusko with Premier Medical Group and a new family medicine site was added in Flowood. Access to Care/Senior Health Services - Served nearly 4,200 vulnerable children and mature adults throughout the state in 2017 through the Care-A-Van program. The mobile screening service hosted by St. Dominics traveled to schools to provide screening and educational programs. St. Dominics employees contributed approximately 600 volunteer hours to the service. Behavioral Health or Mental Health - Conducted screening or education events in communities throughout the state. At two events 700 people were screened for anxiety and depression disorders. Another nine events covered topics from general mental health to adult mental health, including geriatric mental health. Over 1,500 community members attended these events throughout the year. Chronic Disease Care and Screening - Conducted screening or education events at local businesses. The events focused on heart and cancer screenings. In all, 1,487 community members attended education events and/or were screened at 20 separate events. HIV Prevention and Treatment - Initiated social service referrals from St. Dominics Community Health Clinic to the Mississippi Department of Health. In 2017 the Community Health Clinic had 13,162 patient visits. When appropriate, HIV prevention was discussed with patients. For testing, the clinic has partnered with the Mississippi Department of Health. Every other month a bus comes to the clinic to transport individuals who may have a need to the Department of Health for HIV testing.
PART V, SECTION B, LINE 20E:The Hospital proactively screens patients for financial assistance eligibility if there is an indication that the patient may qualify under the financial assistance policy.
FieldValueIRS element (for citing)
Facility37FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (37 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
ST DOMINIC'S HOSPITAL MEDICINE
971 LAKELAND DRIVE SUITE 1453JACKSONMS39216HOSPITALIST CLINIC
ST DOMINIC'S CARDIOVASCULAR SURGERY
971 LAKELAND DRIVE SUITE 657JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S NEUROSURGERY ASSOCIATES
971 LAKELAND DRIVE SUITE 657JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S EAR NOSE & THROAT SURG GP
970 LAKELAND DRIVE SUITE 40JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S NEUROCARE
971 LAKELAND DRIVE SUITE 557JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S INTERNAL MEDICINE GROUP
971 LAKELAND DRIVE SUITE 250JACKSONMS39216PHYSICIAN CLINIC
STDOMINIC'S INTERNAL MEDICINE - MADISON
106 HIGHLAND WAY 200MADISONMS39110PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF MADISON
106 HIGHLAND WAY SUITE 103MADISONMS39110PHYSICIAN CLINIC
ST DOMINIC'S PAIN MANAGEMENT CENTER
971 LAKELAND DRIVE SUITE 1159JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S INFECTIOUS DISEASE
971 LAKELAND DRIVE SUITE 954JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S UROLOGY
971 LAKELAND DRIVE SUITE 360JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S GYNECOLOGIC ONCOLOGY
971 LAKELAND DRIVE SUITE 750JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S RHEUMATOLOGY
106 HIGHLAND WAY SUITE 200MADISONMS39110PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF FLOWOOD
1050 RIVER OAKS DRIVEFLOWOODMS39232PHYSICIAN CLINIC
ST DOMINIC'S PSYCHIATRIC ASSOCIATES
890 LAKELAND DRIVEJACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF CLINTON
728 CLINTON PARKWAY SUITE BCLINTONMS39056PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF BRANDON
1297 WEST GOVERNMENT STREETBRANDONMS39042PHYSICIAN CLINIC
ST DOMINIC'S VASCULAR & ENDOVASCULAR
971 LAKELAND DRIVE SUITE 1250JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S INTERNAL MEDICINE GROUP
112 SOUTH LAKE CIRCLECANTONMS39046PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF JACKSON
890 LAKELAND DRIVEJACKSONMS39056PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICNE OF MAGEE
360 SIMPSON HWY 149 SUITE 220MAGEEMS39111PHYSICIAN CLINIC
ST DOMINIC'S MARTIN SURGICAL ASSOCIATES
971 LAKELAND DRIVE SUITE 211JACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MED OF PELAHATCHIE
610 2ND STREETPELAHATCHIEMS39145PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF RALEIGH
342 MAGNOLIA DRIVERALEIGHMS39153PHYSICIAN CLINIC
ST DOMINIC'S SURGICAL ONCOLOGY
106 HIGHLAND WAY SUITE 200MADISONMS39110PHYSICIAN CLINIC
ST DOMINIC'S CHRONIC CARE CLINIC
890 LAKELAND DRIVEJACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF PEARL
342 GILCHRIST DRIVEPEARLMS39208PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE OF DOGWOOD
205A BELLE MEADE POINTEFLOWOODMS39232PHYSICIAN CLINIC
ST DOMINIC'S OUTREACH PROGRAM-MAGEE
360 SIMPSON HWY 149 SUITE 220MAGEEMS39111PHYSICIAN CLINIC
ST DOMINIC'S FAMILY MEDICINE
1777 ELLIS AVENUEJACKSONMS39204PHYSICIAN CLINIC
ST DOMINIC'S OUTREACH PROGRAM-TELEMEDIC
969 LAKELAND DRIVEJACKSONMS39216PHYSICIAN CLINIC
ST DOMINIC'S OUTREACH PROGRAM-CLEVELAND
810 E SUNFLOWER ROADCLEVELANDMS38732PHYSICIAN CLINIC
ST DOMINIC'S OUTREACH PROGRAM-VICKSBURG
4204 CLAY STREETVICKSBURGMS39180PHYSICIAN CLINIC
ST DOMINIC'S OUTREACH PROGRAM-GREENVILL
1502 S COLORADO STREETGREENVILLEMS38703PHYSICIAN CLINIC
ST DOMINIC'S OUTREACH PROGRAM-PELAHATCH
610 2ND STREETPELAHATCHIEMS39145PHYSICIAN CLINIC
ST DOMINIC'S OUTREACH PROGRAM-KOSCIUSKO
332 HIGHWAY 12 WESTKOSCIUSKOMS39090PHYSICIAN CLINIC
ST DOMINIC'S OUTREACH PROGRAM-BROOKHAVE
427 HWY 51NBROOKHAVENMS39601PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:St. Dominic Hospital has a discount policy that is based on federal poverty guidelines with a sliding scale that offers discounts ranging from 20% to 100%. In addition, St. Dominic offers a 68% discount off gross charges to all uninsured patients.
PART I, LINE 6A:The community benefit report for St. Dominic Hospital is consolidated with the parent organization, St. Dominic Health Services, Inc. The report is available at 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 7, COLUMN (F):The bad debt expense included on form 990, part IX, line 25(a) but subtracted for purposes of calculating the percentage in this column is $26,565,658.
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:St. Dominic Hospital provides significant support to its community through a variety of ways including free health screenings at local schools, participation in various non- profit boards as well as financial support through cash donations.
PART III, LINE 2:The amount reported in part III, line 2 as bad debt expense matches the amount of bad debt expense reported on the Hospital's audited financial statements.
PART III, LINE 3:St. Dominic Hospital frequently has patient accounts that are initially written off as a bad debt expense, but later (through a screening process) it is determined that the patient does qualify for financial assistance under the Hospital's financial assistance policy. The percentage of accounts is estimated to be 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 uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a provision for uncollectible accounts in the period of service on the basis of their past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Hospital's allowance for doubtful accounts for self-pay patients increased from 64% of self-pay accounts receivable at December 31, 2016, to 72% of self-pay accounts receivable at December 31, 2017. In addition, the Hospital's self-pay bad debt write-offs increased from approximately $19,422,000 in 2016 to $24,067,000 in 2017.
PART III, LINE 8:The shortfall should not be included in the community benefit total.
PART III, LINE 9B:St. Dominic Hospital has a board approved collection policy and has written contracts in place with its collection agencies so the appropriate collection activities are followed. The collection agencies that St. Dominic's 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:Needs assessment St. Dominic Hospital assesses the community it serves through various sources which include: 1) analysis of the payor source and disease categories of patients treated at St. Dominic Hospital with particular analysis done on patients presenting to its emergency department; 2) feedback from the board members who represent the community it serves; 3) requests made from the community; and 4) public health information.
PART VI, LINE 3:Patient education of eligibility for assistance St. Dominic Hospital works to educate its patients and community on assistance options by: 1-posting signage in the emergency room and other registration areas informing patients that financial assistance is available. 2-providing brochures in the waiting rooms and at the registration desks that explain the billing and collection process as well as information about the 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-educating 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:Community information The community served by the hospital, including geographic and demographic areas, is addressed in the 2016-2018 community health needs assessment. The CHNA can be accessed at: https://www.stdom.com/about-us/community-benefit-and-needs/.
PART VI, LINE 5:Promotion of community health 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. Dominics 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:Affiliated health care system 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), First Intermed Corporation (physician clinics) and St. Dominic Madison Health Services, Inc. (a medical office building and fitness center). In addition, St. Dominic Health Services operates Community Health Services St. Dominic, Inc., which incorporates the outreach services of The Club at St. Dominic's, New Directions for over 55, St. Dominic Community Health Clinic, Madison school nurse program and the Care-a-Van screening program. As a whole, all of the services, entities and Hospital are collectively referred to as St. Dominic's. St. Dominic's seeks to 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's strives to not only provide care for the sick but also to offer education and wellness services to improve the health status of the community and help eliminate risk factors for more serious health problems.
PART VI, LINE 7:State filing of community benefit report St. Dominic Hospital (consolidated with St. Dominic Health Services, Inc.) prepares annually a community benefit report which is distributed to key members of the local community and state government. However, there are currently no requirements to do so in the State of Mississippi.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
100 BLACK MEN OF JACKSON
5360 HIGHLAND DRIVEJACKSONMS39286640817928501(C)(3)$30,000GENERAL SUPPORT
BEGINNING AGAIN IN CHRIST
PO BOX 26BRANDONMS39042640592123501(C)(3)$15,000GENERAL SUPPORT
BOY SCOUTS OF AMERICA
855 RIVERSIDE DRJACKSONMS39202640303071501(C)(3)$32,000GENERAL SUPPORT
CATHOLIC CHARITIES
850 East River PlaceJACKSONMS39201640466850501(C)(3)$155,000GENERAL SUPPORT
CENTER FOR THE PREVENTION OF VIOLENCE
PO BOX 6279PEARLMS39288581959108501(C)(3)$35,000GENERAL SUPPORT
COMMUNITY HEALTH SERVICES
970 LAKELAND DRJACKSONMS39216640884870501(C)(3)$175,000AFFILIATE SUPPORT
MISSION MISSISSIPPI
PO BOX 22655JACKSONMS39225640824240501(C)(3)$35,000GENERAL SUPPORT
OPERATION SHOESTRING
1711 BAILEY AVENUEJACKSONMS39283640471554501(C)(3)$25,000GENERAL SUPPORT
REAL CHRISTIAN FOUNDATION
PO BOX 180059RICHLANDMS39218640885750501(C)(3)$35,000GENERAL SUPPORT
SOUTHERN CHRISTIAN SERVICES
860 E RIVER PL STE 104JACKSONMS39202640758344501(C)(3)$12,500GENERAL SUPPORT
TUTWILER COMMUNITY EDUCATION CENTER INC
PO BOX 448TUTWILERMS38963581887449501(C)(3)$20,000GENERAL SUPPORT
ST DOMINIC HEALTH SERVICES INC
969 LAKELAND DRIVEJACKSONMS39216640714999501(c)(3)$1,500,000AFFILIATE SUPPORT
LEADERSHIP NEXT GENERATION PLUS
842 N PRESIDENT STREETJACKSONMS39202471606134501(C)(3)$10,000GENERAL SUPPORT
METHODIST CHILDREN'S HOMES
PO BOX 66CLINTONMS39060640303087501(C)(3)$20,000GENERAL SUPPORT
MISSISSIPPI HOUSING PARTNERSHIP
PO BOX 22987JACKSONMS39225640816305501(C)(3)$10,000GENERAL SUPPORT
NEWK'S CARES
2680 CRANE RIDGE DRIVEJACKSONMS39216270705547501(C)(3)$25,000GENERAL SUPPORT
THE WINGARD HOME
1279 N WEST STREETJACKSONMS39202203861994501(C)(3)$13,000GENERAL SUPPORT
GRACE HOUSE SERVICES
PO BOX 68924JACKSONMS392868924640836580501(c)(3)$10,000GENERAL SUPPORT
CANOPY CHILDRENS SOLUTIONS
1465 LAKELAND DRIVEJACKSONMS39216640303085501(C)(3)$25,000GENERAL SUPPORT
MISSION FIRST INC
PO BOX 250JACKSONMS39205640797107501(C)(3)$20,000GENERAL SUPPORT
STEWPOT COMMUNITY SERVICES
1100 WEST CAPITOL STJACKSONMS39203640655566501(C)(3)$15,000GENERAL SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org21Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPS/TUITION REIMBURSEMENTGrantTypeTxt
Recipient45RecipientCnt
Cash Grant$95,863CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt
CLAUDE W HARBARGER
DIRECTOR$801,984$0$46,335$103,990$11,738$964,047$0
LESTER K DIAMOND
PRESIDENT$593,948$0$28,181$73,462$16,326$711,917$0
JENNIFER SINCLAIR
EXECUTIVE VP - OPERATIONS$387,358$0$11,389$47,893$8,370$455,010$0
KEITH VAN CAMP
VP - INFORMATION TECHNOLOGY$329,417$0$4,988$32,665$380$367,450$0
RAYMOND SWARTZFAGER
VP - BUSINESS DEVELOPMENT$276,857$0$0$30,152$8,244$315,253$0
THERESA A HORNE
VP - PATIENT CARE SERVICES$259,775$0$0$18,271$8,228$286,274$0
JOHN LANCON
PHYSICIAN$1,157,236$48,188$60,271$0$15,607$1,281,302$0
D P SEAGO
PHYSICIAN$899,311$0$44,966$0$8,511$952,788$0
PB KERR
PHYSICIAN$891,571$48,259$46,992$0$14,527$1,001,349
VERN A KELLER
PHYSICIAN$1,036,692$0$51,835$0$16,327$1,104,854$0
FRANK LENOIR
VP - HUMAN RESOURCES$272,068$0$0$27,764$7,171$307,003$0
MICHAEL L SANDERS
INTERIM VP - MEDICAL AFFAIRS$316,746$0$0$16,200$13,960$346,906$0
SAMUEL T SCOTT
VP - FINANCE$323,117$0$0$17,925$15,730$356,772$0
TANDRA R DAVISON
VP - QUALITY & PERFORMANCE$224,760$0$0$16,159$7,115$248,034$0
DAVID C HENRY
VP - CLINICAL OPERATIONS$216,015$0$0$15,484$11,731$243,230$0
DAVID W SINCLAIR
VP - NETWORK ADMINISTRATION$282,445$0$1,253$19,662$7,954$311,314$0
ERIC A MCVEY
EXEC VP - MEDICAL AFFAIRS$362,154$0$0$0$11,688$373,842$0
ZACHARY K BALDWIN
PHYSICIAN$874,020$0$43,701$0$16,327$934,048$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4B:FormAndLineReferenceDesc
ExplanationEFFECTIVE FOR THE PLAN YEAR BEGINNING 1/1/2013, THE EXECUTIVE COMPENSATION COMMITTEE ADOPTED A NON QUALIFIED RESTORATION PLAN THAT PROVIDES 5% OF PAY FOR SALARY IN EXCESS OF THE IRS LIMIT (CODE SECTION 401(A)(17)). THE PAYOUTS BEGAN IN FIRST QUARTER 2014, WHICH ARE INCLUDED IN THE FORM W-2 BOX 5 WAGES AND REFLECTED IN OTHER REPORTABLE COMPENSATION ON SCHEDULE J. THESE AMOUNTS ARE: LESTER K. DIAMOND - 28,181 JENNIFER SINCLAIR - 11,389 KEITH VAN CAMP - 4,988 DAVID W. SINCLAIR - 1,253 CLAUDE HARBARGER - 46,335 DEFERRED AMOUNTS UNDER THE 457(F) PLAN REFLECTED IN RETIREMENT AND OTHER DEFERRED COMPENSATION ON SCHEDULE J INCLUDE: LESTER K. DIAMOND - 61,726 JENNIFER SINCLAIR - 28,515 CLAUDE HARBARGER - 84,419 FRANK LENOIR - 10,296 KEITH VAN CAMP - 13,094 SAMUEL T. SCOTT - 9,490 RAYMOND SWARTZFAGER - 10,581 THERESA HORNE - 9,845 TANDRA R. DAVISON - 8,810 DAVID C. HENRY - 8,330 DAVID W. SINCLAIR - 11,227ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonMELANIE GRAFTONPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionSEE PART VRelationshipDescriptionTxt
Transaction$82,324TransactionAmt
TransactionSEE PART VTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

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

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 officers of the Hospital.
FORM 990, PART VI, SECTION A, LINE 7B:The Board of Directors of the sole member of St. Dominic-Jackson Memorial Hospital, St. Dominic Health Services, Inc., has the right to approve the formation of, or participation in, any joint venture or partnership of the Hospital. St. Dominic Health Services, Inc.'s Board of Directors also has the right to approve any dissolution or merger enacted by the Hospital. If the Hospital's Board of Directors has a stalemate in any vote, the final decision rests with the Board of Directors of its sole member, St. Dominic Health Services, Inc. The General Council of the Dominican Sisters of Springfield Illinois has the authority to break any tie vote of the Board of Directors of St. Dominic Health Services, Inc.
FORM 990, PART VI, SECTION B, LINE 11:The Board has delegated review of the form 990 to the Finance Committee of the board prior to filing. A full copy, as approved by the Finance Committee, is provided to the Board.
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:The executive compensation committee of the board of St. Dominic Health Services administers the organizations executive compensation program. The executive compensation committee is responsible for establishing and maintaining a competitive compensation program for the key executives of the organization. The executive compensation committee meets as needed to review the compensation program and make recommendations for any changes as appropriate. The executive compensation committee commissions an annual review by an independent consulting firm to evaluate the organization's executive compensation program against the competitive market. The evaluation is reviewed in the first quarter of each year and is intended to ensure that the compensation program falls within a reasonable range of competitive practices for comparable positions among similarly situated organizations as described in section 4958 of the internal revenue code. Following this review, the committee reviews and approves, for selected key executives, base salary and total compensation ranges for the upcoming year. The executive compensation committee maintains minutes and records to ensure that it can claim the rebuttable presumption of reasonable compensation for purposes of section 4958. The President for the Hospital assigns pay changes for the upcoming year for each of the Hospital executives within the limits established by the executive compensation committee. The President of St. Dominic Health Services, Inc., in conjunction with the Chair of St. Dominic-Jackson Memorial Hospital Board of Directors, assigns the pay change for the President (chief executive officer) of St. Dominic-Jackson Memorial Hospital within the limits established by the executive compensation committee. Key executives of the organization may attend the committee meeting of the executive compensation committee to provide the information needed by such committee. These executives are excused and the executive compensation committee meets in executive session to render its recommendations.
FORM 990, PART XI, LINE 9:Pension Related Changes- 27,057,058 Intercompany Transactions- (484388) Other Changes in Net Assets: 26,572,670
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.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
ST DOMINIC MEDICAL ASSOCIATES
969 LAKELAND DRIVEJACKSONMS39216261969846HEALTHCAREMS$49,024,924$8,941,237SDJMH
ST DOMINIC HOSPITAL MEDICINE LLC
969 LAKELAND DRIVEJACKSONMS39216814908606HEALTHCAREMS$1,315,727$1,384,005SDJMH

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
ST DOMINIC HEALTH SERVICES FOUNDATION
969 LAKELAND DRIVEJACKSONMS39216431992975FUNDRAISINGMS501(C)(3)7SDHSfalse
ST DOMINIC HEALTH SERVICES INC
969 LAKELAND DRIVEJACKSONMS39216640714999HOLDING CO.MS501(C)(3)12-INAfalse
ST CATHERINE'S VILLAGE INC
969 LAKELAND DRIVEJACKSONMS39216640714997RET HOMEMS501(C)(3)10SDHSfalse
COMMUNITY HEALTH SERVICES - ST DOMINIC
969 LAKELAND DRIVEJACKSONMS39216640884870HLTH PROGRAMMS501(C)(3)10SDHSfalse
CONGREGATION OF THE DOMINICAN SISTERS
1237 WEST MONROE STSPRINGFIELDIL62704370968955CONGREGATIONIL501(C)(3)1NAfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
ST DOMINIC AMBULATORY SURGERY CENTER
971 LAKELAND DRIVE SUITE 200JACKSONMS39216640908713HEALTHCAREMSNAfalsefalse
HIGHLAND MEDICAL ARTS LLC
PO BOX 55769JACKSONMS39296743073171MEDICAL BLDGMSNAfalsefalse
D1 SPORTS TRAINING OF MS LLC
7115 SOUTH SPRINGS DRIVEFRANKLINTN37067275277568ATHLETIC TRAIMSNAfalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPct
ST DOMINIC MADISON HEALTH SERVICES INC
969 LAKELAND DRIVEJACKSONMS392164699202870254HEALTHCAREMSSDHSC CORPfalse
FIRST INTERMED CORPORATION
308 CORPORATE DRIVERIDGELANDMS39157640824796MEDICAL SERVICESMSSDHSC CORPfalse
ST DOMINIC INTEGRATED SERVICES INC
969 LAKELAND DRIVEJACKSONMS392164699271493623INVESTMENTSMSSDJMHC CORPYes (true)$661,690$4,381,1851.00000
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ST DOMINIC INTEGRATED SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeQTransactionTypeTxt
Involved$83,743InvolvedAmt
Method Of Amount DeterminationCASHMethodOfAmountDeterminationTxt