AVERA QUEEN OF PEACE: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: AVERA QUEEN OF PEACE (EIN 46-0224604)
Tax period: 2018-07-01 to 2019-06-30
Filed: 2020-05-26
IRS object ID: 202021479349300867
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-05-26T11:57:46-05:00	ReturnTs
Tax Period End	2019-06-30	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	2018-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	460224604	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Avera Queen of Peace Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	AVER	BusinessNameControlTxt
Phone	6059952251	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	525 North Foster Street	AddressLine1Txt
City	Mitchell	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57301	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Julie Norton	PersonNm
Person Title	CFO Avera Health	PersonTitleTxt
Phone	6059952251	PhoneNum
Signature	2020-05-21	SignatureDt
Discuss With Paid Preparer	0	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Kim Hunwardsen CPA	PreparerPersonNm
PTIN	P00484560	PTIN
Phone	6122536500	PhoneNum
Preparation	2020-05-21	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	216.147.181.49	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2020-05-21	IPDt
IP Tm	16:34:34	IPTm
IP Timezone	CD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC	AtSubmissionCreationDeviceId
At Submission Filing Device Id	F9BEE9501A3B4F00F190E63700B8BF2BC70C7B96	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-09-23 17:36:50Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	Avera Queen of Peace Health Service	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	Thomas A Clark	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	525 North Foster Street	AddressLine1Txt
City	Mitchell	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57301	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$127,785,011	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.averaqueenofpeace.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1905	FormationYr
Legal Domicile State	SD	LegalDomicileStateCd
Activity Or Mission	Promotion of health	ActivityOrMissionDesc
Voting Members Governing Body	19	VotingMembersGoverningBodyCnt
Voting Members Independent	14	VotingMembersIndependentCnt
Total Employee	909	TotalEmployeeCnt
Total Volunteers	66	TotalVolunteersCnt
Total Gross UBI	$189,823	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$4,158	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$564,767	PYContributionsGrantsAmt
CY Contributions Grants	$532,887	CYContributionsGrantsAmt
PY Program Service Revenue	$109,555,717	PYProgramServiceRevenueAmt
CY Program Service Revenue	$114,771,742	CYProgramServiceRevenueAmt
PY Investment Income	$2,657,795	PYInvestmentIncomeAmt
CY Investment Income	$2,312,286	CYInvestmentIncomeAmt
PY Other Revenue	-$16,527	PYOtherRevenueAmt
CY Other Revenue	-$114,393	CYOtherRevenueAmt
PY Total Revenue	$112,761,752	PYTotalRevenueAmt
CY Total Revenue	$117,502,522	CYTotalRevenueAmt
PY Grants And Similar Paid	$10,899	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$38,267	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$60,605,431	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$63,508,948	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$114,804	CYTotalFundraisingExpenseAmt
PY Other Expenses	$48,599,268	PYOtherExpensesAmt
CY Other Expenses	$54,488,401	CYOtherExpensesAmt
PY Total Expenses	$109,215,598	PYTotalExpensesAmt
CY Total Expenses	$118,035,616	CYTotalExpensesAmt
PY Revenues Less Expenses	$3,546,154	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$533,094	CYRevenuesLessExpensesAmt
Total Assets BOY	$140,736,352	TotalAssetsBOYAmt
Total Assets EOY	$139,254,238	TotalAssetsEOYAmt
Total Liabilities BOY	$42,955,295	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$43,111,410	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$97,781,057	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$96,142,828	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	$103,845,234	ExpenseAmt
Grant	$38,267	GrantAmt
Revenue	$114,773,017	RevenueAmt
Desc	Avera Queen of Peace's mission is to provide healthcare services to Mitchell, South Dakota residents and residents of the surrounding area. Avera Queen of Peace is a 501(c)(3) organization affiliated with Avera Health. Avera Queen of Peace consists of 42 acute beds, 8 ICU beds and an 84-bed nursing home in Mitchell, SD, a 16-bed critical access hospital in Wessington Springs, SD, a 6-bed critical access hospital in De Smet, SD and 13 physician clinics. The physician clinics include primary care, ob/gyn, pediatrics, orthopedics, general surgery, internal medicine, radiation, radiology, oncology, dermatology, therapy, ophthalmology and optometry. They provide acute care and long-term healthcare services, of which there were 2,624 patient discharges, 127,505 outpatient visits, 1,727 swing-bed patient days, 1,029 nursery patient days, 29,049 nursing home resident days, 8,029 assisted living resident days, 1,609 independent living days, and 81,423 clinic visits. Following is a breakdown of these statistics by facility:Avera Queen of Peace Hospital1,736 Acute patient discharges476 Newborn patient discharges139 Swing Bed patient discharges113,125 Outpatient visits1,134 Swing-bed patient days1,029 Newborn patient days81,423 Clinic visitsAvera Brady Health and Rehabilitation129 Long Term Care patient discharges29,049 Long-term care resident days8,029 Assisted living patient days1,609 Independent living daysAvera Westkota Memorial Medical Center (CAH)57 Acute patient discharges30 Swing Bed discharges4,387 Outpatient visits451 Swing-bed patient daysAvera De Smet Memorial Hospital (CAH)32 Acute patient discharges25 Swing Bed patient discharges9,993 Outpatient visits142 Swing-bed patient daysAvera Queen of Peace 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 $4,478,049.Avera Queen of Peace 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 Queen of Peace 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 or persons and institutions. Avera Queen of Peace 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	$103,845,234	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	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
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
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 With Officer Ent	0	BusinessRlnWithOfficerEntInd
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	141	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	909	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
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	19	GoverningBodyVotingMembersCnt
Independent Voting Member	14	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	0	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	0	WrittenPolicyOrProcedureInd
Own Website	Yes (X)	OwnWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Jamie 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 (26 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Jean Koehler
Chairperson	2.50	0.00	Yes (X)	Yes (X)	$0	$0	$0
Ryan Huber
Vice Chair	2.50	0.00	Yes (X)	Yes (X)	$0	$0	$0
Jason Bradley
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Julie Brookbank
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Quinten Burg
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Sister Kathleen Crowley OSB
Board Member	2.50	2.00	Yes (X)		$0	$0	$0
Sister Joan Reichelt
Board Member	2.50	2.00	Yes (X)		$0	$0	$0
Sister Erin Colgan OSB
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Brad Zomer
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Sharry Knock
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Michael Krause DO
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Ryan Thompson
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Hillary Rockwell MD
Board Member/Physician	2.50	40.00	Yes (X)		$518,172	$0	$45,357
Jay Tolsma
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Gopal Vyas
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Diane Sandhoff
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Scott VanKeulen MD
Board Member/President of Medical Staff	40.00	0.00	Yes (X)		$521,269	$0	$45,120
Thomas Clark
Regional President & CEO	40.00	0.50	Yes (X)	Yes (X)	$0	$516,754	$41,802
William E Flett
Secretary	2.50	40.00	Yes (X)	Yes (X)	$0	$191,338	$38,137
Jim Breckenridge
CFO Avera Health; Sec/Treas	0.10	39.90		Yes (X)	$0	$918,859	$34,586
Rochelle Reider
VP Patient Services	40.00	0.00			$182,403	$0	$34,728	Yes (X)
Chris Krouse DO
Orthopedics, Sports Medicine	40.00	0.00			$1,252,835	$0	$39,297		Yes (X)
Brian Kampmann
Orthopedics, Sports Medicine	40.00	0.00			$1,302,340	$0	$43,857		Yes (X)
Xenofon Papadopoulos MD
Urology	40.00	0.00			$587,022	$0	$43,857		Yes (X)
Dennis Leland
General Surgery	40.00	0.00			$634,927	$0	$38,779		Yes (X)
Aaron Bass
General Surgery	40.00	0.00			$706,075	$0	$43,857		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$5,705,043	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,626,951	TotReportableCompRltdOrgAmt
Total Other Compensation	$449,377	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	67	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Avera Health
3900 W Avera Dr	Sioux Falls	SD	57108	Shared Services, ACS Fees, eCare, and Co	$11,818,283
Avera McKennan
1325 S Cliff Ave	Sioux Falls	SD	57117	Medical Professionals, Interpreter, Prin	$2,123,188
Journey Group Companies
4500 W 58th St	Sioux Falls	SD	571186370	Construction	$677,355
Horizon Health Care Inc
109 N Main PO Box 99	Howard	SD	57349	Medical Professional Services	$253,568
Wapiti Medical Group LTD Co
107 Flynn Dr Ste 600	Milbank	SD	57252	Medical Locums Service	$229,505

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	16	CntrctRcvdGreaterThan100KCnt
Government Grants	$149,398	GovernmentGrantsAmt
All Other Contributions	$383,489	AllOtherContributionsAmt
Total Contributions	$532,887	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
Net Patient & Resident Services	622110	$112,252,502	$112,252,502
Retail Pharmacy	900099	$1,168,738	$978,915	$189,823
Cafeteria	900099	$313,052	$313,052

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,037,450	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,037,450	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$114,771,742	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$156,276	TotalRevenueColumnAmt
Exclusion	$156,276	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$181,333	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$297,001	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$115,668	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$115,668	TotalRevenueColumnAmt
Exclusion	-$115,668	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$12,141,498	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$9,982,559	SecuritiesAmt
Other	$2,929	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$2,158,939	SecuritiesAmt
Other	-$2,929	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,156,010	TotalRevenueColumnAmt
Exclusion	$2,156,010	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	Operating Interest	Desc
Business	900099	BusinessCd
Total Revenue Column	$1,275	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,275	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,275	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$117,502,522	TotalRevenueColumnAmt
Related Or Exempt Func Income	$114,583,194	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$189,823	UnrelatedBusinessRevenueAmt
Exclusion	$2,196,618	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	$38,267	TotalAmt
Program Services	$38,267	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,158,644	TotalAmt
Program Services	$939,598	ProgramServicesAmt
Management And General	$219,046	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$74,035	TotalAmt
Program Services	$74,035	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$48,301,309	TotalAmt
Program Services	$45,554,823	ProgramServicesAmt
Management And General	$2,676,383	ManagementAndGeneralAmt
Fundraising	$70,103	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,839,770	TotalAmt
Program Services	$1,710,886	ProgramServicesAmt
Management And General	$125,379	ManagementAndGeneralAmt
Fundraising	$3,505	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$9,172,905	TotalAmt
Program Services	$8,764,627	ProgramServicesAmt
Management And General	$392,406	ManagementAndGeneralAmt
Fundraising	$15,872	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,962,285	TotalAmt
Program Services	$2,753,526	ProgramServicesAmt
Management And General	$203,869	ManagementAndGeneralAmt
Fundraising	$4,890	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$4,082	TotalAmt
Management And General	$4,082	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$6,355	TotalAmt
Program Services	$6,355	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$20,370,076	TotalAmt
Program Services	$12,178,101	ProgramServicesAmt
Management And General	$8,182,862	ManagementAndGeneralAmt
Fundraising	$9,113	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$8,765	TotalAmt
Program Services	$4,279	ProgramServicesAmt
Management And General	$4,010	ManagementAndGeneralAmt
Fundraising	$476	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,485,485	TotalAmt
Program Services	$1,335,610	ProgramServicesAmt
Management And General	$147,226	ManagementAndGeneralAmt
Fundraising	$2,649	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,236,450	TotalAmt
Program Services	$352,566	ProgramServicesAmt
Management And General	$883,884	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,828,379	TotalAmt
Program Services	$1,376,394	ProgramServicesAmt
Management And General	$451,985	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$378,717	TotalAmt
Program Services	$328,198	ProgramServicesAmt
Management And General	$45,910	ManagementAndGeneralAmt
Fundraising	$4,609	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$193,895	TotalAmt
Program Services	$139,741	ProgramServicesAmt
Management And General	$53,347	ManagementAndGeneralAmt
Fundraising	$807	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,386,781	TotalAmt
Program Services	$1,386,781	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$5,270,572	TotalAmt
Program Services	$5,061,867	ProgramServicesAmt
Management And General	$208,475	ManagementAndGeneralAmt
Fundraising	$230	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$363,165	TotalAmt
Program Services	$363,165	ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$16,270,082	$16,237,476	$32,606
Bad Debt Expense	$4,578,844	$4,578,844
Taxes and Licenses	$62,469	$62,469

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,044,284	TotalAmt
Program Services	$597,626	ProgramServicesAmt
Management And General	$444,108	ManagementAndGeneralAmt
Fundraising	$2,550	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$118,035,616	TotalAmt
Program Services	$103,845,234	ProgramServicesAmt
Management And General	$14,075,578	ManagementAndGeneralAmt
Fundraising	$114,804	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$4,207,368	BOYAmt
EOY	$1,090,367	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$11,286,034	BOYAmt
EOY	$5,912,217	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,715,262	BOYAmt
EOY	$1,715,229	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$637,928	BOYAmt
EOY	$702,529	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$121,434,256	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$67,329,429	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$56,406,630	BOYAmt
EOY	$54,104,827	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$63,966,250	BOYAmt
EOY	$73,348,847	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$988,660	BOYAmt
EOY	$380,347	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,451,150	BOYAmt
EOY	$1,406,837	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$77,070	BOYAmt
EOY	$593,038	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$140,736,352	BOYAmt
EOY	$139,254,238	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$7,874,888	BOYAmt
EOY	$7,964,918	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$33,900,473	BOYAmt
EOY	$33,900,473	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$7,469	BOYAmt
EOY	$44,462	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,172,465	BOYAmt
EOY	$1,201,557	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$42,955,295	BOYAmt
EOY	$43,111,410	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$94,691,411	BOYAmt
EOY	$92,664,596	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,278,250	BOYAmt
EOY	$2,431,286	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$811,396	BOYAmt
EOY	$1,046,946	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$97,781,057	BOYAmt
EOY	$96,142,828	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$140,736,352	BOYAmt
EOY	$139,254,238	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$533,094	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$363,892	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$1,469,027	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 C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$6,355	OtherActivitiesAmt
Total Lobbying Expenditures	$6,355	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1:	FormAndLineReferenceDesc
Explanation	Avera Queen of Peace Hospital paid dues to organizations which have a portion of the dues attributed to lobbying activities.	ExplanationTxt

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	$708,556	BeginningYearBalanceAmt
Contributions	$356	ContributionsAmt
Investment Earnings Or Losses	$25,945	InvestmentEarningsOrLossesAmt
Other Expenditures	$8,156	OtherExpendituresAmt
End Year Balance	$726,701	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,748,708	BeginningYearBalanceAmt
Contributions	$424	ContributionsAmt
Investment Earnings Or Losses	$37,389	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,077,965	OtherExpendituresAmt
End Year Balance	$708,556	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,715,895	BeginningYearBalanceAmt
Contributions	$256,959	ContributionsAmt
Investment Earnings Or Losses	$252,847	InvestmentEarningsOrLossesAmt
Other Expenditures	$463,879	OtherExpendituresAmt
Administrative Expenses	$13,114	AdministrativeExpensesAmt
End Year Balance	$2,748,708	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,859,724	BeginningYearBalanceAmt
Contributions	$304,703	ContributionsAmt
Investment Earnings Or Losses	$241,350	InvestmentEarningsOrLossesAmt
Other Expenditures	$676,074	OtherExpendituresAmt
Administrative Expenses	$13,808	AdministrativeExpensesAmt
End Year Balance	$2,715,895	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,681,098	BeginningYearBalanceAmt
Contributions	$326,197	ContributionsAmt
Investment Earnings Or Losses	$95,588	InvestmentEarningsOrLossesAmt
Other Expenditures	$222,117	OtherExpendituresAmt
Administrative Expenses	$21,042	AdministrativeExpensesAmt
End Year Balance	$2,859,724	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.01320	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.98680	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.00000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$473,670	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$2,875,511	OtherCostOrOtherBasisAmt
Book Value	$3,349,181	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$1,859,884	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$70,914,166	OtherCostOrOtherBasisAmt
Depreciation	$36,454,660	DepreciationAmt
Book Value	$36,319,390	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,483,721	OtherCostOrOtherBasisAmt
Depreciation	$826,999	DepreciationAmt
Book Value	$4,656,722	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$36,575,875	OtherCostOrOtherBasisAmt
Depreciation	$27,461,411	DepreciationAmt
Book Value	$9,114,464	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,251,429	OtherCostOrOtherBasisAmt
Depreciation	$2,586,359	DepreciationAmt
Book Value	$665,070	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$54,104,827	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (3 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
Interest in Avera Health Foundation	$3,108,530	F
Interest in net assets of Mabee Trust	$799,592	F
Assets Limited to use - Avera Pooled Investments	$69,440,725	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$73,348,847	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	Derivative liability	Desc
Amt	$1,201,557	Amt

Field	Value	IRS element (for citing)
Total Liability	$1,201,557	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part IV, Line 2b:	The Organization holds funds in trust on behalf of its residents.
Part V, Line 4:	The organization's endowments consist of a portion of their interest in the net assets of Avera Health Foundation and their beneficial interest in the Mabee Trust. Avera Health Foundation includes endowment funds which have been established for a variety of purposes. The endowment fund assets included in the Organization's beneficial interest in the Mabee Trust have been established to purchase equipment and furnishings for the Organization. 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	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	0	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,315,986	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,315,986	NetCommunityBenefitExpnsAmt
Total Expense	0.01160	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,421,008	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,463,336	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,957,672	NetCommunityBenefitExpnsAmt
Total Expense	0.02610	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$554,342	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$501,119	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$53,223	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,291,336	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,964,455	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,326,881	NetCommunityBenefitExpnsAmt
Total Expense	0.03820	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,219	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,219	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$252,105	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$252,105	NetCommunityBenefitExpnsAmt
Total Expense	0.00220	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$161,256	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$161,256	NetCommunityBenefitExpnsAmt
Total Expense	0.00140	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$417,580	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$417,580	NetCommunityBenefitExpnsAmt
Total Expense	0.00360	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,708,916	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,964,455	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,744,461	NetCommunityBenefitExpnsAmt
Total Expense	0.04180	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,729	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,729	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,460	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,460	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$19	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$19	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,136	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,136	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$496	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$496	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,737	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,737	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$763	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$763	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,340	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,340	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$4,578,844	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$28,448,741	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$40,039,383	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$11,590,642	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	3	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (3 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc	Critical Access HospitalCriticalAccessHospitalInd
Avera Queen of Peace Hospital
1	525 North Foster Street	Mitchell	SD	57301	www.averaqueenofpeace.org	10552	Yes (X)	Yes (X)	Yes (X)	10 Provider Based Clinics
Avera Weskota Memorial Medical Center
2	609 1st Street NE	Wessington Springs	SD	57382	www.avera.org/weskota	48209	Yes (X)		Yes (X)		Yes (X)
Avera De Smet Memorial Hospital
3	306 Prairie Avenue SW	De Smet	SD	57231	www.avera.org/de-smet	50726	Yes (X)		Yes (X)		Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (3 entries)

FacilityFacilityNum	First Licensed CY Or PYFirstLicensedCYOrPYInd	Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd	CHNA ConductedCHNAConductedInd	Community DefinitionCommunityDefinitionInd	Community DemographicsCommunityDemographicsInd	Existing ResourcesExistingResourcesInd	How Data ObtainedHowDataObtainedInd	Community Health NeedsCommunityHealthNeedsInd	Other Health IssuesOtherHealthIssuesInd	Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd	Consulting ProcessConsultingProcessInd	Prior CHNA ImpactPriorCHNAImpactInd	CHNA ConductedCHNAConductedYr	Take Into Account Others InputTakeIntoAccountOthersInputInd	CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd	CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd	CHNA Report Widely AvailableCHNAReportWidelyAvailableInd	Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd	Own Website URLOwnWebsiteURLTxt	Paper Copy Public InspectionPaperCopyPublicInspectionInd	Implementation Strategy AdoptImplementationStrategyAdoptInd	Implementation Strategy AdptImplementationStrategyAdptYr	Strategy Posted WebsiteStrategyPostedWebsiteInd	Strategy Website URLStrategyWebsiteURLTxt	Organization Incur Excise TaxOrganizationIncurExciseTaxInd	Elig Criteria ExplainedEligCriteriaExplainedInd	FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd	FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct	FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct	Asset Level CriteriaAssetLevelCriteriaInd	Medical Indigency CriteriaMedicalIndigencyCriteriaInd	Insurance Status CriteriaInsuranceStatusCriteriaInd	Other CriteriaOtherCriteriaInd	Explained BasisExplainedBasisInd	App Financial Asst ExplnAppFinancialAsstExplnInd	Described InfoDescribedInfoInd	Described Suprt DocDescribedSuprtDocInd	Provided Hospital ContactProvidedHospitalContactInd	Includes Publicity MeasuresIncludesPublicityMeasuresInd	FAP Available On WebsiteFAPAvailableOnWebsiteInd	FAP Available On Website URLFAPAvailableOnWebsiteURLTxt	FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd	FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt	FAP Summary On WebsiteFAPSummaryOnWebsiteInd	FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt	FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd	FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd	FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd	Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd	Communtity Notified FAPCommuntityNotifiedFAPInd	FAP TranslatedFAPTranslatedInd	Other PublicityOtherPublicityInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	Permit No ActionsPermitNoActionsInd	Collection ActivitiesCollectionActivitiesInd	Provided Written NoticeProvidedWrittenNoticeInd	Made Effort Orally NotifyMadeEffortOrallyNotifyInd	Processed FAP ApplicationProcessedFAPApplicationInd	Made Presumptive Elig DetermMadePresumptiveEligDetermInd	Other Actions TakenOtherActionsTakenInd	Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd	Look Back Medicare PrivateLookBackMedicarePrivateInd	Amounts Generally BilledAmountsGenerallyBilledInd	Gross ChargesGrossChargesInd
Avera Queen of Peace Hospital
1	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	18	Yes (1)	0	0	Yes (1)	Yes (X)	See Part V, Section C	Yes (X)	Yes (1)	18	Yes (1)	See Part V, Section C	0	Yes (1)	Yes (X)	150.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	See Section V	Yes (X)	See Section V	Yes (X)	See Section V	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	0
Avera Weskota Memorial Medical Center
2	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	18	Yes (1)	0	0	Yes (1)	Yes (X)	See Part V, Section C	Yes (X)	Yes (1)	18	Yes (1)	See Part V, Section C	0	Yes (1)	Yes (X)	150.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	See Section V	Yes (X)	See Section V	Yes (X)	See Section V	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	0
Avera De Smet Memorial Hospital
3	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	18	Yes (1)	0	0	Yes (1)	Yes (X)	See Part V, Section C	Yes (X)	Yes (1)	18	Yes (1)	See Part V, Section C	0	Yes (1)	Yes (X)	150.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	See Section V	Yes (X)	See Section V	Yes (X)	See Section V	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	0

Supplemental Information SupplementalInformationGrp (23 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Avera Queen of Peace Hospital	Part V, Section B, Line 3j: Avera Queen of Peace Hospital hired inHealth Strategies to conduct the focus group and analyze the results. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources and improvements. Those providing community input were chosen for their familiarity with the needs of medically underserved, low-income and minority populations as they serve with these populations through their activities. The following organizations were represented in the process: Mitchell Area Development Corporation Cornerstones Career Learning Center Mitchell Area Food Pantry Mitchell High School/Second Chance High School Mitchell Middle School Mitchell Ministerial Association Mitchell Department of Public Safety Mitchell Fire & Emergency Management Services (EMS) Hanson County Sheriff's Office Davison County Welfare Office Davison County Sheriff's Office SDDOH County Health Nurse - Davison County SDDOH County Health Nurse - Hanson County
Avera Weskota Memorial Medical Center	Part V, Section B, Line 5: Avera Weskota Hospital hired inHealth Strategies to conduct the focus group and analyze the results. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources and improvements. Those providing community input were chosen for their familiarity with the needs of medically underserved, low-income and minority populations as they serve with these populations through their activities. The following organizations were represented in the process: Wessington Springs Senior Nutrition Program Wessington Springs Food Pantry City of Wessington Springs Jerauld County Auditor Jerauld County Sheriff Jerauld County Commissioner South Dakota Department of Health and Human Services - Jerauld County and Sanborn County Wessington Springs School District
Avera De Smet Memorial Hospital	Part V, Section B, Line 5: Avera De Smet Hospital hired inHealth Strategies to conduct the focus group and analyze the results. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources and improvements. Those providing community input were chosen for their familiarity with the needs of medically underserved, low-income and minority populations as they serve with these populations through their activities. The following organizations were represented in the process: Inter-Lakes Community Action Partnership (ICAP) - Kingsbury County Eastern South Dakota SHINE (seniors over 60 services) Kingsbury County Sheriff's Department City of De Smet Kingsbury Court House - South Dakota Department of Social Services De Smet United Methodist Church American Lutheran Church, De Smet - Community Health Nurse De Smet School District
Avera Queen of Peace Hospital	Part 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.BEHAVORIAL HEALTH AND SUBSTANCE ABUSE* Increase psychology appointments; increase appointments with LCSW* Increase PHQ-9 screening follow-up appointments in ambulatory settings* Decrease average score on PHQ-9 screenings in in-patient settings* Decrease behavioral health crisis ED visits; Increase the number of Avera eBehavioral encountersTRANSPORTATION* Create resource list/algorithm on transportation options for all relevant staff* Evaluate number of rides paid for by the AQOP Foundation* Evaluate the number of conversations AMG-Care Coordination is having with patients about transportation needs* Increase the number of those enrolled in mail-order pharmacyMany of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment. Though the following health need/priority will not be addressed due to resource constraints, the hospital will continue to actively participate in numerous community organizations focused on community needs and improvements: * Lack of affordable housing
Avera Weskota Memorial Medical Center	Part 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.FURTHER COMMUNITY HEALTH EDUCATION* Increase awareness of the national "Stop the Bleed" campaign* Increase collaboration with Horizon Healthcare on community health education* Increase educational posts on FacebookREMOVE BARRIERS TO PRIMARY CARE ACCESS* Increase access to primary care services through hiring of additional primary care providerMany of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment. Though the following health need/priority will not be addressed due to resource constraints, the hospital will continue to actively participate in numerous community organizations focused on community needs and improvements: * Economic stress
Avera De Smet Memorial Hospital	Part 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.REMOVE BARRIERS TO SKILLED HOME HEALTH CARE ACCESS* Increase Avera@Home Home Health patients* Increase the number of Avera@Home Home Health patients using lab services* Provide education and marketing materials for patients* Provide Avera@Home access to community resource informationMany of these activities are continuations of activities the hospital has been conducting related to the prior community health needs assessment. Though the following health needs/priorities will not be addressed due to resource constraints, the hospital recognizes its shared responsibility with the community and is actively participating in at least two community groups that have been formed to address these issues. * Lack of public transportation* Lack of affordable housing
Avera Queen of Peace Hospital	Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera Weskota Memorial Medical Center	Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera De Smet Memorial Hospital	Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera Queen of Peace Hospital	Part V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera Weskota Memorial Medical Center	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.
Avera De Smet Memorial Hospital	Part V, Section B, Line 16j: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera Queen of Peace Hospital	Part V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility. A plain language summary is offered to all uninsured patients at the time of registration.
Avera Weskota Memorial Medical Center	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. A plain language summary is offered to all uninsured patients at the time of registration.
Avera De Smet Memorial Hospital	Part V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility. A plain language summary is offered to all uninsured patients at the time of registration.
Avera Queen of Peace Hospital	Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Avera Weskota Memorial Medical Center	Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Avera De Smet Memorial Hospital	Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Part V, Section B, Line 10a: Implementation Strategy	The most recently adopted implementation strategy for each of the facilities has been posted to the following website:https://www.avera.org/app/files/public/75839/2019-chna-queen-of-peace-implementation-plan.pdf
Avera Queen of Peace Hospital Part V, Line 7a:	https://www.avera.org/about/community-health-needs-assessments/#queen
Avera Weskota Memorial Medical Center Part V, Line 7a:	https://www.avera.org/about/community-health-needs-assessments/#weskota
Avera De Smet Memorial Hospital Part V, Line 7a:	https://www.avera.org/about/community-health-needs-assessments/#de-smet
Part V, Section B, Lines 16a-16c	The financial assistance policy, plain language summary, and application are available for all facilities at:https://www.avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/

Field	Value	IRS element (for citing)
Facility	5	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - Avera Brady Health and Rehab
500 S Ohman St	Mitchell	SD	57301	Nursing Home
2 - Avera Brady Assisted Living
1414 W Cedar Ave	Mitchell	SD	57301	Assisted Living
3 - Avera Medical Group De Smet
801 3rd St SW	De Smet	SD	57231	Clinic
4 - Avera Medical Group OBGYN Mitchell
625 N Foster St Suite 107	Mitchell	SD	57301	Clinic
5 - Avera Medical Group Optometry
1200 East 6th Ave	Mitchell	SD	57301	Clinic

Supplemental Information Detail SupplementalInformationDetail (14 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 on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Costs of other means-tested government programs, line 7c, and subsidized health services, line 7g, were obtained from EPSi analytical reports. Community health improvement services, line 7e and cash and in-kind donations, line 7i were compiled using actual costs recorded in the CBISA software.
Part I, Ln 7 Col(f):	Bad debt expense of $4,578,844 is included on Form 990, Part IX, line 25, column (A) but excluded for purposes of calculating this percentage.
Part II, Community Building Activities:	Avera Queen of Peace supports numerous economic development organizations with participation at meetings and donations throughout its service area. Additionally, Avera Queen of Peace works with Dakota Wesleyan University, the Mitchell Technical Institute, and local high schools to address healthcare worker shortages in the communities of its service area.
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 that describes bad debt expenses is located in Footnote 1 on page 11 of the attached audited financial statements.
Part III, Line 8:	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. Avera Queen of Peace follows the CHA guidelines in reporting community benefits and therefore any Medicare shortfall (as calculated including our non-cost report entities) 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.
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:	Health care needs are assessed through various methods. Given Mitchell is a regional center/hub and the sixth largest city in South Dakota, Avera Queen of Peace is integrally involved with community organizations, universities/colleges, schools, state programs and local governments. The next largest hospital offering the same level of services is 72 miles from Mitchell and most of the towns within our region have a population of less than 2,000. By working with all in our region, we are able to determine health needs and provide programs and solutions where possible. In addition to activities reported in the Community Health Needs Assessment, Avera Queen of Peace, Avera Weskota and Avera De Smet collaborate with a community health committees within their respective community to assess and promote health related matters.
Part VI, Line 3:	A summary of the financial assistance policy is posted in the Hospital facility's emergency rooms, waiting rooms, and admissions office and is included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Part VI, Line 4:	Avera Queen of Peace's service area includes Davison County and surrounding counties in South Dakota. In 2018, the population for Davison County was estimated to be 19,790. Approximately 18.8% of the population is age 65 or older. The average per capita income is $29,342 and approximately 12.0% of individuals are below the federal poverty level. The nearest like hospital in the area is approximately 72 miles from Avera Queen of Peace.
Part VI, Line 5:	Avera Queen of Peace is a State Certified Level #4 Community Trauma Center and operates an emergency department staffed 24 hours per day with board certified physicians. Emergency care is provided on an open door basis regardless of ability to pay. Avera Queen of Peace leases two critical access hospitals which provide a broad range of inpatient, outpatient services and 24 hour emergency rooms in two very rural communities.Similar to the hospitals in the Avera Queen of Peace region, the clinics are operated on an open door basis and care is provided regardless of ability to pay.Medical staff privileges are extended to all licensed and qualified applicants. The Avera Queen of Peace Board of Directors is principally comprised of community members from the primary and secondary services areas. Members come from a variety of backgrounds including banking, education, agriculture, healthcare and private industry.
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

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	City of De Smet Community Foundation	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 42	AddressLine1Txt
City	De Smet	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57231	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	461401425	RecipientEIN
IRC Section	501(c)(3)	IRCSectionDesc
Cash Grant	$25,000	CashGrantAmt
Purpose Of Grant	Community/Athletic	PurposeOfGrantTxt

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

Supplemental Information Detail SupplementalInformationDetail

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

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Hillary Rockwell MD
Board Member/Physician	$479,700	$0	$20,157	$0	$18,315	$0	$13,750	$0	$31,607	$0	$563,529	$0	$0	$0
Scott VanKeulen MD
Board Member/President of Medical St	$461,451	$0	$57,491	$0	$2,327	$0	$13,750	$0	$31,370	$0	$566,389	$0	$0	$0
Thomas Clark
Regional President & CEO	$0	$390,963	$0	$0	$0	$125,791	$0	$13,750	$0	$28,052	$0	$558,556	$0	$0
William E Flett
Secretary	$0	$187,966	$0	$3,000	$0	$372	$0	$9,606	$0	$28,531	$0	$229,475	$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
Rochelle Reider
VP Patient Services	$180,415	$0	$240	$0	$1,748	$0	$9,433	$0	$25,295	$0	$217,131	$0	$0	$0
Chris Krouse DO
Orthopedics, Sports Medicine	$1,146,540	$0	$100,719	$0	$5,576	$0	$13,750	$0	$25,547	$0	$1,292,132	$0	$0	$0
Brian Kampmann
Orthopedics, Sports Medicine	$1,055,262	$0	$243,467	$0	$3,611	$0	$13,750	$0	$30,107	$0	$1,346,197	$0	$0	$0
Xenofon Papadopoulos MD
Urology	$546,523	$0	$15,000	$0	$25,499	$0	$13,750	$0	$30,107	$0	$630,879	$0	$0	$0
Dennis Leland
General Surgery	$538,528	$0	$88,398	$0	$8,001	$0	$13,750	$0	$25,029	$0	$673,706	$0	$0	$0
Aaron Bass
General Surgery	$610,240	$0	$38,266	$0	$57,569	$0	$13,750	$0	$30,107	$0	$749,932	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule J, Part I, Line 3:	FormAndLineReferenceDesc
Explanation	The President/CEO is compensated by Avera Health. Avera Queen of Peace relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	Rhonda Zomer	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	Family member of board member	RelationshipDescriptionTxt
Transaction	$74,035	TransactionAmt
Transaction	Compensation	TransactionDesc
Sharing Of Revenues	0	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Section A, line 2	Jim Breckenridge, Thomas Clark, and Will Flett have a business relationship.
Form 990, Part VI, Section A, line 6	The sole member of the organization is Avera Health, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended.
Form 990, Part VI, Section A, line 7a	Avera Health, as the sole member, has the power to appoint and remove, with or without cause, members of the Board of Directors.
Form 990, Part VI, Section A, line 7b	Avera Health, as the sole member, has the following rights as the Member. 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of Corporation; 2) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Corporation, and to give final approval of any such action with respect thereto; 3) To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the Member; 4) To approve any plan of merger, consolidation or dissolution of the Corporation, or the divestiture of a sponsored work or ministry associated with the Corporation; 5) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the Corporation; 6) To appoint and remove, with or without cause, the Board of Directors of the Corporation. 7) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the Corporation. 8) To approve operating/capital budgets and strategic plans of the Corporation. 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the Member. 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the Member. 11) To establish and maintain employee benefit programs. 12) To establish and maintain insurance programs. 13) To approve major community fund drives. 14) To approve the appointment of auditors. 15) To adopt policies designed to effectuate the reserved powers of the Member.
Form 990, Part VI, Section A, line 8b	Avera Queen of Peace Hospital does not have 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 15b	The CEO and CFO-Avera Health are 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. Depending on the individual's role with the organization, some officers and key employees are compensated by Avera Queen of Peace.
Form 990, Part VI, Section C, line 19	The Organization's governing documents and conflict of interest policy are not available to the general public. The Organization's financial statements are attached to the Form 990 per IRS instructions and therefore are available to the general public.
Form 990, Part IX, line 11g	Recruitment: Program service expenses 0. Management and general expenses 200. Fundraising expenses 0. Total expenses 200. Purchased Services: Program service expenses 5,826,052. Management and general expenses 587,479. Fundraising expenses 9,113. Total expenses 6,422,644. ACS Fees: Program service expenses 4,506,924. Management and general expenses 7,575,562. Fundraising expenses 0. Total expenses 12,082,486. Repairs and Maintenance: Program service expenses 1,845,125. Management and general expenses 19,621. Fundraising expenses 0. Total expenses 1,864,746.
Form 990, Part XI, line 9:	Change in Fair Value of Interest Rate Swap -174,894. Equity Transfers -1,190,478. Change in Beneficial Interest in Mabee Trust -8,702. Change in Interest in Avera Foundation -94,953.
Form 990, Part XII, Line 2c:	The Audit Committee of Avera Health, parent organization, selects the auditor and reviews the consolidated audited financial statements of Avera Health, which includes Avera Queen of Peace.
Form 990, Part VI, Section B, Line 16b:	There is no written policy or procedure since in the event of any such proposed transaction the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member.
Form 990, Part X, Line 20:	The issue price includes the filing Organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Marshall, Avera St. Mary's, Avera St. Anthony, Avera St.Benedict, Avera Holy Family, Avera Tyler, Avera Gettysburg, Avera at Home, and Avera Sacred Heart. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Avera Health's tax return (EIN 46-0422673).

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 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
Avera Gettysburg
606 East Garfield	Gettysburg	SD	57442	460234354	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera St Mary's
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 Marshall
300 S Bruce Street	Marshall	MN	56258	410919153	Healthcare Services	MN	501(c)(3)	Line 3		0	Avera Health
St Benedict Health Center
401 West Glynn Drive	Parkston	SD	57366	460226738	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
St Benedict Health Center Foundation
West Glynn Drive PO Box B	Parkston	SD	57366	460458725	Support Health Related Services	SD	501(c)(3)	Line 12a, I		0	St Benedict Health Center
Avera McKennan
1325 S Cliff Ave PO Box 5045	Sioux Falls	SD	57117	460224743	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
Sacred Heart Health Services
501 Summit Street	Yankton	SD	57078	460225483	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
Avera St Mary's
801 East Sioux Avenue	Pierre	SD	57501	460230199	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
Avera at Home
5116 S Solberg Ave	Sioux Falls	SD	57108	460399291	Home Services	SD	501(c)(3)	Line 10		0	Avera Health
Lewis and Clark Health Education and Service Agency
1000 W 4th Street Suite 9	Yankton	SD	57078	460337013	Healthcare 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 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

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd
Q & M Properties LLC
525 North Foster	Mitchell	SD	57301	731652049	Medical clinic building	SD	N/A
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 102	Sioux Falls	SD	57117	800619999	medical services - home medical equipment	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

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct
Accounts Management Inc
5132 S Cliff Ave Suite 101	Sioux Falls	SD	57108	460373021	collection agency	SD	N/A	C	0
Avera Property Insurance Inc
610 W 23rd St Ste 1 PO Box 38	Yankton	SD	57078	460463155	insurance	SD	N/A	C	0
Dr Donald & Marguerite Mabee Trust
c/o First National Bank of South Da	Mitchell	SD	57301	466056202	investing	SD		T	Yes (1)	Avera Queen of Peace Hospital	-$8,702	$799,592	1.00000
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 Inc
2600 W 49th Street	Sioux Falls	SD	57105	460401087	insurance	SD	N/A	C	0
DakotaCare Administrative Services Inc
2600 W 49th Street	Sioux Falls	SD	57105	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	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd