ST BENEDICT HEALTH CENTER: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- ST BENEDICT HEALTH CENTER (EIN 46-0226738)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-17
- IRS object ID
- 202101379349305235
- Schema version
- 2019v5.2
- 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 | 2021-05-17T13:20:23-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | 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 | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460226738 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Benedict Health Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STBE | BusinessNameControlTxt |
| Phone | 6059283311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 West Glynn Drive | AddressLine1Txt |
| City | Parkston | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57366 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Julie Lautt | PersonNm |
| Person Title | CFO Avera Health | PersonTitleTxt |
| Phone | 6059283311 | PhoneNum |
| Signature | 2021-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2021-05-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera St Benedict Health Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Rita Blasius | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 West Glynn Drive | AddressLine1Txt |
| City | Parkston | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57366 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $29,682,813 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.avera.org/st-benedict | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1965 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | Promotion of health | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 254 | TotalEmployeeCnt |
| Total Volunteers | 125 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $145,932 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,001,623 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $26,821,885 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $25,126,526 | CYProgramServiceRevenueAmt |
| PY Investment Income | $917,116 | PYInvestmentIncomeAmt |
| CY Investment Income | $753,352 | CYInvestmentIncomeAmt |
| PY Other Revenue | $34,426 | PYOtherRevenueAmt |
| CY Other Revenue | $26,233 | CYOtherRevenueAmt |
| PY Total Revenue | $27,919,359 | PYTotalRevenueAmt |
| CY Total Revenue | $27,907,734 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $111,699 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $86,775 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,639,804 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,204,072 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,774,499 | PYOtherExpensesAmt |
| CY Other Expenses | $8,664,416 | CYOtherExpensesAmt |
| PY Total Expenses | $22,526,002 | PYTotalExpensesAmt |
| CY Total Expenses | $22,955,263 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,393,357 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,952,471 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $51,176,712 | TotalAssetsBOYAmt |
| Total Assets EOY | $61,214,683 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,178,254 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,951,813 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $48,998,458 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $53,262,870 | 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 | $19,228,961 | ExpenseAmt |
| Grant | $86,775 | GrantAmt |
| Revenue | $25,132,570 | RevenueAmt |
| Desc | Avera St. Benedict Health Center's (Avera St. Benedict) mission is to provide healthcare services to Parkston, Tripp and Lake Andes, South Dakota residents and residents of the surrounding area. Avera St. Benedict is a 501(c)(3) organization affiliated with Avera Health. Avera St. Benedict consists of a 25-bed critical access hospital, a 49-bed nursing home, a 25-bed assisted living center and three provider based clinics. Services offered by Avera St. Benedict include primary care, emergency, general surgery, orthopedic surgery, podiatry surgery, cardiac rehab, pain management, pharmacy, behavioral health, laboratory, imaging, telemedicine, wellness center, speech therapy, physical therapy and occupational therapy. Avera St. Benedict provides acute care and long-term healthcare services.Following is a breakdown of these statistics by facility:Avera St. Benedict Hospital:367 Acute patient discharges46 Newborn patient discharges148 Swing bed patient discharges17,894 Outpatient visits1,154 Swing-bed patient days77 Newborn patient days20,456 Clinic visitsAvera Bormann Manor:25,267 Nursing home resident days27 Long Term Care patient dischargesAvera St. Benedict 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 $161,924.Avera St. Benedict 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. Benedict 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. Benedict 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 | $19,228,961 | 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 | 0 | 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 | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 44 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 254 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| 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 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 | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| Jim Breckenridge - Left 42020 | ||||||||
| CFO Avera Health; Sec/Treasurer | 0.10 | 41.30 | Yes (X) | $0 | $1,018,166 | $36,856 | ||
| Julie Lautt - Joined 42020 | ||||||||
| CFO Avera Health; Sec/Treasurer | 0.10 | 40.70 | Yes (X) | $0 | $518,454 | $35,583 | ||
| Richard W Honke II MD | ||||||||
| Family Medicine Physician | 40.00 | 0.00 | $418,095 | $0 | $38,090 | Yes (X) | ||
| Jason Wickersham MD | ||||||||
| Family Medicine/OB Physician | 40.00 | 5.00 | $380,390 | $0 | $42,563 | Yes (X) | ||
| Antoinette VanderPol MD | ||||||||
| Board Member/Chief of Staff | 40.00 | 0.00 | $353,681 | $0 | $24,598 | Yes (X) | ||
| Larissa Sanger MD | ||||||||
| Family Medicine Physician | 40.00 | 0.00 | $288,853 | $0 | $41,358 | Yes (X) | ||
| Beth Schroeder PA-C | ||||||||
| Clinic Manager | 40.00 | 0.00 | $240,786 | $0 | $39,541 | Yes (X) | ||
| Jedd Bialas | ||||||||
| CRNA | 40.00 | 0.00 | $191,183 | $0 | $43,065 | Yes (X) | ||
| Rita Blasius | ||||||||
| President/CEO | 40.00 | 0.50 | Yes (X) | $178,768 | $0 | $20,418 | Yes (X) | |
| Patricia Leischner | ||||||||
| Chair | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Dave Neugebauer | ||||||||
| Vice Chair | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Barb Weidenbach | ||||||||
| Secretary | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Sr Patricia Prunty PBVM | ||||||||
| Board Member | 2.00 | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Sr Patricia Ann Toscano | ||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Richard Boettcher | ||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Pat Reiner | ||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Bob Just | ||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Shayne McIntosh | ||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,051,756 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,536,620 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $322,072 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Avera Health | |||||
| 3900 W Avera Dr | Sioux Falls | SD | 57108 | Shared Services & eCare Services | $2,497,296 |
| Avera Queen of Peace | |||||
| 525 North Foster Street | Mitchell | SD | 57301 | ITS, administrative & management fees | $1,376,674 |
| Avera McKennan | |||||
| 1325 S Cliff Ave | Sioux Falls | SD | 57117 | Medical Services | $367,762 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $35,291 | RelatedOrganizationsAmt |
| Government Grants | $1,962,414 | GovernmentGrantsAmt |
| All Other Contributions | $3,918 | AllOtherContributionsAmt |
| Total Contributions | $2,001,623 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient & Resident Service Re | 622110 | $23,801,708 | $23,801,708 |
| Pharmacy Revenue | 900099 | $529,097 | $529,097 |
| Daycare Revenue | 624410 | $145,664 | $145,664 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $650,057 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $650,057 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $25,126,526 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,939 | TotalRevenueColumnAmt |
| Exclusion | $8,939 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $20,189 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $20,189 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,189 | TotalRevenueColumnAmt |
| Exclusion | $20,189 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,509,492 | SecuritiesAmt |
| Other | $10,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,775,079 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $734,413 | SecuritiesAmt |
| Other | $10,000 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $744,413 | TotalRevenueColumnAmt |
| Exclusion | $744,413 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | AR Interest Income | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $5,394 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,394 | RelatedOrExemptFuncIncomeAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $650 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $650 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,044 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,907,734 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,132,570 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $773,541 | 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 | $86,775 | TotalAmt |
| Program Services | $86,775 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $582,316 | TotalAmt |
| Program Services | $382,047 | ProgramServicesAmt |
| Management And General | $200,269 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,926 | TotalAmt |
| Program Services | $102,926 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,419,999 | TotalAmt |
| Program Services | $10,119,458 | ProgramServicesAmt |
| Management And General | $300,541 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $430,233 | TotalAmt |
| Program Services | $415,931 | ProgramServicesAmt |
| Management And General | $14,302 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,915,308 | TotalAmt |
| Program Services | $1,825,380 | ProgramServicesAmt |
| Management And General | $89,928 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $753,290 | TotalAmt |
| Program Services | $720,578 | ProgramServicesAmt |
| Management And General | $32,712 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,128 | TotalAmt |
| Management And General | $27,128 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,965,461 | TotalAmt |
| Program Services | $1,508,620 | ProgramServicesAmt |
| Management And General | $2,456,841 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,295 | TotalAmt |
| Program Services | $1,654 | ProgramServicesAmt |
| Management And General | $1,641 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $328,771 | TotalAmt |
| Program Services | $189,952 | ProgramServicesAmt |
| Management And General | $138,819 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,738 | TotalAmt |
| Program Services | $36,865 | ProgramServicesAmt |
| Management And General | $154,873 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $385,836 | TotalAmt |
| Program Services | $312,141 | ProgramServicesAmt |
| Management And General | $73,695 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,337 | TotalAmt |
| Program Services | $42,500 | ProgramServicesAmt |
| Management And General | $5,837 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,817 | TotalAmt |
| Program Services | $25,936 | ProgramServicesAmt |
| Management And General | $2,881 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,241,136 | TotalAmt |
| Program Services | $1,091,883 | ProgramServicesAmt |
| Management And General | $149,253 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,047 | TotalAmt |
| Program Services | $53,007 | ProgramServicesAmt |
| Management And General | $42,040 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $2,175,579 | $2,168,096 | $7,483 |
| Equipment Lease/Rental | $112,425 | $111,613 | $812 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,846 | TotalAmt |
| Program Services | $33,599 | ProgramServicesAmt |
| Management And General | $27,247 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,955,263 | TotalAmt |
| Program Services | $19,228,961 | ProgramServicesAmt |
| Management And General | $3,726,302 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,030,893 | BOYAmt |
| EOY | $656,432 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,853,676 | BOYAmt |
| EOY | $943,766 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $299,148 | BOYAmt |
| EOY | $328,361 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,779 | BOYAmt |
| EOY | $82,874 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $26,044,661 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $14,048,558 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,710,367 | BOYAmt |
| EOY | $11,996,103 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,007,588 | BOYAmt |
| EOY | $46,912,997 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $178,261 | BOYAmt |
| EOY | $294,150 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,176,712 | BOYAmt |
| EOY | $61,214,683 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,812,963 | BOYAmt |
| EOY | $1,862,311 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,828,725 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,003 | BOYAmt |
| EOY | $7,998 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $361,288 | BOYAmt |
| EOY | $3,252,779 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,178,254 | BOYAmt |
| EOY | $7,951,813 | 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 | $48,109,367 | BOYAmt |
| EOY | $52,314,020 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $889,091 | BOYAmt |
| EOY | $948,850 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,998,458 | BOYAmt |
| EOY | $53,262,870 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,176,712 | BOYAmt |
| EOY | $61,214,683 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,952,471 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$817,617 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $129,558 | 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 | 0 | FederalGrantAuditRequiredInd |
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 | $75,078 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$510 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $74,568 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $68,235 | BeginningYearBalanceAmt |
| Contributions | $108 | ContributionsAmt |
| Investment Earnings Or Losses | $6,735 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $75,078 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $65,370 | BeginningYearBalanceAmt |
| Contributions | $124 | ContributionsAmt |
| Investment Earnings Or Losses | $2,741 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $68,235 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $52,199 | BeginningYearBalanceAmt |
| Contributions | $9,508 | ContributionsAmt |
| Investment Earnings Or Losses | $3,663 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $65,370 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $52,694 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$495 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $52,199 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.82180 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.17820 | 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 | $97,483 | OtherCostOrOtherBasisAmt |
| Book Value | $97,483 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,126,753 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,002,926 | DepreciationAmt |
| Book Value | $9,123,827 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,290,791 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,809,671 | DepreciationAmt |
| Book Value | $2,481,120 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $529,634 | OtherCostOrOtherBasisAmt |
| Depreciation | $235,961 | DepreciationAmt |
| Book Value | $293,673 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,996,103 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Assets Limited to Use - Avera Pooled Investments | $45,394,218 | F |
| Interest in Avera Health Foundation | $1,518,779 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $46,912,997 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Estimated Third-Party Payors Settlements | -$44,209 |
| Contract Liability - Medicare Advanced Payments | $2,997,735 |
| Right of Use Operating Lease Obligations | $108,889 |
| Deferred Payroll Taxes | $190,364 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,252,779 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 2b: | Funds are held on behalf of the residents. |
| Part V, Line 4: | The Organization's endowment consists of a portion of their interest in the net assets of Avera Health Foundation. The Avera Health 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. The organization's permanently restricted endowment funds are donor restricted. The organization currently does not have any board designated endowment funds. |
| 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 |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $130,289 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $130,289 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00570 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,323,657 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $930,240 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $393,417 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01710 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $105,861 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $61,684 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $44,177 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,559,807 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $991,924 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $567,883 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02470 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $108,554 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,390 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $96,164 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00420 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $55,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $55,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,600,651 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,818,064 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $782,587 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03410 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,677 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $26,677 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,791,382 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,830,454 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $960,928 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04190 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,351,189 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,822,378 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,528,811 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06660 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $150,256 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $52,352 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $97,904 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00430 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $177,756 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $52,352 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $125,404 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $385,307 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,137,551 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,149,567 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$12,016 | 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 Benedict Health Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 West Glynn Drive | AddressLine1Txt |
| City | Parkston | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57366 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.avera.org/st-benedict | WebsiteAddressTxt |
| State License | 50749 | 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 | 3 provider based clinics | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Benedict Hospital Inc | 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 | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | 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 |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | 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 | 150.000000000000 | 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, Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Section C | 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 (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| St. Benedict Hospital Inc. | Part V, Section B, Line 5: A variety of individuals and groups of people were involved in the CHNA process from November 2018 through February 2019. Qualitative data was obtained from focus groups with the Parkston Commercial Club and Ministerial Association. The Parkston Commercial Club is a group of businesses in the Parkston area that meet monthly to support the community in a variety of ways, including fundraising for local events and family centered entertainment. Commercial club members are generally involved in many different activities in the community of Parkston, the local school district, and the surrounding area. The Ministerial Association members are clergy from many different congregations, some of which run food and clothing banks for individuals in need. The Ministerial Association meets monthly to work together to address many community and individual needs that are also social determinants of health. Formal individual interviews were conducted with two county health nurses, Andes Central School District Principal; Tripp School District Principal; Parkston School District superintendent; one Hutterite Colony boss; and manager of the only medical clinic in Lake Andes, SD. County health nurses are the only form of public health in Hutchinson County. A survey (electronic and paper) was completed by 103 community members. |
| St. Benedict Hospital Inc. | Part V, Section B, Line 11: Action on the implementation plan has started in most areas. COVID 19 impacted some of the activities by delaying them. Substance use prevention was not addressed as it was considered secondary to COVID 19. The following community health priorities were identified and the following actions have been taken during the tax year.Obesity*Created a "Shop with the Dietician" program.*Incorporated nutritional education for young athletes at Coaches' Clinic.*Provided education opportunities to the community for weight loss.*Provided scheduled free access to Avera St. Benedict's Wellness Center.*Started training elementary school teachers on the value of physical activity through incorporating it into daily classroom activities. Transportation*Gap assessment in transportation has started. Facility has promoted telehealth services to reduce transportations needs and to keep residents safe during pandemic. In-home medical care has happened when able secondary to COVID, specifically in high risk populations.Deterioration of Homes*Collaboration with the Commercial Club and Economic Development has started in hopes of launching a "paint a house" program. After School Activities for Kids*Supported the public library in their efforts to have an after-school program for kids. Due to COVID 19, discussions started and then were delayed. Initial discussion with the local dentists started for the goal of implementing free or reduced cost dental screening program in the community for kids.Access to Care*Worksite wellness screenings took place at two worksites.The following health need needs were not addressed due to resource constraints for the hospital at this time: *Walking/Bike pathsThe activities and priorities identified in the implementation plan will be addressed and implemented as able, secondary to COVID 19. |
| St. Benedict Hospital Inc. | 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. Benedict Hospital Inc. | 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 in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| St. Benedict Hospital Inc. | 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. Benedict Hospital Inc. | 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. |
| Schedule H Part V, Section C, Lines 7a and 10a: | Community Health Needs Assessment and Implementation Strategy websitehttps://www.avera.org/about/community-health-needs-assessments/ |
| Schedule H Part V, Section C, Lines 16a, 16b and 16c: | https://www.avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Avera Bormann Manor | ||||
| 501 North 4th Street | Parkston | SD | 57366 | Nursing Home |
| 2 - Avera St Benedict Assisted Living | ||||
| 400 W Fir | Parkston | SD | 57366 | Assisted Living |
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 expense was converted to cost using an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid was calculated using the costing methods to prepare the cost report. Subsidized health services were calculated based on a combination of the Medicare cost report and an overall cost-to-charge ratio for certain expenses. Other means tested government programs, community health improvement services, health professions education, and cash and in-kind contributions are reported based on actual expenses recorded in the general ledger. |
| Part II, Community Building Activities: | Avera St. Benedict Health Center (ASBHC) operates a community daycare providing a safe environment for the children. Lower income families are provided a safe and affordable place for their children. While not all the families are lower income, the organization sees this as a community need as there is no other facility in the area and the community as a whole would struggle to find daycare for their children. Despite operating at a loss, the Board of Directors is committed to providing the service to the community.Avera St. Benedict Health Center provided donations to various organizations to support activities as listed on Part II. |
| 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 17 and 18. |
| Part III, Line 8: | Any Medicare shortfall for St. Benedict Hospital is excluded from the community benefit report. Patients with Medicare coverage are accepted regardless of whether or not a surplus or deficit is realized from providing the services. This means providing Medicare services promotes access to healthcare services which is a key advantage for our community and therefore any shortfall is considered a community benefit.Total revenue received from Medicare and the Medicare allowable costs are reported from 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: | Community needs are evaluated and assessed on an on-going basis in several ways. ASBHC has completed formal "needs assessments" several times over the course of the past several years. This has been accomplished with input from focus groups, surveys, short and long range planning by the Health Center Board, demographic and health care data analysis, regular meetings with the provider staff, and collaboration with the local school and churches, as well as local law enforcement. |
| Part VI, Line 3: | Patients are informed of the financial assistance/charity care policy through brochures at the registration desks of the Hospital and Clinics. ASBHC has staff in Central Registration that identify if a patient is able to pay for services through insurance or otherwise. If they identify on the front end that the patient needs assistance, the patient is connected to a representative in Patient Financial Services who can assist with determining what benefits the patient may qualify for and help them apply for any benefits. If there is no option for an outside assistance program, the patient is informed and encouraged to complete the application that utilizes a combination of income, assets, and expenses to determine what percentage of charity care they would qualify for. |
| Part VI, Line 4: | Avera St Benedict is a 25-bed critical access hospital in Parkston, South Dakota. The primary service area is defined as Hutchinson County, South Dakota, including the communities of Freeman, Menno, Olivet and Tripp. Olivet is the county seat. According to the U.S. Census Bureau Quick Facts 2019 data, the estimated population of Hutchinson County as of July 1, 2019 is 7,291 and is predominately white at 96.2%. It is estimated that 22.9% of the population is 65 years and over. The median household income is $57,089 with a 10.5% poverty rate. Uninsured individuals under age 65 is estimated at 12.3%.The secondary service area includes the coverage of 8 Hutterian Brethern Colonies and Charles Mix County. Charles Mix County is demographically different from the rest of the service area. The population is 32.7% Native American. The median household income is $50,481 with a 21.2% poverty rate. Uninsured individuals under age 65 is estimated at 17.0%. |
| Part VI, Line 5: | The Organization's governing body is comprised of volunteer members who reside in the community. The Board of Directors meets monthly and has community representation that brings forward issues relative to challenges, needs and services within the community. The local ministerial group meets monthly at the Hospital and also identifies needs and gaps within the parishioners they serve. Medical staff privileges are extended to all qualified physicians in the community. The medical staff, including the physicians/mid-levels/department directors, has the opportunity to meet monthly and also discuss ways to meet the needs of the community they serve. 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.ASBHC has a fitness center on campus that is available to help the community focus on wellness and prevention. This endeavor is subsidized by the facility to improve the health and well-being of the community as a whole. The chaplaincy mission services participate and spearhead many community projects including an angel tree at Christmas to address the needs of children in our service area. ASBHC also donates to the local food pantry and purchases, prepares, and serves a meal to the Love Feast in Mitchell, SD annually. The meal serves 300 plus people in need of nutrition. At that event, bags of groceries are provided to the families in need that are in attendance to take home. There are several other projects of this nature on a smaller scale at the local school system. ASBHC donates to community events such as American Cancer Society projects and sponsors health related educational programs to the community at large. Avera St. Benedict also provides medical, nursing, and other ancillary health professions the opportunity for hands on learning experiences through residencies, internships, clinical rotations and other shadowing and profession mentoring programs to help with students health care training needs. |
| 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 I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| Dakota Heartland Development Association | |||||||
| 601 N Main St | Mitchell | SD | 57301 | 352397643 | 501(c)(3) | $15,000 | Community Development |
| Parkston Area Foundation | |||||||
| PO Box 823 | Parkston | SD | 57366 | 460444442 | 501(c)(3) | $5,000 | Community Development |
| University of South Dakota Foundation | |||||||
| 414 E Clark St | Vermillion | SD | 57069 | 466018891 | 501(c)(3) | $44,000 | Scholarships |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | 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 IRS 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) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jim Breckenridge - Left 42020 | ||||||||||||||
| CFO Avera Health; Sec/Treasurer | $0 | $945,274 | $0 | $1,760 | $0 | $71,132 | $0 | $14,000 | $0 | $22,856 | $0 | $1,055,022 | $0 | $0 |
| Julie Lautt - Joined 42020 | ||||||||||||||
| CFO Avera Health; Sec/Treasurer | $0 | $516,081 | $0 | $400 | $0 | $1,973 | $0 | $14,000 | $0 | $21,583 | $0 | $554,037 | $0 | $0 |
| Richard W Honke II MD | ||||||||||||||
| Family Medicine Physician | $328,725 | $0 | $73,566 | $0 | $15,804 | $0 | $14,000 | $0 | $24,090 | $0 | $456,185 | $0 | $0 | $0 |
| Jason Wickersham MD | ||||||||||||||
| Family Medicine/OB Physician | $277,834 | $0 | $101,166 | $0 | $1,390 | $0 | $14,000 | $0 | $28,563 | $0 | $422,953 | $0 | $0 | $0 |
| Antoinette VanderPol MD | ||||||||||||||
| Board Member/Chief of Staff | $290,468 | $0 | $61,767 | $0 | $1,446 | $0 | $14,000 | $0 | $10,598 | $0 | $378,279 | $0 | $0 | $0 |
| Larissa Sanger MD | ||||||||||||||
| Family Medicine Physician | $222,456 | $0 | $65,512 | $0 | $885 | $0 | $14,000 | $0 | $27,358 | $0 | $330,211 | $0 | $0 | $0 |
| Beth Schroeder PA-C | ||||||||||||||
| Clinic Manager | $163,826 | $0 | $67,556 | $0 | $9,404 | $0 | $11,322 | $0 | $28,219 | $0 | $280,327 | $0 | $0 | $0 |
| Jedd Bialas | ||||||||||||||
| CRNA | $190,777 | $0 | $0 | $0 | $406 | $0 | $10,087 | $0 | $32,978 | $0 | $234,248 | $0 | $0 | $0 |
| Rita Blasius | ||||||||||||||
| President/CEO | $175,475 | $0 | $725 | $0 | $2,568 | $0 | $8,936 | $0 | $11,483 | $0 | $199,187 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Denise Leischner | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Family member of Pat Leischner, Board Member | RelationshipDescriptionTxt |
| Transaction | $102,926 | TransactionAmt |
| Transaction | Compensation and benefits as an employee | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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) Define the purpose, philosophy and mission of this Corporation. 2) Receive and approve budgets of this Corporation. 3) Review and approve audited financial reports of this Corporation. 4) Dissolve, merge or consolidate this Corporation. 5) Approve the selection and retention of the independent auditing firm. 6) Approve any action which would change the character of this Corporation. 7) Initiate and/or approve all amendments to the Articles of Incorporation and Bylaws of this Corporation. 8) Appoint and remove, with or without cause, the Directors, sanction vacancies and determine the number of Directors of this 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 | St. Benedict Hospital does not have any committees 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 15a | The President and CEO of Avera Queen of Peace, a related organization, initiates the annual review for the CEO. He sends out evaluation forms to the board of St. Benedict's. Comparative data from Avera Health System is used to develop a recommended compensation structure. The compensation for the CEO is approved by Avera St. Benedict's board. This is done on an annual basis, usually in January. 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 | Purchased Services: Program service expenses 866,077. Management and general expenses 182,303. Fundraising expenses 0. Total expenses 1,048,380. Repairs and Maintenance: Program service expenses 525,185. Management and general expenses 33,538. Fundraising expenses 0. Total expenses 558,723. Medical Prof Fees: Program service expenses 117,358. Management and general expenses 0. Fundraising expenses 0. Total expenses 117,358. Centralized Services: Program service expenses 0. Management and general expenses 2,241,000. Fundraising expenses 0. Total expenses 2,241,000. |
| Form 990, Part XI, line 9: | Change in Interest in Avera Foundation 129,558. |
| 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 St. Benedict Health Center. |
| Form 990, Part X, Line 20: | St. Benedict Health Center 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. St. Benedict Health Center was not allocated any share of the bond issue, and thus does not have an amount on line 20. |
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 | Promotion of Health | SD | 501(c)(3) | Line 10 | N/A | 0 | |
| 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 | Yes (1) | St Benedict Health Center | |
| 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 | |
| Avera Holy Family Foundation | |||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 421317452 | Support health related services | IA | 501(c)(3) | Line 10 | 0 | Avera Holy Family | |
| 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 North Foster Street | Mitchell | SD | 57301 | 460224604 | 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 ST Suite 9 | Yankton | SD | 57078 | 460337013 | Healthcare education | 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 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 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 (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| 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 |
| 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 |
| Avera Home Medical Equipment of Spencer Hospital LLC | |||||||
| 2400 S Minnesota Ave | Sioux Falls | SD | 57117 | 800619999 | Medical Services - home medical equipment | SD | N/A |
| Q&M Properties LLC | |||||||
| 525 North Foster | Mitchell | SD | 57301 | 731652049 | Medical Clinic Building | SD | N/A |
| Surgical Associates Endoscopy Clinic LLC | |||||||
| 310 S Pennsylvania St | Aberdeen | SD | 57401 | 460461429 | Surgical Associates | SD | N/A |
| Heart Hospital of South Dakota LLC | |||||||
| 4500 W 69th Street | Sioux Falls | SD | 57108 | 562143771 | Healthcare Services | SD | N/A |
| Brookings Health System - Avera HME LLC | |||||||
| 101 22nd Ave Suite 101 | Brookings | SD | 57006 | 453204123 | Medical Services - Home Medical Equipment | SD | N/A |
| National Rural ACO 4 LLC dba Prairie Hills Care Organization | |||||||
| 7509 NW Tiffany Springs Parkway | Kansas City | MO | 64153 | 371780735 | Accountable Care Organization | KS | N/A |
| National Rural ACO 5 LLC dba Great Plains Care Organization | |||||||
| 7509 NW Tiffany Springs Parkway | Kansas City | MO | 64153 | 383958290 | Accountable Care Organization | KS | N/A |
| Caravan Health ACO 41 LLC dba Prairie View Care Organization | |||||||
| 7509 NW Tiffany Springs Parkway | Kansas City | MO | 64153 | 821447782 | Accountable Care Organization | KS | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Accounts Management Inc | |||||||||
| 5132 S Cliff Avenue Suite 101 | Sioux Falls | SD | 57108 | 460373021 | Collection Agency | SD | N/A | C | 0 |
| Avera Property Insurance Inc | |||||||||
| 1000 West 4th Street Suite 1 | Yankton | SD | 57078 | 460463155 | 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 Medical 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 | |||||||||
| 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 |
| 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 | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |