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← COMMUNITY HEALTH SERVICES-ST DOMINIC INC

Form 990 for tax year 2022

Filed by COMMUNITY HEALTH SERVICES-ST DOMINIC INC.

Totals

Total revenue
$580,134
Total expenses
$1,595,798
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$580,134
Investment income
$0
Other revenue
$0
Total assets, end of year
$246,800
Total liabilities, end of year
$1,974,783
Net assets or fund balances, end of year
-$1,727,983
Program services expenses (Part IX)
$1,138,182
Management and general expenses
$457,616
Fundraising expenses
$0
Program service expenses (Part III)
$1,138,182

Program services were 71.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: THE CLUB AT ST. DOMINI

    total $572,539 · related or exempt $572,539

  • 2b · Program service revenue: OTHER REVENUE

    total $7,595 · related or exempt $7,595

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $746,274 · program services $488,460 · management and general $257,814

  • 8 · Pension plan contributions

    total $20,933 · program services $13,702 · management and general $7,231

  • 9 · Other employee benefits

    total -$5,995 · program services -$3,924 · management and general -$2,071

  • 10 · Payroll taxes

    total $59,609 · program services $39,016 · management and general $20,593

  • 11a · Fees: management

    total $33,502 · management and general $33,502

  • 11g · Fees: other

    total $43,464 · program services $19,973 · management and general $23,491

  • 12 · Advertising and promotion

    total $21,678 · program services $9,962 · management and general $11,716

  • 13 · Office expenses

    total $74,865 · program services $40,875 · management and general $33,990

  • 16 · Occupancy

    total $528,652 · program services $525,366 · management and general $3,286

  • 17 · Travel

    total $842 · program services $387 · management and general $455

  • 23 · Insurance

    total $7,063 · program services -$4,312 · management and general $11,375

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $56,087 · program services $4,622 · management and general $51,465

  • 24b · Other expenses: REPAIRS & MAINTENANCE

    total $8,824 · program services $4,055 · management and general $4,769

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $314,071 · end of year $172,993

  • 4 · Accounts receivable

    beginning of year $3,170 · end of year $3,164

  • 10a · Land, buildings and equipment: cost or other basis

    $111,171

  • 10b · Land, buildings and equipment: accumulated depreciation

    $40,528

  • 10c · Land, buildings and equipment, net

    beginning of year $70,643 · end of year $70,643

  • 15 · Other assets

    beginning of year $20,661

  • 17 · Accounts payable and accrued expenses

    beginning of year $156,113 · end of year $53,284

  • 19 · Deferred revenue

    beginning of year $40,860 · end of year $87,053

  • 25 · Other liabilities

    beginning of year $923,891 · end of year $1,834,446

  • 27 · Net assets without donor restrictions

    beginning of year -$712,319 · end of year -$1,727,983

Mission and programs · 2022

Mission

COMMUNITY HEALTH SERVICES - ST. DOMINIC, INC. (CHS) SHARES THE MISSION STATEMENT OF ITS SOLE CORPORATE MEMBER - ST. DOMINIC HEALTH SERVICES. INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH ALL WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING - WITH REVERENCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED TO OUR CARE. WE ARE, WITH GOD'S HELP, A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILIDGED TO SERVE.

Activities or mission (Part I)

COMMUNITY HEALTH SERVICES PROVIDES COMMUNITY HEALTH PROGRAMS, INCLUDING THE CLUB AT ST. DOMINIC, NEW DIRECTIONS, CARE-A-VAN, AND COMMUNITY OUTREACH.

  • THE CLUB AT ST. DOMINIC'S (THE CLUB) - THE CLUB IS A MEDICAL FITNESS FACILITY PROVIDING A FULL SPECTRUM OF INTEGRATED WELLNESS PROGRAMS AND A WELL-EQUIPPED FITNESS CENTER. THE STAFF PROVIDE FREE EDUCATIONAL PROGRAMS AND WELLNESS SCREENINGS IN THE COMMUNITY AS WELL AS OFFER MEMBERSHIPS BASED ON INCOME FOR A NUMBER OF AT RISK GROUPS. THE CLUB HAD 1,255 MEMBERS AND 920 WELLNESS CONTACTS.

    Expenses $688,395 · Revenue $576,759

  • Withheld by Nonprofiteer: this text may name a private individual.

    Expenses $219,480

  • NEW DIRECTIONS - REALIZING THAT OUR POPULATION IS AN AGING ONE, ST. DOMINIC'S CREATED A WELLNESS PROGRAM TO MEET THE UNIQUE NEEDS OF MATURE ADULTS. THE PROGRAM IS BUILT ON THE PREMISE THAT SOCIAL INTERACTION, ENRICHMENT OPPORTUNITIES, AND WELLNESS EDUCATION HELP PROMOTE HEALTHY, ACTIVE LIFESTYLES AMONG SENIORS. NEW DIRECTIONS HAD 35,957 SOCIAL CONTACTS THAT FOCUSED ON SOCIAL INTERACTION, ENRICHMENT OPPORTUNITIES, AND WELLNESS EDUCATION.

    Expenses $84,086 · Revenue $3,375

  • CARE-A-VAN - CARE-A-VAN IS A MOBILE HEALTH SCREENING PROGRAM. BY USING A MOBILE CLINIC, COMMUNITY HEALTH SERVICES - ST DOMINIC, INC (CHS) CAN TAKE HEALTH SCREENING TO THE MOST VULNERABLE POPULATIONS. THE CLINIC VISITS SENIOR CENTERS, DAYCARE CENTERS, ELEMENTARY SCHOOLS, AS WELL AS COMMUNITY-WIDE WELLNESS FAIRS IN RURAL AND UNDESERVED AREAS OF THE METRO JACKSON AREA. COMMUNITY OUTREACH - CHS CONTINUES ITS MISSION THROUGH COLLABORATING AND NETWORKING WITH COMMUNITY AGENCIES, PROVIDERS, BUSINESS LEADERS AND OTHER GROUPS. THERE ARE MORE THAN 100 COMMUNITY PARTNERS WITH WHICH IT SHARES INFORMATION AND RESOURCES. CHS SEEKS TO CONTINUE TO IDENTIFY AND NURTURE PARTNERS TO MEET THE GROWING NEEDS OF THE COMMUNITIES SERVED.THE COST FOR THESE OUTREACH EFFORTS CONSISTS OF THE DIRECT COSTS FOR THE SERVICES OF THE COMMUNITY LIAISON WHO LEADS THIS PROGRAM.

    Expenses $146,221

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here. A text marked withheld matched a screen for wording that may name a private individual, such as an honorific or "in memory of". Most of what it withholds names no one; it is withheld so that what does is never shown.

Listed in Part VII

  • Laquita Brown

    CHAIR

    Total calculated
    $0
    Hours/week
    0.5

  • Jenny Crutchfield

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • Suman K Das MD

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    0.5

  • Sister Mary Trinita Eddington

    SECRETARY

    Total calculated
    $0
    Hours/week
    36 + 5.25 related

  • Scott Kashman

    MARKET PRESIDENT (THRU 6/2023)

    Total calculated
    $708,506
    From this org
    $0
    From related orgs
    $610,569
    Other
    $97,937
    Hours/week
    0.5 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $499,303 related
    Bonus
    $0 + $108,077 related
    Other
    $0 + $3,189 related
    Deferred
    $0 + $70,852 related
    Nontaxable benefits
    $0 + $27,085 related
    Filer's total
    $0 + $708,506 related

  • Glenda Sutherland

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5

  • Kristin Wolkart

    INTERIM MARKET PRES (START 6/2023)

    Total calculated
    $691,424
    From this org
    $0
    From related orgs
    $575,846
    Other
    $115,578
    Hours/week
    0.5 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $440,832 related
    Bonus
    $0 + $131,783 related
    Other
    $0 + $3,231 related
    Deferred
    $0 + $95,636 related
    Nontaxable benefits
    $0 + $19,942 related
    Filer's total
    $0 + $691,424 related

  • Samuel Scott

    SVP, CFO, TREASURER

    Total calculated
    $516,904
    From this org
    $0
    From related orgs
    $484,817
    Other
    $32,087
    Hours/week
    0.5 + 41.75 related

    Schedule J breakdown matched by us

    Base
    $0 + $321,567 related
    Bonus
    $0 + $157,491 related
    Other
    $0 + $5,759 related
    Deferred
    $0 + $14,175 related
    Nontaxable benefits
    $0 + $17,912 related
    Filer's total
    $0 + $516,904 related

  • Mary Watkins

    NURSE PRACTITIONER

    Total calculated
    $138,354
    From this org
    $121,280
    From related orgs
    $0
    Other
    $17,074
    Hours/week
    40

  • Lester Diamond

    FORMER PRESIDENT - SDHS

    Total calculated
    $531,654
    From this org
    $0
    From related orgs
    $531,654
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $531,654 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $531,654 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
THE PRESIDENT IS PAID BY FMOLHS HEALTH SYSTEM, A RELATED TAX EXEMPT ORGANIZATION. THE ST. DOMINIC HEALTH SERVICES, INC. BOARD OF DIRECTORS DESIGNATES A COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT BOARD MEMBERS, TO REVIEW AND SET THE CEO'S COMPENSATION ANNUALLY. THE COMPENSATION COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING A COMPENSATION STUDY/SURVEY FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR MAKING SUCH DETERMINATION IS DOCUMENTED BY THE COMPENSATION COMMITTEE.
PART I, LINES 4A-4B
PART I, LINE 4A: TWO OFFICERS AND ONE DIRECTOR ARE ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION FOR EMPLOYMENT WITHOUT CAUSE, FOR GOOD REASON OR DUE TO CHANGE OF CONTROL. IF TRIGGERED, THE EMPLOYEE WOULD BE PAID HIS/HER BASE SALARY AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 18 MONTHS. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR. A FORMER OFFICER IS ENTITLED TO A SEVERANCE BENEFIT. THE PAYOUT OF SUCH BENEFIT IS REMOTE AS IT IS EFFECTIVE ONLY FOR A TERMINATION FOR EMPLOYMENT WITHOUT CAUSE, FOR GOOD REASON OR DUE TO CHANGE OF CONTROL. IF TRIGGERED, THE EMPLOYEE WOULD BE PAID HIS/HER BASE SALARY AND PROVIDED RETIREMENT AND WELFARE BENEFITS FOR AN ENTITLEMENT PERIOD. THE ENTITLEMENT PERIOD IS 24 MONTHS. LESTER DIAMOND RECEIVED A SEVERANCE PAYMENT OF $531,654 DURING THE CURRENT YEAR. PART I, LINE 4B: FMOLHS MAINTAINS THREE UNFUNDED DEFERRED COMPENSATION PLANS WHICH MEET THE REQUIREMENTS OF IRC SECTION 457(F) AND IRC SECTION 409A. THE PLANS PROVIDE FOR COMPENSATION TO BE DEFERRED AND PAID UPON THE OCCURRENCE OF CERTAIN EVENTS SUCH AS TERMINATION WITHOUT CAUSE, DISABILITY, DEATH OR ATTAINMENT OF A SPECIFIC PAYMENT DATE. PARTICIPATION IN THE PLANS IS LIMITED TO CERTAIN EXECUTIVES AND IS SUBJECT TO APPROVAL OF FMOLHS BOARD OF DIRECTORS OR A DESIGNATED COMMITTEE OF SUCH BOARD. NO PAYMENTS WERE MADE UNDER THE PLAN IN THE CURRENT YEAR.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • LOURDES IMAGING DEVELOPMENT LLC

    N/A · REAL ESTATE · LA

  • PARK PLACE SURGERY CENTER LLC

    N/A · HEALTHCARE · LA

  • BRPT LAKE REHABILITATION CENTERS LLC

    N/A · HEALTHCARE · LA

  • CONVENIENT CARE LLC

    N/A · HEALTHCARE · LA

  • PERKINS PLAZA AMBULATORY SURGERY CENTER LLC

    N/A · HEALTHCARE · LA

  • SURGICAL SPECIALTY CENTER OF BATON ROUGE LLC

    N/A · HEALTHCARE · LA

  • ST ELIZABETH-MARY BIRD PERKINS CANCER CENTER LLC

    N/A · HEALTHCARE · LA

  • NORTHEAST LA CANCER INSTITUTE LLC

    N/A · HEALTHCARE · LA

  • LHCG-XIII LLC DBA LOURDES HOME HEALTH

    N/A · HEALTHCARE · LA

  • LOURDES AFTER HOURS LLC

    N/A · HEALTHCARE · LA

  • LAKE URGENT CARE ASCENSION LLC

    N/A · HEALTHCARE · LA

  • ST FRANCIS URGENT CARE LLC

    N/A · HEALTHCARE · LA

  • GAMMA KNIFE OF LOUISIANA LLC

    N/A · HEALTHCARE · LA

  • LHCG LXVII LLC

    N/A · HEALTHCARE · LA

  • PINNACLE CARE HOLDINGS LLC

    N/A · HEALTHCARE · LA

  • LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIP

    N/A · HEALTHCARE · LA

  • FREMAUX OFFICE MM LLC

    N/A · HEALTHCARE · LA

  • OLOL PONTCHARTRAIN SURGERY CENTER LLC

    N/A · HEALTHCARE · LA

  • LAKE SURGICAL HOSPITAL (SLIDELL) LLC

    N/A · HEALTHCARE · LA

  • PREMIER HEALTH HOLDINGS LLC

    N/A · HEALTHCARE · LA

  • PERKINS PLAZA DEVELOPMENT LLC

    N/A · HEALTHCARE · LA

  • JACKSON HEART & VASCULAR CENTER LLC

    N/A · HEALTHCARE · MS

  • CARDIOVASCULAR AND ARRYTHMIA CENTER LLC (CVAC)

    N/A · HEALTHCARE · LA

  • CARDIOVASCULAR AND ARRYTHMIA MANAGEMENT LLC (CVAM)

    N/A · HEALTHCARE · LA

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • LOUISE INSURANCE COMPANY

    C · INSURANCE · CJ

  • FRANCISICAN HEALTH & WELLNESS SERVICES I

    C · HEALTHCARE · LA

  • FMOL HEALTH SYSTEM HOLDINGS INC

    C · INVESTMENT · LA

  • ST DOMINIC MADISON HEALTH SERVICES INC

    C · HEALTHCARE · MS

  • ST DOMINIC INTEGRATED SERVICES INC

    C · INVESTMENTS · MS

  • LAFAYETTE SURGICARE INC

    C · HEALTHCARE · LA

  • NMC OPERATING COMPANY LLC DBA SPINE HOSPITAL OF LOUISIANA

    S · HEALTHCARE · LA

Provenance

Return type
form_990
Tax year
2022
Filed
14 May 2024
IRS schema version
2022v5.0
Source object
202431369349306188

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