AVERA ST ANTHONYS HOSPITAL: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- AVERA ST ANTHONYS HOSPITAL (EIN 47-0463911)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-12
- IRS object ID
- 202321329349303632
- Schema version
- 2021v4.2
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-12T10:32:25-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | 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 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470463911 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera St Anthony's Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AVER | BusinessNameControlTxt |
| Phone | 4023365132 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 N 2nd Street | AddressLine1Txt |
| City | ONeill | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 687631569 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Julie Lautt | PersonNm |
| Person Title | CFO Avera Health | PersonTitleTxt |
| Phone | 4023365132 | PhoneNum |
| Signature | 2023-05-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Julie | PersonFirstNm |
| Person Last | Lautt | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2023-05-02 | 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 | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Kayleen Lee | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 N 2nd Street | AddressLine1Txt |
| City | ONeill | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 687631569 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $45,101,663 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | See Schedule O | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1955 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | Promotion of health | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 281 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,507,164 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,419,219 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $41,081,260 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $42,795,688 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,751,169 | PYInvestmentIncomeAmt |
| CY Investment Income | $888,337 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,111 | PYOtherRevenueAmt |
| CY Other Revenue | -$29,787 | CYOtherRevenueAmt |
| PY Total Revenue | $45,345,704 | PYTotalRevenueAmt |
| CY Total Revenue | $45,073,457 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,934 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $535 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $21,234,335 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,959,877 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $16,290,388 | PYOtherExpensesAmt |
| CY Other Expenses | $18,006,005 | CYOtherExpensesAmt |
| PY Total Expenses | $37,526,657 | PYTotalExpensesAmt |
| CY Total Expenses | $39,966,417 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,819,047 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,107,040 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $90,346,342 | TotalAssetsBOYAmt |
| Total Assets EOY | $85,747,999 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,331,762 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,223,232 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $78,014,580 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $74,524,767 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Avera is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $35,806,104 | ExpenseAmt |
| Grant | $535 | GrantAmt |
| Revenue | $42,778,647 | RevenueAmt |
| Desc | Avera St. Anthony's mission is to provide healthcare services to O'Neill, Nebraska residents and residents of the surrounding area. Avera St. Anthony's is a 501(c)(3) organization affiliated with Avera Health. Avera St. Anthony's consists of a 25-bed critical access hospital in O'Neill, Nebraska and 6 clinics. The program services offered include primary care, emergency, telemedicine, general surgery, orthopedic surgery, podiatry surgery, cardiac rehab, pain management, OB, chemotherapy, radiology, sleep lab, dialysis, speech therapy, physical therapy, occupational therapy, lab and pharmacy. Avera St. Anthony's provides acute care and long-term healthcare services. Following is a breakdown of these statistics by facility:Avera St. Anthony Hospital641 Acute patient discharges150 Newborn patient discharges90 Swing bed patient discharges36,877 Outpatient visits721 Swing-bed patient days219 Newborn patient days29,675 Clinic visitsAvera St. Anthony's maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy and equivalent service statistics. The amount of charges foregone, based on established rates, were $618,988.Avera St. Anthony's also provides community benefit health activities at less than or at no cost to support those in the area serviced, see Schedule H. As a member of the Avera Health Network, Avera St. Anthony's upholds the vision of the Presentation and Benedictine Sisters to work through collaboration to provide quality, effective health ministry and to improve the healthcare of individuals and our communities through a regionally integrated network of persons and institutions. Avera St. Anthony's engages in activities designed to improve the health of individuals and communities in response to a calling to heal the sick, the elderly, and the oppressed. | Desc |
| Total Program Service Expenses | $35,806,104 | 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 | Yes (1) | 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 | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 41 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 281 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | 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 | 0 | 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 | Jamie Schaefer | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6053223992 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3900 W Avera Dr Ste 300 | AddressLine1Txt |
| City | Sioux Falls | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57108 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Todd Consbruck | ||||||||
| President/CEO | 16.00 | 24.00 | Yes (X) | Yes (X) | $0 | $222,224 | $32,789 | |
| Joe Krotter | ||||||||
| Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Deb Kelly | ||||||||
| Vice Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Sister Kathryn Burt OSB | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sister Lynn Marie Welbig PBVM | ||||||||
| Member | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| Merri Schneider | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Bart Becker | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Richard Fitch | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Russ McIntosh | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Amy Shane | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Kirk Cisler | ||||||||
| Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Barbara Gutshall MD-Member | ||||||||
| Medical Staff Pres/Internal Med. | 1.00 | 40.00 | Yes (X) | $0 | $179,055 | $36,715 | ||
| Julie Lautt | ||||||||
| CFO Avera Health; Sec/Treas | 0.10 | 46.30 | Yes (X) | $0 | $1,051,228 | $16,194 | ||
| Logan Kopf | ||||||||
| CRNA | 40.00 | 0.00 | $302,007 | $0 | $50,156 | Yes (X) | ||
| Josh Becker | ||||||||
| CRNA | 40.00 | 0.00 | $341,532 | $0 | $54,781 | Yes (X) | ||
| Kevin Loecker | ||||||||
| CRNA | 40.00 | 0.00 | $263,042 | $0 | $25,514 | Yes (X) | ||
| Cameron Everitt | ||||||||
| Director of PT | 40.00 | 0.00 | $161,081 | $0 | $22,631 | Yes (X) | ||
| Dean Benson | ||||||||
| Physician Assistant | 40.00 | 0.00 | $157,311 | $0 | $36,508 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,224,973 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,452,507 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $275,288 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Avera Health | |||||
| 3900 W Avera Drive Suite 300 | Sioux Falls | SD | 57108 | Shared Services | $4,438,181 |
| Docs Who Care | |||||
| 800 West Frontier Ln | Olathe | KS | 66061 | Physician Services | $543,326 |
| Avera McKennan Hospital | |||||
| 1325 S Cliff Ave | Sioux Falls | SD | 57105 | Physician Services | $467,883 |
| Avera Sacred Heart Health Services | |||||
| 501 Summit St | Yankton | SD | 57078 | Management, Support, & Lab Services | $333,491 |
| ENT Specialists PC | |||||
| 720 N 129th St | Omaha | NE | 68154 | Physician Services | $306,251 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $85,000 | RelatedOrganizationsAmt |
| Government Grants | $1,334,219 | GovernmentGrantsAmt |
| Total Contributions | $1,419,219 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 622110 | $41,525,194 | $41,525,194 |
| Pharmacy Revenue | 900099 | $944,389 | $944,389 |
| Clinic Revenue | 621110 | $184,612 | $184,612 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $141,493 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $141,493 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $42,795,688 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,229 | TotalRevenueColumnAmt |
| Exclusion | $15,229 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,708 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $22,454 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$12,746 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$12,746 | TotalRevenueColumnAmt |
| Exclusion | -$12,746 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $878,860 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $5,752 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $878,860 | SecuritiesAmt |
| Other | -$5,752 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $873,108 | TotalRevenueColumnAmt |
| Exclusion | $873,108 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | AR Interest Income | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | -$17,041 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$17,041 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$17,041 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,073,457 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $42,778,647 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $875,591 | 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 | $535 | TotalAmt |
| Program Services | $535 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,322,855 | TotalAmt |
| Program Services | $17,115,039 | ProgramServicesAmt |
| Management And General | $207,816 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $647,364 | TotalAmt |
| Program Services | $638,325 | ProgramServicesAmt |
| Management And General | $9,039 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,898,716 | TotalAmt |
| Program Services | $2,844,750 | ProgramServicesAmt |
| Management And General | $53,966 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,090,942 | TotalAmt |
| Program Services | $1,078,685 | ProgramServicesAmt |
| Management And General | $12,257 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,954 | TotalAmt |
| Management And General | $1,954 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,425,017 | TotalAmt |
| Program Services | $5,131,905 | ProgramServicesAmt |
| Management And General | $3,293,112 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,504 | TotalAmt |
| Program Services | $2,578 | ProgramServicesAmt |
| Management And General | $926 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $378,194 | TotalAmt |
| Program Services | $317,299 | ProgramServicesAmt |
| Management And General | $60,895 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $309,283 | TotalAmt |
| Program Services | $153,361 | ProgramServicesAmt |
| Management And General | $155,922 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $487,457 | TotalAmt |
| Program Services | $459,845 | ProgramServicesAmt |
| Management And General | $27,612 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,116 | TotalAmt |
| Program Services | $55,872 | ProgramServicesAmt |
| Management And General | $11,244 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,156 | TotalAmt |
| Program Services | $41,191 | ProgramServicesAmt |
| Management And General | $965 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $232,119 | TotalAmt |
| Program Services | $192,629 | ProgramServicesAmt |
| Management And General | $39,490 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,628,632 | TotalAmt |
| Program Services | $1,477,363 | ProgramServicesAmt |
| Management And General | $151,269 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,474 | TotalAmt |
| Program Services | $96,880 | ProgramServicesAmt |
| Management And General | $123,594 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $6,055,135 | $6,050,999 | $4,136 |
| Equipment Lease/Rental | $7,964 | $7,514 | $450 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,000 | TotalAmt |
| Program Services | $141,334 | ProgramServicesAmt |
| Management And General | $5,666 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,966,417 | TotalAmt |
| Program Services | $35,806,104 | ProgramServicesAmt |
| Management And General | $4,160,313 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $903,529 | BOYAmt |
| EOY | $771,611 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,912,122 | BOYAmt |
| EOY | $4,968,735 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,614 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,491,826 | BOYAmt |
| EOY | $1,449,788 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,176 | BOYAmt |
| EOY | $107,562 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,577,774 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $27,366,069 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,465,023 | BOYAmt |
| EOY | $12,211,705 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $628,206 | BOYAmt |
| EOY | $635,068 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,860,763 | BOYAmt |
| EOY | $65,640,284 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,697 | BOYAmt |
| EOY | -$39,368 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,346,342 | BOYAmt |
| EOY | $85,747,999 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,689,122 | BOYAmt |
| EOY | $2,617,669 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $366,125 | BOYAmt |
| EOY | $387,068 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,018,086 | BOYAmt |
| EOY | $6,658,836 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,258,429 | BOYAmt |
| EOY | $1,559,659 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,331,762 | BOYAmt |
| EOY | $11,223,232 | 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 | $77,863,959 | BOYAmt |
| EOY | $74,450,935 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,621 | BOYAmt |
| EOY | $73,832 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,014,580 | BOYAmt |
| EOY | $74,524,767 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,346,342 | BOYAmt |
| EOY | $85,747,999 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,107,040 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$8,407,590 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$189,263 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,954 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,954 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Avera St. Anthony's Hospital paid dues to organizations which have a portion of the dues attributed to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $150,500 | BeginningYearBalanceAmt |
| End Year Balance | $150,500 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $150,500 | BeginningYearBalanceAmt |
| End Year Balance | $150,500 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $150,500 | BeginningYearBalanceAmt |
| End Year Balance | $150,500 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $150,500 | BeginningYearBalanceAmt |
| End Year Balance | $150,500 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $150,500 | BeginningYearBalanceAmt |
| End Year Balance | $150,500 | 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 | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $745,022 | OtherCostOrOtherBasisAmt |
| Book Value | $745,022 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,056,336 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,929,127 | DepreciationAmt |
| Book Value | $7,127,209 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,254,580 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,519,603 | DepreciationAmt |
| Book Value | $2,734,977 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,521,836 | OtherCostOrOtherBasisAmt |
| Depreciation | $917,339 | DepreciationAmt |
| Book Value | $1,604,497 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,211,705 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Avera Pooled Investments | $64,466,894 | F |
| Investment in Foundation | $1,173,390 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $65,640,284 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Right of Use Operating Lease Obligation | $5,926 |
| Deferred Payroll Taxes | $276,367 |
| Estimated Third Party Payor Settlements | $1,277,366 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,559,659 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | The Foundation's endowment consists of a portion of their interest in the net assets of St. Anthony's Hospital Foundation. The St. Anthony's Hospital Foundation includes endowment funds which have been established for a variety of purposes. As required by generally accepted accounting principles, net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments (if any), are classified and reported based on the existence or absence of donor-imposed restrictions. |
| Part X, Line 2: | Avera Health and its sponsored organizations believe that they have 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 consolidated financial statements. The Organization 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. |
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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $287,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $287,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00720 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,683,424 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,737,157 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $946,267 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02370 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,970,424 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,737,157 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,233,267 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03090 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $387,583 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $84,688 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $302,895 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00760 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $48,049 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $48,049 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,668,255 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,541,909 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,126,346 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.17830 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $35 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $35 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,103,922 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,626,597 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,477,325 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.18710 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,074,346 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,363,754 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,710,592 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.21800 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $848,441 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $13,488,281 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,375,651 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $112,630 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | Avera St Anthony's Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 N 2nd Street | AddressLine1Txt |
| City | ONeill | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68763 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | See Part V Section C | WebsiteAddressTxt |
| State License | 410002 | 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 |
| Other | 1 Provider based clinic, 1 RHC, 4 physician clinics | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony's Hospital | 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 | 0 | 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 Part V Section C | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | See Part V Section C | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V 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 | 250.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| 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 | See Part V, Page 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Page 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Page 8 | 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 |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| 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 (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| St. Anthony's Hospital | Part V, Section B, Line 5: Avera St. Anthony's Hospital initiated a community focus group meeting and also conducted personal interviews with electronic communication responses. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources and improvements. Those providing community input represented the medically underserved, low-income and minority populations as they serve with these populations through their activities. The following organizations were represented in the process: * North Central District Health Department (NCDHD)* North Central Community Care Partnership (NCCCP)* Avera St. Anthony's Hospital Social Service Department* Residents of Holt County* O'Neill Ministerial Association* Social Services* Hispanic citizens* Elderly citizens |
| St. Anthony's Hospital | Part V, Section B, Line 6b: North Central District Health Department |
| St. Anthony's Hospital | Part V, Section B, Line 11: The community health needs assessment was completed during FY2022. The hospital has not taken specific actions with respect to the FY22 implementation strategy. The following community health priority areas were identified and the following actions will be taken by the hospital during future years. - Heart Health- Mental HealthHeart Health:- Promote screening and management of chronic disease throughout the community service area o Explore avenues of physical activity within the O'Neill Community o Continue promotion of health maintenance through health screenings and additional options of detection/care management.Mental Health:- Promote awareness of mental wellness throughout the community service area. o Partner with various community entities/organizations to promote community well-being collaboratives o Explore options for community education and outreach addressing mental health within oncology care and support.The following health needs/priorities will not be addressed due to either a relative low priority, resource/staff constraints or because other facilities or educational entities are addressing the issues:- Increase Mental Health First Aid Training (MHFA) providers in NCDHD district- Increase training of Mental Health First Aide (MHFA) instructors- Initiate a Board Certified Behavior Analyst service for the health district.Avera St. Anthony's continued to address the community health needs identified in the community health needs assessment completed in 2018. The following community health priority areas were identified and steps taken during FY22. CHRONIC DISEASE DETECTION & MANAGEMENT:- Explore feasibility of expanding Social Work support to incorporate a Cancer case management system, child abuse prevention strategies, domestic violence, and Hospice care.RESULT: A staff member with MSW, LICSW, LADC Social Worker designations integrates her services with Avera Coordinated Care, Dialysis and Home Health/Hospice. Referrals were initiated from the providers. Statistics from 2021 show 28 new counseling referrals in 2021 with 280 counseling sessions through the coordinated care program. An increased trend with home health patients was noted. We will evaluate opportunities for social work in oncology and cardiac rehab with potential for growth in number of counseling referrals as integration of mental health services in primary care is noted.- Continue to promote health maintenance through health screenings and additional options of detection/care management (Blood Pressure checks, bone density, skin cancer screening).Health Fair:RESULT: June & July 2021 - Provision of health fair was altered in production and there were 457 lab panels, 139 PSAs and 221 HgbA1Cs completed for our community participants.Women's Health Conference: RESULT: June 2021 - A hospital booth was availableCommunity Food Pantry - monthly/quarterlyRESULT: Opened again in FY2022 after previously being closed due to COVID-19 restrictions. FY2022 Update: Members of Administrative Council/Director of Mission Services will collaborate with NCDHD, KBRX Radio Station, Northeast Community College, United Methodist Church and applicable Avera Service Lines.MENTAL WELLNESS:- Provide support to the Befriend Family mentoring program through financial contribution to maintain coordination and viability of program. Provide program brochure to Medical Staff and clinic waiting areas.Befriend is an advocacy program that was adopted from Oasis Counseling International. It seeks to match mentee families with caring mentor families from local faith communities. Befriend's purpose is to restore at-risk families and individuals to their full God-designed potential through positive and caring relationships.FY2022 Update: The program is still financially viable. The number of families involved is disappointedly low. Barriers of "form phobia and confidentiality compromise are issues that the program hopes to overcome.- Implement Avera suicide staff education, precautions and screening policies in the ED and promote use of Avera Farmer's Stress Hotline resources.FY2022 Update: Continued interventions to predict the presence and severity of depression were completed within the Emergency Department. A screening policy performs the Suicide Risk Primary Screen that additionally addresses abuse and violence/trafficking. This screening then potentially leads to the Columbia Suicide Severity Rating Scale which allows for continued support and/or intervention.Members of Administrative Council/Director of Mission Services will collaborate with OASIS Counseling, Befriend Family Mentoring, NCDHD and Region 4 Behavioral Health System.Many of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment. |
| St. Anthony's Hospital | Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide. |
| St. Anthony's Hospital | Part V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| St. Anthony's Hospital | Part V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility. |
| St. Anthony's Hospital | Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy. |
| Part V, Section A, Line 1 | avera.org/locations/profile/avera-st-anthonys-hospital/ |
| Part V, Section B, Lines 7a, 7b and 10a: | The CHNA and Implementation Strategy reports are available at avera.org/about/community-health-needs-assessments/#anthony |
| Part V, Section B, Lines 16a, 16b, and 16c: | https://www.avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/ |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. |
| Part I, Line 7: | Charity care and unreimbursed Medicaid were converted to cost using the cost-to-charge ratio derived from Worksheet 2. Subsidized health services were calculated using a combination of cost-to-charge ratio derived from Worksheet 2 and the Medicare cost report. Community health improvement services, health professions education and cash and in-kind contributions are actual expenses recorded in the general ledger. |
| Part I, Line 7g: | Provider based clinic costs are included in subsidized health services. Revenues of $4,172,268 and costs of $10,498,025 were included for a net community benefit of $6,325,757. |
| Part III, Line 2: | The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients and residents. |
| Part III, Line 4: | The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 19 and 20. |
| Part III, Line 8: | Avera St. Anthony's provides services to patients under the Medicare program knowing they may not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, in years the costs associated with services provided under the Medicare program are not completely covered, the Medicare shortfall is considered a community benefit. Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. |
| Part III, Line 9b: | If the patient qualifies for the organization's financial assistance policy for low-income, uninsured patients and is cooperating with the organization with regard to efforts to settle an outstanding bill within current self-pay collection policy guidelines and timeframes, the organization or its agent shall not send, nor intimate that it will send, the unpaid bill to any outside collection agency. Avera organizations will allow all individuals 120 days from the first post discharge statement to apply for financial assistance before sending the uncollected account to an outside collection agency. Avera 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 no earlier than 30 days before action is initiated. If the patient qualifies for 100% charity care, no further bills will be sent. A letter will be sent instead indicating that the patient's bill has been completely forgiven. |
| Part VI, Line 2: | Avera St. Anthony's Hospital conducts an annual strategic planning meeting that includes a cross section of community members. Our Hospital Board of Directors, Hospital Finance Committee, Foundation Board of Directors, Community Medical Staff, and Hospital Department Directors meet to assess community input from the local nursing facility, assisted living, and local public health office. Our Hospital and Foundation Boards and Finance Committee are made up of a majority of community members. This group drafts an annual strategic plan of goals, objectives, and strategies that are continuously updated to address the needs of the community. Additionally, input from the local ministerial association, law enforcement, Chamber of Commerce, elementary and secondary public and parochial schools, and the local community college are assessed and incorporated into the plan. Our CHNA report was completed during fiscal year ended June 30, 2022. |
| Part VI, Line 3: | Uninsured patients who hold an inpatient status are counseled by a Patient Advocate to screen them for coverage eligibility and to assist in payer source enrollment. Those that are not eligible are provided a charity care application along with instructions on how to fill out the application. All patients receive statements that indicate who to contact should they need financial assistance. In addition, all patients receive a summary of financial assistance upon registration, as well as in their final statement. Should a patient contact Patient Financial Services and indicate inability to pay, they are transferred to a financial counselor to assist them with the financial assistance application process. Also, inpatient and same day surgery patients receive a brochure in their admissions packet. Pre-collection letters also include information regarding the financial assistance and uninsured programs. |
| Part VI, Line 4: | Avera St Anthony's is a 25-bed hospital in O'Neill, Nebraska. The primary service area is defined as Holt County, Nebraska. O'Neill is the county seat. According to the U.S. Census Bureau Quick Facts 2021 data, the estimated population of Holt County as of July 1, 2021 is 10,049 and is predominately white at 97.1%. It is estimated that 22.6% of the population is 65 years and over. The median household income is $60,214 with a 10.9% poverty rate. Uninsured individuals under age 65 is estimated at 8.6%. |
| Part VI, Line 5: | The Organization's governing body is comprised of volunteer members who reside in the community. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are reinvested in facilities to improve patient care. The hospital operates an emergency room that is available to all, regardless of ability to pay.Avera St. Anthony's has expanded Social Work support to integrate mental health services with Avera Coordinated Care, Dialysis and Home Health/Hospice. The organization also promotes health maintenance through screenings and additional options of detection and care management through blood pressure checks, bone density checks and skin cancer screening. Avera St. Anthony's had a hospital booth at the Women's Health Conference. Avera St. Anthony's supports the Community Food Pantry. They also provide support to the Befriend Family mentoring program through financial contributions to maintain coordination and viability of the program. Program brochures are available in clinic waiting areas. |
| Part VI, Line 6: | Avera is a sponsored ministry of the Benedictine and Presentation Sisters. The communities in which Avera operates all have unique health and community benefit needs. In keeping with the Catholic Healthcare Association guidelines, each hospital strives to meet its community's identified needs. The corporate staff of Avera Health advocates for all members regarding community benefit related matters of state, regional and national importance. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Julie Lautt | ||||||||||||||
| CFO Avera Health; Sec/Treas | $0 | $1,032,072 | $0 | $10,440 | $0 | $8,716 | $0 | $14,500 | $0 | $1,694 | $0 | $1,067,422 | $0 | $0 |
| Josh Becker | ||||||||||||||
| CRNA | $233,852 | $0 | $106,465 | $0 | $1,215 | $0 | $14,500 | $0 | $40,280 | $0 | $396,312 | $0 | $0 | $0 |
| Logan Kopf | ||||||||||||||
| CRNA | $193,506 | $0 | $107,380 | $0 | $1,121 | $0 | $14,500 | $0 | $35,656 | $0 | $352,163 | $0 | $0 | $0 |
| Kevin Loecker | ||||||||||||||
| CRNA | $237,043 | $0 | $23,955 | $0 | $2,044 | $0 | $13,221 | $0 | $12,293 | $0 | $288,556 | $0 | $0 | $0 |
| Todd Consbruck | ||||||||||||||
| President/CEO | $0 | $219,920 | $0 | $0 | $0 | $2,304 | $0 | $11,315 | $0 | $21,474 | $0 | $255,013 | $0 | $0 |
| Barbara Gutshall MD-Member | ||||||||||||||
| Medical Staff Pres/Internal Med. | $0 | $145,342 | $0 | $31,518 | $0 | $2,195 | $0 | $5,821 | $0 | $30,894 | $0 | $215,770 | $0 | $0 |
| Dean Benson | ||||||||||||||
| Physician Assistant | $155,847 | $0 | $0 | $0 | $1,464 | $0 | $8,160 | $0 | $28,349 | $0 | $193,820 | $0 | $0 | $0 |
| Cameron Everitt | ||||||||||||||
| Director of PT | $159,037 | $0 | $480 | $0 | $1,564 | $0 | $8,194 | $0 | $14,437 | $0 | $183,712 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 3: | FormAndLineReferenceDesc |
| Explanation | The President/CEO's compensation is paid by a related organization, Avera Sacred Heart. Avera St. Anthony's Hospital relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Julie Lautt, Barbara Gutshall, and Todd Consbruck have a business relationship. |
| Form 990, Part VI, Section A, line 6 | The sole member of the organization is Avera Health, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended. |
| Form 990, Part VI, Section A, line 7a | Avera Health, as the sole member, has the power to appoint and remove, with or without cause, members of the Board of Directors. |
| Form 990, Part VI, Section A, line 7b | Avera Health, as the sole member, has the following rights as the Member. 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of Corporation; 2) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Corporation, and to give final approval of any such action with respect thereto; 3) To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the Member; 4) To approve any plan of merger, consolidation or dissolution of the Corporation, or the divestiture of a sponsored work or ministry associated with the Corporation; 5) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the Corporation; 6) To appoint and remove, with or without cause, the Board of Directors of the Corporation. 7) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the Corporation. 8) To approve operating/capital budgets and strategic plans of the Corporation. 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the Member. 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the Member. 11) To establish and maintain employee benefit programs. 12) To establish and maintain insurance programs. 13) To approve major community fund drives. 14) To approve the appointment of auditors. 15) To adopt policies designed to effectuate the reserved powers of the Member. |
| Form 990, Part VI, Section A, line 8b | Avera St. Anthony's Hospital does not have a committee with authority to act on behalf of the governing body. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is reviewed by the Avera Health VP of Financial Reporting, Tax Manager, Facility CEO and Finance Committee (if applicable). After initial review the Form 990 is made available to the Board and other Operation Finance Leaders. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy covers board members, officers and key employees. At each board meeting, a request is made for all Board members to disclose any potential conflict of interest pertaining to any item listed on the agenda or pertaining to any potential item that could be discussed during the course of the meeting. The declaration of conflict of interest is recorded in the meeting minutes. The board makes a determination of whether there is a conflict of interest and if so, implements the procedure for evaluating the issue or transaction involved. The board member or officer with the conflict must refrain from voting. A statement of conflict of interest disclosure is made on an annual basis by officers and directors. The information is maintained in a database and a report is provided to the board. |
| Form 990, Part VI, Section B, line 15 | Compensation of the President and CEO is determined by Avera Sacred Heart Hospital, a related exempt organization. The Board of Directors reviews the management agreement with Avera Sacred Heart Hospital and discusses and approves the agreement. The CFO-Avera Health is compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of six (6) System Members appointed by the Religious Orders, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents and conflict of interest policy are not made available to the general public. The Organization's financial statements are attached to the Form 990 per IRS instructions and therefore available to the general public. |
| Form 990, Part IX, line 11g | Repairs and Maintenance: Program service expenses 835,714. Management and general expenses 20,035. Fundraising expenses 0. Total expenses 855,749. Medical Prof Fees: Program service expenses 1,086,054. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,086,054. Purchased Services: Program service expenses 2,363,801. Management and general expenses 44,429. Fundraising expenses 0. Total expenses 2,408,230. Centralized Services: Program service expenses 846,336. Management and general expenses 3,228,648. Fundraising expenses 0. Total expenses 4,074,984. |
| Form 990, Part XI, line 9: | Change in Interest in Avera Foundation -189,263. |
| Form 990, Part XII, Line 2c: | The Audit Committee of Avera Health, parent organization, selects the auditor and reviews the audited financial statements for Avera Health, which includes Avera St. Anthony's Hospital. |
| Form 990, Part X, Line 20: | Avera St. Anthony's Hospital is part of the Avera Obligated Group which consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Sacred Heart, Avera Marshall, Avera St. Mary's, Avera St. Anthony's, Avera St. Benedict, Avera Holy Family, Avera Tyler, Avera Granite Falls, Avera Gettysburg and Avera at Home. Avera St. Anthony's Hospital was not allocated any share of the bond issue, and thus does not have an amount on line 20. |
| Form 990, Item J: | The organization's website is: avera.org/locations/profile/avera-st-anthonys-hospital/ |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Health | |||||||||||
| 3900 W Avera Drive Suite 300 | Sioux Falls | SD | 57108 | 460422673 | Promotion of health | SD | 501(c)(3) | Line 10 | N/A | 0 | |
| Avera Holy Family | |||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 420680370 | Healthcare services | IA | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Holy Family Hospital Foundation | |||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 421317452 | Support health related services | IA | 501(c)(3) | Line 10 | 0 | Avera Holy Family | |
| St Benedict Health Center | |||||||||||
| 401 West Glynn Drive | Parkston | SD | 57366 | 460226738 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| St Benedict Health Center Foundation | |||||||||||
| 401 West Glynn Drive PO Box B | Parkston | SD | 57366 | 460458725 | Support health related services | SD | 501(c)(3) | Line 12a, I | 0 | St Benedict Health Center | |
| Avera McKennan | |||||||||||
| 1325 S Cliff Ave PO Box 5045 | Sioux Falls | SD | 57117 | 460224743 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Gettysburg | |||||||||||
| 606 East Garfield | Gettysburg | SD | 57442 | 460234354 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera St Mary's | |
| Avera Queen of Peace Hospital | |||||||||||
| 525 North Foster | Mitchell | SD | 57301 | 420224604 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Sacred Heart Health Services | |||||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460225483 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera at Home | |||||||||||
| 5116 S Solberg Ave | Sioux Falls | SD | 57108 | 460399291 | Home services | SD | 501(c)(3) | Line 10 | 0 | Avera Health | |
| Lewis and Clark Health Education and Service Agency | |||||||||||
| 1000 W 4th Street Suite 9 | Yankton | SD | 57078 | 460337013 | Healthcare services | SD | 501(c)(3) | Line 10 | 0 | Sacred Heart Health Services | |
| Avera St Luke's | |||||||||||
| 305 South State Street | Aberdeen | SD | 57401 | 460224598 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Marshall | |||||||||||
| 300 S Bruce St | Marshall | MN | 56258 | 410919153 | Healthcare services | MN | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera St Mary's | |||||||||||
| 801 East Sioux Avenue | Pierre | SD | 57501 | 460230199 | Healthcare services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Tyler | |||||||||||
| 240 Willow Street | Tyler | MN | 56178 | 410853163 | Healthcare services | MN | 501(c)(3) | Line 3 | 0 | Avera Marshall | |
| Avera Health Plans Inc | |||||||||||
| 3900 W Avera Drive Suite 101 | Sioux Falls | SD | 57108 | 460451539 | Health financing and health plan admin | SD | 501(c)(4) | 0 | Avera Health | ||
| Avera Granite Falls | |||||||||||
| 345 10th Ave | Granite Falls | MN | 56241 | 843156881 | Healthcare services | MN | 501(c)(3) | Line 3 | 0 | Avera Marshall | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| Avera Home Medical Equipment of Floyd Valley Hospital LLC | |||||||||
| 714 E Lincoln St NE | Lemars | IA | 51031 | 820582350 | Medical services - home medical equipment | SD | N/A | 0 | 0 |
| Avera Home Medical Equipment of Sioux Center LLC | |||||||||
| 38 19th St SW | Sioux Center | IA | 51250 | 753203100 | Medical services - home medical equipment | SD | N/A | 0 | 0 |
| Avera Home Medical Equipment of Spencer Hospital LLC | |||||||||
| 2400 S Minnesota Avenue 102 | Sioux Falls | SD | 57117 | 800619999 | Medical Services - home medical equipment | SD | N/A | 0 | 0 |
| Surgical Associates Endoscopy Clinic LLC | |||||||||
| 310 S Pennsylvania St | Aberdeen | SD | 57401 | 460461429 | Surgical associates | SD | N/A | 0 | 0 |
| Heart Hospital of South Dakota LLC | |||||||||
| 4500 W 69th Street | Sioux Falls | SD | 57108 | 562143771 | Healthcare Services | SD | N/A | 0 | 0 |
| Brookings Health System - Avera HME LLC | |||||||||
| 101 22nd Ave Suite 101 | Brookings | SD | 57006 | 453204123 | Medical Services - Home Medical Equipment | SD | N/A | 0 | 0 |
| Caravan Health ACO 41 LLC dba Prairie View Organization | |||||||||
| 7509 NW Tiffany Springs Parkway | Kansas City | MO | 64153 | 821447782 | Accountable Care Organization | MO | N/A | 0 | 0 |
| Caravan Health ACO 15 LLC dba Prairie Vista Care Organization | |||||||||
| 7509 NW Tiffany Springs Parkway Ste | Kansas City | MO | 64153 | 611843657 | Accountable Care Organization | MO | N/A | 0 | 0 |
| Avera Home Medical Equipment of Lakes Regional Healthcare LLC | |||||||||
| 2301 Hwy 71 South Ste D | Spirit Lake | IA | 51360 | 862949748 | Medical services - home medical equipment | IA | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Accounts Management Inc | ||||||||||||||
| 5132 S Cliff Avenue Suite 101 | Sioux Falls | SD | 57108 | 460373021 | Collection Services | SD | N/A | C | 0 | |||||
| Avera Property Insurance Inc | ||||||||||||||
| 1000 West 4th Street Suite 1 | Yankton | SD | 57078 | 460463155 | Property Insurance | SD | N/A | C | 0 | |||||
| Valley Health Services | ||||||||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460357149 | Rental Real Estate | SD | N/A | C | 0 | |||||
| Alucent Biomedical Inc | ||||||||||||||
| 1325 S Cliff Avenue PO Box 5045 | Sioux Falls | SD | 571175045 | 471818349 | Biotech Research | SD | N/A | C | 0 | |||||
| South Dakota State Medical Holding Company Inc | ||||||||||||||
| 5300 South Broadband Lane | Sioux Falls | SD | 57108 | 460401087 | Insurance | SD | N/A | C | 0 | |||||
| DakotaCare Administrative Services Inc | ||||||||||||||
| 5300 South Broadband Lane | Sioux Falls | SD | 57108 | 460424322 | Insurance | SD | N/A | C | 0 | |||||
| Alucent Australia Pty Ltd | ||||||||||||||
| Biotech Research | N/A | 0 | Level 10 30 Collings Street | Melbourne | VIC 3000 | AS | AS | |||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |