SIOUX CENTER HEALTH: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: SIOUX CENTER HEALTH (EIN 42-0796764)
Tax period: 2022-07-01 to 2023-06-30
Filed: 2024-02-23
IRS object ID: 202430549349301573
Schema version: 2022v5.0
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2024-02-23T16:58:10-06:00	ReturnTs
Tax Period End	2023-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	450250958	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Eide Bailly LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	345 N Reid Pl Ste 400	AddressLine1Txt
City	Sioux Falls	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	571037034	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	420796764	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Sioux Center Health	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	SIOU	BusinessNameControlTxt
Phone	7127221271	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1101 9th St SE	AddressLine1Txt
City	Sioux Center	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	51250	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Cory Nelson	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	7127221271	PhoneNum
Signature	2024-02-22	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	Cory	PersonFirstNm
Person Last	Nelson	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	Yes (1)	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Laurie Hanson CPA	PreparerPersonNm
PTIN	P00851848	PTIN
Phone	6053391999	PhoneNum
Preparation	2024-02-22	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Cory Nelson	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1101 9th St SE	AddressLine1Txt
City	Sioux Center	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	51250	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$65,312,186	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.siouxcenterhealth.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1951	FormationYr
Legal Domicile State	IA	LegalDomicileStateCd
Activity Or Mission	To provide medical care for all ages.	ActivityOrMissionDesc
Voting Members Governing Body	37	VotingMembersGoverningBodyCnt
Voting Members Independent	33	VotingMembersIndependentCnt
Total Employee	748	TotalEmployeeCnt
Total Volunteers	73	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,760,271	PYContributionsGrantsAmt
CY Contributions Grants	$7,159,627	CYContributionsGrantsAmt
PY Program Service Revenue	$51,505,701	PYProgramServiceRevenueAmt
CY Program Service Revenue	$56,286,757	CYProgramServiceRevenueAmt
PY Investment Income	$741,025	PYInvestmentIncomeAmt
CY Investment Income	$1,614,855	CYInvestmentIncomeAmt
PY Other Revenue	$54,651	PYOtherRevenueAmt
CY Other Revenue	$57,398	CYOtherRevenueAmt
PY Total Revenue	$54,061,648	PYTotalRevenueAmt
CY Total Revenue	$65,118,637	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$10,000	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$31,581,762	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$33,785,950	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$24,219,893	PYOtherExpensesAmt
CY Other Expenses	$28,951,882	CYOtherExpensesAmt
PY Total Expenses	$55,801,655	PYTotalExpensesAmt
CY Total Expenses	$62,747,832	CYTotalExpensesAmt
PY Revenues Less Expenses	-$1,740,007	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$2,370,805	CYRevenuesLessExpensesAmt
Total Assets BOY	$114,251,639	TotalAssetsBOYAmt
Total Assets EOY	$103,990,651	TotalAssetsEOYAmt
Total Liabilities BOY	$67,839,723	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$60,754,321	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$46,411,916	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$43,236,330	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Bring hope, health and healing to life.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$55,226,471	ExpenseAmt
Grant	$10,000	GrantAmt
Revenue	$56,286,757	RevenueAmt
Desc	Sioux Center Health operates a 19-bed acute-care hospital, a 101-bed nursing care facility until January 1, 2023 then became 99 beds, medical clinics, specialty physician clinic and independent/assisted living facilities (24 independent, 62 assisted apartments) located in Sioux Center, Iowa. During the fiscal year ending June 30, 2023, patient days were 1,640, swing-bed days were 567, and newborn days were 486.The Center also provides a wide variety of medically-related activities at less than, or at no cost to residents of communities throughout northwest Iowa. These activities include general community education programs and sponsorship of support groups for victims of chronic disease and their families. Other activities designed to measure or enhance the general health status of residents of the community include: classes related to CPR, diabetes, cardiac rehabilitation and childbirth; participation in health fairs at industrial and community sites throughout the area; cost free screenings to alert people with high blood pressure; providing use of meeting facilities at no charge to cancer, Alzheimer's, diabetes, weight maintenance, "senior and hospice support groups; programs for children; providing speakers for various events and education groups; and representation in community education programs.The Health Center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Since the Health Center does not pursue collection of amounts determined to qualify as charity care, they are not reported as patient service revenue. The estimated cost of providing these services was $500,000 for the year ended June 30, 2023, calculated by multiplying the ratio of cost to gross charges for the Health Center by the gross uncompensated charges associated with providing charity care to its patients.	Desc
Total Program Service Expenses	$55,226,471	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	44	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	748	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	37	GoverningBodyVotingMembersCnt
Independent Voting Member	33	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	0	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Crystal Richter	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7127228153	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1101 9th St SE	AddressLine1Txt
City	Sioux Center	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	51250	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (45 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Kyle Hiemstra
President	1.00	Yes (X)	Yes (X)	$0	$0	$0
Nathan Bakker
Vice President	1.00	Yes (X)	Yes (X)	$0	$0	$0
Jennifer Jansen
Secretary	1.00	Yes (X)	Yes (X)	$0	$0	$0
Josh Bowar
Treasurer	1.00	Yes (X)	Yes (X)	$0	$0	$0
Janet Boone
Director	1.00	Yes (X)		$0	$0	$0
Bruce Dooyema
Director	1.00	Yes (X)		$0	$0	$0
Cory Gotto
Director	1.00	Yes (X)		$0	$0	$0
Curt Hohman
Director	1.00	Yes (X)		$0	$0	$0
Dr Jason Koelewyn
Director	1.00	Yes (X)		$0	$0	$0
Neil Van Schouwen
Director	1.00	Yes (X)		$0	$0	$0
Vernon Beernink
Director	1.00	Yes (X)		$0	$0	$0
Terry Boote
Director	1.00	Yes (X)		$0	$0	$0
Leslie Brommer
Director	1.00	Yes (X)		$0	$0	$0
Tim Byl
Director	1.00	Yes (X)		$0	$0	$0
Lisa Christians
Director	1.00	Yes (X)		$0	$0	$0
Paul Clousing
Director	1.00	Yes (X)		$0	$0	$0
Faye DeKam
Director	1.00	Yes (X)		$0	$0	$0
Brenda Dokter
Director	1.00	Yes (X)		$0	$0	$0
David Eekhoff
Director	1.00	Yes (X)		$0	$0	$0
Daniel Finley
Director	1.00	Yes (X)		$0	$0	$0
Dan Hibma
Director	1.00	Yes (X)		$0	$0	$0
Lauren Kaemingk
Director	1.00	Yes (X)		$0	$0	$0
Rick Kattenberg
Director	1.00	Yes (X)		$0	$0	$0
Heidi Kramer
Director	1.00	Yes (X)		$0	$0	$0
Ardith Lein
Director	1.00	Yes (X)		$0	$0	$0
John McDaniel
Director	1.00	Yes (X)		$0	$0	$0
Matt Nice
Director	1.00	Yes (X)		$0	$0	$0
Scott Peterson
Director	1.00	Yes (X)		$0	$0	$0
Jeff Timmer
Director	1.00	Yes (X)		$0	$0	$0
Jaron Vande Hoef
Director	1.00	Yes (X)		$0	$0	$0
Dale Vander Berg
Director	1.00	Yes (X)		$0	$0	$0
Brian Van Engen
Director	1.00	Yes (X)		$0	$0	$0
Doug Van Meetern
Director	1.00	Yes (X)		$0	$0	$0
Lyle Vermeer
Director	1.00	Yes (X)		$0	$0	$0
Marj Wagner
Director	1.00	Yes (X)		$0	$0	$0
Scott Wynja
Director	1.00	Yes (X)		$0	$0	$0
Verdean Wynja
Director	1.00	Yes (X)		$0	$0	$0
Cory Nelson
CEO	40.00		Yes (X)	$271,991	$0	$20,881
Crystal Richter
CFO From 06/2022	40.00		Yes (X)	$108,442	$0	$36,252
Kari Timmer
CFO Until 06/2022	40.00		Yes (X)	$96,245	$0	$9,554
Julie McKay
Physician	40.00			$399,002	$0	$44,606	Yes (X)
Daniel Vanden Bosch
Physician	40.00			$465,978	$0	$65,553	Yes (X)
Alanna Janssen
Physician	40.00			$431,935	$0	$37,309	Yes (X)
Dr Nicholas Mouw
General Surgeon	40.00			$889,877	$0	$36,705	Yes (X)
David Janssen
Physician	40.00			$437,523	$0	$29,155	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,100,993	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$280,015	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	25	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	Yes (1)	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Michael Tadlock
100 S 11th St	Beresford	SD	57013	Anesthesia Services	$383,703
Grape Tree Medical Staffing
2501 Boji Bend Dr Ste10	Milford	IA	51351	Temp Staffing	$343,156
Northwest Iowa Diagnostics
714 Lincoln St NE	le Mars	IA	51031	Radiology/ultrasound	$305,575
Prime Time Healthcare LLC
15380 Weir St	Omaha	NE	68137	Temp Staffing	$262,852
Thomas Posch
234 Marina Dell Ave	Yankton	SD	57078	Radiology Readings	$259,679

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	8	CntrctRcvdGreaterThan100KCnt
Government Grants	$254,631	GovernmentGrantsAmt
All Other Contributions	$6,904,996	AllOtherContributionsAmt
Noncash Contributions	$338,525	NoncashContributionsAmt
Total Contributions	$7,159,627	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue	623990	$50,925,396	$50,925,396
Pharmacy Revenue	900099	$1,853,561	$1,853,561
Assisted and Independent Living	623990	$1,356,508	$1,356,508
Investment in Affiliated	900099	$230,753	$230,753
Daycare Revenue	900099	$2,403	$2,403

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,918,136	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,918,136	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$56,286,757	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$265,998	TotalRevenueColumnAmt
Exclusion	$265,998	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$42,554	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$42,554	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$42,554	TotalRevenueColumnAmt
Exclusion	$42,554	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$1,446,131	SecuritiesAmt
Other	$62,876	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$87,913	SecuritiesAmt
Other	$72,237	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$1,358,218	SecuritiesAmt
Other	-$9,361	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,348,857	TotalRevenueColumnAmt
Exclusion	$1,348,857	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$48,243	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$33,399	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,844	TotalRevenueColumnAmt
Exclusion	$14,844	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$65,118,637	TotalRevenueColumnAmt
Related Or Exempt Func Income	$56,286,757	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$1,672,253	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$10,000	TotalAmt
Program Services	$10,000	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$512,612	TotalAmt
Management And General	$512,612	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$214,942	TotalAmt
Program Services	$214,942	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$25,471,614	TotalAmt
Program Services	$23,559,993	ProgramServicesAmt
Management And General	$1,911,621	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,021,848	TotalAmt
Program Services	$895,392	ProgramServicesAmt
Management And General	$126,456	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,896,432	TotalAmt
Program Services	$4,566,145	ProgramServicesAmt
Management And General	$330,287	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,668,502	TotalAmt
Program Services	$1,507,946	ProgramServicesAmt
Management And General	$160,556	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$16,032	TotalAmt
Management And General	$16,032	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$65,917	TotalAmt
Management And General	$65,917	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$8,826,701	TotalAmt
Program Services	$7,023,800	ProgramServicesAmt
Management And General	$1,802,901	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$214,529	TotalAmt
Program Services	$1,426	ProgramServicesAmt
Management And General	$213,103	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,694,945	TotalAmt
Program Services	$1,032,595	ProgramServicesAmt
Management And General	$662,350	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$427,019	TotalAmt
Program Services	$82,244	ProgramServicesAmt
Management And General	$344,775	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$909,732	TotalAmt
Program Services	$851,346	ProgramServicesAmt
Management And General	$58,386	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$136,700	TotalAmt
Program Services	$130,065	ProgramServicesAmt
Management And General	$6,635	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$38,840	TotalAmt
Program Services	$38,840	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,672,504	TotalAmt
Program Services	$1,447,588	ProgramServicesAmt
Management And General	$224,916	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$5,650,929	TotalAmt
Program Services	$4,937,433	ProgramServicesAmt
Management And General	$713,496	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$329,882	TotalAmt
Program Services	$119,071	ProgramServicesAmt
Management And General	$210,811	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$7,682,080	$7,682,080
Food	$651,086	$642,028	$9,058
Taxes	$448,135	$448,135

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$186,851	TotalAmt
Program Services	$35,402	ProgramServicesAmt
Management And General	$151,449	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$62,747,832	TotalAmt
Program Services	$55,226,471	ProgramServicesAmt
Management And General	$7,521,361	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$17,500,625	BOYAmt
EOY	$9,281,107	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$7,320,826	BOYAmt
EOY	$7,763,485	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$754,721	BOYAmt
EOY	$942,545	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$592,321	BOYAmt
EOY	$594,703	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$111,723,760	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$40,976,253	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$69,356,490	BOYAmt
EOY	$70,747,507	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$6,795,815	BOYAmt
EOY	$7,413,477	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$9,452,654	BOYAmt
EOY	$4,067,409	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$39,941	BOYAmt
EOY	$20,002	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,438,246	BOYAmt
EOY	$3,160,416	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$114,251,639	BOYAmt
EOY	$103,990,651	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$7,937,486	BOYAmt
EOY	$5,686,754	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,847,585	BOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$32,800,165	BOYAmt
EOY	$6,331,807	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$22,261,492	BOYAmt
EOY	$45,186,709	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,992,995	BOYAmt
EOY	$3,549,051	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$67,839,723	BOYAmt
EOY	$60,754,321	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$43,133,942	BOYAmt
EOY	$42,306,998	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,277,974	BOYAmt
EOY	$929,332	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$46,411,916	BOYAmt
EOY	$43,236,330	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$114,251,639	BOYAmt
EOY	$103,990,651	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$2,370,805	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$5,546,391	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$247,170	BeginningYearBalanceAmt
End Year Balance	$247,170	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$247,170	BeginningYearBalanceAmt
End Year Balance	$247,170	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$247,170	BeginningYearBalanceAmt
End Year Balance	$247,170	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$247,170	BeginningYearBalanceAmt
End Year Balance	$247,170	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$385,500	BeginningYearBalanceAmt
Investment Earnings Or Losses	$24,315	InvestmentEarningsOrLossesAmt
Other Expenditures	$162,645	OtherExpendituresAmt
End Year Balance	$247,170	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.00000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	Yes (1)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$1,535,608	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$2,218,493	OtherCostOrOtherBasisAmt
Book Value	$3,754,101	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$87,799,841	OtherCostOrOtherBasisAmt
Depreciation	$27,468,492	DepreciationAmt
Book Value	$60,331,349	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$17,995,657	OtherCostOrOtherBasisAmt
Depreciation	$12,485,485	DepreciationAmt
Book Value	$5,510,172	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,174,161	OtherCostOrOtherBasisAmt
Depreciation	$1,022,276	DepreciationAmt
Book Value	$1,151,885	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$70,747,507	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Deferred Compensation	$2,971,989
Estimated third-party payor settlements	$190,000
Security deposits	$199,279
Operating lease liability	$187,783

Field	Value	IRS element (for citing)
Total Liability	$3,549,051	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$59,572,246	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$5,546,391	OtherRevenueAmt
Revenue Not Reported	-$5,546,391	RevenueNotReportedAmt
Revenue Subtotal	$65,118,637	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$65,118,637	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$62,747,832	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$62,747,832	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$62,747,832	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part V, Line 4:	The Health Center's endowment consists of a portion of their interest in the net assets of the Avera Health Foundation. The Avera Health Foundation includes endowment funds which have been established for a variety of purposes. The Center does not have a formal policy or agreement with the Foundation covering the distribution of endowment fund earnings. The Center expects the Foundation to allow its endowment to grow consistent with the Center's objective to maintain the purchasing power of the endowment assets in order to provide additional real growth through new gifts and investment return. However, there is no current intention of using the permanently endowed funds.
Part X, Line 2:	The Health Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Health Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.
Part XI, Line 2d - Other Adjustments:	Change in net assets of Avera Health Foundation -1,967,521. Net asset released from restriction 2,987,601. Distribution from Avera Health Foundation -6,566,471.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent150	Yes (X)	Percent150Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	349	PersonsServedCnt
Total Community Benefit Expns	$500,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$500,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00800	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$7,749,034	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,124,065	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,624,969	NetCommunityBenefitExpnsAmt
Total Expense	0.04180	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	349	PersonsServedCnt
Total Community Benefit Expns	$8,249,034	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,124,065	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,124,969	NetCommunityBenefitExpnsAmt
Total Expense	0.04980	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Persons Served	3123	PersonsServedCnt
Total Community Benefit Expns	$20,463	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,899	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,564	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Persons Served	83	PersonsServedCnt
Total Community Benefit Expns	$15,117	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$15,117	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	5	ActivitiesOrProgramsCnt
Persons Served	10451	PersonsServedCnt
Total Community Benefit Expns	$13,644,345	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,531,857	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,112,488	NetCommunityBenefitExpnsAmt
Total Expense	0.08150	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$39,854	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$39,854	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	5	ActivitiesOrProgramsCnt
Persons Served	13657	PersonsServedCnt
Total Community Benefit Expns	$13,719,779	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,534,756	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,185,023	NetCommunityBenefitExpnsAmt
Total Expense	0.08260	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	14006	PersonsServedCnt
Total Community Benefit Expns	$21,968,813	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,658,821	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,309,992	NetCommunityBenefitExpnsAmt
Total Expense	0.13240	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	86	PersonsServedCnt

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,872	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,872	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	86	PersonsServedCnt
Total Community Benefit Expns	$2,872	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,872	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$692,415	BadDebtExpenseAmt
Bad Debt Expense Attributable	$19,665	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$13,958,032	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$14,014,591	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$56,559	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Sioux Center Health	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1101 9th St SE	AddressLine1Txt
City	Sioux Center	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	51250	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.siouxcenterhealth.org	WebsiteAddressTxt
State License	840080H	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Sioux Center Health	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	21	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	See Line 7d	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	See Line 7d	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	21	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	See Part V description in Section C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	150.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	siouxcenterhealth.org/patients-visitors/billing-and-financial-assistance	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	siouxcenterhealth.org/patients-visitors/billing-and-financial-assistance	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	siouxcenterhealth.org/patients-visitors/billing-and-financial-assistance	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Sioux Center Health	Part V, Section B, Line 5: Sioux Center Health conducted its Community Health Needs Assessment (CHNA) partly as a collaborative process with three other hospitals and the public health agency in Sioux County, Community Health Partners of Sioux County. Sioux Center Health, along with Community Health Partners, gathered quantitative and qualitative data to determine the best suitable health initiatives that will make a lasting impact for our communities. Each hospital collected input from individuals representing the community as well as those with public health expertise. In order to avoid duplication of effort, the four critical access hospitals in Sioux County worked collaboratively with Community Health Partners to complete this community health needs assessment with a process that began in October of 2021.
Sioux Center Health	Part V, Section B, Line 6a: Hegg Memorial Health System Orange City Area Health System Hawarden Regional Healthcare
Sioux Center Health	Part V, Section B, Line 6b: Community Health Partners of Sioux County, the local public health agency for Sioux County.Promise Community Health Center
Sioux Center Health	Part V, Section B, Line 7d: https://www.siouxcenterhealth.org/wp-content/uploads/2022-Community-Health-Needs-Assessment.pdfPart V, Section B, Line 10a:https://www.siouxcenterhealth.org/wp-content/uploads/2022-CHNA-Report.pdf
Sioux Center Health	Part V, Section B, Line 11: A summary of the health issues raised through community input was presented to the collaborative planning group along with the secondary data report. On May 11, 2022, Community Health Partners convened a stakeholder meeting with attendees representing the participating healthcare organizations. Participants reviewed a summary of all assessments (community input, secondary data), identified and prioritized key issues. To determine priorities that healthcare systems will address collaboratively, the collaborative team used the Stakeholder Survey Results, Community Health Status Report, and stakeholder meeting input to generate a list of health needs / issues. Identified issues were: Health care access Heart diseaseMental health Social determinants While each of the health needs identified is important for overall community health, two additional health needs that came up during the assessment were substance use/abuse and dental services for Medicaid. Thanks to several partnerships in Sioux County, a county-wide Health Improvement Planning group has been established and has sub-groups currently working on these two areas. Sioux Center Health is well represented in this group.In the current year the facility has taken the following actions to address:Mental Health: Provide 24/7 coverage as a resource for those patients needing mental health services. Sioux Center Health utilizes contractual telehealth behavioral services, which have 24-hour behavioral assessments using a video camera. These services provide us with knowledge of available inpatient resources and makes calls to behavioral health facilities to help find placement, should a patient need further treatment. Sioux Center Health continues to build behavioral health programming within our medical clinics. Our Licensed Outpatient Therapists in combination with our Psychiatric-Mental Health Nurse Practitioner works with individuals and families to meet their life-long goals and achieve their emotional well-being. We offer medically managed treatment plans for all ages: children, adolescents, and adults. Sioux Center Health utilizes the mental health resources in Sioux City, Sioux Falls and surrounding areas for those adolescent patients who are requiring inpatient care for mental health needs and detox/treatment. Sioux Center Health has established relationships with local/area mental health agencies and will continue to utilize their services where appropriate. Ongoing staff training in recognizing signs and/or treatment of mental health concerns will be provided.Social Determinates of Health:Sioux Center Health provides a bilingual Care Coordinator to ensure education for how to navigate the health care system, including financial assistance and programs. Financial counselors are on staff at Sioux Center Health to address financial aspects of health care with patients. Sioux Center Health provides on-site certified medical interpreters to provide fluid, transparent, and accurate communication. Our interpreter services are provided free of charge to the individuals being served available during clinic hours on weekdays and provide 24-hour video remote interpretation using healthcare appropriate remote audio and visual language service providers. Sioux Center supports All Kids Can, an organization whose mission is to make healthy living activities accessible to children of all ages through monetary assistance and to provide consistent support and encouragement along the way.Heart Disease Prevention:Sioux Center Trails Council is actively developing new trails, Sioux Center Health has worked closely with this community group and has a representative that sits on this committee to provide valuable input. Sioux Center Health is a partner for Siouxperman Triathlon, Harvest Half Marathon and 10k run, and Healthy Hero's Family Fun 5k run, 2k run, family fun walk, and community health fair. Sioux Center Health employs a diabetic educator, a registered dietician, and pharmacist who work with patients and community members to manage obesity related issues and provide education surrounding effective weight management and the associated health benefits.Healthcare Access:Sioux Center Health ensures a healthcare provider at each of its locations. Medical providers from Sioux Center Health visit Crown Pointe Estates (independent, assisted, and care center) on a regular basis, as well as Hillcrest. Sioux Center Health provides translation services through in-person interpreters. Financial counselors are on staff at Sioux Center Health to address financial aspects of health care with patients. Sioux Center Health continues to evaluate the needs of our communities and continues to hire or contract with additional providers as necessary. Sioux Center Health has also increased access to care through the addition of a Same Day Primary Care Clinic staffed by Advance Practice Providers. This clinic helps create additional access to healthcare providers in a timely manner.
Sioux Center Health	Part V, Section B, Line 13h: Sioux Center Health provides free care based on meeting presumptive eligibility requirements listed in the policy.
Sioux Center Health	Part V, Section B, Line 16j: Self pay patients are given a self-pay packet that explains financial assistance. A statement is sent out to all patients indicating financial assistance is available upon request. The charity care and other financial assistance options are discussed with inpatients if requested.
Sioux Center Health	Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital has confirmed no FAP eligible patients had elective procedures.

Field	Value	IRS element (for citing)
Facility	7	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - Sioux Center Medical Clinic
1101 9th St SE	Sioux Center	IA	51250	Physician clinic
2 - Crown Pointe Estates
1400 7th Ave SE	Sioux Center	IA	51250	Nursing Facility, Independent and Assisted Living
3 - Home Health & Hospice
1400 7th Ave SE	Sioux Center	IA	51250	Home health and hospice
4 - Occupational Health Center
38 19th St SW	Sioux Center	IA	51250	Occupational health
5 - Hawarden Medical Clinic
920 Avenue F	Hawarden	IA	51023	Physician clinic
6 - Hull Medical Clinic
807 Main	Hull	IA	51239	Physician clinic and physical therapy
7 - Franken Manor
527 S Main Ave	sioux Center	IA	51023	Independent and assisted living Closed September 2022

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 3c:	Sioux Center Health (SCH) provides free care based on meeting presumptive eligibility requirements listed in the policy. Federal Poverty Guidelines and financial asset-liabilities are used to determine eligibility for discounted care.Additional factors used to determine financial assistance eligibility include Asset level, medical indigency, and underinsurance status.Part I, Line 6b:The community benefit report is maintained at Sioux Center Health, mailed to community members, and is available to the public upon request.
Part I, Line 7:	Charity care expense on line 7a and Medicaid on line 7b were converted to cost based on an overall cost-to-charge ratio addressing all patient segments. Lines 7e, 7f, and 7i: Costs are reported based on data from the general ledger accounting system. The general ledger accounting system addresses all patient segments (inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, and self-pay). The cost for subsidized health services reported on line 7g was determined using the facility's cost accounting system.
Part II, Community Building Activities:	Sioux Center Health provides benefits to the community through the Hospital's membership in the local Chamber of Commerce and the recruitment of qualified professional staff.
Part III, Line 2:	The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients.
Part III, Line 3:	The estimated amount of implicit price concession attributable to patients that could have been eligible for charity care is based on estimated calculations from our collection agency. The agency calculated 2.84% of the total amount in collections could be charity care due to bankruptcy, deceased and charity adjustments on current accounts.
Part III, Line 4:	The footnote that describes implicit price concessions is on pages 13-15 of the attached audited financial statements.
Part III, Line 8:	Medicare allowable cost of care was calculated from the Medicare cost report for fiscal year ending 6/30/23. Medical services are provided to patients with Medicare coverage regardless of whether or not a surplus or deficit is realized. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. The Medicare cost report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services.
Part III, Line 9b:	Sioux Center Health provides free care based on meeting presumptive eligibility requirements listed in the financial assistance policy. The Hospital does not pursue collection efforts to patients in the process of applying for assistance or persons meeting the presumptive eligibility requirements. Any personal portion due follows normal collection procedures. Sioux Center Health will allow 240 days from the first post discharge billing statement for individuals to apply for financial assistance.Sioux Center Health will allow all individuals 120 days from the first post discharge statement to apply for financial assistance before initiating any extraordinary collection activities (ECA). Sioux Center Health considers placement at a collection agency an ECA.Prior to sending to a collection agency, Sioux Center Health will provide the patient with a statement or final notice that contains a listing of the specific collection action(s) it intends to initiate, and a deadline after which they may be initiated (that is no earlier than 30 days after the date the notice is provided); a summary of the FAP will also be included with the notice. The language to be used on statements or billing notices is: "Extraordinary collection activity may result upon non-payment of your account within 30 days of the date of this notice. This activity may include the placement of your account with a debt collection agency. Subsequent to judgment, the collection agency may choose to proceed with garnishment."
Part VI, Line 2:	Sioux Center Health has a broad based Board of Directors providing community feedback on a quarterly basis. The organization normally holds an open public meeting annually to listen to issues of the community and share information regarding services and programs. The Hospital analyzes statistical data through IHA and Iowa Public Health to determine disease related needs, services and market share. The Hospital works closely with Community Health Partners to identify and address community health related needs. Additionally, the Hospital conducted a community health needs assessment during the year ended 6/30/22 in compliance with 501(r).
Part VI, Line 3:	Patients are made aware of financial assistance programs (English and Spanish) in a variety of ways:1. Self-pay patients are given a self-pay packet that explains financial assistance, payment plans, and the Hospital's 10% lump sum payment options. The self-pay packet includes a Medicaid application. 2. A statement is sent out to all patients indicating financial assistance is available upon request.3. The financial assistance application is available on the Hospital website in English and Spanish versions.4. The financial assistance application is available at the registration and ER desk in English and Spanish versions.5. Financial assistance information is included in SCH Facebook posts to increase awareness.Additionally, the financial assistance policy is available upon request and on the Sioux Center Health website.
Part VI, Line 4:	Sioux Center Health serves the local Sioux Center community and the surrounding area of Sioux County, IA. Sioux County is primarily rural and located in northwest Iowa. The US Census Bureau reported the 2020 county population as 35,872. Sioux Center Health has a strong community focused perspective. The governing board is comprised of 37 volunteer members that reside in the community and primary service area. The hospital is focused on its mission and serving people regardless of their ability to pay. The Hospital participates in mission projects throughout the year yielding support for various causes from local missions that provide after school activities, counseling, or domestic abuse services. This support comes in the form of paid staff volunteering their time, Hospital sponsored fundraisers, and direct financial support from the Hospital and its employees. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are used to make improvements in patient care, medical education, and research. The county is also home to three other critical access hospitals and Sioux Center also has a FQHC. Nearly 90% of Sioux Center Health's discharges come from Sioux County. The 2020 population of Sioux Center is 8,229 as reported by the US Census Bureau, with the median family income of $76,580. The workforce in Sioux Center includes management, business, science, and arts comprising the largest percentage of workers. Of the population above age 16, 73.5% are in the workforce and the percentage of those unemployed is negligible. 5.1% of the population lives below poverty level and 5.4% of the population has no health insurance.
Part VI, Line 5:	Sioux Center Health has a strong community focused perspective. The governing board is comprised of 37 volunteer members that reside in the community and primary service area. The Hospital is focused on its mission and serving people regardless of their ability to pay. The Hospital participates in mission projects throughout the year yielding support for various causes from local missions that provide after school activities, counseling, or domestic abuse services. This support comes in the form of paid staff volunteering their time, Hospital sponsored fundraisers, and direct financial support from the Hospital and its employees. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are used to make improvements in patient care, medical education, and research.Sioux Center Health has a strong mission to bring hope, health and healing to life. We offer services for our patients, residents and family to support the mind, body and spirit. The Hospital operates an emergency room and is available to anyone, regardless of their ability to pay. The Hospital supports continuing education and training of all the healthcare professionals and assists in providing both internal and external opportunities. Sioux Center Health supports the communities it serves by being an active participant in the community. The hospital offers opportunities to volunteer for community events, has staff that participate in governance through chambers, businesses and churches. Also, the staff participate in various advisory groups supporting all ranges of ages and educational levels. The hospital supports advocacy activities focused on improved public health from organization walks, educational seminars and information shared with the public through various communication means.
Part VI, Line 6:	The Hospital is a managed facility of Avera Health. Avera Health and the Hospital work cooperatively to enhance healthcare throughout the community served by the Hospital. The Hospital also has access to "back office" support services, such as legal consultation, quality benchmarking, coding, computer services, contract negotiations, administrative consultation, group purchasing, human resource assistance and many other services. Avera Health is able to provide these services to the Hospital at a cost below that which the Hospital could otherwise achieve. In turn, local caregivers are able to devote more resources to patient and resident care. Avera Health and the Hospital dedicate resources to endeavors that make a positive difference to improve the health of the communities they serve. These activities include leadership development and training for community members, economic development, physical improvements in the community, contributions to nonprofit community organizations, nonprofit event sponsorships, donated medical supplies, community health education and support groups, health screenings, flu-shot clinics, community health education and various other activities.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	0	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Northwest Iowa Community College	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	603 W park St	AddressLine1Txt
City	Sheldon	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	51201	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	421275893	RecipientEIN
IRC Section	501(C)(3)	IRCSectionDesc
Cash Grant	$10,000	CashGrantAmt
Non Cash Assistance	$0	NonCashAssistanceAmt
Purpose Of Grant	SCHOLARSHIP	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2:	FormAndLineReferenceDesc
Explanation	SCH provides the money for scholarships directly to Northwest Iowa Community College Foundation (NICCF). NICCF determines and processes the scholarship funding. Applications and supporting materials are received directly from the applicant. The health instructors at Northwest Iowa Community College make the selection of who receives the money from the group of eligible applicants.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Dr Nicholas Mouw
General Surgeon	$753,923	$0	$114,689	$0	$21,265	$0	$3,800	$0	$33,545	$0	$927,222	$0	$0	$0
Daniel Vanden Bosch
Physician	$397,344	$0	$27,472	$0	$41,162	$0	$18,837	$0	$47,076	$0	$531,891	$0	$0	$0
Alanna Janssen
Physician	$336,030	$0	$49,145	$0	$46,760	$0	$3,800	$0	$33,989	$0	$469,724	$0	$0	$0
David Janssen
Physician	$349,286	$0	$31,499	$0	$56,738	$0	$3,800	$0	$25,714	$0	$467,037	$0	$0	$0
Julie McKay
Physician	$337,941	$0	$60,185	$0	$876	$0	$3,800	$0	$41,446	$0	$444,248	$0	$0	$0
Cory Nelson
CEO	$269,497	$0	$0	$0	$2,494	$0	$8,123	$0	$13,486	$0	$293,600	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule J, Part II:	FormAndLineReferenceDesc
Explanation	Cory Nelson, CEO is compensated through an arrangement with Avera McKennan, 800 E 21st Street, Sioux Falls, SD 57105.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	City of Hull Iowa	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	426004780	BondIssuerEIN
Bond Issued	2017-12-18	BondIssuedDt
Issue Price	$8,300,000	IssuePriceAmt
Purpose	Hospital Facility Revenue Refunding Bond, Series 2017(2012 issue).	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$1,831,173	RetiredAmt
Total Proceeds	$8,300,000	TotalProceedsAmt
Issuance Costs From Proceeds	$156,681	IssuanceCostsFromProceedsAmt
Other Spent Proceeds	$8,143,319	OtherSpentProceedsAmt
Refunding Tax Exempt Bonds	Yes (1)	RefundingTaxExemptBondsInd
Refunding Taxable Bonds	0	RefundingTaxableBondsInd
Final Allocation Made	Yes (1)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	0	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	0	MgmtContractBondFincdPropInd
Any Research Agreements	0	AnyResearchAgreementsInd
Private Bus Use By Others	0.00000	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.00000	PrivateBusConcerningUBIPct
Total Private Business Use	0.00000	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	0	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	Yes (1)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	0	RebateNotDueYetInd
Exception To Rebate	Yes (1)	ExceptionToRebateInd
No Rebate Due	0	NoRebateDueInd
Variable Rate Issue	Yes (1)	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (1)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (1)	ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Kim Bosma
Family member of Cory Gotto, Director	$56,305	Compensation as an employee	0
Val Hiemstra
Family member of Cory Gotto, Director	$52,382	Compensation as an employee	0
Heather Van Engen
Family member of Brian Van Engen, Director	$22,403	Compensation as an employee	0
Matt De Kam
Family member of Faye De Kam, Director	$83,852	Compensation as an employee	0
Dan Hibma
Director	$461,072	Business transaction with organization	0

Schedule M IRS990ScheduleM

Real Estate Other RealEstateOtherGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$338,525	NoncashContributionsRptF990Amt
Method Of Determining Revenues	Market value	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Form8283 Received	1	Form8283ReceivedCnt
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	0	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Column (b):	FormAndLineReferenceDesc
Explanation	Column B represents the number of contributions.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Section A, line 1a	The Executive Committee is composed of four officers: President, Vice President, Secretary, Treasurer, and seven board members. The Executive Committee shall have power to transact all regular business of the facility during the interim between the meetings of the Board of Directors, provided any action taken shall not conflict with the policies and expressed wishes of the Board of Directors and that it shall refer all matters of major importance to the Board of Directors.
Form 990, Part VI, Section A, line 2	Board members Verdean Wynja and Scott Wynja have a family relationship. Board members Dale Vander Berg and Cory Gotto have a business relationship.
Form 990, Part VI, Section A, line 7a	One member of the governing body is appointed by Avera McKennan.
Form 990, Part VI, Section B, line 11b	The 990 is emailed to members of the Board of Directors for review and any questions are addressed prior to filing the return with the IRS.
Form 990, Part VI, Section B, line 12c	Officers, Directors and Trustees are required to complete conflict of interest questionnaires which are monitored and tracked. The questionnaires are reviewed by the Board for any possible conflicts with any noted conflicts being brought to management's attention. Conflicts are also reviewed at the Board level. After a conflict is deemed to exist, the individual(s) involved must abstain from the discussion and vote related to the issue.
Form 990, Part VI, Section B, line 15a	The CEO is employed through a management agreement with Avera McKennan but is considered a common law employee of Sioux Center Health. Avera McKennan annually reviews the compensation of the CEO, using comparability data and a performance rating system and meets with the Board of Directors of Sioux Center Health. Avera McKennan recommends a salary adjustment for the CEO. The Board of Directors is responsible for approval of the salary adjustment. The deliberation and decision is documented at Avera McKennan and in the board minutes. Compensation for the CFO is reviewed and approved annually by the CEO and Human Resources. Market data is used to determine an appropriate salary range. The review process and salary adjustment is documented in the personnel file.
Form 990, Part VI, Section C, line 19	The documents are made available upon request.
Form 990, Part IX, line 11g	Professional Fees: Program service expenses 745,940. Management and general expenses 240,248. Fundraising expenses 0. Total expenses 986,188. Purchased services: Program service expenses 5,819,383. Management and general expenses 1,507,977. Fundraising expenses 0. Total expenses 7,327,360. Repairs and maintenance: Program service expenses 458,477. Management and general expenses 54,676. Fundraising expenses 0. Total expenses 513,153.
Form 990, Part XI, line 9:	Change in interest in net assets of Avera Health Foundation -1,967,521. Net asset released from restriction 2,987,601. Distribution from Avera Health Foundation -6,566,471.