2024-05-15T11:52:42-05:00 2023-06-30 135565207 KPMG LLP 301 MAIN STREET SUITE 2150 BATON ROUGE LA 70801 990 2022-07-01 640714997 ST CATHERINE'S VILLAGE INC STCA 6012006951 969 LAKELAND DRIVE JACKSON MS 392164699 SAM SCOTT TREASURER 6012006642 2024-05-14 1 SAM SCOTT 999009999 0 RYAN HOOKS P00746825 2253444000 2024-05-14 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z SAM SCOTT 969 LAKELAND DRIVE JACKSON MS 392164699 33967482 0 X WWW.STCATHERINESVILLAGE.COM X 1987 MS ST. CATHERINE'S VILLAGE IS A CONTINUING CARE RETIREMENT COMMUNITY THAT OPERATES INDEPENDENT LIVING, ASSISTED LIVING AND NURSING FACILITIES. 9 7 389 23 0 0 6375846 174496 14914361 15768406 1503146 447305 8841139 9485317 31634492 25875524 0 0 0 0 12972983 13199423 0 0 0 11495335 12384548 24468318 25583971 7166174 291553 79716945 80506449 62224068 64412620 17492877 16093829 X INSPIRED BY THE VISION OF ST. FRANCIS OF ASSISI AND IN THE TRADITION OF THE ROMAN CATHOLIC CHURCH, WE EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO GOD'S PEOPLE, ESPECIALLY THOSE MOST IN NEED. WE CALL FORTH ALL WHO SERVE IN THIS HEALTHCARE MINISTRY, TO SHARE THEIR GIFTS AND TALENTS TO CREATE A SPIRIT OF HEALING - WITH REVERENCE AND LOVE FOR ALL OF LIFE, WITH JOYFULNESS OF SPIRIT, AND WITH HUMILITY AND JUSTICE FOR ALL THOSE ENTRUSTED TO OUR CARE. WE ARE, WITH GOD'S HELP, A HEALING AND SPIRITUAL PRESENCE FOR EACH OTHER AND FOR THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. 0 0 17984355 0 25253723 THE VILLAGE IS MISSISSIPPI'S FIRST RETIREMENT COMMUNITY OFFERING THE SECURITY OF ALL-INCLUSIVE LIFE CARE. NESTLED ON 160 ACRES OF ROLLING GREEN HILLS AND TALL PINE TREES, THE VILLAGE OVERLOOKS A TRANQUIL 15 ACRE STOCKED LAKE. REMINISCENT OF A QUAINT EUROPEAN VILLAGE, THE VILLAGE IS CONVENIENTLY LOCATED IN MADISON, MISSISSIPPI 7 MILES NORTH OF JACKSON, THE STATE'S CAPITOL CITY. THE VILLAGE OFFERS A CONTINUUM OF CARE FEATURING: I. 246 INDEPENDENT LIVING UNITS-MULTIPLE INDIVIDUALS IN EACH UNIT INCLUDING 54 GARDEN HOMESII. 120 SKILLED NURSING BEDS LOCATED IN THREE DIFFERENT AREAS OF SKILLED NURSING. THREE LOCATIONS-SIENA, TUSCANY AND HUGHES CENTERIII. LICENSED NURSING HOME WITH 120 BEDS IV. 53 BASIC ASSISTED LIVING BEDS IN MARIAN HALLV. 24 ALZHEIMER'S ASSISTED LIVING BEDS IN CAMPBELL COVETHE VILLAGE IS THE FIRST RETIREMENT COMMUNITY IN MISSISSIPPI TO EARN ACCREDITATION BY CARF INTERNATIONAL. THIS "SEAL OF APPROVAL" SIGNIFIES THAT THE VILLAGE EXCEEDS THE STANDARDS OF EXCELLENCE AS ESTABLISHED BY CARF INTERNATIONAL. THE VILLAGE IS A FREE STANDING NOT-FOR-PROFIT, ALL-INCLUSIVE CONTINUING CARE RETIREMENT COMMUNITY PROVIDING SERVICES TO INDIVIDUALS OVER 62 YEARS OF AGE, AND OPEN TO ALL FAITHS AND RACES. THE VILLAGE IS SPONSORED BY THE FRANCISCAN MISSIONARY OF OUR LADY SISTERS OF BATON ROUGE, LOUISIANA. THE DOMINICAN SISTERS OF SPRINGFIELD, ILLINOIS, WHO OWNED AND OPERATED ST. DOMINIC JACKSON MEMORIAL HOSPITAL FROM 1946 TO 2019, EXTENDED THEIR HEALING MINISTRY TO THE SPECIAL NEEDS OF OLDER ADULTS WITH THE CREATION OF THE VILLAGE. 17984355 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 389 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X SAM SCOTT 6012006951 969 LAKELAND DRIVE JACKSON MS 392164699 BARNEY DALY VICE CHAIR 0.50 0.00 X X 0 0 0 JAMES E WOOD CHAIRMAN 0.50 0.00 X X 0 0 0 KRISTEN WOLKART BOARD MEMBER 0.50 42.75 X 0 575846 115578 LIONEL FRASIER MD BOARD MEMBER 0.50 0.00 X 0 0 0 PATSY TOLLESON BOARD MEMBER 0.50 0.00 X 0 0 0 RANDALL DAY BOARD MEMBER 0.50 0.00 X 0 0 0 SAMUEL SCOTT SVP, CFO, TREASURER 0.50 41.75 X X 0 484817 32087 SCOTT KASHMAN MARKET PRESIDENT 0.50 42.00 X X 0 610569 97937 SISTER MARY TRINITA EDDINGTON SECRETARY 0.50 40.75 X X 0 0 0 WILLIAM E LOPER MD BOARD MEMBER 0.50 0.00 X 0 0 0 LISA WILBURN VP SDHS SR SVCS 40.00 0.00 X 246540 0 28758 FELICHIA FIELDS DIRECTOR SCV OPERATIONS 40.00 0.00 X 141222 0 15526 PRISCILLA SULLIVAN DIRECTOR NURSING 40.00 0.00 X 127882 0 20824 SHEILA SIMPSON SR DIRECTOR ADMINISTRATOR 40.00 0.00 X 142554 0 24945 HENRY SIMPSON SUPERVISOR NURSING 40.00 0.00 X 113004 0 15004 JUNE BIGGS SUPERVISOR NURSING 40.00 0.00 X 105984 0 10312 LESTER DIAMOND FORMER PRESIDENT - SDHS 0.00 0.00 X 0 531654 0 877186 2202886 360971 7 1 1 0 ELIOR INC CURA HOSPITALITY TRIO COMMUN PO BOX 743676 ATLANTA GA 30374 FOOD SERVICES 4031636 D & L FLOORING AND DESIGN LLC 806 MONROE ST JACKSON MS 39202 CONSTRUCTION 439796 DAVID B TURNER BUILDERS LLC 213 PALMERS COURT MADISON MS 39110 CONSTRUCTION 370050 PRO LAWN CARE INC PO BOX 1098 MADISON MS 39130 LANDSCAPING SERVICES 341646 UPCHURCH SERVICES LLC PO BOX 709 HORN LAKE MS 38637 REP AND MAINT PRTS AND LAB 167559 6 174496 174496 RESIDENT SERVICES 623000 15768406 15768406 15768406 153049 153049 9485317 0 9485317 9485317 9485317 8386214 8091958 294256 294256 294256 25875524 25253723 0 447305 X 256576 200299 56277 10462067 8167331 2294736 395973 309121 86852 1289136 1006378 282758 795671 621150 174521 384960 36910 348050 1845 1845 419 419 4588535 2809420 1779115 129018 78954 50064 1238701 818743 419958 7504 4592 2912 1255841 1060173 195668 6273 3839 2434 162 99 63 547562 547562 2546919 2164881 382038 820741 160478 660263 REPAIRS & MAINTENANCE 666566 422011 244555 SUPPLIES 170568 107989 62579 ALL OTHER EXPENSES 18934 11987 6947 25583971 17984355 7599616 0 10324704 12644093 180536 146311 53746 51807 70943392 9573417 62616595 61369975 6541364 6294263 79716945 80506449 2629258 1841408 16829393 15714393 42765417 46856819 62224068 64412620 X 11200474 9799567 6292403 6294262 17492877 16093829 79716945 80506449 291553 91 -1690692 0 X 0 1 X 1 0 X 162667 2655144 868090 174496 3860397 12159915 23130123 22805906 14914361 15768148 88778453 12322582 23130123 25461050 15782451 15942644 92638850 162667 78500 174496 415663 0 162667 78500 174496 415663 92223187 62141 131357 147579 8841139 9638366 18820582 62141 131357 147579 8841139 9638366 18820582 7921 169400 177321 12392644 23261480 25778029 24623590 25581010 111636753 0.82610 0.90840 0.16860 0.08540 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6165365 42355 437204 345110 6299814 6347034 162623 -127040 217252 6165365 5565991 28462 913772 161191 6347034 5465758 68397 39311 7475 5565991 5429426 263163 226831 5465758 1.00000 0 1 1 5956649 5956649 60858091 8280341 52577750 4128652 1293076 2835576 61369975 INTEREST IN SDHS FOUNDATION 6294263 6294263 NET DUE TO/FROM AFFILIATES 12274462 OTHER LONG TERM LIABILITIES 574 RETIREMENT PAYABLE LONG TERM 3310463 SELF INSURANCE LIABILITY - LT 31271320 46856819 X PART X, LINE 2: FMOLHS RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. NO RESERVES FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED. PART V, LINE 4: RESTRICTED NET ASSETS ARE CLASSIFIED AS SUCH BASED ON DONOR STIPULATIONS THAT THEY BE USED IN A LATER PERIOD, FOR A SPECIFIC PURPOSE OR BOTH. AT JUNE 30, 2023 AND JUNE 30, 2022, THE VILLAGE HAD TEMPORARILY RESTRICTED NET ASSETS OF $6,299,814 AND $6,165,365 RESPECTIVELY, RELATED TO THE INTEREST IN NET ASSETS OF THE FOUNDATION. 1 1 0 0 0 0 0 0 0 SCOTT KASHMAN MARKET PRESIDENT 0 499303 0 108077 0 3189 0 70852 0 27085 0 708506 0 0 KRISTEN WOLKART BOARD MEMBER 0 440832 0 131783 0 3231 0 95636 0 19942 0 691424 0 0 LESTER DIAMOND FORMER PRESIDENT - SDHS 0 0 0 0 0 531654 0 0 0 0 0 531654 0 0 SAMUEL SCOTT SVP, CFO, TREASURER 0 321567 0 157491 0 5759 0 14175 0 17912 0 516904 0 0 LISA WILBURN VP SDHS SR SVCS 194895 0 48781 0 2864 0 12289 0 16469 0 275298 0 0 0 SHEILA SIMPSON SR DIRECTOR ADMINISTRATOR 122966 0 18932 0 656 0 7377 0 17568 0 167499 0 0 0 FELICHIA FIELDS DIRECTOR SCV OPERATIONS 120469 0 12886 0 7867 0 7212 0 8314 0 156748 0 0 0 PART I, QUESTION 3: THE FMOL HEALTH SYSTEM 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, LINE 4A: TWO OFFICERS, ONE BOARD MEMBER, AND ONE FORMER OFFICER 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. LESTER DIAMOND RECEIVED A PAYMENT OF $531,654 IN 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 ONE LISTED ON PART VII, SECTION A RECEIVED A PAYMENT FROM THE PLANS IN THE CURRENT YEAR. FORM 990, PART VI, SECTION A, LINE 6 ST. DOMINIC HEALTH SERVICES, INC. IS THE SOLE MEMBER OF THE VILLAGE. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF THE ORGANIZATION'S SOLE MEMBER, ST. DOMINIC HEALTH SERVICES, INC., HAS THE AUTHORITY TO APPROVE THE ELECTION OF THE PRESIDENT/CEO, THE CHAIR OF THE BOARD AND THE VICE-CHAIR OF THE BOARD OF DIRECTORS OF THE VILLAGE AND ALL OTHER DIRECTORS AND OFFICERS OF THE VILLAGE. FORM 990, PART VI, SECTION A, LINE 7B THE RESERVED POWER TO THE MEMBER, ST. DOMINIC HEALTH SERVICES, INC., ARE AS FOLLOWS: I. TO CHANGE PHILOSOPHY, OBJECTIVES AND PURPOSES OF CORPORATION. II. TO APPOINT OR REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION. III. TO AMEND, ALTER, MODIFY OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION. IV. TO AUTHORIZE MERGER, CONSOLIDATION, OR AFFILIATION, OR PARTICIPATE IN JOINT VENTURES. V. TO DISSOLVE AND TO DISTRIBUTE ASSETS OF THE CORPORATION. VI. TO APPOINT AND/OR TERMINATE WITH OR WITHOUT CAUSE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION. VII. TO ACQUIRE, PURCHASE, SELL, LEASE, TRANSFER, OR ENCUMBER ANY IMMOVABLE PROPERTY ON BEHALF OF THE CORPORATION. VIII. TO ADD TO OR INCUR LONG-TERM DEBT IN EXCESS OF $5 MILLION BY THE CORPORATION. IX. TO APPOINT THE FISCAL AUDITOR FOR THE CORPORATION. X. TO APPROVE ANY INCREMENT OR ADDITION TO THE CAPITAL DEBT OR EFFORTS TO RENEGOTIATE, MODIFY OR CHARGE THE EXISTING CAPITAL DEBT OBLIGATIONS OF THE CORPORATION. XI. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION. XII. TO APPROVE A STRATEGIC BUSINESS PLAN OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B AFTER PREPARATION AND REVIEW OF FORM 990 BY KPMG LLP, THE TAXPAYER'S TAX ADVISORS, ONE OR MORE MEMBERS OF SENIOR MANAGEMENT REVIEWS THE RETURN. A COPY OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED 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. 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 OUR BOARD OF DIRECTORS DESIGNATES AN EXECUTIVE COMMITTEE MADE UP OF INDEPENDENT BOARD MEMBERS TO REVIEW AND SET THE COMPENSATION ANNUALLY OF OUR OFFICERS AND KEY EMPLOYEES. THE EXECUTIVE COMMITTEE OBTAINS AND RELIES UPON COMPARABLE DATA INCLUDING INDUSTRY-WIDE COMPENSATION INFORMATION PROVIDED BY AN OUTSIDE CONSULTING FIRM. THE EXECUTIVE COMMITTEE REVIEWS COMPENSATION PACKAGES AND APPROPRIATE COMPENSATION IS DETERMINED AND APPROVED. THE BASIS FOR DETERMINATION IS THEN DOCUMENTED BY THE EXECUTIVE COMMITTEE. THE COMPENSATION FOR THE CEO OF ST. CATHERINE'S VILLAGE IS SET BY THE COMPENSATION COMMITTEE OF FMOL HEALTH SYTEM INC. (A RELATED TAX-EXEMPT ORGANIZATION) ACCORDING TO THEIR PAY PRACTICES WHICH ARE SIMILAR TO THOSE DESCRIBED ABOVE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,360,111. MANAGEMENT AND GENERAL EXPENSES 1,494,582. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,854,693. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 25,401. MANAGEMENT AND GENERAL EXPENSES 16,086. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,487. OTHER FEES: PROGRAM SERVICE EXPENSES 423,908. MANAGEMENT AND GENERAL EXPENSES 268,447. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 692,355. SECTION 1.263(A) -3(N) - BOOK CONFORMITY ELECTION: ST. CATHERINE'S VILLAGE, INC. IS MAKING THE ELECTION UNDER TREAS. REG. SECTION 1.263(A)-3(N) TO CAPITALIZE THE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL IMPROVEMENTS ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDED JUNE 30, 2023. SECTION 1.263(A)-1(F) - DE MINIMIS SAFE HARBOR ELECTION: ST. CATHERINE'S VILLAGE, INC. HEREBY MAKES THE DE MINIMIS SAFE HARBOR ELECTION UNDER SECTION 1.263(A)-1(F) OF THE TREASURY REGULATIONS, EFFECTIVE ONLY FOR THE TAX YEAR ENDING JUNE 30, 2023. TAXPAYER HAS ANAPPLICABLE FINANCIAL STATEMENT FOR THE YEAR OF THE ELECTION. THIS ELECTION PERMITS THE TAXPAYER TO DEDUCT FOR TAX PURPOSES ANY ITEM DEDUCTED UNDER ITS BOOK POLICY THAT DOES NOT EXCEED $5,000 PER INVOICE (OR PER ITEM, AS SUBSTANTIATED BY THE INVOICE) OR ITEMS HAVING AN ECONOMIC USEFUL LIFE OF TWELVE MONTHS OR LESS AS DESCRIBED IN SECTION 1.263(A)-1(F)(1)(I). 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