2017-11-15T08:10:32-06:00 2016-12-31 BKD LLP 190 E Capitol Street Ste 500 Jackson MS 392012190 990 2016-01-01 640714999 St Dominic Health Services Inc % DEIDRA S BELL STDO 6012006844 969 Lakeland Drive Jackson MS 392164699 CLAUDE W HARBARGER PRESIDENT 6012006642 2017-11-15 true Dustin W Taylor CPA P01250644 6019486700 2017-11-15 167.68.126.162 64248120173195000000 2017-11-15 P 74CF8E2DF6EBF5F986EFE73E85371C9B6A8296EA CF5319EC68413B756C2D890789F1DA1A3337D355 2016 2017-02-10 21:41:12Z Claude W Harbarger 969 Lakeland Drive Jackson MS 392164699 17756127 false X www.stdom.com X 1985 MS A not for profit membership corporation, that is the sole member for St. Dominic-Jackson Memorial Hospital, St. Catherine's Village, Inc., (continues on schedule O) 9 8 48 8 118514 1500000 1750000 1951626 2218416 7781637 3124072 0 0 11233263 7092488 2081212 2502113 0 0 4390473 4618286 0 0 804983 4330253 4893617 10801938 12014016 431325 -4921528 246664112 244533462 98045562 98765348 148618550 145768114 INSPIRED BY THE TEACHINGS OF JESUS CHRIST AND THE WITNESS OF ITS FOUNDING DOMINICAN SISTERS, ST. DOMINIC'S PROVIDES COMPASSIONATE CARE AND HOPE AS A HEALING MINISTRY OF THE CATHOLIC CHURCH. CARING FOR THE SICK, THE INJURED, AND THE DYING IS A VISIBLE, PUBLIC CONTINUATION OF CHRIST'S HEALING MINISTRY. PROMOTING THE WELL BEING OF INDIVIDUALS AND THE COMMUNITY ARE ADDITIONAL SIGNS OF ST. DOMINIC'S COMMITMENT TO THE COMMON GOOD. JUST AS JESUS CAME TO MAKE HIS FATHER KNOWN AND LOVED, SO ST. DOMINIC'S, THROUGH WORKS OF MERCY, SEEK TO EXTEND THIS MISSION. false false 4148569 2218416 St. Dominic Health Services (SDHS) is the parent company of a multi dimensional provider of health care services with corporate 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. Adult congregate living facility with 247 independent living beds and 54 assisted living beds II. Licensed nursing home with 120 beds III. Licensed 60-bed Memory Support unit Community Health Services - St. Dominic, Inc. I. The Club (St. Dominic's Community Wellness Program) provides fitness services with an emphasis on medical fitness for those recovering from illness and for senior adults. 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 13 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 2502113 2502113 INSPIRED BY THE TEACHINGS OF JESUS CHRIST AND THE WITNESS OF OUR FOUNDING DOMINICAN SISTERS, SDHS PROVIDES COMPASSIONATE CARE AND HOPE AS A HEALING MINISTRY OF THE CATHOLIC CHURCH. SDHS SUPPORTS THE CONGREGATION OF DOMINICAN SISTERS OF SPRINGFIELD ILLINOIS THROUGH ITS SUPPORT OF OTHER CHARITABLE ORGANIZATIONS IN THE COMMUNITY THAT HAVE MISSIONS IN COMMON WITH THE CHURCH. 6650682 true true false true false false false false false false true true false false true false false true false false true false false false false false false true false true false false false false false false false false false false false false false true true true false false true 25 0 48 true true true false false false false false false false false false X 9 8 false false false false true true true true true false false true true true true true true true true false X DEIDRA S BELL 6012006642 969 LAKELAND DRIVE JACKSON MS 392164699 Sister M Dorothea Sondgeroth Vice Chairman 40.0 0.5 X X 0 0 0 Sister Mary Trinita Eddington Secretary 4.0 37.0 X X 0 0 0 Richard Hickson Director 1.0 0.0 X 0 0 0 E B Robinson Director 1.0 0.0 X 0 0 0 Marcelo J Ruvinsky MD Chairman 1.0 0.0 X X 0 0 0 Claude W Harbarger President 40.0 2.0 X X 844189 0 108728 Sister Kathleen Gallagher Director 1.0 0.0 X 0 0 0 Bishop Joseph Kopacz Director 1.0 0.0 X 0 0 0 Sister Beth Murphy Director 1.0 0.0 X 0 0 0 Deidra S Bell Treasurer & CFO 40.0 2.0 X 449398 0 53397 JAMES JETER EXECUTIVE DIRECTOR OF FDN 0.0 40.0 X 242870 0 37970 FRANK LENOIR VP OF HUMAN RESOURCES 16.0 24.0 X 257388 0 19698 KAREN THOMAS CONTROLLER 40.0 0.0 X 137611 0 12828 WILLIAM SCRUGGS SPECIAL PROJECTS COORDINATOR 40.0 0.0 X 105898 0 23596 JONATHAN WERNE VP - LEGAL SERVICES 40.0 0.0 X 146801 0 13556 2184155 0 269773 7 false true false FOX EVERETT PO BOX 6006 RIDGELAND MS 391586006 Administrative 699670 BRUNINI GRANTHAM GROWER HEWES PO DRAWER 119 JACKSON MS 39205 LEGAL SERVICES 687146 AETNA PO BOX 70944 CHICAGO IL 60673 ADMINISTRATIVE 441807 DOMINICAN SISTERS OF SPRINGFIELD I 1237 WEST MONROE ST SPRINGFIELD IL 627041680 CONTRACT SERVICES 377168 IRONSHORE INSURANCE SERVICES LLC 605 RENAISSANCE WAY RIDGELAND MS 39157 ADMINISTRATIVE 335665 14 1750000 1750000 Management Revenue 561000 890004 890004 Other Revenue 561499 694322 694322 Health Service Revenue 531120 634090 634090 2218416 993577 118514 875063 0 0 0 0 0 12794134 10663639 2130495 2130495 2130495 0 0 0 0 0 0 0 0 0 0 7092488 2218416 118514 3005558 2502113 2502113 0 0 0 1455713 1455713 0 2367187 1854098 513089 496255 483238 13017 127526 90299 37227 171605 154657 16948 0 399063 397455 1608 88171 74891 13280 48000 48000 0 32657 32657 813604 744764 68840 80975 76621 4354 41101 39526 1575 26905 26905 0 123676 123676 0 0 123951 114558 9393 376862 376862 0 994247 993525 722 38427 38427 ADMIN SUNDRY 947480 938393 9087 MISC BLDG EXPENSE 360684 360684 SUPPLIES 134968 133437 1531 FUNDRAISING CAMPAIGN 99859 99859 162987 148534 14453 12014016 6650682 4558351 804983 1207322 1956848 0 0 0 0 0 0 0 0 0 0 8138842 11042359 0 0 39260 12159 41407775 7007665 35823268 34400110 0 0 200481546 198160715 0 0 0 0 973874 -1038729 246664112 244533462 18659032 18864228 0 0 0 0 0 0 0 0 0 0 0 0 1201700 0 78184830 79901120 98045562 98765348 X 148618550 145768114 0 0 0 0 148618550 145768114 246664112 244533462 X -4921528 3909054 -1837962 X false true X true false X X 22 ALZHEIMER'S ASSOCIATION 640786327 7 false 7500 0 AMERICAN CANCER SOCIETY 131788491 7 false 58333 0 AMERICAN HEART ASSOCIATION 135613797 7 false 25000 0 BB KING MUSEUM 460501512 7 false 10000 0 CATHOLIC CHARITIES 640466850 9 false 13000 0 CATHOLIC DIOCESE OF JACKSON 640303073 1 false 25000 0 FONDREN RENAISSANCE 640873626 7 false 9000 0 FOUNDATION FOR MS HISTORY 202649529 7 false 20000 0 GREATER JACKSON CHAMBER OF COMMERCE 640180340 7 false 19975 0 JACKSON HEART FOUNDATION 270723542 7 false 20000 0 JACKSON ZOO 640933460 7 false 7000 0 JUNIOR LEAGUE OF JACKSON 646011106 7 false 10000 0 MISSISSIPPI CHILDREN'S MUSEUM 640850010 7 false 25000 0 MISSISSIPPI OPERA 237113188 7 false 10000 0 MISSISSIPPI SYMPHONY ORCHESTRA 640273405 7 false 30800 0 NATIONAL MULTIPLE SCLEROSIS SOCIETY 135861935 7 false 7500 0 OUR LADY OF THE LAKE FDN FRANCISCAN RELIEF FUND 721014324 7 false 10000 0 PAUL LACOSTEFIT 4 CHANGE 261219564 7 false 40000 0 ST CATHERINE'S VILLAGE 640714997 10 false 611251 0 ST JOSEPH CATHOLIC SCHOOL 640354039 2 false 80000 0 COMMUNITY HEALTH SERVICES - ST DOMINIC 640884870 7 false 1339344 0 THE CONGREGATION OF DOMINICAN SISTERS OF SPRINGFIELD IL 370968955 1 true 0 0 22 2378703 false true false false false false false false false false false false false false false true true PART IV, SECTION A, LINE 1: SDHS IS A SUPPORTING ORGANIZATION THAT IS OPERATED, SUPERVISED, OR CONTROLLED BY ITS SUPPORTED ORGANIZATION, THE CONGREGATION OF DOMINICAN SISTERS OF SPRINGFIELD ILLINOIS. SDHS' CHARTER OF INCORPORATION STATES THAT IT IS ORGANIZED, AND AT ALL TIMES OPERATED, EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, AND TO CARRY OUT THE PURPOSES OF THE CONGREGATION OF DOMINICAN SISTERS OF SPRINGFIELD ILLINOIS AND THE ROMAN CATHOLIC CHURCH. THE PRIMARY PURPOSES, AS DESCRIBED IN THE CHARTER OF INCORPORATION, INCLUDE: 1. TO OWN AND/OR OPERATE A GENERAL HOSPITAL COMPRISING FACILITIES FOR DIAGNOSIS AND TREATMENT OF MEDICAL, SURGICAL AND PSYCHIATRIC PATIENTS (AND ASSOICATED SERVICES SUCH AS, BUT NOT LIMITED TO, EXTENDED CARE, OUTPATIENT CARE, AND HOME CARE). 2. TO PROVIDE HEALTH SERVICES ACCORDING TO THE NEEDS OF THE COMMUNITY SERVED THROUGH A CONTINUAL DEVELOPMENT OF NEW IDEAS, TALENTS AND RESOURCES IN HEALTH, EDUCATION AND RESEARCH. 3. TO MAINTAIN SAFE, HARMONIOUS AND EFFICIENT INSTITUTIONS TO DELIVER MEDICAL AND GENERAL HEALTH CARE SERVICES. 4. TO CARRY ON EDUCATIONAL AND RESEARCH ACTIVITIES RELATING TO HEALTH CARE AND ITS FURTHERANCE. 5. TO PARTICIPATE IN ACTIVITIES SUCH AS DISASTER AND SAFETY PROGRAMS DESIGNED AND CARRIED OUT TO PROMOTE AND SAFEGUARD THE GENERAL HEALTH OF THE COMMUNITY. 6. TO PROVIDE FOR THE SPIRITUAL AND PHYSICAL WELFARE OF THE SICK AND AFFLICTED WITHOUT REGARD TO RACE, COLOR, AGE, SEX, POLITICAL OR RELIGIOUS BELIEF AND TO EXEMPLIFY A SPIRIT OF ECUMENISM AND CHRIST-LIKE CHARITY IN ALL ITS AREAS OF HEALTH CARE ACTIVITIES AND IN ALL PHASES OF HUMAN RELATIONS. 7. TO PROVIDE, WITHIN THE CORPORATION'S REASONABLE FINANCIAL MEANS, CHARITABLE SERVICES FOR THOSE FOUND TO BE MEDICALLY OR OTHERWISE INDIGENT. 8. TO ESTABLISH AND OPERATE RETIREMENT FACILITIES FOR THE AGED, WHERE CONSISTENT WITH ITS MISSION. 9. TO ESTABLISH AND OPERATE NURSING HOMES, HOSPICES AND HOME HEALTH AGENCIES, WHERE CONSISTENT WITH ITS MISSION. 10. TO ESTABLISH AND OPERATE AMBULATORY CARE FACILITIES AND ANY AND ALL OTHER OUTREACH OR OUTPATIENT CLINICAL SERVICES. 11. TO ESTABLISH, MAINTAIN AND OPERATE ANY OTHER MEDICAL OR HEALTH RELATED FACILITY OR PROGRAM THAT IS NOT INCONSISTENT WITH ITS MISSION. SDHS IS TO APPLY FUNDS AT SUCH TIME, IN SUCH MANNER, AND IN SUCH AMOUNTS AS IT DETERMINES FOR THE USES AND PURPOSES STATED ABOVE, OR IT MAY MAKE CONTRIBUTIONS TO OTHER CHARITABLE ORGANIZATIONS TO BE USED WITHIN THE UNITED STATES FOR SUCH PURPOSES OR USES. SDHS RECOGNIZES ITS BASIC PARTICIPATION IN THE MISSION OF THE CHURCH, WHICH INVOLVES TWO MAIN MINISTRIES: EDUCATION AND HEALTHCARE. SDHS SUPPORTS THE CONGREGATION THROUGH ITS SUPPORT OF OTHER CHARITABLE ORGANIZATIONS IN THE COMMUNIUTY THAT HAVE MISSIONS IN COMMON WITH THE CHURCH. ALL ORGANIZATIONS LISTED AS BEING SUPPORTED BY SDHS HAVE AN EDUCATIONAL OR HEALTH CARE RELATED MISSION OR ARE ORGANIZATIONS THAT PROVIDE BENEFITS TO THE COMMUNITY IN WHICH SDHS IS LOCATED, WHICH INDIRECTLY IMPACTS EDUCATION AND HEALTHCARE WITHIN THE COMMUNITY. PART IV, SECTION A, LINE 2: THE FOLLOWING ORGANIZATIONS DO NOT HAVE AN IRS DETERMINATION OF STATUS UNDER SECTION 509(A)(1) OR (2): CATHEDRAL OF ST. PETER THE APOSTLE CATHOLIC DIOCESE OF JACKSON THE ABOVE ORGANIZATIONS ARE CONSIDERED RELIGIOUS ORGANIZATIONS THAT MAY NOT BE REQUIRED TO OBTAIN RECOGNITION OF ITS PUBLIC CHARITY STATUS. PART IV, SECTION B, LINE 2: AS STATED IN SDHS' BYLAWS, ITS PURPOSE IS TO SERVE AS A VISIBLE WITNESS TO THE CHURCH'S MISSION OF CONTINUING CHRIST'S WORK ON EARTH BY CARING FOR THE SICK, THE SUFFERING, AND THE DYING; BY PROVIDING COMPREHENSIVE HEALTH SERVICES TO THE TOTAL PERSON IN KEEPING WITH THE TEACHINGS OF THE CATHOLIC CHURCH AND THE MISSION CHARTER ESTABLISHED BY THE CONGREGATION OF DOMINICAN SISTERS OF SPRINGFIELD ILLINOIS; AND BY PROMOTING THE HEALTH AND WELFARE OF THE COMMUNITY. SDHS SUPPORTS THE PURPOSE AND MISSION OF THE CONGREGATION BY PROVIDING SUPPORT TO OTHER CHARITABLE ORGANIZATIONS THAT HAVE A COMMON GOAL AND PURPOSE. IT IS THROUGH THIS SUPPORT THAT SDHS IS ABLE TO PROMOTE THE WELL BEING OF INDIVIDUALS AND THE COMMUNITY, DEMONSTRATING ITS COMMITTMENT TO THE COMMON GOOD. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 48000 false false 48000 false PART II-B, LINE 1G: ST. DOMINIC HEALTH SERVICES, INC. PAID A LOBBYING CONSULTANT WHO HAD DIRECT CONTACT WITH LEGISLATORS TO DISCUSS VARIOUS PUBLIC POLICY ISSUES AND LEGISLATIVE MATTERS. 24704209 24704209 12548832 5466678 7082154 1561422 1046399 515023 2593312 494588 2098724 34400110 EMPLOYEE BENEFIT TRUST 16425967 F SELF INSURED TRUST 51046009 F IMP TRUST FUNDS 130688739 F 198160715 0 Employee Benefit Trust 16425967 Due from Related Party 63475153 79901120 Part X, Line 2: MANAGEMENT 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. Central America and the Caribbean Investments 11956795 Central America and the Caribbean Investments 14871955 Central America and the Caribbean Investments 11078758 37907508 37907508 false false true true true false PART I, LINE 3: ST. DOMINIC HEALTH SERVICES, INC. OWNS AN INTEREST IN CREDIT SUISSE DOLLAR SENIOR LOAN FUND, BREVAN HOWARD MULTI-STRATEGY FUND LIMITED, AND OZ OVERSEAS FUND II, LTD., HEDGE FUNDS DOMICILED IN THE CAYMAN ISLANDS. THE BOOK VALUE OF THESE INVESTMENTS AS OF 12/31/2016 WAS $11,956,795, $11,078,758 AND $14,871,955 RESPECTIVELY. PART IV, LINE 3: ST. DOMINIC HEALTH SERVICES, INC. (SDHS) WAS NOT REQUIRED TO FILE FORM 5471 DURING THE FISCAL YEAR ENDED 12/31/2016 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 12/31/2016 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. true Alzheimer's Association 1900 Dunbarton Ste H Jackson MS 39216 640786327 501(c)(3) 7500 Financial support AMERICAN CANCER SOCIETY 1380 LIVINGSTON LANE JACKSON MS 39213 131788491 501(c)(3) 58333 FINANCIAL SUPPORT AMERICAN HEART ASSOCIATION 4830 MCWILLIE CIRCLE JACKSON MS 39206 135613797 501(c)(3) 25000 FINANCIAL SUPPORT JACKSON HEART FOUNDATION PO BOX 5021 JACKSON MS 39216 270723542 501(c)(3) 20000 FINANCIAL SUPPORT BB KING MUSEUM 400 2ND ST INDIANOLA MS 38751 460501512 501(c)(3) 10000 SPONSORSHIP CATHOLIC CHARITIES PO BOX 2248 JACKSON MS 39225 640466850 501(c)(3) 13000 SPONSORSHIP CATHOLIC DIOCESE OF JACKSON PO BOX 2248 JACKSON MS 39225 640303073 501(c)(3) 25000 FINANCIAL SUPPORT FONDREN RENAISSANCE 2906 NORTH STATE ST JACKSON MS 39216 640873626 501(c)(3) 9000 FINANCIAL SUPPORT JACKSON ZOO 2918 W CAPITOL ST JACKSON MS 39209 640933460 501(c)(3) 7000 FINANCIAL SUPPORT MISSISSIPPI CHILDREN'S MUSEUM 2660 RIDGEWOOD RD JACKSON MS 39216 640850010 501(c)(3) 25000 FINANCIAL SUPPORT MISSISSIPPI OPERA PO BOX 1551 JACKSON MS 39215 237113188 501(c)(3) 10000 FINANCIAL SUPPORT MISSISSIPPI SYMPHONY ORCHESTRA 201 E PASCAGOULA JACKSON MS 39201 640273405 501(c)(3) 30800 SPONSORSHIP ST JOSEPH CATHOLIC SCHOOL PO BOX 1220 JACKSON MS 39216 640354039 501(c)(3) 80000 FINANCIAL SUPPORT COMMUNITY HEALTH SERVICES - ST DOMINIC 969 LAKELAND DRIVE JACKSON MS 39216 640884870 501(C)(3) 1339344 AFFILIATE SUPPORT NATIONAL MULTIPLE SCLEROSIS SOCIETY 733 THIRD AVE NEW YORK NY 10017 135861935 501(c)(3) 7500 FINANCIAL SUPPORT FOUNDATION FOR MS HISTORY PO BOX 571 JACKSON MS 392050571 202649529 501(C)(3) 20000 FINANCIAL SUPPORT GREATER JACKSON CHAMBER OF COMMERCE PO BOX 22548 JACKSON MS 39255 640180340 501(C)(3) 19975 FINANCIAL SUPPORT JUNIOR LEAGUE OF JACKSON PO BOX 4709 JACKSON MS 39296 646011106 501(C)(3) 10000 FINANCIAL SUPPORT PAUL LACOSTEFIT 4 CHANGE PO BOX 1998 RIDGELAND MS 39158 261219564 501(C)(3) 40000 FINANCIAL SUPPORT THE ROBERTS GROUP 25 E PINE ST ZIONSVILLE IN 46038 352079400 N/A 10000 FINANCIAL SUPPORT OUR LADY OF THE LAKE FDN FRANCHISE RELIEF FUND 7777 HENESSEY BLVD BATON ROUGE LA 70808 721014324 501(C)(3) 10000 FINANCIAL SUPPORT ST CATHERINE'S VILLAGE INC 969 LAKELAND DRIVE JACKSON MS 392164699 640714997 501(C)(3) 611251 APPRAISAL LAND AFFILIATE SUPPORT 21 1 Part I, Line 2: 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 project. 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. X X X X false true false false false false false false false Claude W Harbarger President 800176 0 0 0 44013 0 96943 0 11785 0 952917 0 0 0 Deidra S Bell Treasurer & CFO 435529 0 0 0 13869 0 45937 0 7460 0 502795 0 0 0 JAMES JETER EXECUTIVE DIRECTOR OF FDN 242870 0 0 0 0 0 23732 0 14238 0 280840 0 0 0 FRANK LENOIR VP OF HUMAN RESOURCES 257388 0 0 0 0 0 13940 0 5758 0 277086 0 0 0 KAREN THOMAS CONTROLLER 137611 0 0 0 0 0 4531 0 8297 0 150439 0 0 0 JONATHAN WERNE VP - LEGAL SERVICES 146801 0 0 0 0 0 5861 0 7695 0 160357 0 0 0 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 INCLUDED IN THE FORM W-2 BOX 5 WAGES AND REFLECTED IN OTHER REPORTABLE COMPENSATION ON SCHEDULE J INCLUDE: CLAUDE W. HARBARGER - 44,013 DEIDRA BELL - 13,869 DEFERRED AMOUNTS UNDER THE 457(F) PLAN REFLECTED IN RETIREMENT AND OTHER DEFERRED COMPENSATION ON SCHEDULE J INCLUDE: CLAUDE W. HARBARGER - 81,516 DEIDRA BELL - 30,510 JAMES JETER - 9,701 Form 990, Part I, Line 1: COMMUNITY HEALTH SERVICES-ST. DOMINIC, INC., and ST. DOMINIC HEALTH SERVICES FOUNDATION, INC. ST. DOMINIC HEALTH SERVICES, INC. OWNS THE FOR PROFIT STOCK CORPORATIONS - FIRST INTERMED CORPORATION and ST. DOMINIC MADISON HEALTH SERVICES. Form 990, Part VI, Section A, Line 6: The Prioress General, the Vicaress, and the Three Councilors of the governing council of the congregation of Dominican Sisters of Springfield Illinois and as such serves as the sole member of St. Dominic Health Services, Inc. Form 990, Part VI, Section A, Line 7A: The membership has the authority to elect the President/CEO, the Chair of the Board of Directors and the Vice-Chair of the Board of Directors of St. Dominic Health Services, Inc. and to approve the election of all other officers of St. Dominic Health Services, Inc. Form 990, Part VI, Section A, 7B: The membership has the right to approve any dissolution or merger enacted by St. Dominic Health Services, Inc. The Governing Council of the Dominican Sisters of Springfield Illinois has the authority to break any tie vote of the Board of Directors of St. Dominic Health Services, Inc. Form 990, Part VI, Section B, Line 11: Review and approval of the Form 990 is delegated to the Finance Committee, but a copy of the Form 990 is made available electronically to all board members prior to filing with the IRS. Form 990, Part VI, Section B, Line 12C: DIRECTORS AND OFFICERS RECEIVE A COPY OF THE POLICY AND FORM FOR REPORTING EACH YEAR AT THE FIRST MEETING 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 15: The executive compensation of St. Dominic Health Services, Inc. is administered by the executive compensation committee of the board. The executive compensation committee is responsible for establishing and maintaining a competitive compensation program for the key executives of the organization. The executive compensation committee meets as needed to review the compensation program and make recommendations for any changes as appropriate. The executive compensation committee commissions an annual review by an independent consulting firm to evaluate the 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. Following this review, the committee reviews and approves, for selected key executives, base salary and total compensation range for the upcoming year. The executive compensation committee maintains minutes and records to ensure that it can claim the rebuttable presumption of reasonable compensation for purposes of Section 4958. The chair of St. Dominic Health Services, Inc. Board of Directors shall approve the annual pay change for the President (Chief Executive Officer) of St. Dominic Health Services, Inc. within the limits established by the executive compensation committee. The President and Chief Executive Officer of St. Dominic Health Services, Inc. will assign the pay changes for all other subsidiary organization executives within the limits established by the executive compensation committee. The president of St. Dominic-Jackson Memorial Hospital will assign pay changes for the hospital executives. Key executives of the organization may attend the committee meeting of the executive compensation committee to provide the information needed by such committee. These executives are excused and the executive compensation committee meets in executive session to render its recommendations. Form 990, Part VI, Section C, Line 19: The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Form 990, Part XI, Line 9: Intercompany Transactions: 455,496 Pension Related Changes: (169,766) Madison Health Services Revenue: 176,120 First Intermed Corporation Revenue: (2,300,412) Total other changes: (1,837,962) Form 990, Part XII, Line 2c: The Finance Committee meets quarterly and is charged with reviewing the budget, current performance, the audit, and the Form 990. The Finance Committee makes recommendations that are then taken to the full board for final approval. St Catherine's Village Inc 969 Lakeland Drive Jackson MS 39216 640714997 RET Home MS 501(C)(3) 10 SDHS true Community Health Services - St Dominic 969 Lakeland Drive Jackson MS 39216 640884870 Hlth program MS 501(C)(3) 10 SDHS true St Dominic - Jackson Memorial Hospital 969 Lakeland Drive Jackson MS 39216 640303091 Hospital MS 501(C)(3) 3 SDHS true St Dominic Health Services Foundation 969 Lakeland Drive Jackson MS 39216 431992975 FUNDRAISING MS 501(C)(3) 7 SDHS true The Congregation of Dominican Sisters 1237 West Monroe St Springfield IL 62704 370968955 CONGREGATION IL 501(C)(3) 1 NA false St Dominic Ambulatory Surgery Center L 971 Lakeland Drive Suite 200 Jackson MS 39216 640908713 Healthcare MS NA false false Highland Medical Arts LLC PO Box 55769 Jackson MS 39296 743073171 Med Building MS na false false D1 Sports Training of Mississippi LLC 7715 South Springs Drive Franklin TN 37067 275277568 Athletic Training MS na false false St Dominic Madison Health Services Inc 969 Lakeland Drive Jackson MS 39216 202870254 HEALTHCARE MS SDHS C Corp 366467 18613430 1.00000 true First Intermed Corporation 308 Corporate Drive Ridgeland MS 39157 640824796 MED SERVICES MS SDHS C Corp 29260870 5618936 1.00000 true St Dominic Integrated Services Inc 969 Lakeland Drive Jackson MS 39216 271493623 Investments MS NA C Corp false false true true false false false false false false true true true false false true true true false false COMMUNITY HEALTH SERVICES B 1339344 CASH AMOUNT ST CATHERINE'S VILLAGE B 611251 FMV ST DOMINIC - JACKSON MEMORIAL HOSPITAL C 1750000 CASH AMOUNT ST DOMINIC - JACKSON MEMORIAL HOSPITAL J 619014 FMV ST DOMINIC MEDICAL ASSOCIATES J 477808 FMV ST DOMINIC - JACKSON MEMORIAL HOSPITAL L 890000 FMV ST DOMINIC - JACKSON MEMORIAL HOSPITAL O 540000 CASH AMOUNT ST DOMINIC - JACKSON MEMORIAL HOSPITAL P 621546 FMV ST CATHERINE'S VILLAGE Q 466881 FMV ST DOMINIC MEDICAL ASSOCIATES Q 2994631 FMV ST DOMINIC - JACKSON MEMORIAL HOSPITAL Q 15884358 FMV