SACRED HEART HEALTH SERVICES: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: SACRED HEART HEALTH SERVICES (EIN 46-0225483)
Tax period: 2021-07-01 to 2022-06-30
Filed: 2023-05-12
IRS object ID: 202341329349303484
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 D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-05-12T10:34:26-05:00	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	460225483	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Sacred Heart Health Services	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	SACR	BusinessNameControlTxt
Phone	6056688000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	501 Summit	AddressLine1Txt
City	Yankton	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57078	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Julie Lautt	PersonNm
Person Title	CFO Avera Health	PersonTitleTxt
Phone	6056688000	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	2023-05-04	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

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	Avera Sacred Heart Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	Douglas R Ekeren	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	501 Summit	AddressLine1Txt
City	Yankton	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57078	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$153,607,742	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	avera.org/locations/sacred-heart/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1911	FormationYr
Legal Domicile State	SD	LegalDomicileStateCd
Activity Or Mission	Promotion of health	ActivityOrMissionDesc
Voting Members Governing Body	16	VotingMembersGoverningBodyCnt
Voting Members Independent	13	VotingMembersIndependentCnt
Total Employee	1268	TotalEmployeeCnt
Total Volunteers	183	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$9,923,500	PYContributionsGrantsAmt
CY Contributions Grants	$5,615,771	CYContributionsGrantsAmt
PY Program Service Revenue	$138,048,330	PYProgramServiceRevenueAmt
CY Program Service Revenue	$143,345,590	CYProgramServiceRevenueAmt
PY Investment Income	$12,368,103	PYInvestmentIncomeAmt
CY Investment Income	$3,884,270	CYInvestmentIncomeAmt
PY Other Revenue	-$196,562	PYOtherRevenueAmt
CY Other Revenue	$36,073	CYOtherRevenueAmt
PY Total Revenue	$160,143,371	PYTotalRevenueAmt
CY Total Revenue	$152,881,704	CYTotalRevenueAmt
PY Grants And Similar Paid	$193,218	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$44,736	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$68,960,030	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$73,231,926	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$15,250	CYTotalFundraisingExpenseAmt
PY Other Expenses	$69,352,286	PYOtherExpensesAmt
CY Other Expenses	$70,007,784	CYOtherExpensesAmt
PY Total Expenses	$138,505,534	PYTotalExpensesAmt
CY Total Expenses	$143,284,446	CYTotalExpensesAmt
PY Revenues Less Expenses	$21,637,837	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$9,597,258	CYRevenuesLessExpensesAmt
Total Assets BOY	$414,934,041	TotalAssetsBOYAmt
Total Assets EOY	$382,193,873	TotalAssetsEOYAmt
Total Liabilities BOY	$58,930,166	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$54,490,946	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$356,003,875	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$327,702,927	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	$125,885,423	ExpenseAmt
Grant	$44,736	GrantAmt
Revenue	$143,489,672	RevenueAmt
Desc	Avera Sacred Heart's mission is to provide healthcare services to Yankton, South Dakota residents and residents of the surrounding area. Avera Sacred Heart is a 501(c)(3) organization affiliated with Avera Health. Avera Sacred Heart consists of a 99-bed hospital and a 187-bed nursing home, congregate housing facility and a hospice house in Yankton, SD, a 23-bed critical access hospital and a 47-bed nursing home in Creighton, NE, and 14 physician clinics. The physician clinics include primary care, ob/gyn, pediatrics, orthopedics, general surgery, internal medicine, radiation, radiology, oncology, podiatry, therapy, dialysis, behavioral health, and palliative care. Following is a breakdown of these statistics by facility:Avera Sacred Heart Hospital2,813 Acute inpatient discharges538 Newborn patient discharges51 Swing bed patient discharges94,449 Outpatient visits292 Swing-bed patient days1,322 Newborn patient days35,008 Clinic visitsAvera Sacred Heart Majestic Bluffs337 Long term care patient discharges60,768 Long-term care resident daysAvera Creighton Hospital (CAH)127 Acute inpatient discharges76 Swing bed patient discharges16,961 Outpatient visits683 Swing-bed patient days18,999 Clinic visitsAvera Creighton Care Centre22 Long term care patient discharges13,802 Long-term care resident daysAvera Sacred Heart 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 $1,653,252.Avera Sacred Heart 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 Sacred Heart 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 Sacred Heart 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	$125,885,423	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	Yes (1)	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	Yes (1)	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	Yes (1)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	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	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	137	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1268	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	16	GoverningBodyVotingMembersCnt
Independent Voting Member	13	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	Yes (1)	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	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	0	WrittenPolicyOrProcedureInd
Own Website	Yes (X)	OwnWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Jamie A 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 (25 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	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Douglas Ekeren
President/CEO	40.00	7.00	Yes (X)	Yes (X)	$0	$689,391	$45,202
Brian Steward
Chair	2.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
Kathy Greeneway
Vice Chair	2.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
Jack Hurley
Board Member	2.00	0.00	Yes (X)		$0	$0	$0
Sr Lucille Welbig PBVM
Board Member	2.00	5.00	Yes (X)		$0	$0	$0
Richard Strom MD
Board Member	2.00	0.00	Yes (X)		$0	$0	$0
Carolyn Becker
Board Member	2.00	0.00	Yes (X)		$0	$0	$0
Steve Schindler
Board Member	2.00	0.00	Yes (X)		$0	$0	$0
Amy M Leon
Board Member	2.00	0.00	Yes (X)		$0	$0	$0
Bernie Hunhoff
Board Member	2.00	0.00	Yes (X)		$0	$0	$0
Sr Debra Kolecka OSB
Board Member	2.00	6.00	Yes (X)		$0	$0	$0
Tom Lorang EdD
Board Member	2.00	0.00	Yes (X)		$0	$0	$0
Beth Mikkelsen MD
Board Member	2.00	0.00	Yes (X)		$0	$0	$0
Scott Hiltunen MD
Board Member/Chief of Staff	42.00	0.00	Yes (X)		$408,589	$0	$48,164
Sr Roxanne Seifert PBVM
Board Member	2.00	8.00	Yes (X)		$0	$0	$0
Steve Schmeichel
Board Member	2.00	0.00	Yes (X)		$0	$0	$0
Julie Lautt
CFO Avera Health; Sec/Treas	0.10	46.30		Yes (X)	$0	$1,051,228	$16,194
Anthony Erickson
Executive Director Senior Services	40.00	0.00			$202,970	$0	$34,066	Yes (X)
Lindsay Flannery
VP Patient Care Services	40.00	1.00			$209,310	$0	$10,722	Yes (X)
Steve Gutnik MD FACP
Gastroenterology/Internal Medicine	40.00	0.00			$848,705	$0	$26,381		Yes (X)
Derrick Doolittle
Diagnostic Radiology	40.00	0.00			$610,519	$0	$52,815		Yes (X)
Michael Peterson MD
Radiation Oncology	40.00	0.00			$651,066	$0	$38,051		Yes (X)
Matthew Winkelbauer MD
Family Medicine/OB	40.00	1.00			$576,767	$0	$45,415		Yes (X)
Courtney Elizabeth Merkwan
Emergency Medicine	40.00	0.00			$521,927	$0	$45,414		Yes (X)
Jamie SchaeferFormer
Sec/Treas & VP Finance	0.00	40.00			$0	$287,691	$48,165			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$4,029,853	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,028,310	TotReportableCompRltdOrgAmt
Total Other Compensation	$410,589	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	84	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	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 Dr Ste 301	Sioux Falls	SD	57108	Shared Services	$15,676,914
Avera McKennan
1325 S Cliff Ave	Sioux Falls	SD	57105	Physician Services	$1,851,546
Yankton Medical Clinic PC
1104 W 8th St	Yankton	SD	57078	Physician Services	$1,798,583
Yankton Anesthesiology PC
1000 W 4th St Ste 13	Yankton	SD	57078	Anesthesiologists	$609,142
Sioux Laundry Inc
510 Centennial Dr	North Sioux City	IA	57049	Professional Services	$397,634

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	13	CntrctRcvdGreaterThan100KCnt
Related Organizations	$163,842	RelatedOrganizationsAmt
Government Grants	$5,443,429	GovernmentGrantsAmt
All Other Contributions	$8,500	AllOtherContributionsAmt
Total Contributions	$5,615,771	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Revenue	622110	$139,456,447	$139,456,447
Pharmacy Revenue	900099	$765,501	$765,501

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,123,642	TotalRevenueColumnAmt
Related Or Exempt Func Income	$3,123,642	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$143,345,590	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$117	TotalRevenueColumnAmt
Exclusion	$117	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$618,029	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$726,038	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$108,009	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$108,009	TotalRevenueColumnAmt
Exclusion	-$108,009	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$3,843,053	SecuritiesAmt
Other	$41,100	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$3,843,053	SecuritiesAmt
Other	$41,100	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,884,153	TotalRevenueColumnAmt
Exclusion	$3,884,153	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	A/R Interest Income	Desc
Business	900099	BusinessCd
Total Revenue Column	$144,082	TotalRevenueColumnAmt
Related Or Exempt Func Income	$144,082	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$144,082	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$152,881,704	TotalRevenueColumnAmt
Related Or Exempt Func Income	$143,489,672	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$3,776,261	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	$44,736	TotalAmt
Program Services	$44,736	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$930,919	TotalAmt
Program Services	$473,414	ProgramServicesAmt
Management And General	$457,505	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$342,551	TotalAmt
Program Services	$342,551	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$57,438,407	TotalAmt
Program Services	$56,267,626	ProgramServicesAmt
Management And General	$1,170,781	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,990,260	TotalAmt
Program Services	$1,925,789	ProgramServicesAmt
Management And General	$64,471	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$8,686,315	TotalAmt
Program Services	$8,468,658	ProgramServicesAmt
Management And General	$217,657	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,843,474	TotalAmt
Program Services	$3,714,649	ProgramServicesAmt
Management And General	$128,825	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$26,252	TotalAmt
Management And General	$26,252	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$29,544,540	TotalAmt
Program Services	$19,096,120	ProgramServicesAmt
Management And General	$10,443,044	ManagementAndGeneralAmt
Fundraising	$5,376	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$18,529	TotalAmt
Program Services	$15,580	ProgramServicesAmt
Management And General	$2,949	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,526,708	TotalAmt
Program Services	$1,155,033	ProgramServicesAmt
Management And General	$371,346	ManagementAndGeneralAmt
Fundraising	$329	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$995,322	TotalAmt
Program Services	$479,475	ProgramServicesAmt
Management And General	$515,847	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,830,304	TotalAmt
Program Services	$2,636,490	ProgramServicesAmt
Management And General	$193,814	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$347,052	TotalAmt
Program Services	$324,412	ProgramServicesAmt
Management And General	$22,640	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$249,970	TotalAmt
Program Services	$199,177	ProgramServicesAmt
Management And General	$50,793	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,431,093	TotalAmt
Program Services	$300,588	ProgramServicesAmt
Management And General	$1,130,505	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,235,467	TotalAmt
Program Services	$5,448,028	ProgramServicesAmt
Management And General	$1,785,511	ManagementAndGeneralAmt
Fundraising	$1,928	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$755,813	TotalAmt
Program Services	$140,946	ProgramServicesAmt
Management And General	$614,867	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$23,684,233	$23,655,343	$28,890
Equipment Lease/Rental	$113,011	$109,257	$3,754

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,249,490	TotalAmt
Program Services	$1,087,551	ProgramServicesAmt
Management And General	$154,322	ManagementAndGeneralAmt
Fundraising	$7,617	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$143,284,446	TotalAmt
Program Services	$125,885,423	ProgramServicesAmt
Management And General	$17,383,773	ManagementAndGeneralAmt
Fundraising	$15,250	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$7,079,028	BOYAmt
EOY	$2,699,257	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$16,741,242	BOYAmt
EOY	$19,223,179	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,473,654	BOYAmt
EOY	$2,562,008	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$864,140	BOYAmt
EOY	$1,064,659	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$176,221,809	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$117,119,435	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$62,407,836	BOYAmt
EOY	$59,102,374	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$312,527,266	BOYAmt
EOY	$288,812,533	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$958,856	BOYAmt
EOY	$1,075,779	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$6,925,628	BOYAmt
EOY	$6,897,639	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$4,956,391	BOYAmt
EOY	$756,445	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$414,934,041	BOYAmt
EOY	$382,193,873	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$10,836,089	BOYAmt
EOY	$11,211,735	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,441,064	BOYAmt
EOY	$671,150	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$42,247,031	BOYAmt
EOY	$40,629,381	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$98,953	BOYAmt
EOY	$104,880	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$4,307,029	BOYAmt
EOY	$1,873,800	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$58,930,166	BOYAmt
EOY	$54,490,946	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	$341,778,496	BOYAmt
EOY	$315,209,674	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$14,225,379	BOYAmt
EOY	$12,493,253	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$356,003,875	BOYAmt
EOY	$327,702,927	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$414,934,041	BOYAmt
EOY	$382,193,873	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$9,597,258	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$36,316,929	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$1,581,277	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
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 D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	0	AgentTrusteeEtcInd
Incl Escrow Custodial Acct Liab	Yes (1)	InclEscrowCustodialAcctLiabInd
Explanation Provided	Yes (X)	ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,251,529	BeginningYearBalanceAmt
Contributions	$7,165	ContributionsAmt
Investment Earnings Or Losses	-$126,486	InvestmentEarningsOrLossesAmt
Other Expenditures	$36,504	OtherExpendituresAmt
End Year Balance	$1,095,704	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,055,534	BeginningYearBalanceAmt
Contributions	$18,096	ContributionsAmt
Investment Earnings Or Losses	$178,943	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,044	OtherExpendituresAmt
End Year Balance	$1,251,529	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,157,988	BeginningYearBalanceAmt
Contributions	$31,030	ContributionsAmt
Investment Earnings Or Losses	-$10,503	InvestmentEarningsOrLossesAmt
Other Expenditures	$122,981	OtherExpendituresAmt
End Year Balance	$1,055,534	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,282,484	BeginningYearBalanceAmt
Contributions	$38,285	ContributionsAmt
Investment Earnings Or Losses	$41,728	InvestmentEarningsOrLossesAmt
Other Expenditures	$204,509	OtherExpendituresAmt
End Year Balance	$1,157,988	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,071,080	BeginningYearBalanceAmt
Contributions	$28,881	ContributionsAmt
Investment Earnings Or Losses	$188,014	InvestmentEarningsOrLossesAmt
Other Expenditures	$5,491	OtherExpendituresAmt
End Year Balance	$1,282,484	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.61128	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.38872	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	$4,355,594	OtherCostOrOtherBasisAmt
Book Value	$4,355,594	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$119,516,284	OtherCostOrOtherBasisAmt
Depreciation	$78,541,455	DepreciationAmt
Book Value	$40,974,829	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$44,950,821	OtherCostOrOtherBasisAmt
Depreciation	$33,481,374	DepreciationAmt
Book Value	$11,469,447	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,399,110	OtherCostOrOtherBasisAmt
Depreciation	$5,096,606	DepreciationAmt
Book Value	$2,302,504	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$59,102,374	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
Avera Pooled Investments	$275,276,189	F
Interest in Avera Health Foundation	$13,536,344	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$288,812,533	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Estimated third-party payor settlements	$304,700
Derivative Liability	$228,351
Deferred Payroll Taxes	$1,080,403
Right of Use Operating Lease Obligations	$260,346

Field	Value	IRS element (for citing)
Total Liability	$1,873,800	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part IV, Line 2b:	Resident trust funds are held on behalf of the residents.
Part V, Line 4:	The Organization's endowment consists of various individual funds established for a variety of purposes. Its endowment represents donor-restricted endowment funds. As required by generally accepted accounting principles, net assets associated with endowment funds 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	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	0	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$428,072	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$428,072	NetCommunityBenefitExpnsAmt
Total Expense	0.00300	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,421,845	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$11,963,705	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,458,140	NetCommunityBenefitExpnsAmt
Total Expense	0.03110	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$104,981	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$49,769	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$55,212	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,954,898	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,013,474	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,941,424	NetCommunityBenefitExpnsAmt
Total Expense	0.03450	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$374,512	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$374,512	NetCommunityBenefitExpnsAmt
Total Expense	0.00260	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$49,052	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$49,052	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,385,804	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$60,695	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,325,109	NetCommunityBenefitExpnsAmt
Total Expense	0.00920	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$156,679	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$156,679	NetCommunityBenefitExpnsAmt
Total Expense	0.00110	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,966,047	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$60,695	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,905,352	NetCommunityBenefitExpnsAmt
Total Expense	0.01320	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$18,920,945	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,074,169	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,846,776	NetCommunityBenefitExpnsAmt
Total Expense	0.04770	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,500	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$7,500	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,856	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,856	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,035	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,035	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,395	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,395	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$818	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$818	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$18,604	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$18,604	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$6,079,927	BadDebtExpenseAmt
Reimbursed By Medicare	$33,041,308	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$31,013,667	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$2,027,641	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	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc	Critical Access HospitalCriticalAccessHospitalInd
Avera Sacred Heart Hospital
1	501 Summit Street	Yankton	SD	57078	See Part V Section C	10576	Yes (X)	Yes (X)	Yes (X)	7 provider based clinics
Avera Creighton Hospital
2	1503 Main Street	Creighton	NE	68729	See Part V Section C	490001	Yes (X)	Yes (X)	Yes (X)	1 provider based clinic and 5 RHC's	Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNum	First Licensed CY Or PYFirstLicensedCYOrPYInd	Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd	CHNA ConductedCHNAConductedInd	Community DefinitionCommunityDefinitionInd	Community DemographicsCommunityDemographicsInd	Existing ResourcesExistingResourcesInd	How Data ObtainedHowDataObtainedInd	Community Health NeedsCommunityHealthNeedsInd	Other Health IssuesOtherHealthIssuesInd	Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd	Consulting ProcessConsultingProcessInd	Prior CHNA ImpactPriorCHNAImpactInd	CHNA ConductedCHNAConductedYr	Take Into Account Others InputTakeIntoAccountOthersInputInd	CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd	CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd	CHNA Report Widely AvailableCHNAReportWidelyAvailableInd	Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd	Own Website URLOwnWebsiteURLTxt	Other WebsiteOtherWebsiteInd	Other Website URLOtherWebsiteURLTxt	Paper Copy Public InspectionPaperCopyPublicInspectionInd	Implementation Strategy AdoptImplementationStrategyAdoptInd	Implementation Strategy AdptImplementationStrategyAdptYr	Strategy Posted WebsiteStrategyPostedWebsiteInd	Strategy Website URLStrategyWebsiteURLTxt	Organization Incur Excise TaxOrganizationIncurExciseTaxInd	Elig Criteria ExplainedEligCriteriaExplainedInd	FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd	FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct	FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct	Asset Level CriteriaAssetLevelCriteriaInd	Medical Indigency CriteriaMedicalIndigencyCriteriaInd	Insurance Status CriteriaInsuranceStatusCriteriaInd	Other CriteriaOtherCriteriaInd	Explained BasisExplainedBasisInd	App Financial Asst ExplnAppFinancialAsstExplnInd	Described InfoDescribedInfoInd	Described Suprt DocDescribedSuprtDocInd	Provided Hospital ContactProvidedHospitalContactInd	Includes Publicity MeasuresIncludesPublicityMeasuresInd	FAP Available On WebsiteFAPAvailableOnWebsiteInd	FAP Available On Website URLFAPAvailableOnWebsiteURLTxt	FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd	FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt	FAP Summary On WebsiteFAPSummaryOnWebsiteInd	FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt	FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd	FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd	FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd	Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd	Communtity Notified FAPCommuntityNotifiedFAPInd	FAP TranslatedFAPTranslatedInd	Other PublicityOtherPublicityInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	Permit No ActionsPermitNoActionsInd	Collection ActivitiesCollectionActivitiesInd	Provided Written NoticeProvidedWrittenNoticeInd	Made Effort Orally NotifyMadeEffortOrallyNotifyInd	Processed FAP ApplicationProcessedFAPApplicationInd	Made Presumptive Elig DetermMadePresumptiveEligDetermInd	Other Actions TakenOtherActionsTakenInd	Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd	Look Back Medicare PrivateLookBackMedicarePrivateInd	Amounts Generally BilledAmountsGenerallyBilledInd	Gross ChargesGrossChargesInd
Avera Sacred Heart Hospital
1	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	21	Yes (1)	0	0	Yes (1)	Yes (X)	See part V Section C	Yes (X)	See Part V Section C	Yes (X)	Yes (1)	21	Yes (1)	See Part V Section C	0	Yes (1)	Yes (X)	250.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	See Part V Section C	Yes (X)	See Part V Section C	Yes (X)	See Part V Section C	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	0
Avera Creighton Hospital
2	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	21	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (X)	See Part V Section C	Yes (X)	See Part V Section C	Yes (X)	Yes (1)	21	Yes (1)	See Part V Section C	0	Yes (1)	Yes (X)	250.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	See Part V Section C	Yes (X)	See Part V Section C	Yes (X)	See Part V Section C	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	0

Supplemental Information SupplementalInformationGrp (17 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Avera Sacred Heart Hospital	Part V, Section B, Line 5: Avera Sacred Heart utilized aspects of the Community Health Needs Assessment and Implementation Planning toolkit developed by the South Dakota Department of Health and focus groups conducted by Maximizing Excellence, LLC to conduct the FY2022 Community Health Needs Assessment. The process involved determining the participant's opinions on the community's strengths, weaknesses, resources and improvements. Careful consideration was taken to ensure that input gathered was representative of the community at large including the medically underserved, low-income or minority populations.
Avera Creighton Hospital	Part V, Section B, Line 5: Avera Creighton Hospital, in collaboration with the North Central District Health Department (NCDHD), used community stakeholder meetings, a focus group meeting and surveys to determine the 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.
Avera Creighton Hospital	Part V, Section B, Line 6a: Antelope Memorial HospitalAvera St. Anthony's HospitalWest Holt HospitalCHI Plainview HospitalOsmond General Hospital
Avera Creighton Hospital	Part V, Section B, Line 6b: North Central District Health DepartmentHolt County Economic DevelopmentNorthstarValentine Community SchoolCentral Nebraska Community Action PartnershipProteus, Inc. Services to Empower FarmworkersLegal Aid of NebraskaO'Neill Public Schools
Avera Sacred Heart Hospital	Part V, Section B, Line 11: Avera Sacred Heart conducted a community health needs assessment during FY2022. Two significant needs were identified and prioritized in the community health needs assessment process: Behavioral health and substance abuse/addiction and workforce and health care capacity.The following actions will be taken in future years to address the identified and prioritized community health needs:BEHAVIORAL HEALTH AND SUBSTANCE ABUSE/ADDICTIONIncrease community resources relating to behavioral health with special focus on substance abuse and addiction issues.Analyze the feasibility of an inpatient behavioral health unit at Avera Sacred Heart Hospital.Advocate for and support the Lewis and Clark Behavioral Health Services, Inc. residential chemical dependency program and unit.Advocate for and support the Lewis and Clark Behavioral Health Services, Inc. as they seek to build a new facility.Actively recruit psychologists and/or psychiatrists with specialties in behavioral health.Implement the Avera's "Ask the Question: Are you thinking about suicide" campaign.Implement strategies identified through the Communities that Care grant program as appropriate and feasible.Implement SBIRT (Screening, Brief Intervention, and Referral to Treatment), an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs.Implement the Edinburgh Scale for depression and suicide screening for OB patients.WORKFORCE AND HEALTH CARE CAPACITYIncrease workforce and health care capacity to adequately prepare Avera Sacred Heart to meet the future needs of the community.Further develop and implement an Avera Sacred Heart version of Avera Academy that fits the Yankton community.Further develop and implement the Avera Scholars program with Mount Marty University.Develop and implement an Avera Nurse Residency Program at Avera Sacred Heart for new college graduates.Develop and implement a Nurse Recruitment Team with the Avera Sacred Heart Endowed Chair of Nursing recipient at Mount Marty University.Utilize Build Dakota Scholarships to build a workforce for Avera Sacred Heart in difficult to recruit positions.Continue to promote the Avera Student Loan Program benefit and evaluate critical needs for eligibility with the program.Many of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment.The following health needs were identified but were not selected for focus: Transportation and affordability. Avera Sacred Heart is committed to providing high quality health care services to meet the needs of its service area. Although not the focus, Avera Sacred Heart is actively implementing cost saving initiatives to contain or minimize costs and will continue to advocate for increased transportation availability in the community. Avera Sacred Heart 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 the following actions were taken during FY22.CHRONIC DISEASE & NUTRITIONEnhance the nutrition wellness section of the Avera Sports Coach Rozy strength and conditioning programs.Provide annual education and/or cooking demonstrations on healthy eating as a component for wellness for those who experience chronic diseases.FY2022: Continued to provide education on healthy eating as a component for wellness via social media for those who experience chronic diseases. This has been done on both the Avera Health and Avera Sacred Heart social media sites. Dieticians worked with the Avera Sports Coach Rozy program to integrate nutrition education into the programs.Enhance the relationship between Avera Sacred Heart Hospital and the local grocery store Hy-Vee's dietician.Enhance the nutrition education provided to the Lewis and Clark Behavioral Health Services, Inc. residential chemical dependency program and unit located on third floor of the Avera Sacred Heart Hospital Benedictine Center.FY2022: Continued to enhance and implement nutrition education. Nutrition education and enhancements were made to the service provided to the Lewis and Clark residential chemical dependency program and unit.Provide an annual meal preparation and planning program.FY2022: Meal preparation and planning program continued to be offered on the Avera Health social media sites. This information has been shared on the Avera Sacred Heart social media site as well.BEHAVIORAL HEALTH & SUBSTANCE ABUSEAnalyze the feasibility of an inpatient behavior health unit at Avera Sacred Heart Hospital. Advocate for and support the Lewis and Clark Behavioral Health Services, Inc. residential chemical dependency program and the unit located on the third floor of the Avera Sacred Heart Hospital Benedictine Center.FY2022: The Lewis and Clark Behavioral Health Services, Inc. residential chemical dependency program is actively planning for expansion in a new building project.Actively recruit psychologists and/or certified nurse practitioners with specialties in behavioral health for the Avera Medical Group Behavioral Health Clinic.FY2022: Initial recruitment was unsuccessful and paused during the Covid pandemic. The recruitment process will be reassessed in the future.Provide educational and informational opportunities for the community.FY2022: Continued to provide posts regarding community educational and informational opportunities, including wellness and nutrition tips, on Avera Health and Avera Sacred Heart's social media sites.Implement the Avera Medical Group's opioid reduction strategies in the Avera Medical Group clinics in the Avera Sacred Heart Region.FY2022: Continued the opioid reduction strategies previously implemented. Avera Medical Group Pain Management will implement quarterly behavioral health evaluations for all patients on a pain contract.FY2022: Continued to maintain the quarterly evaluation program as implemented.
Avera Creighton Hospital	Part V, Section B, Line 11: Avera Creighton conducted a community health needs assessment during FY2022. The priority areas to be addressed by Avera Creighton include: Behavioral Health and Heart Health.The following actions will be taken in future years to address the identified and prioritized community health needs:BEHAVIORAL HEALTHContinue the screenings, education, counseling, transportation and other programs implemented under previous health need assessmentsContinue to collaborate with other facilities and institutions to improve behavioral health care and services in the communityImprove access to behavioral health providersBehavioral health education for health care providers and nursing staffBehavioral health education in collaboration with the area school system on suicide preventionBehavioral health education for the communityUtilize media outlets to increase awareness of Mental Health and SuicideHEART HEALTHContinue screenings and programs implemented under previous health need assessmentsExplore options for increasing the number and location of blood pressure screenings in the communityPatient education campaign focused on definition and treatment of hypertensionExplore options for bringing Planet Heart screenings to the communityIncrease amount of CPR certified Instructors in the communityMany of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment.The following health need was identified but will not be addressed, however, Avera Creighton Hospital will continue to assess and monitor the need through planning efforts to serve the health and well-being of the service area of the communities.No after-hours care options for non-emergent conditions outside of Emergency DepartmentAvera Creighton Hospital has limited staffing availability to expand clinic hours in the evening, which leaves the Emergency Department as the only option for after-hours care in the area.Avera Creighton 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 the following actions were taken during FY22.BEHAVIORAL HEALTHImprove access to behavioral health providersBehavioral health education for health care providers and nursing staffBehavioral health education in collaboration with the area school system on suicide preventionBehavioral health education for the communityFY2022: Clinic providers continue to use the Avera Behavioral Health Outpatient Triage program. This allows them to access a behavioral health counselor virtually to visit with the patient on the day they presented to the clinic rather than waiting to schedule an appointment. Continue to require PSQ-9 screening question for every patient seen in the clinic, the emergency room or admitted as an inpatient. The PSQ-9 screening tool helps evaluate a patient's overall mental health with a focus on depression. The 9 questions generate a score, symptom severity and action needed based on the score. If this screen is positive, it will generate further screening for suicide risk to help the provider determine next steps in treatment. In September 2021 the implementation of eSANE was done through a grant that provided equipment and training for providers and nursing staff to care for a patient that has been sexually assaulted. This included developing a relationship with Bright Horizons so they would be contacted to provide advocacy for the patient.The hospital completed the Age Friendly designation in fall of 2021. This designation involves reliably providing a set of 4 evidence-based elements to all older adults known as the 4 M's: What Matters, Medication, Mentation and Mobility. During the work on Mentation, a Delirium guide for patients, family members and caregivers was developed. The NuDESC Delirium Screen was added as a required screening in the EMR for inpatients and is completed every 12 hours. Providers and nursing staff were trained in symptoms of delirium, the use of the screening tool and how to help patients that are experiencing delirium. These Delirium guides are given to patients and family on admission as appropriate. HYPERTENSIONExplore options for increasing the number and location of blood pressure screenings in the communityPatient education campaign focused on definition and treatment of hypertensionFY2022: Continued the services of the Patient Coordinated Care nurse position. This nurse focuses on chronic health conditions for any patient of AMG clinics in Creighton, Verdigre, Niobrara, Crofton, Hartington and Pierce. This nurse provides education to the patients on hypertension, medications and other ways to reduce blood pressure. DIABETESContinued evaluation of the current diabetic education programMarket the current diabetic program through collaboration with marketing to distribute information in multiple ways*Provide an educational program on diabetes recognition and treatmentFY2022: Continued the services of the Patient Coordinated Care nurse position. This nurse focuses on chronic health conditions for any patient of AMG clinics in Creighton, Verdigre, Niobrara, Crofton, Hartington and Pierce. This nurse provides education to diabetic patients on diet, exercise, monitoring blood sugar and diabetic medications. The Covid-19 pandemic did have an impact on the implementation of the CHNA activities from March 2020 to the spring of 2022 but progress was made on each focus area despite the pandemic.
Avera Sacred Heart 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.
Avera Creighton 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.
Avera Sacred Heart 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.
Avera Creighton 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.
Avera Sacred Heart 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.
Avera Creighton 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.
Avera Sacred Heart 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.
Avera Creighton 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 organization's website	The website for Avera Sacred Heart Hospital is:avera.org/locations/sacred-heart/The website for Avera Creighton Hospital is:avera.org/locations/profile/avera-creighton-hospital
Part V, Section B, Line 7a, 7b, and 10a:	www.avera.org/about/community-health-needs-assessments/#sacredwww.avera.org/about/community-health-needs-assessments/#creighton
Part V, Section B, Line 16a, 16b, and 16c:	avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/

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 - Avera Sister James Care Center
2111 W 11th Street	Yankton	SD	57078	Skilled nursing facility
2 - Avera Sacred Heart Majestic Bluffs
2111 W 11th Street	Yankton	SD	57078	Assisted living
3 - Avera Sacred Heart Hospital-Swing Bed
501 Summit Street	Yankton	SD	57078	Swing Bed
4 - Avera Creighton Care Centre
1603 Main Street	Creighton	NE	687292999	Long Term Care
5 - Avera Sacred Heart Hospital-Dialysis
501 Summit Street	Yankton	SD	57078	Dialysis Unit
6 - AMG Gastroenterology
1104 West 8th Street	Yankton	SD	57078	Gastroenterology clinic
7 - AMG Willcockson Eye Associates
415 W Third	Yankton	SD	57078	Optical/Eye Clinic

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:	A combination of costing methodology was used to calculate the amounts reported in the table. A cost accounting system was used to calculate Medicaid and Means-tested Government Program expenses and shortfalls and Subsidized Health Services for our tertiary medical center. A cost to charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges was used to calculate charity care at cost for all entities and Medicaid and Means-tested Government Program expenses and shortfalls and Subsidized Health Services for any operations outside of the tertiary medical center. For all other amounts, costs and revenues as reflected by the general ledger system were used.
Part II, Community Building Activities:	The community building activities include monetary assistance to organizations that focus their efforts on providing furniture for low income families, neighborhood improvement projects in high needs areas, children and youth development programs, local economic development, and job creation and training programs.
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:	Sacred Heart Health Services 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 Sacred Heart Hospital includes community members on committees, boards and advisory groups to allow community reaction and input in the actions we take. We also review all data provided by the health departments regarding disease rates, mortality, morbidity, population changes, etc. The hospital also conducts focus groups, consumer perception studies, and patient satisfaction surveys to identify primary needs of the community and responds with preventative/educational information or activities for the community.
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 Sacred Heart is a 99-bed hospital in Yankton, South Dakota. Avera Sacred Heart primarily serves the city and county of Yankton and the counties of Bon Homme, Charles Mix, Hutchinson and Clay in South Dakota and counties of Knox and Cedar in Nebraska. The majority of discharges are from Yankton County. According to the U.S. Census Bureau Quick Facts 2021 data, the estimated population of Yankton County as of July 1, 2021 is 23,297 and is predominately white at 91.6%. It is estimated that 20.1% of the population is 65 years and over. The median household income is $61,878 with a 10.4% poverty rate. Uninsured individuals under age 65 is estimated at 12.6%.
Part VI, Line 5:	The Hospital board is comprised of individuals who represent the interests of the community served by the organization. The Hospital offers staff privileges to all qualified physicians in the community. Selected services such as Radiation Oncology and Swingbed Services would not be available in our service area unless provided by the organization. The Hospital serves all individuals regardless of their ability to pay, providing 24 hours a day emergency services. The facility participates in the education of medical students from The University of South Dakota through their Yankton location. The Hospital also offers a 2-year Radiology Technologist program that graduates approximately 6 students per year. Sacred Heart Hospital also provides clinical education for Mount Marty University students. The Hospital is also proud of the fact that 183 individuals chose to volunteer at the hospital facility in Yankton during fiscal year 2022.
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 benefits needs. In keeping with Catholic Health 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 I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Mount Marty University	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1105 W 8th Street	AddressLine1Txt
City	Yankton	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57078	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	460283336	RecipientEIN
IRC Section	501(c)(3)	IRCSectionDesc
Cash Grant	$40,000	CashGrantAmt
Non Cash Assistance	$0	NonCashAssistanceAmt
Purpose Of Grant	Fieldhouse	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2:	FormAndLineReferenceDesc
Explanation	The Organization provides grants/contributions to other organizations which are tax-exempt under IRC Section 501(c)(3) and governmental divisions that benefit the community and region through programs and activities.	ExplanationTxt

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 (11 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
Steve Gutnik MD FACP
Gastroenterology/Internal Medicine	$802,303	$0	$15,000	$0	$31,402	$0	$14,500	$0	$11,881	$0	$875,086	$0	$0	$0
Douglas Ekeren
President/CEO	$0	$675,177	$0	$700	$0	$13,514	$0	$14,500	$0	$30,702	$0	$734,593	$0	$0
Michael Peterson MD
Radiation Oncology	$620,649	$0	$20,250	$0	$10,167	$0	$14,500	$0	$23,551	$0	$689,117	$0	$0	$0
Derrick Doolittle
Diagnostic Radiology	$448,530	$0	$122,319	$0	$39,670	$0	$14,500	$0	$38,315	$0	$663,334	$0	$0	$0
Matthew Winkelbauer MD
Family Medicine/OB	$502,734	$0	$70,618	$0	$3,415	$0	$14,500	$0	$30,915	$0	$622,182	$0	$0	$0
Courtney Elizabeth Merkwan
Emergency Medicine	$466,663	$0	$50,219	$0	$5,045	$0	$14,500	$0	$30,914	$0	$567,341	$0	$0	$0
Scott Hiltunen MD
Board Member/Chief of Staff	$362,927	$0	$41,086	$0	$4,576	$0	$14,500	$0	$33,664	$0	$456,753	$0	$0	$0
Jamie SchaeferFormer
Sec/Treas & VP Finance	$0	$280,378	$0	$5,000	$0	$2,313	$0	$14,500	$0	$33,665	$0	$335,856	$0	$0
Anthony Erickson
Executive Director Senior Services	$199,059	$0	$520	$0	$3,391	$0	$8,812	$0	$25,254	$0	$237,036	$0	$0	$0
Lindsay Flannery
VP Patient Care Services	$207,642	$0	$0	$0	$1,668	$0	$10,382	$0	$340	$0	$220,032	$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 and CFO-Avera Health are compensated by Avera Health. Avera Sacred Heart relied on the related organization for determining the compensation for the President/CEO and CFO-Avera Health using the methods described in Part I, Line 3.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	Lawrence Leon	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	Spouse of board member	RelationshipDescriptionTxt
Transaction	$342,551	TransactionAmt
Transaction	Employee compensation and benefits	TransactionDesc
Sharing Of Revenues	0	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Section A, line 2	Sr. Debra Kolecka, Julie Lautt, Jamie Schaefer and Douglas Ekeren 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 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 board members. The information is maintained in a database and a report is provided to the Board.
Form 990, Part VI, Section B, line 15b	The CEO was compensated by Avera Health System. 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. Depending on the individuals's role with the organization, some officers and key employees are compensated by Avera Sacred Heart.
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	Purchased Services: Program service expenses 8,145,526. Management and general expenses 631,575. Fundraising expenses 5,376. Total expenses 8,782,477. Repairs and Maintenance: Program service expenses 2,871,188. Management and general expenses 182,034. Fundraising expenses 0. Total expenses 3,053,222. Centralized Services: Program service expenses 4,530,600. Management and general expenses 9,034,308. Fundraising expenses 0. Total expenses 13,564,908. Medical Professional Fees: Program service expenses 3,548,806. Management and general expenses 595,127. Fundraising expenses 0. Total expenses 4,143,933.
Form 990, Part XI, line 9:	Change in Interest in Avera Foundation -1,786,483. Change in Fair Value of Interest Rate Swap 205,206.
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 Sacred Heart Health Services.
Form 990, Part VI, Line 16:	There is no written policy or procedure. In the event of any such proposed transaction, the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member.
Form 990, Part X, Line 20:	The issue price includes the filing organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Marshall, Avera St. Mary's, Avera St. Anthony's, Avera St. Benedict, Avera Holy Family, Avera Tyler, Avera Granite Falls, Avera Gettysburg, Avera at Home,and Sacred Heart Health Services. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Avera Health's tax return (EIN 46-0422673).

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 West Avera Drive Suite 300	Sioux Falls	SD	57108	460422673	Healthcare services	SD	501(c)(3)	Line 10	N/A	0
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		Yes (1)	Sacred Heart Health Services
Avera St Anthony's Hospital
300 N 2nd Street	ONeill	NE	68763	470463911	Healthcare services	NE	501(c)(3)	Line 3		0	Avera Health
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
Avera Marshall
300 S Bruce St	Marshall	MN	56258	410919153	Healthcare services	MN	501(c)(3)	Line 3		0	Avera Health
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
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 Queen of Peace Hospital
525 N Foster Street	Mitchell	SD	57301	460224604	Healthcare services	SD	501(c)(3)	Line 3		0	Avera Health
Avera St Luke's
305 South State Street	Aberdeen	SD	57401	460224598	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 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 West Avera Drive Suite 101	Sioux Falls	SD	57108	460451539	Health financing and health plans 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
Surgical Associates Endoscopy Clinic LLC
310 S Pennsylvania St	Aberdeen	SD	57401	460461429	Surgical associates	SD	N/A	0	0
Avera Home Medical Equipment of Floyd Valley Hospital LLC
714 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 MN Ave 102	Sioux Falls	SD	57117	800619999	Medical services - home medical equipment	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 Care 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	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
Valley Health Services Inc
501 Summit Street	Yankton	SD	57078	460357149	Rental real estate	SD	Sacred Heart Health Services	C	-$74,059	$1,505,964	1.00000	Yes (1)
Accounts Management Inc
5132 S Cliff Ave Suite 101	Sioux Falls	SD	57108	460373021	Collection agency	SD		C				0	N/A
Avera Property Insurance Inc
1000 West 4th Street Suite 1	Yankton	SD	57078	460463155	Insurance	SD		C				0	N/A
Alucent Biomedical Inc
1325 S Cliff Avenue PO Box 5045	Sioux Falls	SD	571175045	471818349	Biotech Research	SD		C				0	N/A
South Dakota State Medical Holding Company Inc
5300 South Broadband Lane	Sioux Falls	SD	57108	460401087	Insurance	SD		C				0	N/A
DakotaCare Administrative Services Inc
5300 South Broadband Lane	Sioux Falls	SD	57108	460424322	Insurance	SD		C				0	N/A
Alucent Australia Pty Ltd
					Biotech Research							0	N/A	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	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	0	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	Valley Health Services Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	Q	TransactionTypeTxt
Involved	$159,990	InvolvedAmt
Method Of Amount Determination	FMV	MethodOfAmountDeterminationTxt