2019-05-14T15:28:08-05:00 2018-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2017-07-01 460422673 AVERA HEALTH AVER 6053227300 3900 WEST AVERA DRIVE No 300 SIOUX FALLS SD 57108 Jim Breckenridge Secretary and CFO 6053224700 2019-05-13 1 Kim Hunwardsen P00078516 6122536500 2019-05-13 8.39.233.107 2019-05-13 14:34:11 CD P D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC EFC25E59FA7409AE560978A003AFB9E955B778C6 2017 2019-02-21 02:37:17Z Bob Sutton 3900 WEST AVERA DRIVE No 300 SIOUX FALLS SD 57108 227619779 0 0928 X www.avera.org X 1998 SD Promotion of Health 14 11 1381 39 1289487 357326 15789136 14467701 187050828 199967555 15603501 2304385 450275 8717462 218893740 225457103 5790679 15582714 0 0 110023045 121091438 0 0 0 79902077 98223646 195715801 234897798 23177939 -9440695 1067436720 1282022027 755278638 978667960 312158082 303354067 X Avera Health 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. 0 0 209907828 15582714 207086072 Avera Health is a nonprofit corporation jointly sponsored by the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota and the Benedictine Convent of the Sacred Heart, together referenced as the "Sisters." Avera Health acts as the leader of the Avera health ministry, serving as an overall parent to support its affiliated tax-exempt health care organizations. These organizations provide services principally in eastern South Dakota and surrounding states. Avera Health provides management consulting, fund raising and other administrative services to the hospitals, long-term health care facilities, clinics, services and programs that are sponsored or otherwise affiliated with the Sisters.Avera eCARE is a visionary care delivery model that provides rural health care professionals around-the-clock access to specialty care physicians, nurses and pharmacists. Using advanced communication technology, eCARE supports rural facilities in the provision of evidence-based, high-quality care and offsets workforce shortages in rural communities. eCARE is a natural extension of Avera's Health mission and its century-long commitment to its rural communities to maintain access to quality care close to home. Avera eCARE works with some of the most underserved populations in the United States. This includes frontier populations, long term care residents, Native American Reservations, disabled veterans, and inmates. By bringing high quality, on demand access to specialty care, these unique populations are able to receive care within their home community and in a familiar, culturally appropriate setting. They are treated in coordination with the local practitioners that best understand their ongoing care needs. 209907828 1 1 0 1 0 0 0 0 1 1 1 1 0 1 1 1 0 1 0 0 1 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 0 0 1 303 0 1 1381 1 1 1 0 0 0 0 1 1 0 0 0 0 X 14 11 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 0 AL AR CA FL GA HI IL KS KY MD MA MI MN NV NH NJ NM NY NC OR PA RI SC TN UT VA WV WI AK OK X X Jamie Schaefer 6053223992 3900 W Avera Dr Ste 300 Sioux Falls SD 57108 X Dan Eisenbraun Chair 5.00 0.00 X X 0 0 0 Sister Debra Kolecka OSB Vice Chair 5.00 2.50 X X 0 0 0 Ken Karels Director 5.00 0.00 X 0 0 0 Sister Mary Jaeger Director 5.00 1.00 X 0 0 0 Sister Barbara McTague Director 5.00 0.00 X 0 0 0 Sister Janet Horstman Director 5.00 0.00 X 0 0 0 Clark Sinclair Director 5.00 0.00 X 0 0 0 Dr Merritt Gregg Warren Director 5.00 40.00 X 0 203313 33123 Sister Mary Kay Panowicz Director 5.00 1.00 X 0 0 0 Gary Gaspar Director 5.00 0.00 X 0 0 0 Cathy Clark Director 5.00 0.00 X 0 0 0 Dr J Michael Bacharach Director 5.00 0.00 X 0 0 0 Dr Dale Vizcarra Director 5.00 1.00 X 0 0 0 Sister Pam Donelan Director 5.00 0.00 X 0 0 0 John Porter President and CEO thru May 2018 40.00 0.00 X X 1768380 0 38156 Bob Sutton President and CEO began June 2018 40.00 0.00 X X 522924 0 42493 James Breckenridge Secretary and CFO 38.70 1.30 X 887406 0 34116 Fredrick Slunecka Chief Operating Officer 40.00 0.00 X 1167988 0 35556 David Flicek Pres/CEO - Avera McKennan 40.00 40.00 X 742425 0 43493 David Erickson Chief Medical Officer 40.00 0.00 X 761544 0 42599 Todd Forkel Pres/CEO - Avera St. Luke's 0.00 40.00 X 683117 0 32568 Richard Korman Senior VP - General Counsel 40.00 0.00 X 625619 0 42493 Robin Bates Exec VP - Ins Serv and Pop Health 40.00 0.00 X 552489 0 38156 Douglas Ekeren Pres/CEO - Avera Sacred Heart 0.00 40.00 X 502279 0 38156 David Kapaska - Former HCE Pres/CEO - Avera McKennan 0.00 0.00 X 983620 0 23808 9197791 203313 444717 154 1 1 0 CDW Government 230 N Milwaukee Ave Vernon Hills IL 60061 Computer Hardware Consulting 16776538 Avera McKennan 1325 S Cliff Avenue Sioux Falls SD 57117 Services, computer hardware & software 9684315 Elekta 400 Perimeter Center Terrace Suite Atlanta GA 30346 Computer Hardware/Software/Consulting/Ca 4057292 Medspeed 655 West Grand Avenue Elmhurst IL 60126 Courier Services 3529604 Medical Information Technology 1 Meditech Circle Westwood MA 02090 Hardware/Software Consulting 3313011 113 642325 1079377 68711 1888591 10788697 251665 14467701 ACS revenue 900099 154420664 154420664 eCare revenue 900099 29994806 29994806 PACE revenue 561000 6997773 6140163 857610 Premier expense credit 900099 6465972 6465972 Inc from affiliates 561000 70838 -271908 342746 2017502 2017502 199967555 1317953 1317953 1877516 1788385 89131 89131 89131 967564 18868 0 0 967564 18868 986432 986432 683749 1079377 374291 309458 309458 A/R Interest 900099 8318873 8318873 8318873 225457103 207086072 1289487 2613843 X 15422839 15422839 159875 159875 3880365 3880365 59526 59526 87748173 77316335 10431838 7662990 6791268 871722 15269339 12960815 2308524 6471045 6005256 465789 106657 106657 1179018 763699 415319 40956 40956 42162359 37023388 5138971 9314758 9238883 75875 7774385 7350691 423694 9497033 9398966 98067 3874873 3259112 615761 1932969 1756295 176674 1203941 1053376 150565 255078 255078 19718585 19030129 688456 353236 232869 120367 Grant Prog Expenditures 583899 583899 License & publications 519747 512733 7014 UBI tax 486511 486511 Foundation expenses 340126 340126 -1120485 606792 -1727277 234897798 209907828 24989970 0 X 2587101 22583709 819321 230615 11520461 15166840 4750610 4652651 962367 511303 7678449 10269822 178432095 79910975 102696792 98521120 755017402 796174085 156100597 180652447 33615 21208 16139552 16139552 9130453 137098675 1067436720 1282022027 20592416 31744090 6078613 3745366 10473243 28066451 645715791 708539428 30823538 29145378 41595037 177427247 755278638 978667960 X 308992474 300038875 2720423 2824509 445185 490683 312158082 303354067 1067436720 1282022027 X -9440695 4718111 -4081431 X 0 1 X 1 1 1 X 8015201 12575041 17527901 15789136 14467701 68374980 125942998 150269980 170255307 186832895 207086072 840387252 578521 612510 691652 683749 2566432 133958199 163423542 188395718 203313683 222237522 911328664 5755 78763 33177 101472 219167 67619274 93124170 113505331 122171044 130522462 526942281 67619274 93129925 113584094 122204221 130623934 527161448 384167216 761213 626811 456596 2875452 1317953 6038025 761213 626811 456596 2875452 1317953 6038025 105051 129714 92791 344310 671866 134824463 164180067 188945105 206189135 223899785 918038555 0.41850 0.43170 0.00660 0.00720 X 0 1 0 0 0 0 1 21837 0 1 19119 40956 0 Part II-B, Line 1: Through paid staff and paid consultants Avera Health meets with legislatures. Avera Health provides grants to other organizations for lobbying and pays dues of which a small portion is attributable to lobbying. 0 1 X 5004011 421937 280361 386932 23814 5295563 4854052 583639 147566 548377 32869 5004011 4361194 413851 391376 277515 34854 4854052 3542771 367555 782973 296350 35755 4361194 3302432 477896 155637 370880 22314 3542771 0.55570 0.23780 0.20650 0 0 948600 948600 29744865 8510237 21234628 4554336 2467172 2087164 122983198 68933566 54049632 20201096 20201096 98521120 Interest in Innovation Institute 12519867 F Non-publicly traded hedge, private equity, debt, and multi-strategy funds 155199527 F Non-publicly traded real estate 12232767 F NPPC, LLC 100000 C Premier Purchasing Partners, L.P. 600286 F 180652447 Deferred financing costs 7988854 Bond project fund 128041099 Interest in South Dakota Community Foundation 1068222 Due from related entity 500 137098675 Estimated insurance claims payable 37157888 Bond interest payable 8544579 Due to affiliated entities 131724780 177427247 X Part IV, Line 2b: Avera Health administers the Avera Health Pooled Investment Fund, a fund that is maintained for the benefit of facilities that are sponsored, operated, or managed by Avera Health. Investments are made in conformity with the objectives and guidelines of the Avera Health Pooled Investment Committee. Within the fund, participating facilities share in a pool of investments that are managed by various fund managers. Investments that are held for participating facilities are recorded as Avera Health Pooled Investments with a corresponding liability account of Custodial Funds - Avera Health Pooled Investments on the balance sheet. Avera Health also holds its own investments within the pooled fund and records their allocated share of income and losses from these investments as investment income in the financial statements. Part V, Line 4: The Organization's endowment consists of approximately 98 individual funds established for a variety of purposes related to health and wellness programs in Avera affiliated organizations. Part X, Line 2: Avera Health and most of its sponsored organizations are considered nonprofit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. These organizations are required to file a Return of Organization Exempt from Income Tax (Form 990) with the Internal Revenue Service (IRS). Avera Health and certain sponsored organizations also file an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report their unrelated business taxable income. 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. The federal Form 990T filings and taxable subsidiary returns for consolidated subsidiaries are no longer subject to federal tax examinations by tax authorities for years before 2015. Certain consolidated entities are subject to federal income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. Deferred tax assets and liabilities are not material as of June 30, 2018 and 2017. The Organization paid an immaterial amount of federal and state income taxes for the years ended June 30, 2018 and 2017. Central America and the Caribbean - 0 0 Investments reported on cost basis 106809297 0 0 0 0 0 0 106809297 0 106809297 1 0 0 0 0 0 Form 990, Schedule F, Part IV: Avera Health reviews its direct and indirect investments during the tax period for determining required foreign filings. The Organization's ownership interests in foreign corporations do not require a Form 5471 to be filed. The Organization invests in partnerships that hold direct or indirect interest in passive foreign investment companies. The investment partnerships have properly filed Form 8621, or the underlying investments did not generate any unrelated business income. Under these facts, Avera Health is not required to file an additional Form 8621. Race Against Breast Cancer 500173 328301 171872 11500 139638 The Big Grape Reserve 215836 173950 41886 43840 29 1047117 577126 469991 179313 1763126 1079377 683749 11500 362791 374291 309458 1 Aberdeen Catholic School System 1400 N Dakota St Aberdeen SD 57401 460336005 501c3 89500 Sponsorship Aberdeen Christian School 1500 Hwy 281 N Aberdeen SD 57401 911806433 501c3 10500 Sponsorship Aberdeen Ride Line 205 N 4th St Aberdeen SD 57401 466000010 501c3 15000 Sponsorship ALS Association - MNNDSD Chapter 333 N Washington Ave Ste 105 Minneapolis MN 55401 411756085 501c3 15000 Sponsorship American Cancer Society 250 Williams St Atlanta GA 30303 131788491 501c3 37900 Sponsorship American Cancer Society Cancer Action Network 555 11th St NW Ste 300 Washington DC 20004 522340031 501c4 8500 Sponsorship American Heart Association - Midwest Affiliate PO Box 50035 Prescott AZ 86304 135613797 501c3 25000 Sponsorship American Red Cross of Eastern SD 808 West Ave North Sioux Falls SD 57104 530196605 501c3 10000 Sponsorship Boys & Girls Club of Aberdeen Area 1121 1st Ave SE Aberdeen SD 57401 237062273 501c3 60000 Sponsorship Boys & Girls Club of the Sioux Empire 824 E 14th St Sioux Falls SD 57104 460399482 501c3 10000 Sponsorship Brandon Valley Baseball Association PO Box 605 Brandon SD 57005 460401362 501c3 10000 Sponsorship Brandon Valley Booster Club PO Box 572 Brandon SD 57005 460393971 501c3 6500 Sponsorship Brookings Health System 300 22nd Ave Brookings SD 57006 466000069 City of Brookings 30500 Sponsorship Brookings School District 2130 8th St S Brookings SD 57006 466000834 City of Brookings 36050 Sponsorship Canton School District 41-1 800 N Main St Canton SD 57013 466002143 City of Canton 10000 Sponsorship Sioux Falls School District 49-5 (CTE Academy) 4700 W Career Cir Sioux Falls SD 57107 466002586 City of Sioux Falls 12500 Sponsorship Catholic Community Foundation for Eastern SD 523 N Duluth Ave Sioux Falls SD 57104 466000424 501c3 100000 Sponsorship Charis Ministry Partners 1300 E 10th St Sioux Falls SD 57103 383775128 501c3 7000 Sponsorship Children's Home Society of South Dakota Foundation PO Box 1749 Sioux Falls SD 57101 460224542 501c3 12000 Sponsorship Citizens Involvement Council 2520 E Franklin Pierre SD 57501 460317107 501c3 10000 Sponsorship City of Mitchell 612 N Main St Mitchell SD 57301 466000305 City of Mitchell 15000 Sponsorship Compass Center 1704 S Cleveland Ave Ste 3 Sioux Falls SD 57103 460350199 501c3 5500 Sponsorship Dakota Resources 25795 475th Ave Ste 1 Renner SD 57055 460442430 501c3 35000 Sponsorship Dakota Wesleyan University 1200 W University Ave Mitchell SD 57301 460224589 501c3 34500 Sponsorship DakotAbilities 1116 S 4th Ave Sioux Falls SD 57105 460306216 501c3 13000 Sponsorship Daktronics Inc PO Box 86 Minneapolis MN 55486 460306862 11250 Community Development Delta Dental of South Dakota Foundation 804 N Euclid Ave Ste 101 Pierre SD 57501 911776857 501c3 20000 Sponsorship Destiny Healthcare International 1417 S Minnesota Ave Sioux Falls SD 57105 510529480 501c3 15000 Sponsorship Dow Rummel Village 1321 W Dow Rummel St Sioux Falls SD 57104 460271277 501c3 25000 Sponsorship Downtown Sioux Falls Inc 230 S Phillips Ave Ste 102 Sioux Falls SD 57104 363627217 501c4 21000 Sponsorship EmBe 300 W 11th St Sioux Falls SD 57104 460234998 501c3 31500 Sponsorship Etc for Her 1112 S Holly Dr Sioux Falls SD 57105 263803061 19000 Sponsorship Family Visitation Center 311 E 14th St Sioux Falls SD 57104 263654937 501c3 18500 Sponsorship Feeding South Dakota 4701 N Westport Ave Sioux Falls SD 57107 363293534 501c3 25100 Sponsorship Fellowship of Christian Athletes 8701 Leeds Road Kansas City MO 64129 440610626 501c3 20000 Sponsorship Forward Sioux Falls PO Box 907 Sioux Falls SD 57101 460396647 150000 Sponsorship Furniture Mission of South Dakota 209 N Nesmith Ave Sioux Falls SD 57103 810584450 501c3 9000 Sponsorship Glacial Lakes Area Development PO Box 231 Britton SD 57430 870787080 501c3 10000 Sponsorship Governor's Office of Economic Development 711 E Wells Ave Pierre SD 57501 466000364 State of SD 16000 Sponsorship Ground Works 201 N Weber Ave Ste 201 Sioux Falls SD 57103 475498537 501c3 6000 Sponsorship Habitat for Humanity of the Brookings Area PO Box 412 Brookings SD 57006 460437158 501c3 15000 Sponsorship Harrisburg Baseball Association PO Box 434 Harrisburg SD 57032 270606157 501c3 18000 Sponsorship Harrisburg School District PO Box 187 Harrisburg SD 57032 466002218 City of Harrisburg 27000 Sponsorship Helpline Center Inc 1000 N West Ave Ste 310 Sioux Falls SD 57104 237424387 501c3 15000 Sponsorship Holy Redeemer Catholic Church 503 W Lyon St Marshall MN 56258 410718327 501c3 50000 Sponsorship Junior Achievement of South Dakota 1000 N West Ave Ste 110 Sioux Falls SD 57104 460306352 501c3 17025 Sponsorship LifeLight Communications Inc 2601 S Western Ave Sioux Falls SD 57105 460460742 501c3 10000 Sponsorship Make-A-Wish Foundation of SD 1400 W 17th St Sioux Falls SD 57104 460375953 501c3 10000 Sponsorship Marshall Fire Department Relief Assn 201 E Saratoga St Marshall MN 56258 410978542 501c4 7500 Sponsorship McCrossan Boys Ranch 47135 260th St Sioux Falls SD 57107 460311913 501c3 11000 Sponsorship Mitchell Aquatic Club PO Box 1371 Mitchell SD 57301 460461058 501c3 25000 Sponsorship Mitchell Technical Institute Foundation 1800 E Spruce St Mitchell SD 57301 460452950 501c3 80250 Sponsorship Mitchell United Way 417 N Main St Suite 103 Mitchell SD 57301 461250302 501c3 6000 Sponsorship Mount Marty College 1105 W 8th St Yankton SD 57078 460283336 501c3 258081 Sponsorship NAMI South Dakota PO Box 88808 Sioux Falls SD 57109 363593027 501c3 27500 Sponsorship National Field Archery Association Foundation 800 Archery Ln Yankton SD 57078 330430066 501c3 25000 Sponsorship National Kidney Foundation 30 East 33rd St 3rd fl New York NY 10016 131673104 501c3 15500 Sponsorship The National MS Society Upper Midwest Chapter 200 12th Ave S Minneapolis MN 55415 410790658 501c3 16000 Sponsorship NSU Foundation 620 15th Ave SE Aberdeen SD 57401 237002314 501c3 150000 Sponsorship OLLI at University Center 4801 N Career Ave Sioux Falls SD 57107 466000364 State of SD 7500 Sponsorship Philanthropy Promotions Inc 2601 W 60th St N Sioux Falls SD 57107 870695596 501c3 20000 Sponsorship Pierre Area Chamber of Commerce 800 W Dakota Ave Pierre SD 57501 460177425 501c6 6700 Sponsorship Pierre School District 211 S Poplar St Pierre SD 57501 466001892 City of Pierre 10000 Sponsorship Post 8 Baseball PO Box 431 Pierre SD 57501 466008690 501c3 10000 Sponsorship Prairie Family Business Association 4801 N Career Ave Ste 140 Sioux Falls SD 57107 466000364 State of SD 5500 Sponsorship Presentation College 1500 N Main St Aberdeen SD 57401 460280847 501c3 250600 Sponsorship Presentation Sisters of the Blessed Virgin Mary 1500 N 2nd St Aberdeen SD 57401 460253283 501c3 22500 Sponsorship Pride in the Tiger Foundation 400 Tiger Dr Marshall MN 56258 411948007 501c3 10000 Sponsorship Ronald McDonald House Charities of SD 825 S Lake Ave Sioux Falls SD 57104 460371152 501c3 20000 Sponsorship Safe Harbor PO Box 41 Aberdeen SD 57402 460344310 501c3 11000 Sponsorship SculptureWalk Inc 300 S Phillips Ave Ste L104 Sioux Falls SD 57104 208535871 501c3 19500 Sponsorship SD Youth Foundation Inc 1310 Main Ave S Ste 109 Brookings SD 57006 474832848 501c3 10000 Sponsorship South Dakot Agriculatural & Rural Leadership Inc 1905 N Plaza Blvd Rapid City SD 57702 364293293 501c3 10000 Sponsorship South Dakota State University Box 2201 Brookings SD 57007 466000364 501c3 8010 Sponsorship SDSU Foundation 815 Medary Ave Brookings SD 57006 460273801 501c3 165000 Scholarship Sioux Empire Baseball Association 1601 W 44th Pl Ste 3 Sioux Falls SD 57105 411903475 501c3 16000 Sponsorship Sioux Empire United Way 1000 N West Ave Ste 120 Sioux Falls SD 57104 460233701 501c3 84240 Sponsorship Sioux Falls Catholic Schools 3100 W 41st St Sioux Falls SD 57105 460413591 501c3 1000000 Sponsorship Sioux Falls Jazz & Blues Society PO Box 1285 Sioux Falls SD 57101 460418356 501c3 20000 Sponsorship Sioux Falls Youth Hockey Association 4235 W Mesa Pass Sioux Falls SD 57106 460427805 501c3 17500 Sponsorship South Dakota Chamber of Commerce and Industry PO Box 190 Pierre SD 57501 460141180 501c6 7500 Sponsorship South Dakota Hall of Fame 1480 S Main Chamberlain SD 57325 460324210 501c3 25000 Sponsorship South Dakota Community Foundation 1714 North Lincoln Ave Pierre SD 57501 460398115 501c3 50000 Sponsorship South Dakota Symphony Orchestra 301 S Main Ave Sioux Falls SD 57104 466017026 501c3 57250 Sponsorship Southeast Technical Institute Foundation 2320 N Career Ave Sioux Falls SD 57107 364112897 501c3 20000 Scholarship Special Olympics South Dakota 800 East I-90 Lane Sioux Falls SD 57104 460359776 501c3 17500 Sponsorship Stockyards Plaza Inc PO Box 2042 Sioux Falls SD 57101 465391991 501c3 50000 Sponsorship Teach for America-South Dakota 25 Broadway 12th fl New York NY 10004 133541913 501c3 12500 Sponsorship Tempo Soccer Club PO Box 776 Tea SD 57064 475029561 501c3 7000 Sponsorship United Way of Northeastern SD Inc PO Box 1065 Aberdeen SD 57401 237086355 501c3 10000 Sponsorship United Way of Yankton 610 W 23rd St Ste 11 Yankton SD 57078 460252854 501c3 12500 Sponsorship University of Sioux Falls 1101 W 22nd St Sioux Falls SD 57105 460224600 501c3 400000 Sponsorship USD Foundation PO Box 5555 Vermillion SD 57069 466018891 501c3 75000 Scholarship USD Sanford School of Medicine 414 E Clark St Vermillion SD 57069 466000364 State of SD 25250 Sponsorship Vision Brookings Foundation 2301 Research Park Way Ste 113 Brookings SD 57006 460440746 501c3 20000 Sponsorship Volunteers of America Dakotas PO Box 89306 Sioux Falls SD 57109 237353508 501c3 15000 Sponsorship Yankton Area Progressive Growth 803 E 4th St Yankton SD 57078 460348636 501c6 60000 Sponsorship Yankton School District 63-3 2410 W City Limits Rd Yankton SD 57078 466003280 City of Yankton 15000 Sponsorship Bishop Dudley Hospitality House 101 N Indiana Ave Sioux Falls SD 57103 911836528 501c3 10000 Sponsorship Avera McKennan Hospital 1325 S Cliff Ave Sioux Falls SD 57105 460224743 501c3 4180006 Sponsorship Avera St Mary's 801 E Sioux Avenue Pierre SD 57501 460230199 501c3 129164 Sponsorship Avera Gettysburg 606 East Garfield Gettysburg SD 57442 460234354 501c3 23000 Sponsorship Avera Holy Family 826 North 8th Street Estherville IA 51334 420680370 501c3 238253 Sponsorship St Benedict Health Center 401 West Glynn Drive Parkston SD 57366 460226738 501c3 11458 Sponsorship Avera Queen of Peace Hospital 525 North Foster Mitchell SD 57301 460224604 501c3 528928 Sponsorship Sacred Heart Health Services 501 Summit Street Yankton SD 57078 460225483 501c3 42131 Sponsorship Avera at Home 5116 S Solberg Avenue Sioux Falls SD 57108 460399291 501c3 166525 Sponsorship Avera St Luke's 305 South State Street Aberdeen SD 57401 460224598 501c3 51449 Sponsorship Avera Marshall 300 South Bruce Street Marshall MN 56258 410919153 501c3 80720 Sponsorship Avera Tyler 240 Willow Street Tyler MN 56178 410853163 501c3 9981 Sponsorship American Red Cross 431 18th Street NW Washington DC 20006 530196605 501c3 28088 Sponsorship Weskota Foundation 604 1st Street NE Wessington Springs SD 57382 460415751 501c3 7569 Sponsorship Catholic Charities USA 2050 Ballenger Avenue Alexandria VA 22314 530196620 501c3 35588 Sponsorship Children's Museum of South Dakota 521 4th Street Brookings SD 57006 263493723 501c3 38657 Sponsorship Eureka Community Health Services PO Box 517 Eureka SD 57437 460246437 501c3 833813 Sponsorship Floyd Valley Healthcare 714 Lincoln Street NE Lemars IA 51031 420928451 501c3 255289 Sponsorship Friends for Health in Haiti PO Box 122 Pewaukee WI 53072 204832316 501c3 9450 Sponsorship Hegg Memorial Health Center 1202 21st Avenue Rock Valley IA 51247 420932564 501c3 34620 Sponsorship King of Glory Church 1001 East 17th Street Sioux Falls SD 57104 452247326 501c3 7500 Sponsorship Lakes Regional Healthcare 2301 Hwy 71 Spirit Lake IA 51360 426037582 501c3 24782 Sponsorship Landmann-Jungman Memorial Hospital 600 Billars Street Scotland SD 57059 466015787 501c3 78964 Sponsorship Marshall County Healthcare Center 413 9th Street Britton SD 57430 460380552 501c3 33495 Sponsorship Pipestone County Medical Center 916 4th Avenue SW Pipestone MN 56164 411392082 501c3 14625 Sponsorship Platte Health Center 601 East 7th Street Platte SD 57369 460239781 501c3 39865 Sponsorship Weskota Manor Inc 609 1st Street NE Wessington Springs SD 57382 460273307 501c3 68787 Sponsorship 116 9 Haiti scholarships 27 34597 Medical assistance to employees 67 125278 Part I, Line 2: The Organization makes grants to other organizations exempt under 501(c)(3) to ensure the funds will be used for charitable purposes. During the year ending June 30, 2018, the Organization made contributions to other non-public charities in furtherance of community development. The contributions are approved by the Board for this purpose. Scholarship funds have different sets of criteria for determining eligibility and winners. Assistance to individuals is determined with assistance from each hospital's social services department or within a committee at the hospital. X X X X 1 0 0 0 0 0 0 0 0 Dr Merritt Gregg Warren Director 0 176171 0 21940 0 5202 0 10266 0 22856 0 236435 0 0 John Porter President and CEO thru May 2018 1282547 0 0 0 485833 0 13500 0 24656 0 1806536 0 0 0 Bob Sutton President and CEO began June 2018 392340 0 520 0 130064 0 13500 0 28993 0 565417 0 0 0 James Breckenridge Secretary and CFO 815781 0 0 0 71625 0 13500 0 20616 0 921522 0 0 0 Fredrick Slunecka Chief Operating Officer 1097138 0 0 0 70850 0 13500 0 22056 0 1203544 0 0 0 David Flicek Pres/CEO - Avera McKennan 689489 0 0 0 52936 0 13500 0 29993 0 785918 0 0 0 David Erickson Chief Medical Officer 557540 0 0 0 204004 0 13500 0 29099 0 804143 0 0 0 Todd Forkel Pres/CEO - Avera St. Luke's 512786 0 50 0 170281 0 7865 0 24703 0 715685 0 0 0 Richard Korman Senior VP - General Counsel 570831 0 0 0 54788 0 13500 0 28993 0 668112 0 0 0 Robin Bates Exec VP - Ins Serv and Pop Health 506105 0 0 0 46384 0 13500 0 24656 0 590645 0 0 0 Douglas Ekeren Pres/CEO - Avera Sacred Heart 376003 0 1500 0 124776 0 13500 0 24656 0 540435 0 0 0 David Kapaska - Former HCE Pres/CEO - Avera McKennan 374121 0 0 0 609499 0 13500 0 10308 0 1007428 0 0 0 Part I, Line 4a David Kapaska received $454,243 in severance payments. The amount is reported on Part VII, column (D). A South Dakota Health and Educational Facilities Authority 460315509 83755VUS1 2012-05-01 206383927 2012A funded a project and refunded Series 2008A and Series 2002 0 0 0 B South Dakota Health and Educational Facilities Authority 460315509 83755VNH3 2008-07-01 61495000 2008C refunded 2006 Series 0 0 0 C South Dakota Health and Educational Facilities Authority 460315509 83755VNB6 2008-06-18 189222932 2012B refunded Series 1994, 2000, and bridge loan 0 0 0 D South Dakota Health and Educational Facilities Authority 460315509 83755VVY7 2014-06-26 61821688 2014A Various capital projects 0 0 0 A 144093927 206383927 1032422 38100000 167251505 2014 1 1 1 1 B 7520000 61495000 388831 31169 61075000 2010 1 0 1 1 C 71102932 189222932 1272562 282213 91009361 96658796 2010 1 0 1 1 D 3071688 61821688 821688 61000000 2015 0 0 1 1 A 0 1 1 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 0 0 1 1 1 Bank of America/Merrill 25.000000000000 0 1 0 0 1 C 0 0 0 1 1 1 Bank of America/Merrill 24.100000000000 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 Schedule K, Part IV, Line 2C: The arbitrage analysis is performed annually, therefore the analysis was completed as of June 30, 2018 for Bonds A, B, and C. A South Dakota Health and Educational Facilities Authority 460315509 83755VG99 2017-10-11 242848916 Series 2017 refund bond issued 6/18/08;construct/equip healthcare facilities 0 0 0 A 242848916 1786422 190000000 51062494 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 1 A 1 Grant Flicek Family member of David Flicek, key employee 59526 Compensation as an employee 0 Interstates Office Products Inc Owned by board member 3397145 Office product purchases 0 X 8 119655 Avg of high/low X Cryotherapy Chamber 1 75000 cost X Items for patients and auction 21 31666 cost X Audio Lighting 1 20515 cost X Food for 2018 Gala 1 4829 cost 0 0 1 1 Part I, Column (b): Number of contributions are included in column (b). Part I, Line 32b: Avera Health uses third parties to process and sell the stocks received. Part I, Line 33: The only amounts included in revenue for the financial statement reporting are non-cash contributions of stock securities. Non-cash contributions not included for financial statements include items for the benefit of the Avera facilities which include special event donations. Form 990, Part VI, Section A, line 6 The organization has two classes of members: Sponsorship Members and System Members. Sponsorship Members shall consist collectively of (i) those persons serving from time to time as the President and Council of the Presentation Sisters of the Blessed Virgin Mary of Aberdeen, South Dakota and (ii) those persons serving from time to time as the Prioress and Council of the Benedictine Convent of the Sacred Heart (Yankton, S.D.). System Members shall consist of six Sisters- three Presentation Sisters appointed by the Presentation Sponsorship Members and three Benedictine Sisters appointed by the Benedictine Sponsorship Members. Form 990, Part VI, Section A, line 7a The System Members have the power to appoint the Board of Directors of Avera Health and to suspend or remove a Director at any time, with or without cause. They also have the power to appoint Benedictine or Presentation Sisters to the Boards of Directors of any sponsored work or ministry of Avera Health. Form 990, Part VI, Section A, line 7b The following powers shall be reserved to and exercised exclusively by the Sponsorship Members and none of the following actions shall be taken by Avera Health without action of the Sponsorship Members: (a) To approve the adoption, amendment or repeal of the statements of philosophy, mission, Guiding Principles and values of Avera Health; (b) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Avera Health, and to give final approval of any such action with respect thereto; (c) To establish policies regarding the alienation of real property and precious artifacts associated with the healthcare ministry which are under the canonical stewardship of the Presentation Sisters or the Benedictine Sisters; (d) To approve any plan of merger, consolidation or dissolution of Avera Health, or the divestiture of any sponsored work or ministry associated with Avera Health; (e) To change the composition of the Sponsorship Members, including the addition of other individuals, parties or entities to be Sponsorship Members; and (f) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of Avera Health. The following powers shall be reserved to and exercised exclusively by the System Members and none of the following actions shall be taken by Avera Health without action of the System Members: (a) To appoint the Board of Directors of Avera Health and to suspend or remove a Director at any time, with or without cause; (b) To appoint Benedictine or Presentation Sisters to the Boards of Directors of any sponsored work or ministry of Avera Health; (c) To appoint the Chair and Vice Chair of the Board of Directors; (d) To appoint, evaluate, suspend or remove the President and Chief Executive Officer; (e) To review and approve the operating and capital budgets, including expenditures outside of budget, and the strategic plan, of Avera Health; (f) To adopt procedures for assuring that corporate actions are consistent with the philosophy, mission, Guiding Principles and values of Avera Health; (g) To provide recommendations to the Sponsorship Members on matters requiring Sponsorship Members' approval or action; (h) To adopt policies designed to effectuate the powers reserved to the System Members; and (i) To exercise oversight of the Guiding Principles and such authorities which may be assigned or delegated by the Sponsorship Members. Form 990, Part VI, Section A, line 8b Avera Health does not have any committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the VP of Financial Reporting, Tax Manager, and Finance Committee (if applicable). After initial review the Form 990 is made available to the Board and other Operation Finance Leaders. Form 990, Part VI, Section B, line 12c The conflict of interest policy covers board members, officers and key employees. At each board meeting, a request is made for all board members to disclose any potential conflict of interest pertaining to any item listed on the agenda or pertaining to any potential item that could be discussed during the course of the meeting. The declaration of conflict of interest is recorded in the meeting minutes. The board makes a determination of whether there is a conflict of interest and if so, implements the procedure for evaluating the issue or transaction involved. The board member or officer with the conflict must refrain from voting. A statement of conflict of interest disclosure is made on an annual basis by officers and directors. The information is maintained in a database and a report is provided to the board. Form 990, Part VI, Section B, line 15 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 for compensation of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are not made available to the general public. Form 990, Part VI, Section B, Line 16b: There is no written policy or procedure. In the event of any such proposed transaction, the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member. Form 990, Part VII: David Flicek served as Chief Administration Officer for Avera Health through calendar year 2017. Starting in calendar year 2018 he served as President/CEO for Avera McKennan, a related organization. Part VII shows 40 hours served for Avera Health, the reporting organization, and 40 hours served for Avera McKennan, a related organization. Form 990, Part IX, line 11g Purchased services: Program service expenses 585,713. Management and general expenses 9,317. Fundraising expenses 0. Total expenses 595,030. Contracted services: Program service expenses 34,710,645. Management and general expenses 5,097,505. Fundraising expenses 0. Total expenses 39,808,150. Repairs and maintenance: Program service expenses 1,216,231. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,216,231. Professional fees: Program service expenses 170,435. Management and general expenses 15,251. Fundraising expenses 0. Total expenses 185,686. Recruitment: Program service expenses 340,364. Management and general expenses 16,898. Fundraising expenses 0. Total expenses 357,262. 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 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. 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). Form 990, Part XI, line 9: Net equity transfers -2,065,416. Insurance program admin income not recognized for tax reporting -826,050. Change in interest in net assets of foundations and trusts 47,507. Contributions received by Avera Health Foundation not reflected in financial statements -11,836,392. Net assets released from restrictions -528,894. Grants to organizations distributed by Avera Health Foundation not reflected in financial statements 11,127,814. Avera eCare LLC 3900 West Avera Drive Sioux Falls SD 571085721 Telehealth SD 0 0 Avera Health Avera St Anthony's Hospital 300 N 2nd Street ONeill NE 68763 470463911 Healthcare services NE 501(c)(3) Line 3 Avera Health 1 Avera Holy Family 826 North 8th Street Estherville IA 51334 420680370 Healthcare services IA 501(c)(3) Line 3 Avera Health 1 Avera Holy Family Foundation 826 North 8th Street Estherville IA 51334 421317452 Support health related services IA 501(c)(3) Line 10 Avera Holy Family 0 St Benedict Health Center 401 West Glynn Drive Parkston SD 57366 460226738 Healthcare services SD 501(c)(3) Line 3 Avera Health 1 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 St Benedict Health Center 0 Avera McKennan 1325 S Cliff Ave PO Box 5045 Sioux Falls SD 57117 460224743 Healthcare services SD 501(c)(3) Line 3 Avera Health 1 Avera Queen of Peace Hospital 525 North Foster Mitchell SD 57301 460224604 Healthcare services SD 501(c)(3) Line 3 Avera Health 1 Sacred Heart Health Services 501 Summit Street Yankton SD 57078 460225483 Healthcare services SD 501(c)(3) Line 3 Avera Health 1 Avera Gettysburg 606 East Garfield Gettysburg SD 57442 460234354 Healthcare services SD 501(c)(3) Line 3 Avera St Mary's 0 Avera at Home 5116 S Solberg Ave Sioux Falls SD 57108 460399291 Home services SD 501(c)(3) Line 10 Avera Health 1 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 Sacred Heart Health Services 0 Avera St Luke's 305 South State Street Aberdeen SD 57401 460224598 Healthcare services SD 501(c)(3) Line 3 Avera Health 1 Avera St Mary's 801 East Sioux Avenue Pierre SD 57501 460230199 Healthcare services SD 501(c)(3) Line 3 Avera Health 1 Avera Marshall 300 S Bruce Street Marshall MN 56258 410919153 Healthcare services MN 501(c)(3) Line 3 Avera Health 1 Avera Tyler 240 Willow Street Tyler MN 56178 410853163 Healthcare services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Health Plans Inc 3900 West Avera Drive Suite 101 Sioux Falls SD 57108 460451539 Health financing & health plan admin SD 501(c)(4) Avera Health 1 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 Q&M Properties LLC 525 North Foster Mitchell SD 57301 731652049 Medical clinic building SD N/A Surgical Associates Endoscopy Clinic LLC 310 S Penn Aberdeen SD 57401 460461429 Surgical associates SD N/A Avera Home Medical Equipment of Spencer Hospital LLC 2400 S Minnesota Ave Sioux Falls SD 57117 800619999 Medical Services - home medical equipment SD N/A 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 Healthcare Services 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 Accounts Management Inc 5132 S Cliff Ave Suite 101 Sioux Falls SD 57108 460373021 Collection agency SD Avera Health C 2898977 2179088 0.75000 1 Avera Property Insurance Inc 610 W 23rd St PO Box 38 Yankton SD 57078 460463155 Insurance SD Avera Health C 487404 1090635 1.00000 1 Valley Health Services 501 Summit Street Yankton SD 57078 460357149 Rental real estate SD N/A C 0 Alucent Medical Inc 1325 S Cliff Avenue PO Box 5045 Sioux Falls SD 571175045 471818349 Biotech Research SD N/A C 0 South Dakota State Medical Holding Company Inc 2600 W 49th Street Sioux Falls SD 57105 460401087 Insurance SD Avera Health C 57513230 26530916 1.00000 1 DakotaCare Administrative Services Inc 2600 W 49th Street Sioux Falls SD 57105 460424322 Insurance SD Avera Health C 5865922 13195270 1.00000 1 0 1 1 1 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 Avera St Mary's D 176831 Change in note receivable Accounts Management Inc L 400980 General ledger Avera at Home L 2307756 General ledger Avera Health Plans Inc L 441996 General ledger Avera Marshall L 5883612 General ledger Avera McKennan L 87687096 General ledger Avera Queen of Peace Hospital L 11499528 General ledger Avera Sacred Heart Health Services L 14500104 General ledger Avera St Luke's L 16947516 General ledger Avera St Mary's L 7369836 General ledger South Dakota State Medical Holding Company L 99996 General ledger Avera Health Plans Inc P 1863759 Vendor payment listing Avera Marshall P 566922 Vendor payment listing Avera McKennan P 12115564 Vendor payment listing Avera Queen of Peace Hospital P 464551 Vendor payment listing Avera Sacred Heart Health Services P 431977 Vendor payment listing Avera St Luke's P 309764 Vendor payment listing Avera St Mary's P 59806 Vendor payment listing Accounts Management Inc Q 114943 Customer invoice listing Avera at Home Q 687800 Customer invoice listing Avera Health Plans Inc Q 130118 Customer invoice listing Avera Holy Family Q 376451 Customer invoice listing Avera Marshall Q 1683351 Customer invoice listing Avera McKennan Q 37324093 Customer invoice listing Avera Queen of Peace Hospital Q 4474154 Customer invoice listing Avera Sacred Heart Health Services Q 4720010 Customer invoice listing Avera St Anthony's Hospital Q 626183 Customer invoice listing Avera St Luke's Q 7764684 Customer invoice listing Avera St Mary's Q 2648092 Customer invoice listing St Benedict Health Center Q 341401 Customer invoice listing South Dakota State Medical Holding Company Q 505420 Customer invoice listing Avera at Home R 166525 General ledger Avera Holy Family R 238253 General ledger Avera Marshall R 80720 General ledger Avera McKennan R 17716536 General ledger Avera Queen of Peace Hospital R 528928 General ledger Avera St Luke's R 51449 General ledger Avera St Mary's R 119164 General ledger