FURP.ORG / PUBLIC DATA EXPLORER

AVERA ST ANTHONYS HOSPITAL: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
AVERA ST ANTHONYS HOSPITAL (EIN 47-0463911)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-05-26
IRS object ID
202011479349300741
Schema version
2018v3.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2020-05-26T11:57:46-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN470463911EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Avera St Anthony's HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlAVERBusinessNameControlTxt
Phone4023365132PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 N 2nd StreetAddressLine1Txt
CityONeillCityNm
State AbbreviationNEStateAbbreviationCd
ZIP687631569ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJulie NortonPersonNm
Person TitleCFO Avera HealthPersonTitleTxt
Phone4023365132PhoneNum
Signature2020-05-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2020-05-14PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address216.147.181.49IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-05-14IPDt
IP Tm07:59:29IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdD8A1E5117AA53286D53F57459EBB2DE5C7CA50FCAtSubmissionCreationDeviceId
At Submission Filing Device IdF9BEE9501A3B4F00F190E63700B8BF2BC70C7B96AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTodd ConsbruckPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 N 2nd StreetAddressLine1Txt
CityONeillCityNm
State AbbreviationNEStateAbbreviationCd
ZIP687631569ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$43,159,331GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressSee Schedule OWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1955FormationYr
Legal Domicile StateNELegalDomicileStateCd
Activity Or MissionPromotion of healthActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee285TotalEmployeeCnt
Total Volunteers14TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$150,960PYContributionsGrantsAmt
CY Contributions Grants$149,580CYContributionsGrantsAmt
PY Program Service Revenue$42,883,615PYProgramServiceRevenueAmt
CY Program Service Revenue$41,518,798CYProgramServiceRevenueAmt
PY Investment Income$1,441,256PYInvestmentIncomeAmt
CY Investment Income$1,480,021CYInvestmentIncomeAmt
PY Other Revenue$3,149PYOtherRevenueAmt
CY Other Revenue-$14,952CYOtherRevenueAmt
PY Total Revenue$44,478,980PYTotalRevenueAmt
CY Total Revenue$43,133,447CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$3,621CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$16,814,091PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$17,002,687CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$20,262,173PYOtherExpensesAmt
CY Other Expenses$20,323,732CYOtherExpensesAmt
PY Total Expenses$37,076,264PYTotalExpensesAmt
CY Total Expenses$37,330,040CYTotalExpensesAmt
PY Revenues Less Expenses$7,402,716PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,803,407CYRevenuesLessExpensesAmt
Total Assets BOY$62,545,747TotalAssetsBOYAmt
Total Assets EOY$68,496,816TotalAssetsEOYAmt
Total Liabilities BOY$11,323,450TotalLiabilitiesBOYAmt
Total Liabilities EOY$10,758,150TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$51,222,297NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$57,738,666NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAvera 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$32,001,215ExpenseAmt
Grant$3,621GrantAmt
Revenue$41,521,930RevenueAmt
DescAvera St. Anthony's mission is to provide healthcare services to O'Neill, Nebraska residents and residents of the surrounding area. Avera St. Anthony is a 501(c)(3) organization affiliated with Avera Health. Avera St. Anthony consists of a 25-bed critical access hospital in O'Neill, Nebraska and 7 clinics. The program services offered include primary care, emergency, telemedicine, general surgery, cardiac rehab, chemotherapy, radiology, sleep lab, speech therapy, physical therapy and occupational therapy. Avera St. Anthony provides acute care and long-term healthcare services. Following is a breakdown of these statistics by facility:Avera St. Anthony Hospital784 Acute patient discharges150 Newborn patient discharges91 Swing bed patient discharges30,260 Outpatient visits768 Swing-bed patient days264 Newborn patient days31,308 Clinic visitsAvera St. Anthony 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 $941,590.Avera St. Anthony also provides community benefit health activities at less than or at no cost to support those in the area serviced, see Schedule H. As a member of the Avera Health Network, Avera St. Anthony upholds the vision of the Presentation and Benedictine Sisters to work through collaboration to provide quality, effective health ministry and to improve the healthcare of individuals and our communities through a regionally integrated network of persons and institutions. Avera St. Anthony 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$32,001,215TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document55IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee285EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jamie SchaeferBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6053223992PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13900 W Avera Dr Ste 300AddressLine1Txt
CitySioux FallsCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57108ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Jack Hurley
Chair1.000.00Yes (X)Yes (X)$0$0$0
Joe Krotter
Vice-Chair1.000.00Yes (X)Yes (X)$0$0$0
MaLaine Strope
Member1.000.00Yes (X)$0$0$0
Dick Grosch
Member1.000.00Yes (X)$0$0$0
Paul Carlson
Member1.000.00Yes (X)$0$0$0
Russ McIntosh
Member1.000.00Yes (X)$0$0$0
Sister Kathryn Burt OSB
Member1.000.00Yes (X)$0$0$0
Sister Lynn Marie Welbig PBVM
Member1.002.00Yes (X)$0$0$0
Deb Kelly
Member1.000.00Yes (X)$0$0$0
Kirk Cisler
Member1.000.00Yes (X)$0$0$0
Wayne ScheidemannMember
Medical Staff Pres/Ortho Surgery1.0040.00Yes (X)$0$572,008$23,205
Todd Consbruck
President & CEO24.0016.00Yes (X)Yes (X)$0$198,691$32,814
Jim Breckenridge
CFO Avera Health; Sec/Treas0.1039.90Yes (X)$0$918,859$34,586
Dean Benson
Physician Assistant40.000.00$157,921$0$10,417Yes (X)
Josh Becker
CRNA40.000.00$311,594$0$44,087Yes (X)
Kevin Loecker
CRNA40.000.00$239,515$0$40,640Yes (X)
Wendell Spencer
CRNA40.000.00$346,765$0$47,221Yes (X)
Cameron Everitt
Director of PT40.000.00$159,011$0$21,414Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,214,806TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,689,558TotReportableCompRltdOrgAmt
Total Other Compensation$254,384TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K10IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Avera Sacred Heart
501 Summit StYanktonSD57078Management, Support, & Lab Services$7,710,046
Avera Health
3900 W Avera Drive Suite 300Sioux FallsSD57108Shared Services$3,218,197
Docs Who Care
800 West Frontier LnOlatheKS66061ER Coverage Services$478,632
Avera McKennan Hospital
1325 S Cliff AveSioux FallsSD57105Physician Services$286,149
GE Medical Systems
3000 N Grandview BlvdWaukeshaWI53188Maintenance Agreements$188,242
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt
Government Grants$124,678GovernmentGrantsAmt
All Other Contributions$24,902AllOtherContributionsAmt
Total Contributions$149,580TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue622110$39,221,792$39,221,792
Pharmacy Revenue900099$1,750,442$1,750,442
Clinic Revenue621110$267,673$267,673

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$278,891TotalRevenueColumnAmt
Related Or Exempt Func Income$278,891RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$41,518,798TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$120,691TotalRevenueColumnAmt
Exclusion$120,691ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$7,800RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$25,884RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$18,084RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$18,084TotalRevenueColumnAmt
Exclusion-$18,084ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,263,330SecuritiesAmt
Other$96,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,263,330SecuritiesAmt
Other$96,000OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,359,330TotalRevenueColumnAmt
Exclusion$1,359,330ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescAR Interest IncomeDesc
Business900099BusinessCd
Total Revenue Column$3,132TotalRevenueColumnAmt
Related Or Exempt Func Income$3,132RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$3,132OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$43,133,447TotalRevenueColumnAmt
Related Or Exempt Func Income$41,521,930RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,461,937ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$3,621TotalAmt
Program Services$3,621ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$12,815,365TotalAmt
Program Services$12,021,213ProgramServicesAmt
Management And General$794,152ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$513,636TotalAmt
Program Services$490,804ProgramServicesAmt
Management And General$22,832ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,827,547TotalAmt
Program Services$2,462,478ProgramServicesAmt
Management And General$365,069ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$846,139TotalAmt
Program Services$813,028ProgramServicesAmt
Management And General$33,111ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,934TotalAmt
Management And General$2,934ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$2,108TotalAmt
Management And General$2,108ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$10,593,949TotalAmt
Program Services$6,775,947ProgramServicesAmt
Management And General$3,818,002ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,030TotalAmt
Program Services$1,991ProgramServicesAmt
Management And General$39ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$433,416TotalAmt
Program Services$354,351ProgramServicesAmt
Management And General$79,065ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$160,762TotalAmt
Program Services$151,396ProgramServicesAmt
Management And General$9,366ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$448,706TotalAmt
Program Services$432,849ProgramServicesAmt
Management And General$15,857ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$288,296TotalAmt
Program Services$276,083ProgramServicesAmt
Management And General$12,213ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$37,666TotalAmt
Program Services$32,495ProgramServicesAmt
Management And General$5,171ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$309,388TotalAmt
Program Services$309,388ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,001,165TotalAmt
Program Services$1,996,101ProgramServicesAmt
Management And General$5,064ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$89,143TotalAmt
Program Services$89,143ProgramServicesAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Medical Supplies$5,418,220$5,418,220
Bad Debts$287,708$287,708

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$248,241TotalAmt
Program Services$84,399ProgramServicesAmt
Management And General$163,842ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$37,330,040TotalAmt
Program Services$32,001,215ProgramServicesAmt
Management And General$5,328,825ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$8,092,325BOYAmt
EOY$856,950EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,168,999BOYAmt
EOY$5,306,346EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,154,898BOYAmt
EOY$1,260,806EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$60,081BOYAmt
EOY$95,829EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$39,777,050LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$25,251,819LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$14,654,176BOYAmt
EOY$14,525,231EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,796,315BOYAmt
EOY$1,824,942EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$31,618,953BOYAmt
EOY$44,626,712EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$62,545,747BOYAmt
EOY$68,496,816EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,326,015BOYAmt
EOY$2,684,664EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$7,784,035BOYAmt
EOY$7,082,771EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,213,400BOYAmt
EOY$990,715EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,323,450BOYAmt
EOY$10,758,150EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$51,071,797BOYAmt
EOY$57,628,766EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$150,500BOYAmt
EOY$109,900EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$51,222,297BOYAmt
EOY$57,738,666EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$62,545,747BOYAmt
EOY$68,496,816EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,803,407ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$658,590NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$54,372OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$2,108OtherActivitiesAmt
Total Lobbying Expenditures$2,108TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationAvera St. Anthony's Hospital paid dues to organizations which have a portion of the dues attributed to lobbying activities.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$150,500BeginningYearBalanceAmt
End Year Balance$150,500EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$150,500BeginningYearBalanceAmt
End Year Balance$150,500EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$150,500BeginningYearBalanceAmt
End Year Balance$150,500EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$150,500BeginningYearBalanceAmt
End Year Balance$150,500EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$150,500BeginningYearBalanceAmt
End Year Balance$150,500EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$745,022OtherCostOrOtherBasisAmt
Book Value$745,022BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$25,336,906OtherCostOrOtherBasisAmt
Depreciation$15,664,014DepreciationAmt
Book Value$9,672,892BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,583,668OtherCostOrOtherBasisAmt
Depreciation$8,826,619DepreciationAmt
Book Value$3,757,049BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,111,454OtherCostOrOtherBasisAmt
Depreciation$761,186DepreciationAmt
Book Value$350,268BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$14,525,231TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Assets Limited to Use - Avera Pooled Investments$43,490,427F
Investment in Foundation$1,136,285F
FieldValueIRS element (for citing)
Total Book Value Securities$44,626,712TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescEstimated Third Party Payor SettlementsDesc
Amt$990,715Amt
FieldValueIRS element (for citing)
Total Liability$990,715TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:The Foundation's endowment consists of a portion of their interest in the net assets of St. Anthony's Hospital Foundation. The St. Anthony's Hospital Foundation includes endowment funds which have been established for a variety of purposes. As required by generally accepted accounting principles, net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments (if any), are classified and reported based on the existence or absence of donor-imposed restrictions.
Part X, Line 2:Avera Health and its sponsored organizations believe that they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$478,428TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$478,428NetCommunityBenefitExpnsAmt
Total Expense0.01290TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,687,969TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,014,709DirectOffsettingRevenueAmt
Net Community Benefit Expns$673,260NetCommunityBenefitExpnsAmt
Total Expense0.01820TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,166,397TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,014,709DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,151,688NetCommunityBenefitExpnsAmt
Total Expense0.03110TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$340,075TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$25,131DirectOffsettingRevenueAmt
Net Community Benefit Expns$314,944NetCommunityBenefitExpnsAmt
Total Expense0.00850TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,371TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,371NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,209,595TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$465,121DirectOffsettingRevenueAmt
Net Community Benefit Expns$744,474NetCommunityBenefitExpnsAmt
Total Expense0.02010TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$88TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$88NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,558,129TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$490,252DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,067,877NetCommunityBenefitExpnsAmt
Total Expense0.02880TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,724,526TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,504,961DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,219,565NetCommunityBenefitExpnsAmt
Total Expense0.05990TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served12731PersonsServedCnt
Total Community Benefit Expns$206,100TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$144,067DirectOffsettingRevenueAmt
Net Community Benefit Expns$62,033NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$47,429TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$47,429NetCommunityBenefitExpnsAmt
Total Expense0.00130TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served12731PersonsServedCnt
Total Community Benefit Expns$253,529TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$144,067DirectOffsettingRevenueAmt
Net Community Benefit Expns$109,462NetCommunityBenefitExpnsAmt
Total Expense0.00300TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$287,708BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$16,618,909ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$16,835,767CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$216,858MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Avera St Anthony's HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 N 2nd StreetAddressLine1Txt
CityONeillCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68763ZIPCd
FieldValueIRS element (for citing)
Website AddressSee Part V, Page 10WebsiteAddressTxt
State License410002StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherProvider based clinics - 1 RHC & 6 physician clinicsOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1St Anthony's HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee website address on 7d narrativeOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSee website address on 7d narrativeOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee website address on Part V narrative.StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Part V, Page 8FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Part V, Page 8FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Page 8FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
St. Anthony's HospitalPart V, Section B, Line 5: Avera St. Anthony's Hospital initiated a community focus group meeting and also conducted personal interviews with electronic communication responses. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources and improvements. Those providing community input represented the medically underserved, low-income and minority populations as they serve with these populations through their activities. The following organizations were represented in the process: * O'Neill Police Department (OPD)* O'Neill Public Schools (OPS)* North Central District Health Department (NCDHD)* Avera St. Anthony's Hospital Social Service Department* University of Nebraska Lincoln Extension* Central Nebraska Community Action Partnership* O'Neill Ministerial Association* United Methodist Church Food Pantry* Holt County Economic Development
St. Anthony's HospitalPart V, Section B, Line 6a: Antelope Memorial HospitalAvera Creighton HospitalBrown County HospitalCHI Health Plainview HospitalOsmond General Hospital
St. Anthony's HospitalPart V, Section B, Line 6b: North Central District Health Department Region 4 Behavioral Health SystemO'Neill Public School Rural Region One Medical Response System
St. Anthony's HospitalPart V, Section B, Line 7d: Other website: www.avera.org/about/community-health-needs-assessments/
St. Anthony's HospitalPart V, Section B, Line 11: The community health needs assessment was completed during the tax year and as such the hospital has not taken specific actions with respect to the current implementation strategy. The following community health priority areas were identified and the following actions will be taken by the hospital during future years.CHRONIC DISEASE DETECTION & MANAGEMENT* Explore feasibility of expanding Social Work support to incorporate a Cancer case management system, child abuse prevention strategies, domestic violence, and Hospice care.* Continue to promote health maintenance through health screenings and additional options of detection/care management (Blood Pressure checks, bone density, skin cancer screening).* Provide support to the community food pantry through financial contribution and physical presence to offer blood pressure screening, mental wellness screening tools, nutrition education.* Promote dietary education internally and externally of the hospital through provision of calorie counts of food items and nutritional information tools. MENTAL WELLNESS* Provide support to the Befriend Family mentoring program through financial contribution to maintain coordination and viability of program. Provide program brochure to Medical Staff and clinic waiting areas.* Partner with North Central District Health Department in suicide prevention initiative through sponsorship of public viewing of Suicide Prevention video "The Ripple Effect".* Implement Avera suicide staff education, precautions and screening policies in the ED and promote use of Avera Farmer's Stress Hotline resources.The following health needs/priorities will not be addressed due to either a relative low priority, resource constraints or, because other facilities or educational entities are addressing the issues:* Resources Across the Lifespan* Substance AbuseMany of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment.
St. Anthony's HospitalPart V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
St. Anthony's HospitalPart V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
St. Anthony's HospitalPart V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility.
St. Anthony's HospitalPart 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, Lines 16a, 16b, and 16c:https://www.avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted.
Part I, Line 7:Charity care and unreimbursed Medicaid were converted to cost using the cost-to-charge ratio derived from Worksheet 2. Subsidized health services were calcalated using a combination of cost-to-charge ratio derived from Worksheet 2 and the Medicare cost report. Community health improvement services, health professions education and cash and inkind donations are actual expenses recorded in the general ledger.
Part I, Ln 7 Col(f):Bad debt expense of $287,708 is included on Form 990, Part IX, line 25, column (A) but excluded for purposes of calculating this percentage.
Part II, Community Building Activities:We provide transportation at a reduced rate to the community. Many children use our transportation to get to school keeping them out of the elements. The elderly and disabled use our transportation to get to appointments, shopping, and loved ones. Workforce development keeps and recruits health care professionals to this small community.
Part III, Line 2:Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year.Bad debt expense on line 2 is reported at charges as presented on the financial statements.
Part III, Line 3: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 III, Line 4:The footnote to the Organization's financial statements can be found on page 11 of the attached audited financial statements.
Part III, Line 8:St. Anthony's Hospital follows the CHA guidelines in reporting community benefits and therefore any Medicare shortfall is excluded from our community benefit report. However, Medicare is the Organization's largest payer and patients with Medicare coverage are accepted regardless of whether or not a surplus or deficit is realized from providing the services. This basis therefore means providing Medicare services promotes access to healthcare services which is a key advantage for our community.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.
Schedule H, Part V, Section A, Line 1https://www.avera.org/locations/profile/avera-st-anthonys-hospital/
Part VI, Line 2:Avera St. Anthony's Hospital conducts an annual strategic planning meeting that includes a cross section of community members. Our Hospital Board of Directors, Hospital Finance Committee, Foundation Board of Directors, Community Medical Staff, and Hospital Department Directors meet to assess community input from the local nursing facility, assisted living, and local public health office. Our Hospital and Foundation Boards and Finance Committee are made up of a majority of community members. This group drafts an annual strategic plan of goals, objectives, and strategies that are continuously updated to address the needs of the community. Additionally, input from the local ministerial association, law enforcement, Chamber of Commerce, elementary and secondary public and parochial schools, and the local community college are assessed and incorporated into the plan. Our CHNA report was completed during fiscal year ended June 30, 2019.
Part VI, Line 3:Patients are informed of the financial assistance/charity care policy through brochures and posted policies at the registration desks of the Hospital and Emergency Department. Avera St. Anthony's has staff in central registration that identify if a patient has the financial means to pay for services or insurance to cover these services. Public assistance is also pursued if deemed appropriate. If patients are identified as candidates for charity care they are directed to our financial services representative and the application process is initiated for charity care. Patient financial services can assist with determining what benefits the patient may qualify for and assists with helping 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. Anthony's Hospital is located in O'Neill, Nebraska, the county seat of Holt County. We serve a large radius to include patients from Brown, Rock, Boyd, Keya Paha, Wheeler, Knox, Garfield, and Antelope counties. In 2018, the population estimate for Holt County was estimated to be 10,178. Approximately 21.6% of the population is age 65 or older. The average per capita income is $29,975 and approximately 12.1% of the population is below the federal poverty level. The nearest hospital in the area is approximately 18 miles from Avera St. Anthony.
Part VI, Line 5:The Organization's governing body is comprised of volunteer members who reside in the community. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are reinvested in facilities to improve patient care. The hospital operates an emergency room that is available to all, regardless of ability to pay.
Part VI, Line 6:Avera is a sponsored ministry of the Benedictine and Presentation Sisters. The communities in which Avera operates all have unique health and community benefit needs. In keeping with the Catholic Healthcare Association guidelines, each hospital strives to meet its community's identified needs. The corporate staff of Avera Health advocates for all members regarding community benefit related matters of state, regional and national importance.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Wayne ScheidemannMember
Medical Staff Pres/Ortho Surgery$0$507,088$0$17,100$0$47,820$0$13,750$0$9,455$0$595,213$0$0
Todd Consbruck
President & CEO$0$198,035$0$0$0$656$0$10,334$0$22,480$0$231,505$0$0
Jim Breckenridge
CFO Avera Health; Sec/Treas$0$693,359$0$1,720$0$223,780$0$13,750$0$20,836$0$953,445$0$0
Dean Benson
Physician Assistant$157,438$0$0$0$483$0$7,940$0$2,477$0$168,338$0$0$0
Josh Becker
CRNA$201,354$0$109,880$0$360$0$13,750$0$30,337$0$355,681$0$0$0
Kevin Loecker
CRNA$221,975$0$16,800$0$740$0$12,353$0$28,287$0$280,155$0$0$0
Wendell Spencer
CRNA$230,094$0$113,300$0$3,371$0$13,750$0$33,471$0$393,986$0$0$0
Cameron Everitt
Director of PT$158,107$0$420$0$484$0$8,142$0$13,272$0$180,425$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule J, Part I, Line 3:FormAndLineReferenceDesc
ExplanationThe President/CEO's compensation is paid by a related organization, Avera Sacred Heart. Avera St. Anthony's Hospital relied on the related organizations for determining the compensation for the President/CEO using the methods described in Part I, Line 3.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6The 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 7aAvera 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 7bAvera Health, as the sole member, has the following rights as the Member. 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of Corporation; 2) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Corporation, and to give final approval of any such action with respect thereto; 3) To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the Member; 4) To approve any plan of merger, consolidation or dissolution of the Corporation, or the divestiture of a sponsored work or ministry associated with the Corporation; 5) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the Corporation; 6) To appoint and remove, with or without cause, the Board of Directors of the Corporation. 7) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the Corporation. 8) To approve operating/capital budgets and strategic plans of the Corporation. 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the Member. 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the Member. 11) To establish and maintain employee benefit programs. 12) To establish and maintain insurance programs. 13) To approve major community fund drives. 14) To approve the appointment of auditors. 15) To adopt policies designed to effectuate the reserved powers of the Member.
Form 990, Part VI, Section A, line 8bAvera St. Anthony's Hospital does not have a committee with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11bThe 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 12cThe 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 15Compensation of the President and CEO is determined by Avera Sacred Heart Hospital, a related exempt organization. The Board of Directors reviews the management agreement with Avera Sacred Heart Hospital and discusses and approves the agreement. The CFO-Avera Health is compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of six (6) System Members appointed by the Religious Orders, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes. Negotiations are done as needed. For other staff members, some of whom may serve on the board of directors, as officers, or as key employees, a salary review is done by a committee based on hospital association surveys, including hospital size.
Form 990, Part VI, Section C, line 19The 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 11gRepairs and Maintenance: Program service expenses 814,317. Management and general expenses 13,436. Fundraising expenses 0. Total expenses 827,753. Professional Fees: Program service expenses 5,961,630. Management and general expenses 262,107. Fundraising expenses 0. Total expenses 6,223,737. ACS Fees: Program service expenses 0. Management and general expenses 3,542,459. Fundraising expenses 0. Total expenses 3,542,459.
Form 990, Part XI, line 9:Change in Interest in Avera Foundation 54,372.
Form 990, Part XII, Line 2c:The Audit Committee of Avera Health, parent organization, selects the auditor and reviews the audited financial statements for Avera Health, which includes Avera St. Anthony's Hospital.
Form 990, Part X, Line 20:Avera St. Anthony's Hospital is part of the Avera Obligated Group which consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Sacred Heart, Avera Marshall, Avera St. Mary's, Avera St. Anthony's, Avera St. Benedict, Avera Holy Family, Avera Tyler, Avera Gettysburg and Avera at Home. Avera St. Anthony's Hospital was not allocated any share of the bond issue, and thus does not have an amount on line 20.
Form 990, Page 1, Item J Website:avera.org/locations/profile/avera-st-anthonys-hospital/

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Avera Health
3900 W Avera Drive Suite 300Sioux FallsSD57108460422673Promotion of healthSD501(c)(3)Line 10N/A0
Avera Holy Family
826 North 8th StreetEsthervilleIA51334420680370Healthcare servicesIA501(c)(3)Line 30Avera Health
Avera Holy Family Foundation
826 North 8th StreetEsthervilleIA51334421317452Support health related servicesIA501(c)(3)Line 100Avera Holy Family
St Benedict Health Center
401 West Glynn DriveParkstonSD57366460226738Healthcare servicesSD501(c)(3)Line 30Avera Health
St Benedict Health Center Foundation
401 West Glynn Drive PO Box BParkstonSD57366460458725Support health related servicesSD501(c)(3)Line 12a, I0St Benedict Health Center
Avera McKennan
1325 S Cliff Ave PO Box 5045Sioux FallsSD57117460224743Healthcare servicesSD501(c)(3)Line 30Avera Health
Avera Gettysburg
606 East GarfieldGettysburgSD57442460234354Healthcare servicesSD501(c)(3)Line 30Avera St Mary's
Avera Queen of Peace Hospital
525 North FosterMitchellSD57301420224604Healthcare servicesSD501(c)(3)Line 30Avera Health
Sacred Heart Health Services
501 Summit StreetYanktonSD57078460225483Healthcare servicesSD501(c)(3)Line 30Avera Health
Avera at Home
5116 S Solberg AveSioux FallsSD57108460399291Home ServicesSD501(c)(3)Line 100Avera Health
Lewis and Clark Health Ed and Serv Agency
1000 W 4th Street Suite 9YanktonSD57078460337013Healthcare educationSD501(c)(3)Line 100Sacred Heart Health Services
Avera St Luke's
305 South State StreetAberdeenSD57401460224598Healthcare servicesSD501(c)(3)Line 30Avera Health
Avera Marshall
300 S Bruce StMarshallMN56258410919153Healthcare ServicesMN501(c)(3)Line 30Avera Health
Avera St Mary's
801 East Sioux AvenuePierreSD57501460230199Healthcare servicesSD501(c)(3)Line 30Avera Health
St Anthony's Hospital Foundation
300 North 2nd StreetONeillNE68763470728707Support health related servicesNE501(c)(3)Line 12a, IYes (1)Avera St Anthony's Hospital
Avera Tyler
240 Willow StreetTylerMN56178410853163Healthcare servicesMN501(c)(3)Line 30Avera Marshall
Avera Health Plans Inc
3900 W Avera Drive Suite 101Sioux FallsSD57108460451539Health financing and health plan adminSD501(c)(4)0Avera Health

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
Avera Home Medical Equipment of Floyd Valley Hospital LLC
714 E Lincoln St NELemarsIA51031820582350Medical services - home medical equipmentSDN/A
Avera Home Medical Equipment of Sioux Center LLC
38 19th St SWSioux CenterIA51250753203100Medical services - home medical equipmentSDN/A
Avera Home Medical Equipment of Spencer Hospital LLC
2400 S Minnesota Avenue 102Sioux FallsSD57117800619999Medical Services - home medical equipmentSDN/A
Q&M Properties LLC
525 North FosterMitchellSD57301730652049Medical clinic buildingSDN/A
Surgical Associates Endoscopy Clinic LLC
310 S Pennsylvania StAberdeenSD57401460461429Surgical associatesSDN/A
Heart Hospital of South Dakota LLC
4500 W 69th StreetSioux FallsSD57108562143771Healthcare ServicesSDN/A
Brookings Health System - Avera HME LLC
101 22nd Ave Suite 101BrookingsSD57006453204123Medical Services - Home Medical EquipmentSDN/A
National Rural ACO 4 LLC dba Prairie Hills Care Organization
7509 NW Tiffany Springs ParkwayKansas CityMO64153371780735Accountable Care OrganizationKSN/A
National Rural ACO 5 LLC dba Great Plains Care Organization
7509 NW Tiffany Springs ParkwayKansas CityMO64153383958290Accountable Care OrganizationKSN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Accounts Management Inc
5132 S Cliff Avenue Suite 101Sioux FallsSD57108460373021Collection ServicesSDN/AC0
Avera Property Insurance Inc
610 W 23rd StreetYanktonSD57078460463155Property InsuranceSDN/AC0
Valley Health Services
501 Summit StreetYanktonSD57078460357149Rental Real EstateSDN/AC0
Alucent Medical Inc
31325 S Cliff Avenue PO Box 5045Sioux FallsSD571175045471818349Biotech ResearchSDN/AC0
South Dakota State Medical Holding Company Inc
2600 W 49th StreetSioux FallsSD57105460401087InsuranceSDN/AC0
DakotaCare Administrative Services Inc
2600 W 49th StreetSioux FallsSD57105460424322InsuranceSDN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other OrgYes (1)AssetSaleToOtherOrgInd
Asset Purchase From Other OrgYes (1)AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd