AVERA MCKENNAN: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: AVERA MCKENNAN (EIN 46-0224743)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-15
IRS object ID: 201811359349300141
Schema version: 2016v3.0
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 G
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-15T07:47:17-05:00	ReturnTs
Tax Period End	2017-06-30	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	2016-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	460224743	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	AVERA MCKENNAN	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	AVER	BusinessNameControlTxt
Phone	6053228000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1325 S CLIFF AVE PO BOX 5045	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	571175045	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JULIE NORTON	PersonNm
Person Title	SEC/TREAS & SR VP FINANCE	PersonTitleTxt
Phone	6053228000	PhoneNum
Signature	2018-05-14	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KIM HUNWARDSEN CPA	PreparerPersonNm
PTIN	P00484560	PTIN
Phone	6122536500	PhoneNum
Preparation	2018-05-14	PreparationDt

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Address Change	Yes (X)	AddressChangeInd
Principal Officer	DAVID FLICEK	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1325 S CLIFF AVE PO BOX 5045	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	571175045	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,037,316,496	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.AVERAMCKENNAN.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1911	FormationYr
Legal Domicile State	SD	LegalDomicileStateCd
Activity Or Mission	PROMOTION OF HEALTH	ActivityOrMissionDesc
Voting Members Governing Body	20	VotingMembersGoverningBodyCnt
Voting Members Independent	13	VotingMembersIndependentCnt
Total Employee	7913	TotalEmployeeCnt
Total Volunteers	1983	TotalVolunteersCnt
Total Gross UBI	$22,663,584	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$6,568,194	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$5,933,754	PYContributionsGrantsAmt
CY Contributions Grants	$5,804,637	CYContributionsGrantsAmt
PY Program Service Revenue	$911,860,224	PYProgramServiceRevenueAmt
CY Program Service Revenue	$997,538,670	CYProgramServiceRevenueAmt
PY Investment Income	$3,301,125	PYInvestmentIncomeAmt
CY Investment Income	$16,218,621	CYInvestmentIncomeAmt
PY Other Revenue	$1,606,146	PYOtherRevenueAmt
CY Other Revenue	$2,254,411	CYOtherRevenueAmt
PY Total Revenue	$922,701,249	PYTotalRevenueAmt
CY Total Revenue	$1,021,816,339	CYTotalRevenueAmt
PY Grants And Similar Paid	$636,606	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,310,717	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$446,210,437	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$491,407,050	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$17,835	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$181,520	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$1,439,889	CYTotalFundraisingExpenseAmt
PY Other Expenses	$454,016,043	PYOtherExpensesAmt
CY Other Expenses	$488,841,065	CYOtherExpensesAmt
PY Total Expenses	$900,880,921	PYTotalExpensesAmt
CY Total Expenses	$981,740,352	CYTotalExpensesAmt
PY Revenues Less Expenses	$21,820,328	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$40,075,987	CYRevenuesLessExpensesAmt
Total Assets BOY	$885,040,456	TotalAssetsBOYAmt
Total Assets EOY	$924,237,536	TotalAssetsEOYAmt
Total Liabilities BOY	$333,331,066	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$337,671,365	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$551,709,390	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$586,566,171	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	AVERA MCKENNAN, AS PART OF 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	$554,303,409	ExpenseAmt
Grant	$1,287,393	GrantAmt
Revenue	$741,665,241	RevenueAmt
Desc	AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTERAVERA MCKENNAN PROMOTES THE HEALTH OF THE COMMUNITY BY PROVIDING A VARIETY OF CHARITABLE HEALTH CARE SERVICES. AVERA MCKENNAN OPERATES UNDER THE TENETS OF THE ROMAN CATHOLIC CHURCH AND IN ACCORDANCE WITH THE PHILOSOPHY AND VALUES ESTABLISHED FOR AVERA HEALTH, A SPONSORED MINISTRY OF THE BENEDICTINE AND PRESENTATION SISTERS.MAJOR SERVICE LINES INCLUDE ONCOLOGY, SURGERY, OBSTETRICS, PEDIATRICS, NEONATOLOGY, EMERGENCY AND TRAUMA, CRITICAL CARE INCLUDING EICU, RADIOLOGY AND DIAGNOSTIC IMAGING, PSYCHIATRY, PULMONARY, ORTHOPEDICS, NEUROLOGY, CARDIOLOGY AND GASTROENTEROLOGY. TRANSPLANT SERVICES INCLUDE SOLID ORGAN (KIDNEY, LIVER, AND PANCREAS) AND BONE MARROW TRANSPLANT.THE FOLLOWING ARE SPECIFIC EXEMPT PURPOSE ACHIEVEMENTS FOR AVERA MCKENNAN HOSPITAL:CHARITY AND UNCOMPENSATED CARE: AVERA MCKENNAN PROVIDES NECESSARY MEDICAL SERVICES (DIAGNOSTIC AND TREATMENT) FOR WHOEVER COMES TO US FOR CARE, REGARDLESS OF THEIR ABILITY TO PAY. IN FISCAL YEAR 2017, SERVICES PROVIDED TO THOSE WHO ARE UNABLE TO PAY TOTALED $44,766,000.ELIGIBILITY FOR DISCOUNTED OR FREE SERVICES UNDER THE CHARITY CARE POLICY IS BASED ON INCOME LEVELS. GENERALLY, INDIVIDUALS EARNING INCOME OF UP TO 400% OF THE FEDERAL POVERTY INCOME GUIDELINES ARE ELIGIBLE FOR VARYING LEVELS OF DISCOUNTS, INCLUDING FULL DISCOUNTS FOR CERTAIN INCOME LEVELS. APPLICATION FOR COVERAGE UNDER THE PROGRAM MAY BE OBTAINED AT ANY AVERA MCKENNAN PATIENT REGISTRATION AREA OR BY CALLING AVERA MCKENNAN PATIENT FINANCIAL SERVICES.AVERA MCKENNAN HELPS PATIENTS APPLY FOR ANY APPLICABLE GOVERNMENT INSURANCE PROGRAMS, AND OFFERS HEALTH CARE SERVICES ON A DISCOUNTED OR CHARITABLE BASIS TO THOSE WHO ARE UNINSURED OR UNDERINSURED. CHARITY CARE IS NOT CAPPED BY A BUDGET FIGURE - UNREIMBURSED EXPENSES ARE COVERED BY THE ORGANIZATION AS NEEDED, NOT UNTIL A BUDGET FIGURE IS MET.IN ADDITION TO CHARITY CARE, IN THE PAST FISCAL YEAR AVERA MCKENNAN PROVIDED $260,525 IN LODGING, TRANSPORTATION AND PRESCRIPTIONS TO THOSE IN NEED.ACCESSIBILITY TO HEALTH CARE: AVERA MCKENNAN MAKES MEDICAL CARE ACCESSIBLE TO THE ENTIRE COMMUNITY IT SERVES. IN 2017 AVERA MCKENNAN HAD 22,837 HOSPITAL DISCHARGES, 122,495 PATIENT DAYS AND 309,886 OUTPATIENT VISITS. AVERA MCKENNAN IS A VERIFIED LEVEL II TRAUMA CENTER AND WAS THE FIRST SUCH CENTER IN THE STATE OF SOUTH DAKOTA. AVERA MCKENNAN'S EMERGENCY DEPARTMENT IS STAFFED 24 HOURS A DAY WITH BOARD-CERTIFIED EMERGENCY SPECIALISTS AND PROVIDES EMERGENCY CARE REGARDLESS OF ABILITY TO PAY. AVERA MCKENNAN HAD 33,746 EMERGENCY DEPARTMENT VISITS IN FY 2017. OPERATING BOTH FIXED WING AND HELICOPTER MEDICAL AIR TRANSPORTS, AVERA MCKENNAN'S FLIGHT TEAMS COVER A LARGE GEOGRAPHIC AREA PROVIDING STATE-OF-THE-ART AIR TRANSPORT SERVICES AND ACCESS TO CRITICAL CARE, WITH 1,671 FLIGHTS IN THE PAST YEAR.HEALTH CARE CLINIC: IN 1992, AVERA MCKENNAN ESTABLISHED A HEALTH CARE CLINIC TO PROVIDE FREE CARE FOR PEOPLE WHO ARE UNINSURED OR UNDERINSURED IN THE COMMUNITY. THE CLINIC IS MANAGED BY A REGISTERED NURSE AND STAFFED BY REGISTERED NURSES, TWO MIDLEVEL PROVIDERS, MEDICAL RESIDENTS AND VOLUNTEER HEALTH CARE PROVIDERS. THE GOAL OF THE CLINIC IS TO PREVENT OR TREAT PATIENTS' MEDICAL CONDITIONS BEFORE THEY BECOME CATASTROPHIC. THE CLINIC AVERAGES 450 VISITS PER MONTH, PROVIDING PREVENTATIVE CARE, DIAGNOSIS AND TREATMENT OF ILLNESSES AND INJURIES, MEDICATION ASSISTANCE AND ASSISTANCE IN OBTAINING SPECIALIST CARE FOR PATIENTS WITH COMPLEX CASES. THE CLINIC ALSO SERVES TO TRAIN PHYSICIANS, NURSES AND OTHER HEALTH CARE STUDENTS. IT PROVIDES A FREE EVENING CLINIC ONE EVENING PER MONTH, STAFFED BY MEDICAL STUDENTS UNDER SUPERVISION OF PHYSICIANS. AVERA MCKENNAN IS THE ONLY HEALTH CARE ORGANIZATION TO PROVIDE FREE SERVICES SUCH AS THIS IN THE STATE OF SOUTH DAKOTA. THE CLINIC HAD 4,804 VISITS IN 2017, AND WAS OPERATED AT AN ANNUAL COST OF $864,046. PARTNERSHIP IN LIVE WELL SIOUX FALLS: THE CITY OF SIOUX FALLS RECEIVED A COMMUNITY HEALTH TRANSFORMATION GRANT FROM THE SOUTH DAKOTA DEPARTMENT OF HEALTH, SPARKING A PROJECT TO IMPROVE THE HEALTH AND WELL-BEING OF THE CITIZENS OF SIOUX FALLS. GUIDED BY THE CITY OF SIOUX FALLS HEALTH DEPARTMENT, THIS ONGOING PROJECT IS KNOWN AS LIVE WELL SIOUX FALLS. IT INVOLVES MORE THAN 24 COMMUNITY PARTNER ORGANIZATIONS. AMONG THESE PARTNERS ARE AVERA MCKENNAN AND THE OTHER MAJOR HEALTH CARE SYSTEM IN SIOUX FALLS, SANFORD HEALTH. AVERA PLANS TO WORK IN PARTNERSHIP WITH THE CITY OF SIOUX FALLS AND SANFORD HEALTH TO ADDRESS THE PRIORITIES OF LIVE WELL SIOUX FALLS, AND ARRIVE AT SOLUTIONS WHICH ARE COLLABORATIVE IN NATURE.AVERA MCKENNAN COLLABORATES WITH LIVE WELL SIOUX FALLS TO PROMOTE THE BIG SQUEEZE, A HYPERTENSION INITIATIVE IN APRIL TO PROMOTE BLOOD PRESSURE SCREENING AND EDUCATION, WITH THE GOAL OF DIAGNOSING HIGH BLOOD PRESSURE. ONE IN THREE AMERICAN ADULTS HAVE HIGH BLOOD PRESSURE, BUT ONLY HALF OF THEM HAVE IT UNDER CONTROL, ADDING TO THE RISK OF STROKE, HEART ATTACK AND VASCULAR DISEASE.RESIDENCY/HEALTH PROFESSIONS TRAINING AND INTERNSHIPS: IN 2017, AVERA MCKENNAN HAD 90 MEDICAL RESIDENTS IN TRAINING AT AVERA MCKENNAN IN INTERNAL MEDICINE, FAMILY PRACTICE, PSYCHIATRY, GERIATRICS AND TRANSITIONAL RESIDENCY PROGRAMS OFFERED IN PARTNERSHIP WITH THE UNIVERSITY OF SOUTH DAKOTA SCHOOL OF MEDICINE. OVER 1,000 STUDENTS IN MEDICINE, NURSING, PHARMACY, PHYSICIAN ASSISTANT PROGRAMS, MEDICAL ASSISTING, RADIOLOGY AND RESPIRATORY THERAPY ALSO COMPLETED CLINICAL ROTATIONS AT AVERA MCKENNAN. IN NON-CLINICAL AREAS, AVERA MCKENNAN OFFERED OVER 90 UNPAID, PAID, AND NONPAID INTERNSHIPS IN 2017 IN THE AREAS OF RESEARCH, FINANCE, ADMINISTRATION, THERAPIES, EXERCISE SCIENCE AND SOCIAL WORK. AVERA MCKENNAN IS CURRENTLY LEGALLY AFFILIATED WITH APPROXIMATELY 158 INSTITUTIONS OF HIGHER EDUCATION.PATIENT AND COMMUNITY EDUCATION: AVERA MCKENNAN IS A REGIONAL LEADER IN OFFERING EDUCATIONAL PROGRAMS FOR A VARIETY OF LEARNERS, LEADERS AND EMPLOYEES. UTILIZING ADVANCED TECHNOLOGY, MANY OF THESE PROGRAMS ARE PROVIDED ELECTRONICALLY THROUGHOUT THE TRI-STATE AREA. EDUCATIONAL SESSIONS ARE OFFERED TO MEDICAL STAFF, EMPLOYEES, HEALTH CARE PROFESSIONALS, STUDENTS AT ALL LEVELS AND THE GENERAL PUBLIC. UTILIZING AVERA MCKENNAN'S EDUCATION CENTER, A BROAD CROSS-SECTION OF CLASSES INVOLVING DIVERSE AUDIENCES ARE PROVIDED AS A COMMUNITY SERVICE EACH YEAR.1. ONLINE RESOURCES: AVERA MCKENNAN OFFERS VAST FREE PATIENT EDUCATIONAL ONLINE RESOURCES ON ITS PUBLIC WEBSITE ON NUMEROUS HEALTH TOPICS, WITH SUGGESTIONS FOR LIFESTYLE CHANGE, BEHAVIOR MODIFICATION AND MANAGEMENT FOR IMPROVED HEALTH.2. TO BE WELL FREE EDUCATION EVENTS WERE HELD ON TOPICS INCLUDING ORTHOPEDICS, CANCER, DIABETES, WEIGHT LOSS/HEALTHY EATING, MULTIPLE SCLEROSIS, ANXIETY AND ACUPUNCTURE. 3. FORUMS: THE AVERA BEHAVIORAL HEALTH CENTER OFFERS FREE FRIDAY FORUMS, IN WHICH SCHOOL COUNSELORS AND THERAPISTS ARE INVITED TO PRESENTATIONS ON CHILDREN'S MENTAL HEALTH TOPICS SUCH AS CONFLICT CYCLES, REACTIVE ATTACHMENT DISORDER, DEPRESSION AND BIPOLAR DISORDER IN CHILDREN, AND TEEN SUBSTANCE USE, ABUSE AND ADDICTION. 4. THE AVERA BEHAVIORAL HEALTH CENTER OFFERS FREE MONTHLY EDUCATIONAL SESSIONS ON VARIOUS TOPICS FOLLOWED BY DISCUSSION FOR ADULTS WHO HAVE BEEN IMPACTED BY A LOVED ONE'S MENTAL ILLNESS. TOPICS HAVE INCLUDED GRIEF AND LOSS, ANXIETY, AND PARENTING STRATEGIES FOR MANAGING CHALLENGING BEHAVIORS.5. WOMEN'S & CHILDREN'S SERVICES: AVERA MCKENNAN'S WOMEN'S & CHILDREN'S SERVICES OFFERS A NUMBER OF PARENTING AND COMMUNITY EDUCATION OPPORTUNITIES, FOR FREE OR AT A MINIMAL COST. IN FISCAL YEAR 2017, 86 CHILDBIRTH EDUCATION CLASSES WERE HELD WITH 480 ATTENDEES. A TOTAL OF 7 PARENT AND FAMILY EDUCATION CLASSES WERE HELD WITH 89 ATTENDEES. A TOTAL OF 86 CAR SEATS WERE ISSUED THROUGH THE SOUTH DAKOTA CHILD SAFETY SEAT DISTRIBUTION PROGRAM. FREE BURN EDUCATION WAS PROVIDED TO 2,063 STUDENTS DURING PRESENTATIONS IN SCHOOLS.6. DAYCARE TRAINING: FREE OF CHARGE, AVERA MCKENNAN OFFERS FOUR IN-SERVICE TRAINING SESSIONS PER MONTH TO DAYCARE PROVIDERS THROUGH EMBE, WITH A TOTAL OF 28 SCHEDULED ANNUALLY, AND ADDITIONAL SESSIONS FOR REQUESTED TOPICS. SUPPORT GROUPS: AVERA MCKENNAN OFFERS APPROXIMATELY 10 FREE SUPPORT GROUPS. THEY RANGE IN TOPIC FROM CANCER TO LIVER DISEASE, DIABETES, BONE MARROW TRANSPLANT, STROKE AND GRIEF AND LOSS. THE ORGANIZATION PROVIDES FREE MEETING SPACE AS WELL AS SPEAKERS AND LEADERS. INFORMATION AND ASSISTANCE: AVERA MCKENNAN OPERATES A 24-HOUR MEDICAL CALL CENTER, THROUGH WHICH PATIENTS HAVE ACCESS TO THE ASK-A-NURSE PROGRAM. PATIENTS CAN CALL A TOLL-FREE NUMBER AND TALK PERSONALLY WITH A REGISTERED NURSE TO ASK HEALTH QUESTIONS OR RECEIVE GENERAL HEALTH INFORMATION. IN 2017, THE MEDICAL CALL CENTER HANDLED 152,205 CALLS. AVERA MCKENNAN'S WEB SITE ALSO PROVIDES AN EXTENSIVE HEALTH LIBRARY THAT CONSUMERS CAN ACCESS FREE OF CHARGE.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$49,360,886	ExpenseAmt
Grant	$9,298	GrantAmt
Revenue	$64,917,362	RevenueAmt
Desc	RURAL CRITICAL ACCESS HOSPITALSAVERA MCKENNAN OWNS OR LEASES RURAL CRITICAL ACCESS HOSPITALS IN FLANDREAU, GREGORY, DELL RAPIDS, MILBANK AND MILLER (HAND COUNTY), S.D. AS SUCH, THEY OPERATE AS A DEPARTMENT OF AVERA MCKENNAN. THE HOSPITALS IN FLANDREAU, GREGORY AND HAND COUNTY SERVE MEDICALLY UNDERSERVED COUNTIES. IN ADDITION TO THE FOLLOWING EXEMPT PURPOSE ACHIEVEMENTS, RURAL HOSPITALS PARTICIPATE IN MANY OF THE ABOVE AS PART OF AVERA MCKENNAN.AMONG SERVICES OFFERED BY RURAL HOSPITALS ARE RADIOLOGY AND IMAGING, COLONOSCOPY AND ENDOSCOPY, THERAPY AND REHABILITATION, 24-HOUR EMERGENCY CARE, CHEMOTHERAPY, ORTHOPEDICS, CARDIOVASCULAR TESTING AND CARE, OBSTETRICS, SURGERY, AND DIALYSIS.CHARITY AND UNCOMPENSATED CARE: AS PART OF AVERA MCKENNAN, THESE FACILITIES PROVIDE NECESSARY MEDICAL SERVICES (DIAGNOSTIC AND TREATMENT) FOR WHOMEVER COMES TO US FOR CARE, REGARDLESS OF THEIR ABILITY TO PAY. IN FISCAL YEAR 2017, CHARITY AND UNCOMPENSATED CARE PROVIDED BY RURAL HOSPITALS TOTALED $1,278,000.ACCESSIBILITY TO HEALTH CARE: AVERA MCKENNAN REGIONAL HOSPITALS MAKE MEDICAL CARE ACCESSIBLE TO THE ENTIRE COMMUNITY THEY SERVE REGARDLESS OF A PATIENT'S ABILITY TO PAY. IN 2017, RURAL HOSPITALS HAD 1,786 DISCHARGES, 7,528 PATIENT DAYS AND 75,224 OUTPATIENT VISITS. EACH OF THE HOSPITALS PROVIDES 24-HOUR EMERGENCY CARE WITH EEMERGENCY SERVICES THROUGH AVERA MCKENNAN. EICU SERVICES ARE ALSO AVAILABLE AT THESE HOSPITALS, PROVIDING ACCESS TO CRITICAL CARE MEDICINE NEAR HOME AND LESSENING THE NEED FOR TRANSPORT. THERE IS NO ADDITIONAL BILLING TO PATIENTS. TELEMEDICINE CONSULTS ARE ALSO OFFERED AT RURAL LOCATIONS IN A NUMBER OF MEDICAL SPECIALTIES.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$206,771,883	ExpenseAmt
Grant	$14,026	GrantAmt
Revenue	$154,900,918	RevenueAmt
Desc	CLINICSAVERA MCKENNAN PROVIDES CLINICAL CARE, SECONDARY AND PRIMARY, IN 91 OWNED/JOINT VENTURE CLINICS IN SOUTH DAKOTA, NORTHWEST IOWA, SOUTHWEST MINNESOTA AND NORTHEASTERN NEBRASKA. IN ADDITION TO THE FOLLOWING EXEMPT PURPOSE ACHIEVEMENTS, CLINICS PARTICIPATE IN MANY OF THE ABOVE AS PART OF AVERA MCKENNAN. CLINIC VISITS IN 2017 TOTALED 1,107,015.CLINICS PROVIDE PRIMARY CARE AND URGENT CARE, AND AMONG SPECIALTIES ARE CARDIOLOGY; DERMATOLOGY; ENDOCRINOLOGY; GASTROENTEROLOGY; HEMATOLOGY; HEPATOLOGY; INFECTIOUS DISEASE; INTERNAL MEDICINE; NEONATOLOGY; NEPHROLOGY; NEUROLOGY AND NEUROSURGERY; OB/GYN; ONCOLOGY; OPHTHALMOLOGY; ORTHOPEDICS; PAIN MANAGEMENT; PEDIATRICS; PSYCHIATRY; PULMONOLOGY; SPORTS MEDICINE; SURGERY; AND VASCULAR SERVICES.CHARITY AND UNCOMPENSATED CARE: AS PART OF AVERA MCKENNAN, CLINICS PROVIDE NECESSARY MEDICAL SERVICES (DIAGNOSTIC AND TREATMENT) FOR WHOEVER COMES TO US FOR CARE, REGARDLESS OF THEIR ABILITY TO PAY. IN FISCAL YEAR 2017, CHARITY AND UNCOMPENSATED CARE PROVIDED BY CLINICS TOTALED $464,000.ACCESSIBILITY TO HEALTH CARE: IN ADDITION TO REGULAR CLINIC HOURS, AVERA MCGREEVY CLINIC PROVIDES URGENT CARE, SEEING PATIENTS ON A WALK-IN BASIS AT TWO LOCATIONS DURING THE EVENING HOURS ON WEEKDAYS, AND THROUGHOUT THE DAYTIME HOURS ON SATURDAYS AND SUNDAYS. THIS PROVIDES GREATER ACCESSIBILITY WITHOUT HAVING TO RELY ON EMERGENCY ROOM CARE. IN ADDITION, THROUGH OUR AVERANOW CLINICS, AVERA OFFERS CONVENIENT, AFFORDABLE CLINIC CARE IN PARTNERSHIP WITH LOCAL HYVEE PHARMACIES.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$12,319,306	ExpenseAmt
Revenue	$13,393,227	RevenueAmt
Desc	OTHER PROGRAM SERVICESAVERA MCKENNAN ALSO PROVIDES LONG-TERM CARE, RETAIL SERVICES, HOME INFUSION, RESEARCH, FITNESS CENTER, REGIONAL LAB AND MOBILE SERVICES.MEDICAL RESEARCH: AS A RESEARCH INSTITUTION, AVERA MCKENNAN DRAWS PHYSICIANS WHO ARE COMMITTED TO SEEKING NEW TREATMENTS AND PREVENTIVE MEASURES. IN 2017, THE AVERA RESEARCH INSTITUTE PARTICIPATED IN OVER 90 CLINICAL TRIALS AND REGISTRIES, INVOLVING CANCER, ALZHEIMER'S DISEASE, BEHAVIORAL HEALTH, DIABETES AND MORE. THE AVERA RESEARCH INSTITUTE ALSO CONTINUES ONGOING APPLIED RESEARCH IN THE AREA OF DEVELOPING A NOVEL PHOTOCHEMICAL TISSUE-BONDING TECHNOLOGY THAT HAS VASCULAR, OPHTHALMOLOGIC AND DERMATOLOGICAL APPLICATIONS. THROUGH ITS GENETICS LAB, AVERA MCKENNAN IS STUDYING CLINICAL APPLICATIONS OF PERSONALIZED MEDICINE THROUGH PHARMACOGENOMICS IN AREAS OF PAIN MANAGEMENT, BEHAVIORAL HEALTH, CARDIOVASCULAR HEALTH, INTERNAL MEDICINE, AND CANCER. IN FISCAL YEAR 2017, AVERA MCKENNAN OPERATED THE AVERA RESEARCH INSTITUTE AT A LOSS OF $8,439,163.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$12,319,306	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue	$13,393,227	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$822,755,484	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	Yes (1)	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	Yes (1)	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	Yes (1)	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (1)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	475	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	7913	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
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	20	GoverningBodyVotingMembersCnt
Independent Voting Member	13	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	0	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	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	JULIE NORTON	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6053228000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1325 S CLIFF AVE	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	571175045	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (32 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
JAMES WIEDERRICH
CHAIR	2.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
HUGH VENRICK
VICE CHAIR	2.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
DAVID KAPASKA DO
PRESIDENT & CEO	40.00	0.00	Yes (X)	Yes (X)	$0	$912,822	$42,634
TOM BIEGLER
BOARD TRUSTEE	2.00	0.00	Yes (X)		$0	$0	$0
SISTER CARMELLA LUKE
BOARD TRUSTEE	2.00	0.00	Yes (X)		$0	$0	$0
LUIS ROJAS MD
BOARD TRUSTEE	40.00	0.00	Yes (X)		$585,257	$0	$30,582
RICK KOOIMA MD
BOARD TRUSTEE	40.00	0.00	Yes (X)		$282,164	$0	$24,930
SISTER JOAN REICHELT
BOARD TRUSTEE	2.00	3.80	Yes (X)		$0	$0	$0
JENNIFER MCKAY MD
CHIEF OF STAFF UNTIL DEC. 2016	2.00	40.00	Yes (X)		$0	$265,923	$16,660
KAREN GARNAAS MD
CHIEF OF STAFF AS OF JAN. 2017	40.00	0.00	Yes (X)		$232,393	$0	$18,127
DAVID FLECK
BOARD TRUSTEE	2.00	0.00	Yes (X)		$0	$0	$0
SANDRA PAY
BOARD TRUSTEE	2.00	0.00	Yes (X)		$0	$0	$0
BILL ROSSING MD
BOARD TRUSTEE	40.00	0.00	Yes (X)		$305,774	$0	$5,800
CINDY WALSH
BOARD TRUSTEE	2.00	0.00	Yes (X)		$0	$0	$0
DAVID CHICOINE
BOARD TRUSTEE	2.00	0.00	Yes (X)		$0	$0	$0
MARY DALLY
BOARD TRUSTEE	2.00	0.00	Yes (X)		$0	$0	$0
ALEJANDRO RAMIREZ
BOARD TRUSTEE	2.00	0.00	Yes (X)		$0	$0	$0
RAED SULAIMAN MD
BOARD TRUSTEE	2.00	0.00	Yes (X)		$0	$0	$0
CAROL TWEDT
BOARD TRUSTEE	2.00	0.00	Yes (X)		$0	$0	$0
SISTER LUCILLE WELBIG
BOARD TRUSTEE	2.00	2.00	Yes (X)		$0	$0	$0
SISTER MARIBETH WENTZLAFF
BOARD TRUSTEE	2.00	0.00	Yes (X)		$0	$0	$0
JULIE N NORTON
SEC/TREAS & SRVP FINANCE	40.00	0.00		Yes (X)	$509,996	$0	$29,142
LORI POPKES
SR VICE PRESIDENT	40.00	0.00			$313,185	$0	$25,744	Yes (X)
DAVID FLICEK
CHIEF ADMINISTRATIVE OFFICER	0.00	40.00			$0	$609,904	$38,280	Yes (X)
STEVE PETERSEN
AVP-PHARMACY	40.00	0.00			$0	$255,095	$40,420	Yes (X)
MARY LEEDOM
AVP-SURGERY	40.00	0.00			$188,780	$0	$0	Yes (X)
CURT HOHMAN
SR VICE PRESIDENT	40.00	0.00			$361,265	$0	$13,810	Yes (X)
ARVIN SANTOS MD
TRANSPLANT	40.00	0.00			$1,116,052	$0	$30,230		Yes (X)
HENDRIK KLOPPER MD
NEUROSURGERY	40.00	0.00			$1,160,213	$0	$28,484		Yes (X)
BRIAN KNUTSON MD
DERMATOLOGY	40.00	0.00			$1,299,729	$0	$28,484		Yes (X)
STEVEN CONDRON MD
GASTROENTEROLOGY	40.00	0.00			$1,262,311	$0	$31,034		Yes (X)
JEFFERY STEERS MD
TRANSPLANT	40.00	0.00			$1,125,708	$0	$28,484		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$8,742,827	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,043,744	TotReportableCompRltdOrgAmt
Total Other Compensation	$432,845	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	748	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 WEST AVERA DRIVE	SIOUX FALLS	SD	57108	SHARED SERVICES	$82,539,703
SIOUX FALLS CONSTRUCTION
PO BOX 2728	SIOUX FALLS	SD	571072728	CONSTRUCTION	$27,054,048
SANFORD SCHOOL OF MEDICINE
1400 W 22ND ST 120	SIOUX FALLS	SD	571051505	PHYSICIAN SERVICES	$3,870,299
PHYSICIANS LABORATORY LTD
1301 S CLIFF AVE SUITE 700	SIOUX FALLS	SD	571051019	PATHOLOGY	$1,935,187
SURGICAL INSTITUTE OF SD PC
911 E 20TH ST 700	SIOUX FALLS	SD	57105	MEDICAL DIRECTOR & PROFESSIONAL FEES	$1,815,576

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	90	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$43,463	FederatedCampaignsAmt
Related Organizations	$3,376,603	RelatedOrganizationsAmt
Government Grants	$359,655	GovernmentGrantsAmt
All Other Contributions	$2,024,916	AllOtherContributionsAmt
Total Contributions	$5,804,637	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE RE	622110	$929,126,976	$929,126,976
OTHER PATIENT AND CLIN	621500	$43,719,601	$23,548,766	$20,170,835
INCOME FROM SUBSIDIARI	423000	$8,166,020	$8,166,020
INTEREST IN FOUNDATION	900099	$1,879,632	$1,879,632
MEANINGFUL USE REVENUE	900099	$623,882	$623,882

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,022,559	TotalRevenueColumnAmt
Related Or Exempt Func Income	$14,022,559	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$997,538,670	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$103,887	TotalRevenueColumnAmt
Exclusion	$103,887	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,360,303	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,660,901	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$300,598	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$300,598	TotalRevenueColumnAmt
Exclusion	-$300,598	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$29,953,990	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$13,839,256	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$16,114,734	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$16,114,734	TotalRevenueColumnAmt
Exclusion	$16,114,734	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
COMMERCIAL TESTING	621500	$1,278,180	$1,278,180
SPORTS PROGRAM	900099	$1,214,569	$1,214,569
A/R INTEREST INCOME	900099	$62,260		$62,260

Field	Value	IRS element (for citing)
Other Revenue Total	$2,555,009	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,021,816,339	TotalRevenueColumnAmt
Related Or Exempt Func Income	$977,430,095	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$22,663,584	UnrelatedBusinessRevenueAmt
Exclusion	$15,918,023	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	$1,030,692	TotalAmt
Program Services	$1,030,692	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$280,025	TotalAmt
Program Services	$280,025	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$3,533,886	TotalAmt
Program Services	$2,248,364	ProgramServicesAmt
Management And General	$1,285,522	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$1,711,686	TotalAmt
Program Services	$1,711,686	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$388,466,939	TotalAmt
Program Services	$359,114,606	ProgramServicesAmt
Management And General	$28,907,420	ManagementAndGeneralAmt
Fundraising	$444,913	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$27,472,762	TotalAmt
Program Services	$24,894,752	ProgramServicesAmt
Management And General	$2,539,812	ManagementAndGeneralAmt
Fundraising	$38,198	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$43,837,569	TotalAmt
Program Services	$38,120,082	ProgramServicesAmt
Management And General	$5,663,619	ManagementAndGeneralAmt
Fundraising	$53,868	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$26,384,208	TotalAmt
Program Services	$24,080,209	ProgramServicesAmt
Management And General	$2,271,591	ManagementAndGeneralAmt
Fundraising	$32,408	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$221,693	TotalAmt
Program Services	$21,758	ProgramServicesAmt
Management And General	$199,935	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$24,872	TotalAmt
Management And General	$24,872	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$56,428	TotalAmt
Management And General	$56,428	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$181,520	TotalAmt
Fundraising	$181,520	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$154,470,856	TotalAmt
Program Services	$63,342,421	ProgramServicesAmt
Management And General	$91,050,663	ManagementAndGeneralAmt
Fundraising	$77,772	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$902,833	TotalAmt
Program Services	$575,503	ProgramServicesAmt
Management And General	$200,712	ManagementAndGeneralAmt
Fundraising	$126,618	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$13,336,655	TotalAmt
Program Services	$7,826,107	ProgramServicesAmt
Management And General	$5,346,485	ManagementAndGeneralAmt
Fundraising	$164,063	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$6,629,076	TotalAmt
Program Services	$3,593,790	ProgramServicesAmt
Management And General	$3,008,596	ManagementAndGeneralAmt
Fundraising	$26,690	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$18,564,869	TotalAmt
Program Services	$14,718,338	ProgramServicesAmt
Management And General	$3,846,341	ManagementAndGeneralAmt
Fundraising	$190	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$2,530,556	TotalAmt
Program Services	$2,080,738	ProgramServicesAmt
Management And General	$431,526	ManagementAndGeneralAmt
Fundraising	$18,292	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$2,199,054	TotalAmt
Program Services	$2,060,092	ProgramServicesAmt
Management And General	$138,152	ManagementAndGeneralAmt
Fundraising	$810	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$8,726,876	TotalAmt
Program Services	$8,497,763	ProgramServicesAmt
Management And General	$229,113	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$39,925,519	TotalAmt
Program Services	$34,266,025	ProgramServicesAmt
Management And General	$5,655,720	ManagementAndGeneralAmt
Fundraising	$3,774	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$4,220,172	TotalAmt
Program Services	$2,208,876	ProgramServicesAmt
Management And General	$2,011,296	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$205,782,470	$205,782,470
BAD DEBT EXPENSE	$22,370,725	$22,370,725
EQUIPMENT LEASE AND REN	$3,862,730	$3,331,584	$530,176	$970
UBI TAX	$909,670	$909,670

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,106,011	TotalAmt
Program Services	-$310,792	ProgramServicesAmt
Management And General	$4,147,000	ManagementAndGeneralAmt
Fundraising	$269,803	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$981,740,352	TotalAmt
Program Services	$822,755,484	ProgramServicesAmt
Management And General	$157,544,979	ManagementAndGeneralAmt
Fundraising	$1,439,889	FundraisingAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part X	Yes (X)	InfoInScheduleOPartXInd

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$28,776,240	BOYAmt
EOY	$30,650,368	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$2,281,517	BOYAmt
EOY	$3,119,577	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$121,016,756	BOYAmt
EOY	$133,136,739	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$112,500	BOYAmt
EOY	$62,500	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$2,693,429	BOYAmt
EOY	$2,504,517	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$20,390,785	BOYAmt
EOY	$22,282,021	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$12,440,285	BOYAmt
EOY	$14,101,648	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$783,297,922	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$401,417,667	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$381,897,606	BOYAmt
EOY	$381,880,255	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$7,281,683	BOYAmt
EOY	$7,042,556	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$226,728,566	BOYAmt
EOY	$238,011,941	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$10,574,070	BOYAmt
EOY	$10,209,460	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$42,654,138	BOYAmt
EOY	$40,953,412	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$28,192,881	BOYAmt
EOY	$40,282,542	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$885,040,456	BOYAmt
EOY	$924,237,536	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$67,597,970	BOYAmt
EOY	$76,519,186	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$322,933	BOYAmt
EOY	$763,404	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$238,371,954	BOYAmt
EOY	$234,252,193	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$27,038,209	BOYAmt
EOY	$26,136,582	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$333,331,066	BOYAmt
EOY	$337,671,365	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$536,715,789	BOYAmt
EOY	$570,992,680	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$11,819,039	BOYAmt
EOY	$11,808,971	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,174,562	BOYAmt
EOY	$3,764,520	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$551,709,390	BOYAmt
EOY	$586,566,171	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$885,040,456	BOYAmt
EOY	$924,237,536	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$40,075,987	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$2,699,684	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$7,918,890	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	$56,428	OtherActivitiesAmt
Total Lobbying Expenditures	$56,428	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	PART II-B LINE 1I: AVERA MCKENNAN PARTICIPATES THROUGH VARIOUS HOSPITAL ORGANIZATIONS TO PROMOTE LEGISLATION THAT WOULD RESULT IN STRENGTHENING HEALTH CARE DELIVERY SYSTEMS ON A NATIONAL, REGIONAL, AND LOCAL LEVEL. DUES WERE PAID TO THE FOLLOWING ORGANIZATIONS AND A PORTION IS ATTRIBUTABLE TO LOBBYING. SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGANIZATIONS $32,722 AMERICAN HOSPITAL ASSOCIATION 18,628 CATHOLIC HEALTH ASSOCIATION 5,032 LEADINGAGE 46	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	Yes (1)	AgentTrusteeEtcInd
Beginning Balance	$14,471	BeginningBalanceAmt
Additions During Year	$199,817	AdditionsDuringYearAmt
Distributions During Year	$198,136	DistributionsDuringYearAmt
Ending Balance	$16,152	EndingBalanceAmt
Incl Escrow Custodial Acct Liab	0	InclEscrowCustodialAcctLiabInd

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,174,562	BeginningYearBalanceAmt
Investment Earnings Or Losses	$589,958	InvestmentEarningsOrLossesAmt
End Year Balance	$3,764,520	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,828,539	BeginningYearBalanceAmt
Investment Earnings Or Losses	$346,023	InvestmentEarningsOrLossesAmt
End Year Balance	$3,174,562	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,692,789	BeginningYearBalanceAmt
Investment Earnings Or Losses	$135,750	InvestmentEarningsOrLossesAmt
End Year Balance	$2,828,539	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,631,677	BeginningYearBalanceAmt
Investment Earnings Or Losses	$61,112	InvestmentEarningsOrLossesAmt
End Year Balance	$2,692,789	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,141,642	BeginningYearBalanceAmt
Investment Earnings Or Losses	$490,035	InvestmentEarningsOrLossesAmt
End Year Balance	$2,631,677	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	1.00000	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	$9,849,434	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$27,228,590	OtherCostOrOtherBasisAmt
Book Value	$37,078,024	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$4,526,544	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$464,862,186	OtherCostOrOtherBasisAmt
Depreciation	$200,711,935	DepreciationAmt
Book Value	$268,676,795	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,567,816	OtherCostOrOtherBasisAmt
Depreciation	$1,521,064	DepreciationAmt
Book Value	$1,046,752	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$263,334,842	OtherCostOrOtherBasisAmt
Depreciation	$194,216,164	DepreciationAmt
Book Value	$69,118,678	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$10,928,510	OtherCostOrOtherBasisAmt
Depreciation	$4,968,504	DepreciationAmt
Book Value	$5,960,006	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$381,880,255	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (4 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
ASSETS LIMITED AS TO USE - AVERA POOLED INVESTMENTS	$201,115,301	F
HEART HOSPITAL OF SOUTH DAKOTA, LLC	$18,765,314	F
INTEREST IN AVERA HEALTH FOUNDATION	$13,282,111	F
INVESTMENTS IN AFFILIATED COMPANIES	$4,849,215	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$238,011,941	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
OTHER LIABILITIES	$3,359,759
DUE TO OTHER ORGANIZATIONS	$1,174,897
MARKET VALUE OF INTEREST SWAP	$7,654,265
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS	$8,614,305
MINORITY INTEREST	$4,262,501
INSURANCE LOSS LIABILITY	$1,070,855

Field	Value	IRS element (for citing)
Total Liability	$26,136,582	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART IV, LINE 1B:	THE ORGANIZATION HOLDS FUNDS IN TRUST ON BEHALF OF ITS LONG-TERM CARE RESIDENTS. MANY SMALL DOLLAR TRANSACTIONS FLOW IN AND OUT OF THIS ACCOUNT. THE ACCOUNT IS MANAGED BY THE NURSING HOME STAFF. THE STATE HAS STRICT GUIDELINES ON HOW THESE ACCOUNTS ARE MANAGED.
PART V, LINE 4:	THE ORGANIZATION'S ENDOWMENT CONSISTS OF A PORTION OF THEIR INTEREST IN THE NET ASSETS OF AVERA HEALTH FOUNDATION. THE AVERA HEALTH FOUNDATION INCLUDES ENDOWMENT FUNDS WHICH HAVE BEEN ESTABLISHED FOR A VARIETY OF PURPOSES. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS (IF ANY), ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. THE ORGANIZATION'S PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE DONOR RESTRICTED. THE ORGANIZATION CURRENTLY DOES NOT HAVE ANY BOARD DESIGNATED ENDOWMENT FUNDS.
PART X, LINE 2:	THE ORGANIZATION IS ORGANIZED AS A NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). CERTAIN CONSOLIDATED SUBSIDIARIES, INCLUDING HEART HOSPITAL OF SOUTH DAKOTA LLC, ALUMEND LLC, AND ALUCENT MEDICAL, INC. ARE NOT TAX-EXEMPT ENTITIES AND ARE CONSIDERED PARTNERSHIPS OR DISREGARDED ENTITIES FOR TAX PURPOSES. AVERA MCKENNAN IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, AVERA MCKENNAN IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. AVERA MCKENNAN FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. FOR THE YEARS ENDED JUNE 30, 2017 AND 2016, CASH PAID FOR INCOME TAXES WAS $2,169,516 AND $847,154, RESPECTIVELY. THE ORGANIZATION BELIEVES THAT IT HAS 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 WERE INCURRED.

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Mail Solicitations	Yes (X)	MailSolicitationsInd
Email Solicitations	Yes (X)	EmailSolicitationsInd
In Person Solicitations	Yes (X)	InPersonSolicitationsInd
Solicitation Of Non Govt Grants	Yes (X)	SolicitationOfNonGovtGrantsInd
Special Fundraising Events	Yes (X)	SpecialFundraisingEventsInd
Agrmt Prof Fundraising Acty	Yes (1)	AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	ActivityActivityTxt	Fundraiser Control Of FundsFundraiserControlOfFundsInd	Gross ReceiptsGrossReceiptsAmt	Retained By ContractorRetainedByContractorAmt	Net To OrganizationNetToOrganizationAmt
JON OIEN
600 E SUNNYBROOK DR	SIOUX FALLS	SD	57105	MAJOR AND PLANNED GIFT SOLICITATIONS	0	$0	$19,020	$0
MICHAEL SABA
26560 N SHORE PL	HARTFORD	SD	57033	MAJOR AND PLANNED GIFT SOLICITATIONS	0	$0	$162,500	$0

Field	Value	IRS element (for citing)
Total Retained By Contractors	$181,520	TotalRetainedByContractorsAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, SCHEDULE G, PART I, LINE 2B:	JOHN OIEN AND MICHAEL SABA WERE PAID FOR SERVICES WITH THE MAJOR AND PLANNED GIFT SOLICITATIONS. THE ORGANIZATION DOES NOT RECORD CONTRIBUTIONS IN COLUMN (IV). CONTRIBUTIONS FROM THE SOLICITATIONS ARE RECEIVED THROUGH AVERA HEALTH FOUNDATION.
FORM 990, SCHEDULE G, PART I, LINE 3:	AVERA MCKENNAN IS NOT REQUIRED TO BE REGISTERED OR LICENSED IN ANY STATES AS AVERA HEALTH FOUNDATION, A RELATED ORGANIZATION, SOLICITS AND RECEIVES CONTRIBUTIONS AND IS REGISTERED AND LICENSED IN THE APPROPRIATE STATES.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
Most Hospitals Policy	Yes (X)	MostHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent150	Yes (X)	Percent150Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,833,697	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$12,833,697	NetCommunityBenefitExpnsAmt
Total Expense	0.01340	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$76,129,806	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$57,002,282	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$19,127,524	NetCommunityBenefitExpnsAmt
Total Expense	0.01990	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,586,258	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,536,322	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,049,936	NetCommunityBenefitExpnsAmt
Total Expense	0.00110	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$91,549,761	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$58,538,604	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$33,011,157	NetCommunityBenefitExpnsAmt
Total Expense	0.03440	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,714,627	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$600,682	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,113,945	NetCommunityBenefitExpnsAmt
Total Expense	0.00320	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,399,149	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,611,374	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,787,775	NetCommunityBenefitExpnsAmt
Total Expense	0.00710	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$50,364,222	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$43,994,522	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,369,700	NetCommunityBenefitExpnsAmt
Total Expense	0.00660	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,913,480	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,348,941	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,564,539	NetCommunityBenefitExpnsAmt
Total Expense	0.00890	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,601,368	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,601,368	NetCommunityBenefitExpnsAmt
Total Expense	0.00270	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$75,992,846	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$48,555,519	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$27,437,327	NetCommunityBenefitExpnsAmt
Total Expense	0.02850	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$167,542,607	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$107,094,123	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$60,448,484	NetCommunityBenefitExpnsAmt
Total Expense	0.06290	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$13,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$13,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$125,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$125,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$55,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$55,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$45,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$45,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$238,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$238,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$22,370,725	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$219,569,673	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$249,874,921	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$30,305,248	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	7	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (7 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Childrens HospitalChildrensHospitalInd	Teaching HospitalTeachingHospitalInd	Research FacilityResearchFacilityInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc	Critical Access HospitalCriticalAccessHospitalInd
AVERA MCKENNAN
1	1325 S CLIFF AVE	SIOUX FALLS	SD	57117	WWW.AVERAMCKENNAN.ORG	10563	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	35 PROVIDER BASED CLINICS
HEART HOSPITAL OF SOUTH DAKOTA LLC
2	4500 W 69TH STREET	SIOUX FALLS	SD	57108	WWW.AVERA.ORG/HEART-HOSPITAL	41953	Yes (X)	Yes (X)				Yes (X)	2/3 OWNER IN JOINT VENTURE
AVERA MILBANK AREA HOSPITAL
3	901 VIRGIL AVE	MILBANK	SD	57252	WWW.AVERA.ORG/MILBANK	48451	Yes (X)	Yes (X)				Yes (X)	2 PROVIDER BASED CLINICS & 2 RURAL HEALTH PB CLINICS	Yes (X)
AVERA GREGORY HEALTHCARE CENTER
4	400 PARK AVE	GREGORY	SD	57533	WWW.AVERA.ORG/GREGORY-HOSPITAL	54875	Yes (X)	Yes (X)				Yes (X)	2 PROVIDER BASED CLINICS & 2 RURAL HEALTH PB CLINICS	Yes (X)
AVERA DELLS AREA HEALTH CENTER
5	909 N IOWA AVENUE	DELL RAPIDS	SD	57022	WWW.AVERA.ORG/DELL-RAPIDS	50754	Yes (X)	Yes (X)				Yes (X)	3 PROVIDER BASED CLINICS	Yes (X)
AVERA FLANDREAU MEDICAL CENTER
6	214 N PRAIRIE	FLANDREAU	SD	57028	WWW.AVERA.ORG/FLANDREAU-MEDICAL	10540	Yes (X)	Yes (X)				Yes (X)	1 RURAL HEALTH PROVIDER BASED CLINIC	Yes (X)
AVERA HAND COUNTY MEMORIAL HOSPITAL
7	300 W 5TH ST	MILLER	SD	57362	WWW.AVERA.ORG/MILLER	53862	Yes (X)	Yes (X)				Yes (X)	1 PROVIDER BASED CLINIC	Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (7 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 MCKENNAN
1	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	15	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (X)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	Yes (X)	Yes (1)	15	Yes (1)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	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)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	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	Yes (1)
HEART HOSPITAL OF SOUTH DAKOTA LLC
2	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	15	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (X)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	Yes (X)	Yes (1)	15	Yes (1)	WWW.AVERA.ORG/ABOUT/COMMUNITY-NEEDS-HEALTH-ASSESSMENTS/	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)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	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 GREGORY HEALTHCARE CENTER
4	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)		Yes (X)	Yes (X)	Yes (X)	15	Yes (1)	0	0	Yes (1)	Yes (X)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	Yes (X)	Yes (1)	15	Yes (1)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	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)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	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	Yes (1)
AVERA MILBANK AREA HOSPITAL
3	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)		Yes (X)	Yes (X)	Yes (X)	15	Yes (1)	0	0	Yes (1)	Yes (X)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	Yes (X)	Yes (1)	15	Yes (1)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	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)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	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	Yes (1)
AVERA DELLS AREA HEALTH CENTER
5	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)		Yes (X)	Yes (X)	Yes (X)	15	Yes (1)	0	0	Yes (1)	Yes (X)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	Yes (X)	Yes (1)	15	Yes (1)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	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)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	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	Yes (1)
AVERA FLANDREAU MEDICAL CENTER
6	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)		Yes (X)	Yes (X)	Yes (X)	15	Yes (1)	0	0	Yes (1)	Yes (X)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	Yes (X)	Yes (1)	15	Yes (1)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	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)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	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	Yes (1)
AVERA HAND COUNTY MEMORIAL HOSPITAL
7	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)		Yes (X)	Yes (X)	Yes (X)	15	Yes (1)	0	0	Yes (1)	Yes (X)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	Yes (X)	Yes (1)	15	Yes (1)	WWW.AVERA.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/	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)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	Yes (X)	WWW.AVERA.ORG/PATIENTS-VISITORS/CHARITY-PATIENT-ASSISTANCE-PROGRAMS/	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	Yes (1)

Supplemental Information SupplementalInformationGrp (45 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
AVERA MCKENNAN	PART V, SECTION B, LINE 5: IN CONDUCTING THE MOST RECENT CHNA, AVERA MCKENNAN SOLICITED COMMUNITY INPUT IN A VARIETY OF METHODS. A GENERALIZABLE SURVEY OF RESIDENTS IN THE SIOUX FALLS METROPOLITAN STATISTICAL AREA WAS CONDUCTED IN MARCH 2015. THREE FOCUS GROUP INTERVIEWS WERE CONDUCTED IN MAY 2015. INDIVIDUAL INTERVIEWS WITH 13 COMMUNITY LEADERS WERE HELD REPRESENTING INTERESTS IN BANKING, BUSINESS, NONPROFIT HUMAN SERVICES, NONPROFIT CHILD CARE SERVICES, COMMUNITY COLLEGE ADMINISTRATION, COMMUNITY COLLEGE STUDENT, MINORITY HEALTH CARE PROVIDER, FAITH BASED HUMAN SERVICES AND HEALTH CARE PUBLIC POLICY WERE HELD IN JUNE-AUGUST 2015. SOUTH DAKOTA GOOD & HEALTH COMMUNITY CHECKLIST WAS USED TO CONDUCT ASSESSMENTS COVERING WORKSITE, HEALTH CARE, COMMUNITY AND SCHOOL SECTORS.
HEART HOSPITAL OF SOUTH DAKOTA, LLC	PART V, SECTION B, LINE 5: IN CONDUCTING THE MOST RECENT CHNA, HEART HOSPITAL OF SOUTH DAKOTA, LLC, SOLICITED COMMUNITY INPUT IN A VARIETY OF METHODS. A GENERALIZABLE SURVEY OF RESIDENTS IN THE SIOUX FALLS METROPOLITAN STATISTICAL AREA WAS CONDUCTED IN MARCH 2015. THREE FOCUS GROUP INTERVIEWS WERE CONDUCTED IN MAY 2015. INDIVIDUAL INTERVIEWS WITH 13 COMMUNITY LEADERS WERE HELD REPRESENTING INTERESTS IN BANKING, BUSINESS, NONPROFIT HUMAN SERVICES, NONPROFIT CHILD CARE SERVICES, COMMUNITY COLLEGE ADMINISTRATION, COMMUNITY COLLEGE STUDENT, MINORITY HEALTH CARE PROVIDER, FAITH BASED HUMAN SERVICES AND HEALTH CARE PUBLIC POLICY WERE HELD IN JUNE-AUGUST 2015. SOUTH DAKOTA GOOD & HEALTH COMMUNITY CHECKLIST WAS USED TO CONDUCT ASSESSMENTS COVERING WORKSITE, HEALTH CARE, COMMUNITY AND SCHOOL SECTORS.
AVERA GREGORY HEALTHCARE CENTER	PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS SOLICITED USING FOCUS GROUPS, PERSONAL INTERVIEWS AND GOVERNMENT MEETINGS. FOCUS GROUPS INCLUDED TWO GROUPS COVERING A VARIETY OF COMMUNITY MEMBERS AND A THIRD GROUP COMPRISED OF SCHOOL BOARD MEMBERS, PRINCIPALS AND SUPERINTENDENT OF SCHOOLS. PERSONAL INTERVIEWS WERE ALSO CONDUCTED WITH THE LEADERS OF THE LOCAL FOOD BANK, THRIFT CLOTHING STORE AND SENIOR MEALS CENTER. CHNA TEAM MEMBERS ALSO ATTENDED LOCAL AND COUNTY GOVERNMENT MEETINGS TO SOLICIT FEEDBACK.
AVERA MILBANK AREA HOSPITAL	PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS SOLICITED THROUGH SURVEYS AND PERSONAL INTERVIEWS. THE FACILITY SURVEYED COMMUNITY MEMBERS USING BOTH ONLINE AND PRINTED SURVEYS. PERSONAL INTERVIEWS WERE CONDUCTED WITH THE HIGH SCHOOL PRINCIPAL, SCHOOL DISTRICT SUPERINTENDENT, COMMUNITY HEALTH NURSE AND DIRECTOR OF INTER-LAKES COMMUNITY ACTION PARTNERSHIP.
AVERA DELLS AREA HEALTH CENTER	PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS SOLICITED USING A VARIETY OF METHODS. THE FACILITY DISTRIBUTED AND COLLECTED COMMUNITY SURVEYS IN FEBRUARY 2016. IN MARCH 2016, THREE FOCUS GROUPS REPRESENTING A VARIETY OF COMMUNITY RESIDENTS WERE HELD. AN INDIVIDUAL INTERVIEW WAS HELD WITH MOODY COUNTY COMMUNITY SERVICES MANAGER. DATA WAS ALSO GATHERED FROM AVERA MEDICAL GROUP DELL RAPIDS MEDICAL STAFF AND CLINIC MANAGER, AND AVERA DELLS AREA HOSPITAL INTERIM ADMINISTRATOR AND DIRECTOR OF NURSING.
AVERA FLANDREAU MEDICAL CENTER	PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS SOLICITED USING FOCUS GROUPS AND A SURVEY. THREE FOCUS GROUPS OF INDIVUDALS WITH A VESTED INTEREST IN THE HOSPITAL AND HEALTH OF THE COUNTY PARTICIPATED. COMMUNITY SURVEYS WERE CONDUCTED IN AUGUST 2015. A COMMUNITY COALITION WAS CREATED WITH A CORE OF TEN COMMUNITY LEADERS ALONG WITH AN ADDITIONAL GROUP OF 40 COMMUNITY LEADERS WHO ACTIVELY ENGAGED IN PRIMARY DATA COLLECTION.
AVERA HAND COUNTY MEMORIAL HOSPITAL	PART V, SECTION B, LINE 5: THE HOSPITAL USED A SURVEY TOOL TO BEGIN THE PROCESS OF QUALITATIVE DATA COLLECTION. THE SURVEY WAS AVAILABLE TO HAND COUNTY COMMUNITY HEALTH STAFF, MILLER AREA HEALTH BOARD, MILLER SENIOR CITIZENS AND HOSPITAL AUXILIARY MEMBERS DURING WINTER OF 2015. THESE GROUPS REPRESENTED A CROSS SECTION OF THE COMMUNITY SERVED. IN ADDITION, COMMUNITY SMALL GROUPS WERE SELECTED FOR PRESENTATION AND DIALOGUE. THESE CONSISTED OF AHCMH AUXILIARY, FOUNDATION COMMITTEE MEMBERS, MILLER SCHOOL GUIDANCE COUNSELOR, ON HAND DEVELOPMENT LEADERSHIP AND HAND COUNTY PUBLIC HEALTH NURSE.
AVERA MCKENNAN	PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED WITH HEART HOSPITAL OF SOUTH DAKOTA, LLC AND SANFORD USD MEDICAL CENTER.
HEART HOSPITAL OF SOUTH DAKOTA, LLC	PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED WITH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTER AND SANFORD USD MEDICAL CENTER.
AVERA MCKENNAN	PART V, SECTION B, LINE 6B: SIOUX FALLS HEALTH DEPARTMENT
HEART HOSPITAL OF SOUTH DAKOTA, LLC	PART V, SECTION B, LINE 6B: SIOUX FALLS HEALTH DEPARTMENT
AVERA MCKENNAN	PART V, SECTION B, LINE 11: AVERA MCKENNAN ADOPTED AN IMPLEMENTATION STRATEGY TO ADDRESS THREE HIGHLY IDENTIFIED NEEDS IN THE 2015 CHNA CONDUCTED IN FY2016. THOSE NEEDS ARE OBESITY (INCLUDES NUTRITION, PHYSICAL ACTIVITY AND OTHER CHRONIC DISEASE RISK FACTORS), MENTAL HEALTH SERVICES AND SUBSTANCE ABUSE AND ACCESS TO CARE (INCLUDES ISSUES SUCH AS AVAILABILITY, COST AND COORDINATION OF CARE). A COMMUNITY BEHAVIORAL HEALTH TASK FORCE HAS BEEN ORGANIZED WITH AVERA MCKENNAN BEHAVIORAL HEALTH LEADERSHIP PARTICIPATING. THE FORCE IS WORKING TO DEFINE THE COMMUNITY'S BEHAVIORAL HEALTH STATUS, DEMOGRAPHICS AND ISSUES AND DEVELOPING AN ACTION PLAN. THIS INVOLVES 12 OTHER HEALTH CARE, NON-PROFIT AND CITY AGENCIES. AVERA MCKENNAN PARTICIPATED IN THE HAYWARD THRIVE PROJECT, EDUCATING AN UNDERSERVED NEIGHBORHOOD ON FOOD PREPARATION, GARDENING, GROCERY SHOPPING, WELLNESS SCREENINGS AND COMMUNITY ENGAGEMENT ALONG WITH A BLOCK PARTY. THE ORGANIZATION CONTINUES TO SUPPORT THE SIOUX EMPIRE NETWORK OF CARE DEVELOPMENT AND EXPANSION TO COORDINATE CARE ACCESS. THE FACILITY ALSO PILOTED A PROJECT TO ADDRESS TRANSPORTATION FOR APPOINTMENTS AND ACCESS TO MEDICATIONS. RESULTS WERE MIXED, BUT OTHER AVENUES ARE BEING EXPLORED ON A TRIAL BASIS. AVERA MCKENNAN WORKED WITH A LOCAL GROCER, PAROCHIAL GRADE SCHOOL AND LOCAL NON-PROFIT GROUNDWORKS, TO PROVIDE THIRD GRADERS WITH MONTHLY EDUCATION ON HEALTH/WELLNESS, FOOD CHOICES AND PREPARATION AND EXERCISE. YOUTH, EDUCATION, AND HOUSING WERE IDENTIFIED BUT WILL NOT BE DIRECTLY ADDRESSED. OTHER ORGANIZATIONS IN THE COMMUNITY ARE ADDRESSING THESE CONCERNS. THESE AREAS ALSO FALL OUTSIDE OF OUR AREA OF EXPERTISE AND THOSE AGENCIES ARE BETTER EQUIPPED TO HANDLE THE SPECIFIC ISSUES. FINALLY, WITH FINITE RESOURCES THE DECISION WAS MADE TO FOCUS ON NO MORE THAN THE FIVE INITIATIVES IN ORDER TO MAKE THE GREATEST IMPACT.
HEART HOSPITAL OF SOUTH DAKOTA, LLC	PART V, SECTION B, LINE 11: HEART HOSPITAL OF SOUTH DAKOTA, LLC ADOPTED AN IMPLEMENTATION STRATEGY IN FY2016 TO ADDRESS THREE HIGHLY IDENTIFIED NEEDS. THOSE NEEDS ARE OBESITY (INCLUDES NUTRITION, PHYSICAL ACTIVITY AND OTHER CHRONIC DISEASE RISK FACTORS), MENTAL HEALTH SERVICES AND SUBSTANCE ABUSE AND ACCESS TO CARE (INCLUDES ISSUES SUCH AS AVAILABILITY, COST AND COORDINATION OF CARE). HEART HOSPITAL PARTICIPATED IN THE HAYWARD THRIVE PROJECT, EDUCATING AN UNDERSERVED NEIGHBORHOOD ON FOOD PREPARATION, GARDENING, GROCERY SHOPPING, WELLNESS SCREENINGS AND COMMUNITY ENGAGEMENT ALONG WITH A BLOCK PARTY. THE FACILITY CONTINUES TO EXPLORE AVENUES TO ADDRESS TRANSPORTATION FOR PATIENTS THROUGH THE CITY AND ASSOCIATION WITH AVERA MCKENNAN. HEART HOSPITAL CONTINUES TO WORK ON IMPLEMENTATION OF AND PARTICIPATION IN PLANS TO ADDRESS COMMUNITY EDUCATION ON OBESITY AND ASSOCIATED FACTORS ALONG WITH ACCESS TO CARE. YOUTH AND EDUCATION AND HOUSING WERE IDENTIFIED BUT WILL NOT BE DIRECTLY ADDRESSED. OTHER ORGANIZATIONS IN THE COMMUNITY ARE ADDRESSING THESE CONCERNS. THESE AREAS ALSO FALL OUTSIDE OF OUR CORE AREA OF EXPERTISE AND THOSE AGENCIES ARE BETTER EQUIPPED TO HANDLE THE SPECIFIC ISSUES. FINALLY, WITH FINITE RESOURCES, THE DECISION WAS MADE TO FOCUS ON NO MORE THAN THE FIVE INITIATIVES IN ORDER TO MAKE THE GREATEST IMPACT.
AVERA GREGORY HEALTHCARE CENTER	PART V, SECTION B, LINE 11: AVERA GREGORY ADOPTED AN IMPLEMENTATION PLAN IN FY2016 TO ADDRESS THREE IDENTIFIED NEEDS: COMMUNITY MEMBERS WITH DISABILITIES, ENROLLMENT AND ACCESS TO HEALTH INSURANCE, OBESITY/DIABETES AND TOBACCO USE. THE FACILITY IS WORKING WITH FEASIBILITY STUDY FIRMS TO CONDUCT A COMMUNITY SURVEY ON THE PLANNED NEW FACILITY. TWO NURSES HAVE BEEN EDUCATED AND CERTIFIED TO EVALUATE FOR COMPETENCY, MONITOR AND SUPERVISE THE SCHOOL'S UNLICENSED ASSISTIVE PERSONNEL. THE NURSES CONTINUE WORKING WITH THE SCHOOL AND THESE PERSONNEL BEYOND INITIAL TRAINING AS WELL. THE ADMINISTRATOR AND MAYOR CONTINUE DISCUSSIONS ON EXERCISE TRAILS AND FACILITIES. THE SERVICE EXCELLENCE TEAM WORKED WITH A LOCAL GROCER ON PROMOTION AND EDUCATION ON BENEFITS OF EATING FRUITS AND VEGETABLES. TOBACCO CESSATION EDUCATION IS OFFERED AT EVERY CLINICAL VISIT FOR PATIENTS WHO SMOKE. CPR TRAINING WAS ALSO PROVIDED TO HIGH SCHOOL SENIORS. OTHER CHNA IMPLEMENTATION PLANS CONTINUE AS WELL.
AVERA MILBANK AREA HOSPITAL	PART V, SECTION B, LINE 11: AVERA MILBANK ADOPTED AN IMPLEMENTATION PLAN IN FY2016 TO ADDRESS THREE IDENTIFIED NEEDS: MENTAL HEALTH, TRANSLATION SERVICES AND PATIENT EDUCATION. AVERA MILBANK IS ADDRESSING MENTAL HEALTH BY RECRUITING A PSYCHOLOGIST SCHEDULED TO START IN JUNE 2018 AND PARTICIPATION IN MONTHLY CHILD PROTECTION TEAM MEETINGS WITH LAW ENFOREMENT, COMMUNITY HEALTH, SCHOOL AND ICAP OFFICE OFFICIALS. TELEPHONIC TRANSLATION SERVICES HAVE BEEN ADDED AS WELL AS UTILIZING BILINGUAL EMPLOYEES WITHIN THE HEALTHCARE FACILITY AND IN PERSON TRANSLATOR SERVICES WHEN NECESSARY. THE FACILITY IS HOSTING, DEVELOPING AND/OR PLANNING EDUCATION TO PARENTS, PROVIDERS AND COMMUNITY MEMBERS ON A VARIETY OF TOPICS SUCH AS SUBSTANCE ABUSE, NUTRITION, HEALTH LIFESTYLE CHOICES AND FACILITY OFFERINGS. TWO NEEDS WERE IDENTIFIED IN THE ASSESSMENT BUT WILL NOT BE ADDRESSED BY THE FACILITY: COST OF A COMMUNITY CENTER AND INCREASED DRUG RELATED CRIMES. THESE NEEDS ARE OUTSIDE THE EXPERTISE OF THE FACILITY.
AVERA DELLS AREA HEALTH CENTER	PART V, SECTION B, LINE 11: AVERA DELLS ADOPTED AN IMPLEMENTATION PLAN IN FY2016 TO ADDRESS THREE IDENTIFIED NEEDS: PUBLIC AWARENESS OF HEALTH CARE SERVICES, IMPROVEMENT OF LOCAL/EMERGENCY TRANSPORTATION SERVICES AND EDUCATION/MOTIVATION ON HEALTHIER LIFESTYLES FOR COMMUNITY MEMBERS. THE FACILITY HAS PARTICIPATED IN AND SUPPORTED LOCAL COMMUNITY EVENTS, UTILIZED LOCAL NEWSPAPER FOR FACILITY ARTICLES, AND DEPLOYED ONLINE TOOLS TO PROMOTE HEALTHCARE SERVICES AWARENESS. A HELIPORT WAS CONSTRUCTED ON CAMPUS FOR EMERGENT PATIENT TRANSPORT. FREE 30-DAY GYM MEMBERSHIPS WERE GIVEN TO NEW COMMUNITY MEMBERS, EXERCISE EQUIPMENT DONATED TO LOCAL SCHOOLS, FREE DIETARY CONSULTS PROVIDED TO IDENTIFIED PATIENTS AND PARTICIPATION IN LOCAL WELLNESS ACTIVITIES CONDUCTED. GREATER CONVENIENCE TO CARE WAS INDENTIFIED IN THE ASSESSMENT BUT WILL NOT BE FURTHER ADDRESSED BY THE FACILITY. CLINIC HOURS ALREADY INCLUDE EXPANSION TO HOURS OUTSIDE OF 8-5 AND THE CLINIC DOES NOT HAVE THE FINANCIAL RESOURCES TO EXPAND FURTHER.
AVERA FLANDREAU MEDICAL CENTER	PART V, SECTION B, LINE 11: AVERA FLANDREAU ADOPTED AN IMPLEMENTATION PLAN IN FY2016 TO ADDRESS FIVE IDENTIFIED NEEDS: NUTRITION, PHYSICAL ACTIVITY, CHRONIC DISEASE PREVENTION/MANAGEMENT, PUBLIC AWARENESS AND GREATER CONVENIENCE OF CARE. FREE DIETARY CONSULTATIONS HAVE BEEN PROVIDED BY A REGISTERED DIETICIAN TO COMMUNITY MEMBERS. THE PUBLIC HEALTH OFFICE HAS PROVIDED NUTRITION EDUCATION THROUGHOUT THE SCHOOL YEAR AT THE LOCAL ELEMENTARY SCHOOL AND VARIETY OF HEALTH AND CAREER TOPICS TO HIGH SCHOOL STUDENTS. PROVIDERS HAVE BEEN EDUCATED ON COORDINATED CARE SERVICES AND THE HEALTH TRACKER TOOL AND COORDINATORS ARE PHYSICALLY ON SITE EVERY OTHER WEEK. THE FACILITY CONTINUES TO PROMOTE, SUPPORT AND PARTICIPATE IN COMMUNITY WELLNESS ACTIVITIES AND PROVIDE SCREENING SERVICES AT LOCAL EVENTS. A NEW WEBSITE HAS BEEN DEPLOYED AND EFFORTS CONTINUE IN A VARIETY OF AVENUES TO PROMOTE HEALTH CARE SERVICES AWARENESS. EARLY CLINIC HOURS HAVE BEEN ADDED, SCREENING AVAILABILITY EXPANDED AND A FOURTH PROVIDER ADDED TO EXPAND CARE OPTIONS.
AVERA HAND COUNTY MEMORIAL HOSPITAL	PART V, SECTION B, LINE 11: AVERA HAND COUNTY ADOPTED AN IMPLEMENTATION PLAN IN FY2016 TO ADDRESS THREE IDENTIFIED NEEDS: ASSISTANCE NAVIGATING MEDICAL RECORDS THROUGH PATIENT PORTAL/HOSPITAL WEBSITE, ACCESS TO PUBLIC TRANSPORTATION AND ACCESS TO AFFORDABLE HOUSING. MULTIPLE EDUCATION PROGRAMS HAVE BEEN HELD AT THE FACILITY TO EDUCATE COMMUNITY MEMBERS ON PORTAL SERVICES, BENEFITS OF SIGNUP AND CONTINUED ACCESS AS WELL AS AT LOCAL FARM SHOW, AND ONE ON ONE EDUCATION WHEN NEEDED. PROVIDERS AND SUPERVISORS HAVE BEEN EDUCATED ON THE TRANSPORTATION PROVIDERS, THEIR SCHEDULES AND CHANGES, AND OFFER TRANSPORTATION ASSISTANCE WHO NEED THE SERVICE. THE ADMINISTRATOR SERVES ON THE LOCAL HOUSING DEVELOPMENT AND HOUSING COMMITTEES WORKING WITH THE CITY TO DEVELOP AFFORDABLE HOUSING OPPORTUNITIES IN THE REGION.
AVERA MCKENNAN	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.
HEART HOSPITAL OF SOUTH DAKOTA, LLC	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 GREGORY HEALTHCARE 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 MILBANK AREA 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 DELLS AREA HEALTH 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 FLANDREAU 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 HAND COUNTY 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 MCKENNAN	PART V, SECTION B, LINE 16J: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOMS, WAITING ROOMS, AND ADMISSIONS OFFICE AND INCLUDED ON THE BILLING STATEMENT. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY IS DISCUSSED WITH THE PATIENT UPON ADMISSION TO THE FACILITY.
HEART HOSPITAL OF SOUTH DAKOTA, LLC	PART V, SECTION B, LINE 16J: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOMS, WAITING ROOMS, AND ADMISSIONS OFFICE AND INCLUDED ON THE BILLING STATEMENT.
AVERA GREGORY HEALTHCARE 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 ON THE BILLING STATEMENT. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY IS DISCUSSED WITH THE PATIENT UPON ADMISSION TO THE FACILITY.
AVERA MILBANK AREA HOSPITAL	PART V, SECTION B, LINE 16J: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOMS, WAITING ROOMS, AND ADMISSIONS OFFICE AND INCLUDED ON THE BILLING STATEMENT. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY IS DISCUSSED WITH THE PATIENT UPON ADMISSION TO THE FACILITY.
AVERA DELLS AREA HEALTH 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 ON THE BILLING STATEMENT. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY IS DISCUSSED WITH THE PATIENT UPON ADMISSION TO THE FACILITY.
AVERA FLANDREAU 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 ON THE BILLING STATEMENT. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY IS DISCUSSED WITH THE PATIENT UPON ADMISSION TO THE FACILITY.
AVERA HAND COUNTY 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 ON THE BILLING STATEMENT. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY IS DISCUSSED WITH THE PATIENT UPON ADMISSION TO THE FACILITY.
AVERA MCKENNAN	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.
HEART HOSPITAL OF SOUTH DAKOTA, LLC	PART V, SECTION B, LINE 20E: IF A PATIENT IS SELF-PAY AND HAS A LARGE BALANCE, AN AVERA PATIENT ADVOCATE WILL HELP THEM APPLY FOR OTHER FORMS OF ASSISTANCE. IF THEY ARE NOT ELIGIBLE FOR ANY OTHER COVERAGE, THE PATIENT IS GIVEN A FINANCIAL ASSISTANCE APPLICATION TO COMPLETE AND RETURN TO THE FACILITY.
AVERA GREGORY HEALTHCARE 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.
AVERA MILBANK AREA HOSPITAL	PART V, SECTION B, LINE 20E: IF A PATIENT IS SELF-PAY AND HAS A LARGE BALANCE, AN AVERA PATIENT ADVOCATE WILL HELP THEM APPLY FOR OTHER FORMS OF ASSISTANCE. IF THEY ARE NOT ELIGIBLE FOR ANY OTHER COVERAGE, THE PATIENT IS GIVEN A FINANCIAL ASSISTANCE APPLICATION TO COMPLETE AND RETURN TO THE FACILITY.
AVERA DELLS AREA HEALTH 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.
AVERA FLANDREAU 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.
AVERA HAND COUNTY 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.
AVERA MCKENNAN	PART V, SECTION B, LINE 24: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT CHARGED GROSS CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE; HOWEVER MAY BE CHARGED GROSS CHARGES FOR ELECTIVE CARE.
AVERA GREGORY HEALTHCARE CENTER	PART V, SECTION B, LINE 24: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT CHARGED GROSS CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE; HOWEVER MAY BE CHARGED GROSS CHARGES FOR ELECTIVE CARE.
AVERA MILBANK AREA HOSPITAL	PART V, SECTION B, LINE 24: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT CHARGED GROSS CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE; HOWEVER MAY BE CHARGED GROSS CHARGES FOR ELECTIVE CARE.
AVERA DELLS AREA HEALTH CENTER	PART V, SECTION B, LINE 24: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT CHARGED GROSS CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE; HOWEVER MAY BE CHARGED GROSS CHARGES FOR ELECTIVE CARE.
AVERA FLANDREAU MEDICAL CENTER	PART V, SECTION B, LINE 24: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT CHARGED GROSS CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE; HOWEVER MAY BE CHARGED GROSS CHARGES FOR ELECTIVE CARE.
AVERA HAND COUNTY MEMORIAL HOSPITAL	PART V, SECTION B, LINE 24: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT CHARGED GROSS CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE; HOWEVER MAY BE CHARGED GROSS CHARGES FOR ELECTIVE CARE.

Field	Value	IRS element (for citing)
Facility	41	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (41 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - AVERA MCKENNAN BEHAVIORAL HEALTH CENTER
4400 W 69TH ST	SIOUX FALLS	SD	57108	INPATIENT & OUTPATIENT BEHAVIORAL HEALTH SERVICES
2 - AVERA PLAZA 2 PHARMACY
1301 S CLIFF AVENUE	SIOUX FALLS	SD	57105	RETAIL PHARMACY
3 - AVERA PRINCE OF PEACE
4500 S PRINCE OF PEACE PLACE	SIOUX FALLS	SD	57103	SKILLED NURSING FACILITY
4 - AVERA MCKENNAN HOME INFUSION
1020 S CLIFF AVENUE	SIOUX FALLS	SD	57105	COMPREHENSIVE HOME INFUSION THERAPIES & SUPPLIES
5 - MCKENNAN REGIONAL LABORATORY
1325 S CLIFF AVENUE	SIOUX FALLS	SD	57105	LABORATORY SERVICES
6 - AVERA MEDICAL GROUP MATERNAL FETAL MED
1417 SOUTH CLIFF AVENUE SUITE 100	SIOUX FALLS	SD	57105	HIGH-RISK PREGNANCY CARE CLINIC
7 - AVERA MEDICAL GROUP WORTHINGTON
508 TENTH STREET	WORTHINGTON	MN	56187	PRIMARY CARE CLINIC
8 - AVERA MEDICAL GROUP PEDIATRIC SPECIALIST
1417 S CLIFF AVENUE SUITE 010	SIOUX FALLS	SD	57105	PEDIATRIC SPECIALTIES CLINIC
9 - AVERA ROSEBUD COUNTRY CARE CENTER
300 PARK AVENUE	GREGORY	SD	57533	SKILLED NURSING FACILITY
10 - AVERA MCKENNAN FITNESS CENTER
3400 S SOUTHEASTERN DRIVE	SIOUX FALLS	SD	57105	FITNESS CENTER
11 - AVERA 69TH STREET PHARMACY - BEHAVIORAL
4400 W 69TH ST SUITE 300	SIOUX FALLS	SD	57108	RETAIL PHARMACY
12 - AVERA MEDICAL GROUP WINDOM
820 - 2ND AVENUE	WINDOM	MN	56101	PRIMARY CARE CLINIC
13 - AVERA MEDICAL GROUP ORTHO & SPORTS MED
911 E 20TH STREET	SIOUX FALLS	SD	57105	ORTHOPEDIC CLINIC
14 - AVERA MCKENNAN HOSP & UNIV CAMPUS PHARM
1325 S CLIFF AVENUE	SIOUX FALLS	SD	57105	RETAIL PHARMACY
15 - AVERA INSTITUTE FOR HUMAN GENETICS
4400 W 69TH ST SUITE 200	SIOUX FALLS	SD	57108	GENETIC RESEARCH PROGRAM
16 - LAUREL OAKS APARTMENTS
4510 S PRINCE OF PEACE PLACE	SIOUX FALLS	SD	57103	INDEPENDENT LIVING APARTMENTS
17 - AVERA MEDICAL GROUP SIBLEY
600-9TH AVENUE NORTH	SIBLEY	IA	51249	PRIMARY CARE CLINIC
18 - AVERA MEDICAL GROUP COMPREHENSIVE BREAST
1000 EAST 23RD STREET SUITE 360	SIOUX FALLS	SD	57105	SPECIALTY CLINIC
19 - AVERA RESEARCH INSTITUTE
3720 W 69TH ST	SIOUX FALLS	SD	57108	CLINICAL RESEARCH STUDIES
20 - AVERA MEDICAL GROUP OPTOMETRY
702 TENTH STREET	WORTHINGTON	MN	56187	OPHTHALMOLOGY AND OPTOMETRY CLINIC
21 - AVERA DERMATOLOGY PHARMACY
6701 SOUTH MINNESOTA AVENUE	SIOUX FALLS	SD	57108	RETAIL PHARMACY
22 - AVERA MEDICAL GROUP OCCUPATIONAL MED
2100 S MARION RD	SIOUX FALLS	SD	57106	BUSINESS AND CORPORATE HEALTH CARE CLINIC
23 - AVERA MEDICAL GROUP WOMEN'S MIDLIFE CARE
911 EAST 20TH STREET - SUITE 200	SIOUX FALLS	SD	57105	WOMEN'S SERVICES CLINIC
24 - AVERA MEDICAL GROUP OPTOMETRY
1006 4TH AVENUE	WINDOM	MN	56101	OPHTHALMOLOGY AND OPTOMETRY CLINIC
25 - CURAQUICK AVERA CLINIC
3000 S MINNESOTA AVE	SIOUX FALLS	SD	57105	PRIMARY CARE CLINIC
26 - AVERA MEDICAL GROUP BIG STONE CITY
451 MAIN STREET	BIG STONE CITY	SD	57216	PRIMARY CARE CLINIC
27 - HEGG MEDICAL CLINIC AVERA
2121 HEGG DRIVE	ROCK VALLEY	IA	51247	PRIMARY CARE CLINIC
28 - HEALTH CARE CLINIC
300 NORTH DAKOTA AVENUE SUITE 117	SIOUX FALLS	SD	57104	FREE HEALTHCARE CLINIC
29 - COMMUNITY BLOOD BANK
1301 SOUTH CLIFF AVENUE SUITE 3	SIOUX FALLS	SD	57105	COMMUNITY BLOOD SERVICES
30 - YORKSHIRE EYE CLINIC
2311 YORKSHIRE DRIVE	BROOKINGS	SD	57006	OPHTHALMOLOGY AND OPTOMETRY CLINIC
31 - AVERA MEDICAL GROUP ESTHERVILLE
926 NORTH 8TH STREET	ESTHERVILLE	IA	51334	PRIMARY CARE CLINIC
32 - RURAL MEDICAL CLINICS
301 SOUTH WALNUT STREET	FREEMAN	SD	57029	PRIMARY CARE CLINIC
33 - DAKOTA FAMILY MEDICAL CENTER
101 SOUTH FRONT PO BOX 27	CHAMBERLAIN	SD	57325	PRIMARY CARE CLINIC
34 - PIPESTONE MEDICAL GROUP AVERA
920 - 4TH AVENUE SW	PIPESTONE	MN	56164	PRIMARY CARE CLINIC
35 - AVERA MEDICAL GROUP MCGREEVY SALEM
740 SOUTH HILL	SALEM	SD	57058	PRIMARY CARE CLINIC
36 - AVERA MEDICAL GROUP LARCHWOOD
916 HOLDER STREET PO BOX 8	LARCHWOOD	IA	51241	PRIMARY CARE CLINIC
37 - AVERA MEDICAL GROUP BUTTE
730 WILSON STREET	BUTTE	NE	68722	SATELLITE PRIMARY CARE CLINIC
38 - AVERA MEDICAL GROUP ELKTON
203 ELK STREET	ELKTON	SD	57026	SATELLITE PRIMARY CARE CLINIC
39 - AVERA MEDICAL GROUP FULDA
201 N ST PAUL AVENUE	FULDA	MN	56131	SATELLITE PRIMARY CARE CLINIC
40 - AVERA MEDICAL GROUP LAKEFIELD
221 - 3RD AVENUE	LAKEFIELD	MN	56150	SATELLITE PRIMARY CARE CLINIC
41 - AVERA MEDICAL GROUP VOLGA
210 KASAN AVENUE	VOLGA	SD	57071	SATELLITE PRIMARY CARE CLINIC

Supplemental Information Detail SupplementalInformationDetail (17 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 6A:	AVERA MCKENNAN'S COMMUNITY BENEFIT REPORT IS CONTAINED IN A REPORT PREPARED BY AVERA HEALTH, A RELATED ORGANIZATION. IT IS AVAILABLE THROUGH THE WEBSITE AND REQUESTED MAILING, AND IS FILED WITH THE CATHOLIC HEALTH ASSOCIATION.
PART I, LINE 7:	A COMBINATION OF COSTING METHODOLOGY WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. A COST ACCOUNTING SYSTEM WAS USED TO CALCULATE MEDICAID AND MEANS-TESTED GOVERNMENT PROGRAM EXPENSES AND SHORTFALLS AND SUBSIDIZED HEALTH SERVICES FOR OUR TERTIARY MEDICAL CENTER. A COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES WAS USED TO CALCULATE CHARITY CARE AT COST FOR ALL ENTITIES AND MEDICAID AND MEANS-TESTED GOVERNMENT PROGRAM EXPENSES AND SHORTFALLS AND SUBSIDIZED HEALTH SERVICES FOR ANY OPERATIONS OUTSIDE OF THE TERTIARY MEDICAL CENTER. FOR ALL OTHER AMOUNTS, COSTS AND REVENUES AS REFLECTED BY THE GENERAL LEDGER SYSTEM WERE USED.
PART I, LINE 7G:	PHYSICIAN CLINIC COSTS FOR TRANSPLANT AND BEHAVIORAL HEALTH SERVICES ARE INCLUDED IN SUBSIDIZED HEALTH SERVICES. NET REVENUES OF $8,677,669 AND COSTS OF $14,674,489 WERE INCLUDED FOR A NET COMMUNITY BENEFIT OF $5,996,820. OUR FACILITY IS THE PRINCIPAL PROVIDER OF BONE MARROW AND PANCREAS TRANSPLANT SERVICES THROUGH OUR SERVICE AREA, IN ADDITION TO DEVELOPING A LIVER TRANSPLANT PROGRAM, WITH THE CLINICS AS A CRUCIAL COMPONENT OF SUCCESSFUL PRE AND POST TRANSPLANT CARE. WE ARE THE SOLE PROVIDER OF HOSPITAL BEHAVIORAL SERVICES TO THE COMMUNITY OF WHICH THE CLINICS ARE AN INTEGRAL PART OF SERVICES.
PART I, LN 7 COL(F):	BAD DEBT EXPENSE OF $22,370,725 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BUT EXCLUDED FOR PURPOSES OF CALCULATING THIS PERCENTAGE.
PART II, COMMUNITY BUILDING ACTIVITIES:	THE COMMUNITY BUILDING ACTIVITIES INCLUDE MONETARY ASSISTANCE TO ORGANIZATIONS THAT FOCUS THEIR EFFORTS ON PROVIDING FURNITURE FOR LOW INCOME FAMILIES, NEIGHBORHOOD IMPROVEMENT PROJECTS IN HIGH NEEDS AREAS, CHILDREN AND YOUTH DEVELOPMENT PROGRAMS, LOCAL ECONOMIC DEVELOPMENT, AND JOB CREATION AND TRAINING PROGRAMS.
PART III, LINE 2:	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:	AVERA MCKENNAN HAS SEVERAL PROCEDURES IN PLACE TO DETERMINE WHICH PATIENTS WOULD QUALIFY FOR FINANCIAL ASSISTANCE, THEREFORE THE HOSPITAL FEELS CONFIDENT THAT NO AMOUNT OF BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
PART III, LINE 4:	THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSES CAN BE FOUND ON PAGE 9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:	THE MEDICARE REVENUES RECEIVED (LINE 5), ALLOWABLE COSTS (LINE 6), AND THE RESULTING LOSS (LINE 7) DOES NOT INCLUDE A SIGNIFICANT PORTION OF THE ORGANIZATION'S EXPENSES. THESE LINES REQUIRE USE OF THE MEDICARE COST REPORT AS PREPARED BY THE REQUIRED GUIDELINES WHICH DISALLOWS NUMEROUS COSTS OF HOSPITALS, PARTICULARLY IF THEY ARE PART OF AN INTEGRATED SYSTEM SUCH AS AVERA MCKENNAN. IN THESE CASES THE ENTITY MUST FILE A HOME OFFICE COST REPORT WHICH "STEPS DOWN" OVERHEAD TO NON-COST REPORT ENTITIES DISPROPORTIONATELY TO ACTUAL ALLOWABLE SHARE AND ESSENTIALLY REMOVING THE COSTS FROM THE HOSPITAL'S COST REPORT ENTIRELY. EXAMPLES OF A PORTION OF THESE OVERHEAD COSTS WOULD BE FINANCE, BUSINESS OFFICE, INFORMATION TECHNOLOGY, HUMAN RESOURCES AND ADMINISTRATION. EXAMPLES OF NON-COST REPORT ENTITIES OPERATED BY AVERA MCKENNAN INCLUDE CLINICS, MOBILE IMAGING SERVICES, LONG-TERM CARE FACILITIES, AND OTHER HEALTH CARE RELATED BUSINESSES. THERE ARE ALSO COSTS COMPLETELY DISALLOWED BY COST REPORT RULES SUCH AS BAD DEBT EXPENSE, HOSPITALISTS CARE, CRNA'S, AND INTEREST EXPENSE. AVERA MCKENNAN ALSO RECEIVES A MEDICARE DISPROPORTIONATE SHARE HOSPITAL (DSH) ADJUSTMENT AS PART OF THE COST REPORT DUE TO ITS SIGNIFICANT NUMBER OF LOW-INCOME PATIENTS SERVED. PART III, LINE 5 REQUIRES INCLUSION OF THIS REVENUE THOUGH EXPENSES INCLUDED ARE MUCH LOWER. SCHEDULE H INSTRUCTIONS ALSO REQUIRE THE EXCLUSION OF $1,955,451 OF MEDICARE LOSSES BECAUSE THEY ARE INCLUDED IN SCHEDULE H, PART 1, LINE 7F OR 7G. INCLUDING THE MEDICARE PERCENTAGE OF DISALLOWED COSTS, ENTITIES WHICH DON'T FILE A COST REPORT BUT NEVERTHELESS CARE FOR MEDICARE PATIENTS, AND THE IMPACT OF THE HOME OFFICE COST REPORT, THE MEDICARE SHORTFALL IS $48,837,803 AS OPPOSED TO A SHORTFALL OF $30,305,248.AVERA MCKENNAN FOLLOWS THE CATHOLIC HEALTH ASSOCIATION 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.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 & MEDICAID SERVICES.
PART III, LINE 9B:	IF THE PATIENT QUALIFIES FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME, UNINSURED PATIENTS AND IS COOPERATING WITH THE ORGANIZATION WITH REGARD TO EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN CURRENT SELF-PAY COLLECTION POLICY GUIDELINES AND TIMEFRAMES, THE ORGANIZATION OR ITS AGENT SHALL NOT SEND, NOR INTIMATE THAT IT WILL SEND, THE UNPAID BILL TO ANY OUTSIDE COLLECTION AGENCY. AVERA ORGANIZATIONS WILL ALLOW ALL INDIVIDUALS 120 DAYS FROM THE FIRST POST DISCHARGE STATEMENT TO APPLY FOR FINANCIAL ASSISTANCE BEFORE SENDING THE UNCOLLECTED ACCOUNT TO AN OUTSIDE COLLECTION AGENCY. AVERA WILL PROVIDE THE PATIENT WITH A STATEMENT OR FINAL NOTICE THAT CONTAINS A LISTING OF THE SPECIFIC COLLECTION ACTION(S) IT INTENDS TO INITIATE, AND A DEADLINE AFTER WHICH THEY MAY BE INITIATED NO EARLIER THAN 30 DAYS BEFORE ACTION IS INITIATED. IF THE PATIENT QUALIFIES FOR 100% CHARITY CARE, NO FURTHER BILLS WILL BE SENT. A LETTER WILL BE SENT INSTEAD INDICATING THAT THE PATIENT'S BILL HAS BEEN COMPLETELY FORGIVEN.
PART VI, LINE 2:	COMMUNITY NEEDS ASSESSMENT OCCURS AT VARIOUS POINTS IN THE SYSTEM. THROUGH ANNUAL STRATEGIC PLANNING SESSIONS, COMMUNITY LEADERS ARE BROUGHT IN TO UPDATE AND EDUCATE AVERA MCKENNAN BOARD MEMBERS AND ADMINISTRATIVE COUNCIL ON THE SUCCESSES, CHALLENGES, AND SERVICE GAPS IN THE COMMUNITY. EXAMPLES INCLUDE SCHOOL DISTRICT OFFICIALS, STATE HEALTH DEPARTMENT, AND COMMUNITY HEALTH ORGANIZATIONS. LEADERS ALSO SERVE ON BOARDS OF VARIOUS COMMUNITY ORGANIZATIONS WHICH SEEK TO ADDRESS THE HEALTH AND WELL-BEING OF AREA CITIZENS. LOCAL GOVERNING BOARDS AT OUTLYING FACILITIES, WHO ARE MEMBERS OF THE COMMUNITY, DISCUSS AND HELP DIRECT RESOURCES TO AREAS OF TARGETED NEEDS AS WELL.
PART VI, LINE 3:	NOTICES ARE POSTED IN ENGLISH AND SPANISH IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMITTING OFFICES, AND OUTPATIENT SERVICE SETTINGS AS WELL AS THE ORGANIZATION WEBSITE. POSTED NOTICES STATE THAT THE ORGANIZATION HAS A FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS WHO MAY NOT BE ABLE TO PAY THEIR BILL AND THAT THIS POLICY PROVIDES FOR CHARITY CARE AND REDUCED-PAYMENT FOR HEALTHCARE SERVICES. THERE IS ALSO IDENTIFICATION OF A CONTACT PHONE NUMBER THAT A PATIENT CAN CALL TO OBTAIN MORE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ABOUT HOW TO APPLY FOR SUCH ASSISTANCE. ADDITIONALLY, ADMITTING STAFF MAKES AVAILABLE A BROCHURE DESIGNED TO HELP PATIENTS UNDERSTAND HOW WE BILL PATIENTS AND PROVIDES SUMMARY INFORMATION ON FINANCIAL ASSISTANCE IF YOU ARE UNABLE TO PAY. PATIENT ADVOCATES WORK WITH UNINSURED PATIENTS IN OUR MAIN TERTIARY FACILITY TO ENROLL THEM IN APPLICABLE SOCIAL PROGRAMS AND IDENTIFY CHARITY ELIGIBILITY, ELIGIBILITY AND ENROLLMENT FOR COUNTY, STATE OR FEDERAL RISK POOLS, AND ELIGIBILITY FOR MODIFIED MEDICARE OR MEDICAID PROGRAMS.
PART VI, LINE 4:	AVERA MCKENNAN'S SERVICE AREA IS A LARGELY RURAL POPULATION. SERVICES ARE PROVIDED THROUGH A HEALTH CARE NETWORK OF CLINICS, CRITICAL ACCESS HOSPITALS AND TERTIARY FACILITIES COVERING COMMUNITIES IN FOUR STATES. THE MAIN TERTIARY FACILITY IS LOCATED IN A POPULATION CENTER OF OVER 178,000 SERVED BY ANOTHER NON-PROFIT HOSPITAL OF SIMILAR SIZE, VETERANS ADMINISTRATION HOSPITAL, A HOSPITAL DEDICATED TO DIAGNOSIS AND TREATMENT OF HEART DISEASE, AND A HOSPITAL FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS. OUTSIDE OF THIS POPULATION CENTER, MOST OF THE COMMUNITIES SERVED HAVE LESS THAN 4,000 RESIDENTS. THE PRIMARY SERVICE AREA INCLUDES FOUR COUNTIES COVERING APPROXIMATELY 2,600 SQUARE MILES AND CONTAINS SEVEN FEDERALLY DESIGNATED MEDICALLY UNDERSERVED COMMUNITIES. THE 2016 U.S. CENSUS BUREAU DATA ESTIMATES 9.9% OF RESIDENTS IN THE PRIMARY SERVICE AREA ARE AT OR BELOW THE POVERTY LEVEL. OUR SECONDARY SERVICE AREA COVERS AN ADDITIONAL 17 COUNTIES IN SOUTH DAKOTA, IOWA AND MINNESOTA WITH AN ESTIMATED TOTAL POPULATION OF 235,000 BASED ON 2016 U.S. CENSUS BUREAU.
PART VI, LINE 5:	SURPLUS FUNDS ARE REINVESTED IN FACILITIES TO IMPROVE PATIENT CARE.MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. THE AVERA MCKENNAN BOARD OF TRUSTEES IS PRINCIPALLY COMPRISED OF COMMUNITY MEMBERS FROM THE PRIMARY SERVICE AREA. MEMBERS COME FROM A VARIETY OF BACKGROUNDS RANGING FROM PRIVATE INDUSTRY AND BANKING TO HEALTHCARE.AVERA MCKENNAN IS A VERIFIED LEVEL II TRAUMA CENTER AND WAS THE FIRST SUCH CENTER IN THE STATE OF SOUTH DAKOTA. AVERA MCKENNAN'S EMERGENCY DEPARTMENT IS STAFFED 24 HOURS A DAY WITH BOARD-CERTIFIED EMERGENCY SPECIALISTS AND PROVIDES EMERGENCY CARE REGARDLESS OF ABILITY TO PAY. AVERA MCKENNAN HAD 33,746 EMERGENCY DEPARTMENT VISITS IN FY 2017. OPERATING BOTH FIXED WING AND HELICOPTER MEDICAL AIR TRANSPORTS, AVERA MCKENNAN'S FLIGHT TEAMS COVER A LARGE GEOGRAPHIC AREA PROVIDING STATE-OF-THE-ART AIR TRANSPORT SERVICES AND ACCESS TO CRITICAL CARE, WITH 1,671 FLIGHTS IN THE PAST YEAR.HEALTH CARE CLINIC: IN 1992, AVERA MCKENNAN ESTABLISHED A HEALTH CARE CLINIC TO PROVIDE FREE CARE FOR PEOPLE WHO ARE UNINSURED OR UNDERINSURED IN THE COMMUNITY. THE CLINIC IS MANAGED BY A REGISTERED NURSE AND STAFFED BY REGISTERED NURSES, TWO MIDLEVEL PROVIDERS, MEDICAL RESIDENTS AND VOLUNTEER HEALTH CARE PROVIDERS. THE GOAL OF THE CLINIC IS TO PREVENT OR TREAT PATIENTS' MEDICAL CONDITIONS BEFORE THEY BECOME CATASTROPHIC. THE CLINIC AVERAGES 450 VISITS PER MONTH, PROVIDING PREVENTATIVE CARE, DIAGNOSIS AND TREATMENT OF ILLNESSES AND INJURIES, MEDICATION ASSISTANCE AND ASSISTANCE IN OBTAINING SPECIALIST CARE FOR PATIENTS WITH COMPLEX CASES. THE CLINIC ALSO SERVES TO TRAIN PHYSICIANS, NURSES AND OTHER HEALTH CARE STUDENTS. IT PROVIDES A FREE EVENING CLINIC ONE EVENING PER MONTH, STAFFED BY MEDICAL STUDENTS UNDER SUPERVISION OF PHYSICIANS. AVERA MCKENNAN IS THE ONLY HEALTH CARE ORGANIZATION TO PROVIDE FREE SERVICES SUCH AS THIS IN THE STATE OF SOUTH DAKOTA. THE CLINIC HAD 4,804 VISITS IN 2017, AND WAS OPERATED AT AN ANNUAL COST OF $864,046. PARTNERSHIP IN LIVE WELL SIOUX FALLS: THE CITY OF SIOUX FALLS RECEIVED A COMMUNITY HEALTH TRANSFORMATION GRANT FROM THE SOUTH DAKOTA DEPARTMENT OF HEALTH, SPARKING A PROJECT TO IMPROVE THE HEALTH AND WELL-BEING OF THE CITIZENS OF SIOUX FALLS. GUIDED BY THE CITY OF SIOUX FALLS HEALTH DEPARTMENT, THIS ONGOING PROJECT IS KNOWN AS LIVE WELL SIOUX FALLS. IT INVOLVES MORE THAN 24 COMMUNITY PARTNER ORGANIZATIONS. AMONG THESE PARTNERS ARE AVERA MCKENNAN AND THE OTHER MAJOR HEALTH CARE SYSTEM IN SIOUX FALLS, SANFORD HEALTH. AVERA PLANS TO WORK IN PARTNERSHIP WITH THE CITY OF SIOUX FALLS AND SANFORD HEALTH TO ADDRESS THE PRIORITIES OF LIVE WELL SIOUX FALLS, AND ARRIVE AT SOLUTIONS WHICH ARE COLLABORATIVE IN NATURE.AVERA MCKENNAN COLLABORATES WITH LIVE WELL SIOUX FALLS TO PROMOTE THE BIG SQUEEZE, A HYPERTENSION INITIATIVE IN APRIL TO PROMOTE BLOOD PRESSURE SCREENING AND EDUCATION, WITH THE GOAL OF DIAGNOSING HIGH BLOOD PRESSURE. ONE IN THREE AMERICAN ADULTS HAVE HIGH BLOOD PRESSURE, BUT ONLY HALF OF THEM HAVE IT UNDER CONTROL, ADDING TO THE RISK OF STROKE, HEART ATTACK AND VASCULAR DISEASE.RESIDENCY/HEALTH PROFESSIONS TRAINING AND INTERNSHIPS: IN 2017, AVERA MCKENNAN HAD 90 MEDICAL RESIDENTS IN TRAINING AT AVERA MCKENNAN IN INTERNAL MEDICINE, FAMILY PRACTICE, PSYCHIATRY, GERIATRICS AND TRANSITIONAL RESIDENCY PROGRAMS OFFERED IN PARTNERSHIP WITH THE UNIVERSITY OF SOUTH DAKOTA SCHOOL OF MEDICINE. OVER 1,000 STUDENTS IN MEDICINE, NURSING, PHARMACY, PHYSICIAN ASSISTANT PROGRAMS, MEDICAL ASSISTING, RADIOLOGY AND RESPIRATORY THERAPY ALSO COMPLETED CLINICAL ROTATIONS AT AVERA MCKENNAN. IN NON-CLINICAL AREAS, AVERA MCKENNAN OFFERED OVER 90 UNPAID, PAID, AND NONPAID INTERNSHIPS IN 2017 IN THE AREAS OF RESEARCH, FINANCE, ADMINISTRATION, THERAPIES, EXERCISE SCIENCE AND SOCIAL WORK. AVERA MCKENNAN IS CURRENTLY LEGALLY AFFILIATED WITH APPROXIMATELY 158 INSTITUTIONS OF HIGHER EDUCATION.PATIENT AND COMMUNITY EDUCATION: AVERA MCKENNAN IS A REGIONAL LEADER IN OFFERING EDUCATIONAL PROGRAMS FOR A VARIETY OF LEARNERS, LEADERS AND EMPLOYEES. UTILIZING ADVANCED TECHNOLOGY, MANY OF THESE PROGRAMS ARE PROVIDED ELECTRONICALLY THROUGHOUT THE TRI-STATE AREA. EDUCATIONAL SESSIONS ARE OFFERED TO MEDICAL STAFF, EMPLOYEES, HEALTH CARE PROFESSIONALS, STUDENTS AT ALL LEVELS AND THE GENERAL PUBLIC. UTILIZING AVERA MCKENNAN'S EDUCATION CENTER, A BROAD CROSS-SECTION OF CLASSES INVOLVING DIVERSE AUDIENCES ARE PROVIDED AS A COMMUNITY SERVICE EACH YEAR.1. ONLINE RESOURCES: AVERA MCKENNAN OFFERS VAST FREE PATIENT EDUCATIONAL ONLINE RESOURCES ON ITS PUBLIC WEBSITE ON NUMEROUS HEALTH TOPICS, WITH SUGGESTIONS FOR LIFESTYLE CHANGE, BEHAVIOR MODIFICATION AND MANAGEMENT FOR IMPROVED HEALTH.2. TO BE WELL FREE EDUCATION EVENTS WERE HELD ON TOPICS INCLUDING ORTHOPEDICS, CANCER, DIABETES, WEIGHT LOSS/HEALTHY EATING, MULTIPLE SCLEROSIS, ANXIETY AND ACUPUNCTURE. 3. FORUMS: THE AVERA BEHAVIORAL HEALTH CENTER OFFERS FREE FRIDAY FORUMS, IN WHICH SCHOOL COUNSELORS AND THERAPISTS ARE INVITED TO PRESENTATIONS ON CHILDREN'S MENTAL HEALTH TOPICS SUCH AS CONFLICT CYCLES, REACTIVE ATTACHMENT DISORDER, DEPRESSION AND BIPOLAR DISORDER IN CHILDREN, AND TEEN SUBSTANCE USE, ABUSE AND ADDICTION. 4. THE AVERA BEHAVIORAL HEALTH CENTER OFFERS FREE MONTHLY EDUCATIONAL SESSIONS ON VARIOUS TOPICS FOLLOWED BY DISCUSSION FOR ADULTS WHO HAVE BEEN IMPACTED BY A LOVED ONE'S MENTAL ILLNESS. TOPICS HAVE INCLUDED GRIEF AND LOSS, ANXIETY, AND PARENTING STRATEGIES FOR MANAGING CHALLENGING BEHAVIORS.5. WOMEN'S & CHILDREN'S SERVICES: AVERA MCKENNAN'S WOMEN'S & CHILDREN'S SERVICES OFFERS A NUMBER OF PARENTING AND COMMUNITY EDUCATION OPPORTUNITIES, FOR FREE OR AT A MINIMAL COST. IN FISCAL YEAR 2017, 86 CHILDBIRTH EDUCATION CLASSES WERE HELD WITH 480 ATTENDEES. A TOTAL OF 7 PARENT AND FAMILY EDUCATION CLASSES WERE HELD WITH 89 ATTENDEES. A TOTAL OF 86 CAR SEATS WERE ISSUED THROUGH THE SOUTH DAKOTA CHILD SAFETY SEAT DISTRIBUTION PROGRAM. FREE BURN EDUCATION WAS PROVIDED TO 2,063 STUDENTS DURING PRESENTATIONS IN SCHOOLS.6. DAYCARE TRAINING: FREE OF CHARGE, AVERA MCKENNAN OFFERS FOUR IN-SERVICE TRAINING SESSIONS PER MONTH TO DAYCARE PROVIDERS THROUGH EMBE, WITH A TOTAL OF 28 SCHEDULED ANNUALLY, AND ADDITIONAL SESSIONS FOR REQUESTED TOPICS. SUPPORT GROUPS: AVERA MCKENNAN OFFERS APPROXIMATELY 10 FREE SUPPORT GROUPS. THEY RANGE IN TOPIC FROM CANCER TO LIVER DISEASE, DIABETES, BONE MARROW TRANSPLANT, STROKE AND GRIEF AND LOSS. THE ORGANIZATION PROVIDES FREE MEETING SPACE AS WELL AS SPEAKERS AND LEADERS. INFORMATION AND ASSISTANCE: AVERA MCKENNAN OPERATES A 24-HOUR MEDICAL CALL CENTER, THROUGH WHICH PATIENTS HAVE ACCESS TO THE ASK-A-NURSE PROGRAM. PATIENTS CAN CALL A TOLL-FREE NUMBER AND TALK PERSONALLY WITH A REGISTERED NURSE TO ASK HEALTH QUESTIONS OR RECEIVE GENERAL HEALTH INFORMATION. IN 2017, THE MEDICAL CALL CENTER HANDLED 152,205 CALLS. AVERA MCKENNAN'S WEB SITE ALSO PROVIDES AN EXTENSIVE HEALTH LIBRARY THAT CONSUMERS CAN ACCESS FREE OF CHARGE.INTERPRETER SERVICE: AVERA MCKENNAN EMPLOYS TWO FULL-TIME SPANISH INTERPRETERS IN-HOUSE, AND THEIR SERVICES ARE OFFERED TO PATIENTS FREE OF CHARGE. IN ADDITION, IN COOPERATION WITH EXTERNAL AGENCIES, AVERA MCKENNAN IS ABLE TO HANDLE 210 DIFFERENT LANGUAGES AND DIALECTS THROUGH PHONE, VIDEO REMOTE INTERPRETING AND OTHER MEANS. INTERPRETATION SERVICES ARE AVAILABLE FOR PATIENTS WHEN THEY ARE AT AVERA MCKENNAN IN PERSON, OR WHEN THEY CALL BY PHONE. ALL THE ABOVE SERVICES ARE PROVIDED AT NO COST TO THE PATIENT.
PART VI, LINE 6:	THE COMMUNITIES IN WHICH THE AVERA SYSTEM OPERATES ALL HAVE UNIQUE HEALTH AND COMMUNITY BENEFIT NEEDS AND IN KEEPING WITH THE CATHOLIC HEALTHCARE ASSOCIATION GUIDELINES EACH HOSPITAL STRIVES TO MEET ITS COMMUNITY'S IDENTIFIED NEEDS. THE AVERA CENTRAL OFFICE ADVOCATES FOR ALL ON COMMUNITY BENEFIT-RELATED MATTERS OF STATE, REGIONAL, AND NATIONAL IMPORTANCE.
PART VI, LINE 5, CONTINUED:	PRENATAL AND DELIVERY CARE: BECAUSE EARLY AND REGULAR PRENATAL CARE IS IMPORTANT TO PREVENT PREMATURE BIRTH, AVERA MCKENNAN COLLABORATES IN A COMMUNITY EFFORT TO PROVIDE OBSTETRICS CARE FOR WOMEN WHO DO NOT QUALIFY FOR MEDICAID, BUT CANNOT AFFORD HEALTH INSURANCE. THE PROGRAM OFFERS PRENATAL CARE, AND HOSPITAL LABOR AND DELIVERY SERVICES FOR A LOW FEE OF $1,000. WOMEN RECEIVE CARE WHETHER THEY CAN COVER ANY OR ALL OF THE FEE. CARE IS PROVIDED PRIMARILY BY FIRST-YEAR FAMILY PRACTICE RESIDENTS, SUPERVISED BY EXPERIENCED PHYSICIANS. THROUGH THIS PROGRAM IN 2017, AVERA MCKENNAN ASSISTED WITH 26 BIRTHS AND PROVIDED 271 PRENATAL AND POST-PARTUM VISITS.TRANSPORT TO TRANSPLANT: AVERA MCKENNAN DEVELOPED THE TRANSPORT TO TRANSPLANT PROJECT, WHICH REMOVES TRANSPORTATION BARRIERS FOR PATIENTS FROM RURAL AREAS WHICH MAY PREVENT THEM FROM COMPLETING THE EVALUATION AND TESTING NEEDED FOR KIDNEY AND/OR PANCREAS TRANSPLANT. A VAN FUNDED THROUGH A GRANT FROM THE AVERA MCKENNAN FOUNDATION IS USED TO TRANSPORT PATIENTS WHO DEMONSTRATE A FINANCIAL NEED. PATIENTS ARE BROUGHT TO THE AVERA TRANSPLANT INSTITUTE FOR A CONDENSED MULTI-DAY EVALUATION WITH ALL TESTING AND VISITS COMPLETED IN LESS THAN ONE WEEK. ULTIMATELY, THE PROJECT RESULTS IN IMPROVED MORBIDITY AND MORTALITY, AS KIDNEY TRANSPLANT DOUBLES PATIENT SURVIVAL AS COMPARED TO REMAINING ON DIALYSIS.AVERA FAMILY WELLNESS: THIS PROGRAM COMBINES POSITIVE ACTIVITIES LIKE VIOLIN LESSONS AND FAMILY WELLNESS COORDINATION AT NO CHARGE FOR CHILDREN BEGINNING IN EARLY CHILDHOOD PROGRAMS IN THE SIOUX FALLS SCHOOL DISTRICT. THE FAMILIES HAVE DIRECT ACCESS TO MENTAL HEALTH SERVICES WHEN NEEDED. THE GOAL IS TO LESSEN THE NUMBER OF ADVERSE CHILDHOOD EXPERIENCES TO IMPROVE THE CHANCES FOR CHILDREN LIVING IN POVERTY TO BE SUCCESSFUL IN SCHOOL AND IN LIFE. FAMILIES WITH THE MOST DIFFICULT SITUATIONS ARE BEING REFERRED BY THE SCHOOL DISTRICT. CURRENTLY, OVER 350 STUDENTS AND THEIR FAMILIES ARE BEING SERVED BY THE PROGRAM.THE WALSH FAMILY VILLAGE: THIS HOSPITALITY HOUSE COMPLEX ADJACENT TO THE AVERA MCKENNAN CAMPUS PROVIDES A HOME AWAY FROM HOME FOR PATIENTS AND THEIR FAMILIES WHO COME FOR CARE AT AVERA MCKENNAN FROM OUTSIDE OF SIOUX FALLS. THE PROJECT WAS FUNDED BY DONATIONS AND IS OPERATED BY AVERA MCKENNAN. ELEVEN GUEST ROOMS ARE AVAILABLE. AVERA MCKENNAN ALSO DONATES USE OF A BUILDING IN THE COMPLEX FOR A RONALD MCDONALD HOUSE FOR FAMILIES OF PEDIATRIC PATIENTS. IF THEY CAN AFFORD IT, GUESTS ARE CHARGED A LOW FEE PER NIGHT. GUESTS ARE NOT TURNED AWAY DUE TO INABILITY TO PAY THE FEE. EMPLOYEES REGULARLY DONATE NON-PERISHABLE FOOD ITEMS TO STOCK A FOOD PANTRY FOR GUESTS. IN FY2017, THE WALSH FAMILY VILLAGE SERVED 6,769 GUESTS, STAYING IN 4,015 NIGHTLY ROOMS, AN 88 PERCENT OCCUPANCY. AVERA MCKENNAN PROVIDES A SUBSIDY OF APPROXIMATELY $176,000 PER YEAR TO OPERATE THE HOSPITALITY COMPLEX. PREVENTION AND SUPPORT OF SUBSTANCE USE DISORDER: AVERA MCKENNAN IS A PARTNER WITH FACE IT TOGETHER SIOUX FALLS, A NONPROFIT ORGANIZATION WHICH SERVES AS THE LOCAL FACE AND VOICE FOR RECOVERY FROM ADDICTION THROUGH ITS RECOVERY SUPPORT SERVICES, ADVOCACY AND AWARENESS PROGRAMS. AVERA HAS BEEN A PARTNER WITH FACE IT TOGETHER SINCE ITS INCEPTION, AND IN A RECENT AWARENESS CAMPAIGN. COMMUNITY CONNECTIONS: AVERA MCKENNAN REACHES OUT TO PEOPLE AND COMMUNITIES THROUGHOUT EASTERN SOUTH DAKOTA, SOUTHWESTERN MINNESOTA AND NORTHWEST IOWA THROUGH HOME TOWN CONNECTIONS. PROVIDING A CRITICAL FEEDBACK LINK TO LOCAL REFERRING DOCTORS, THIS PROGRAM COMPLETES THE COMMUNICATIONS LINKS NECESSARY TO KEEP LOCAL HEALTH CARE PROVIDERS CURRENT ON THE TREATMENT OF THEIR PATIENTS AT AVERA MCKENNAN.SUPPORT OF THE ARTS AND CULTURAL LIFE: AVERA MCKENNAN HOSTS SIOUX FALLS' ONLY INDOOR SCULPTUREWALK, AN EXTENSION OF THE COMMUNITY'S DOWNTOWN SCULPTUREWALK. ARTISTS DONATE SCULPTURES FOR ONE YEAR, WHICH ARE PLACED AT LOCATIONS THROUGHOUT AVERA MCKENNAN'S CAMPUS, IN BUILDINGS CONNECTED BY SKYWALKS. BROCHURES CONTAIN A MAP, AND VISITORS WHO FOLLOW THE ROUTE SUGGESTED WALK APPROXIMATELY 1 MILE, MAKING THIS A HEALTHY AS WELL AS A CULTURAL JOURNEY.DIABETES PROGRAMMING: AVERA PARTICIPATES IN A COLLABORATIVE PROJECT WITH SIOUX FALLS PUBLIC SCHOOLS AND THE SOUTH DAKOTA BOARD OF NURSING TO IMPLEMENT ECONSULT SERVICES WITH DIABETIC EDUCATION SPECIALISTS MONITORING MEDICATIONS AND THE HEALTH OF CHILDREN WITH DIABETES IN THE SCHOOL SETTING. AVERA MCKENNAN DIABETES EDUCATORS PROVIDED CLASSES AND ONE-ON-ONE CONSULTATIONS AT A LOSS OF $156,000 IN THE PAST FISCAL YEAR.COMMUNITY BENEFITS: AVERA MCKENNAN PROVIDES ADDITIONAL COMMUNITY BENEFITS INCLUDING: SUPPORT OF YOUTH PROGRAMS; HOMELESS PROGRAMS; COMMUNITY ARTS PROGRAMMING; HEALTH PREVENTION; AWARENESS AND EDUCATION ABOUT CANCER, HEART DISEASE AND OTHER CONDITIONS; AND SUPPORT OF THE SIOUX EMPIRE UNITED WAY AND OTHER SERVICES IN THE REGION. PRESCHOOL VISION AND HEARING SCREENING: AVERA MCKENNAN PROVIDED FREE SCREENING FOR 266 PRESCHOOL CHILDREN IN FISCAL YEAR 2017.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
SOUTH DAKOTA DEPARTMENT OF HEALTH - ALL WOMEN COUNT
615 E 4TH STREET	PIERRE	SD	57501	466000364	STATE OF SD	$15,000	DONATION
RONALD MCDONALD HOUSE
2001 S NORTON	SIOUX FALLS	SD	57105	460371152	501(C)(3)		DONATION	$176,267	FMV	RENTED SPACE
DARWIN FOUNDATION
4600 EAST-WEST HWY SUITE 525	BETHESDA	MD	20814	371473821	501(C)(3)		DONATION	$541,859	FMV	EQUIPMENT

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
SCHOLARSHIPS	4	$19,500
ASSISTANCE WITH MEDICAL EXPENSES	2800	$260,525

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	THE GOVERNING BOARD AND MANAGEMENT DEVELOP PROGRAMS WHICH ENHANCE THE CHARITABLE MISSION OF THE ORGANIZATION. DISBURSEMENT FOR GRANTS OR ASSISTANCE FOR THESE PROGRAMS ARE MADE IN ACCORDANCE WITH PRESCRIBED PROCEDURES AND ARE SUBJECT TO CONDITIONS ESTABLISHED BY THE ORGANIZATION'S GOVERNING BOARD AND MANAGEMENT, WHICH ARE DESIGNED TO ENSURE THAT INDIVIDUALS AND ORGANIZATIONS RECEIVING GRANTS OR ASSISTANCE ARE ADEQUATELY INVESTIGATED TO ENSURE THAT THEY ARE QUALIFIED RECIPIENTS.	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 (17 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
DAVID KAPASKA DO
PRESIDENT & CEO	$0	$680,086	$0	$0	$0	$232,736	$0	$21,200	$0	$21,434	$0	$955,456	$0	$0
LUIS ROJAS MD
BOARD TRUSTEE	$582,632	$0	$0	$0	$2,625	$0	$5,300	$0	$26,088	$0	$616,645	$0	$0	$0
RICK KOOIMA MD
BOARD TRUSTEE	$279,022	$0	$0	$0	$3,142	$0	$0	$0	$25,736	$0	$307,900	$0	$0	$0
JENNIFER MCKAY MD
CHIEF OF STAFF UNTIL DEC. 2016	$0	$265,629	$0	$0	$0	$294	$0	$16,660	$0	$344	$0	$282,927	$0	$0
KAREN GARNAAS MD
CHIEF OF STAFF AS OF JAN. 2017	$230,091	$0	$0	$0	$2,302	$0	$4,535	$0	$13,995	$0	$250,923	$0	$0	$0
BILL ROSSING MD
BOARD TRUSTEE	$303,159	$0	$0	$0	$2,615	$0	$5,300	$0	$500	$0	$311,574	$0	$0	$0
JULIE N NORTON
SEC/TREAS & SRVP FINANCE	$470,159	$0	$0	$0	$39,837	$0	$5,300	$0	$24,992	$0	$540,288	$0	$0	$0
LORI POPKES
SR VICE PRESIDENT	$290,439	$0	$0	$0	$22,746	$0	$2,962	$0	$23,126	$0	$339,273	$0	$0	$0
DAVID FLICEK
CHIEF ADMINISTRATIVE OFFICER	$0	$484,384	$0	$0	$0	$125,520	$0	$15,900	$0	$23,186	$0	$648,990	$0	$0
STEVE PETERSEN
AVP-PHARMACY	$0	$234,796	$0	$0	$0	$20,299	$0	$15,490	$0	$26,080	$0	$296,665	$0	$0
MARY LEEDOM
AVP-SURGERY	$187,106	$0	$0	$0	$1,674	$0	$0	$0	$321	$0	$189,101	$0	$0	$0
CURT HOHMAN
SR VICE PRESIDENT	$329,817	$0	$0	$0	$31,448	$0	$5,300	$0	$9,180	$0	$375,745	$0	$0	$0
ARVIN SANTOS MD
TRANSPLANT	$1,113,805	$0	$0	$0	$2,247	$0	$5,300	$0	$25,736	$0	$1,147,088	$0	$0	$0
HENDRIK KLOPPER MD
NEUROSURGERY	$1,156,918	$0	$0	$0	$3,295	$0	$5,300	$0	$23,990	$0	$1,189,503	$0	$0	$0
BRIAN KNUTSON MD
DERMATOLOGY	$1,294,271	$0	$0	$0	$5,458	$0	$5,300	$0	$23,990	$0	$1,329,019	$0	$0	$0
STEVEN CONDRON MD
GASTROENTEROLOGY	$1,256,851	$0	$0	$0	$5,460	$0	$5,300	$0	$26,540	$0	$1,294,151	$0	$0	$0
JEFFERY STEERS MD
TRANSPLANT	$1,113,956	$0	$0	$0	$11,752	$0	$5,300	$0	$23,990	$0	$1,154,998	$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'S COMPENSATION IS PAID BY A RELATED ORGANIZATION, AVERA HEALTH. AVERA MCKENNAN 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

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

Field	Value	IRS element (for citing)
Person	JEFFERY STEERS MD	PersonNm
Relationship With Org	EMPLOYEE	RelationshipWithOrgTxt
Loan Purpose	COMMUNITY NEEDS LOAN	LoanPurposeTxt
Loan From Organization	Yes (X)	LoanFromOrganizationInd
Original Principal	$250,000	OriginalPrincipalAmt
Balance Due	$62,500	BalanceDueAmt
Default	0	DefaultInd
Board Or Committee Approval	Yes (1)	BoardOrCommitteeApprovalInd
Written Agreement	Yes (1)	WrittenAgreementInd

Field	Value	IRS element (for citing)
Total Balance Due	$62,500	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (15 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
VINCENTA ROSSING
FAMILY OF BOARD MEMBER	$41,084	EMPLOYEE COMPENSATION	0
MATTHEW LEEDOM
FAMILY OF KEY EMPLOYEE	$80,294	EMPLOYEE COMPENSATION	0
SARAH KAPPEL
FAMILY OF KEY EMPLOYEE	$105,020	EMPLOYEE COMPENSATION	0
KATHERINE SMIDT
FAMILY OF BOARD MEMBER	$141,026	EMPLOYEE COMPENSATION	0
ALLISON CHRISTENSEN
FAMILY OF KEY EMPLOYEE	$56,802	EMPLOYEE COMPENSATION	0
VICTORIA PETERSEN
FAMILY OF KEY EMPLOYEE	$40,194	EMPLOYEE COMPENSATION	0
ASHLEY STEFFEN
FAMILY OF KEY EMPLOYEE	$71,086	EMPLOYEE COMPENSATION	0
DEANN MATTHIESSEN
FAMILY OF KEY EMPLOYEE	$85,046	EMPLOYEE COMPENSATION	0
RICHARD CRAWFORD
FAMILY OF BOARD MEMBER	$282,622	EMPLOYEE COMPENSATION	0
NICK CHRISTENSEN
FAMILY OF KEY EMPLOYEE	$65,357	EMPLOYEE COMPENSATION	0
KATHY KOOIMA
FAMILY OF BOARD MEMBER	$34,961	EMPLOYEE COMPENSATION	0
KRISTY MICKELSON
FAMILY OF KEY EMPLOYEE	$49,106	EMPLOYEE COMPENSATION	0
CHRISTIANE MAROUN MD
FAMILY OF BOARD MEMBER	$133,515	EMPLOYEE COMPENSATION	0
KIMBERLEE MCKAY MD
FAMILY OF BOARD MEMBER	$474,828	EMPLOYEE COMPENSATION	0
GRANT FLICEK
FAMILY OF KEY EMPLOYEE	$50,745	EMPLOYEE COMPENSATION	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4A	INTERPRETER SERVICE: AVERA MCKENNAN EMPLOYS TWO FULL-TIME SPANISH INTERPRETERS IN-HOUSE, AND THEIR SERVICES ARE OFFERED TO PATIENTS FREE OF CHARGE. IN ADDITION, IN COOPERATION WITH EXTERNAL AGENCIES, AVERA MCKENNAN IS ABLE TO HANDLE 210 DIFFERENT LANGUAGES AND DIALECTS THROUGH PHONE, VIDEO REMOTE INTERPRETING AND OTHER MEANS. INTERPRETATION SERVICES ARE AVAILABLE FOR PATIENTS WHEN THEY ARE AT AVERA MCKENNAN IN PERSON, OR WHEN THEY CALL BY PHONE. ALL THE ABOVE SERVICES ARE PROVIDED AT NO COST TO THE PATIENT. PRENATAL AND DELIVERY CARE: BECAUSE EARLY AND REGULAR PRENATAL CARE IS IMPORTANT TO PREVENT PREMATURE BIRTH, AVERA MCKENNAN COLLABORATES IN A COMMUNITY EFFORT TO PROVIDE OBSTETRICS CARE FOR WOMEN WHO DO NOT QUALIFY FOR MEDICAID, BUT CANNOT AFFORD HEALTH INSURANCE. THE PROGRAM OFFERS PRENATAL CARE, AND HOSPITAL LABOR AND DELIVERY SERVICES FOR A LOW FEE OF $1,000. WOMEN RECEIVE CARE WHETHER THEY CAN COVER ANY OR ALL OF THE FEE. CARE IS PROVIDED PRIMARILY BY FIRST-YEAR FAMILY PRACTICE RESIDENTS, SUPERVISED BY EXPERIENCED PHYSICIANS. THROUGH THIS PROGRAM IN 2017, AVERA MCKENNAN ASSISTED WITH 26 BIRTHS AND PROVIDED 271 PRENATAL AND POST-PARTUM VISITS. TRANSPORT TO TRANSPLANT: AVERA MCKENNAN DEVELOPED THE TRANSPORT TO TRANSPLANT PROJECT, WHICH REMOVES TRANSPORTATION BARRIERS FOR PATIENTS FROM RURAL AREAS WHICH MAY PREVENT THEM FROM COMPLETING THE EVALUATION AND TESTING NEEDED FOR KIDNEY AND/OR PANCREAS TRANSPLANT. A VAN FUNDED THROUGH A GRANT FROM THE AVERA MCKENNAN FOUNDATION IS USED TO TRANSPORT PATIENTS WHO DEMONSTRATE A FINANCIAL NEED. PATIENTS ARE BROUGHT TO THE AVERA TRANSPLANT INSTITUTE FOR A CONDENSED MULTI-DAY EVALUATION WITH ALL TESTING AND VISITS COMPLETED IN LESS THAN ONE WEEK. ULTIMATELY, THE PROJECT RESULTS IN IMPROVED MORBIDITY AND MORTALITY, AS KIDNEY TRANSPLANT DOUBLES PATIENT SURVIVAL AS COMPARED TO REMAINING ON DIALYSIS. AVERA FAMILY WELLNESS: THIS PROGRAM COMBINES POSITIVE ACTIVITIES LIKE VIOLIN LESSONS AND FAMILY WELLNESS COORDINATION AT NO CHARGE FOR CHILDREN BEGINNING IN EARLY CHILDHOOD PROGRAMS IN THE SIOUX FALLS SCHOOL DISTRICT. THE FAMILIES HAVE DIRECT ACCESS TO MENTAL HEALTH SERVICES WHEN NEEDED. THE GOAL IS TO LESSEN THE NUMBER OF ADVERSE CHILDHOOD EXPERIENCES TO IMPROVE THE CHANCES FOR CHILDREN LIVING IN POVERTY TO BE SUCCESSFUL IN SCHOOL AND IN LIFE. FAMILIES WITH THE MOST DIFFICULT SITUATIONS ARE BEING REFERRED BY THE SCHOOL DISTRICT. CURRENTLY, OVER 350 STUDENTS AND THEIR FAMILIES ARE BEING SERVED BY THE PROGRAM. THE WALSH FAMILY VILLAGE: THIS HOSPITALITY HOUSE COMPLEX ADJACENT TO THE AVERA MCKENNAN CAMPUS PROVIDES A HOME AWAY FROM HOME FOR PATIENTS AND THEIR FAMILIES WHO COME FOR CARE AT AVERA MCKENNAN FROM OUTSIDE OF SIOUX FALLS. THE PROJECT WAS FUNDED BY DONATIONS AND IS OPERATED BY AVERA MCKENNAN. ELEVEN GUEST ROOMS ARE AVAILABLE. AVERA MCKENNAN ALSO DONATES USE OF A BUILDING IN THE COMPLEX FOR A RONALD MCDONALD HOUSE FOR FAMILIES OF PEDIATRIC PATIENTS. IF THEY CAN AFFORD IT, GUESTS ARE CHARGED A LOW FEE PER NIGHT. GUESTS ARE NOT TURNED AWAY DUE TO INABILITY TO PAY THE FEE. EMPLOYEES REGULARLY DONATE NON-PERISHABLE FOOD ITEMS TO STOCK A FOOD PANTRY FOR GUESTS. IN FY2017, THE WALSH FAMILY VILLAGE SERVED 6,769 GUESTS, STAYING IN 4,015 NIGHTLY ROOMS, AN 88 PERCENT OCCUPANCY. AVERA MCKENNAN PROVIDES A SUBSIDY OF APPROXIMATELY $176,000 PER YEAR TO OPERATE THE HOSPITALITY COMPLEX. PREVENTION AND SUPPORT OF SUBSTANCE USE DISORDER: AVERA MCKENNAN IS A PARTNER WITH FACE IT TOGETHER SIOUX FALLS, A NONPROFIT ORGANIZATION WHICH SERVES AS THE LOCAL FACE AND VOICE FOR RECOVERY FROM ADDICTION THROUGH ITS RECOVERY SUPPORT SERVICES, ADVOCACY AND AWARENESS PROGRAMS. AVERA HAS BEEN A PARTNER WITH FACE IT TOGETHER SINCE ITS INCEPTION, AND IN A RECENT AWARENESS CAMPAIGN. COMMUNITY CONNECTIONS: AVERA MCKENNAN REACHES OUT TO PEOPLE AND COMMUNITIES THROUGHOUT EASTERN SOUTH DAKOTA, SOUTHWESTERN MINNESOTA AND NORTHWEST IOWA THROUGH HOME TOWN CONNECTIONS. PROVIDING A CRITICAL FEEDBACK LINK TO LOCAL REFERRING DOCTORS, THIS PROGRAM COMPLETES THE COMMUNICATIONS LINKS NECESSARY TO KEEP LOCAL HEALTH CARE PROVIDERS CURRENT ON THE TREATMENT OF THEIR PATIENTS AT AVERA MCKENNAN. SUPPORT OF THE ARTS AND CULTURAL LIFE: AVERA MCKENNAN HOSTS SIOUX FALLS' ONLY INDOOR SCULPTUREWALK, AN EXTENSION OF THE COMMUNITY'S DOWNTOWN SCULPTUREWALK. ARTISTS DONATE SCULPTURES FOR ONE YEAR, WHICH ARE PLACED AT LOCATIONS THROUGHOUT AVERA MCKENNAN'S CAMPUS, IN BUILDINGS CONNECTED BY SKYWALKS. BROCHURES CONTAIN A MAP, AND VISITORS WHO FOLLOW THE ROUTE SUGGESTED WALK APPROXIMATELY 1 MILE, MAKING THIS A HEALTHY AS WELL AS A CULTURAL JOURNEY. DIABETES PROGRAMMING: AVERA PARTICIPATES IN A COLLABORATIVE PROJECT WITH SIOUX FALLS PUBLIC SCHOOLS AND THE SOUTH DAKOTA BOARD OF NURSING TO IMPLEMENT ECONSULT SERVICES WITH DIABETIC EDUCATION SPECIALISTS MONITORING MEDICATIONS AND THE HEALTH OF CHILDREN WITH DIABETES IN THE SCHOOL SETTING. AVERA MCKENNAN DIABETES EDUCATORS PROVIDED CLASSES AND ONE-ON-ONE CONSULTATIONS AT A LOSS OF $156,000 IN THE PAST FISCAL YEAR. COMMUNITY BENEFITS: AVERA MCKENNAN PROVIDES ADDITIONAL COMMUNITY BENEFITS INCLUDING: SUPPORT OF YOUTH PROGRAMS; HOMELESS PROGRAMS; COMMUNITY ARTS PROGRAMMING; HEALTH PREVENTION; AWARENESS AND EDUCATION ABOUT CANCER, HEART DISEASE AND OTHER CONDITIONS; AND SUPPORT OF THE SIOUX EMPIRE UNITED WAY AND OTHER SERVICES IN THE REGION. PRESCHOOL VISION AND HEARING SCREENING: AVERA MCKENNAN PROVIDED FREE SCREENING FOR 266 PRESCHOOL CHILDREN IN FISCAL YEAR 2017.
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 SECTION 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, ALL MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	AVERA HEALTH 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 MCKENNAN 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 CEO, SENIOR VP FINANCE, AND ASSISTANT VP OF FINANCIAL REPORTING. AFTER THE INITIAL REVIEW, A DRAFT IS PROVIDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW. THE APPROVED RETURN IS PROVIDED TO FULL BOARD PRIOR TO FILING.
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 PRESIDENT/CEO IS COMPENSATED BY AVERA HEALTH SYSTEM. ANNUALLY THE COMPENSATION COMMITTEE OF AVERA HEALTH, WHICH IS COMPRISED OF SIX (6) SYSTEM MEMBERS APPOINTED BY THE RELIGIOUS ORDERS, MEETS WITH AN INDEPENDENT CONSULTANT REGARDING FAIR MARKET VALUE 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. ANNUALLY, THE COMPENSATION COMMITTEE OF AVERA MCKENNAN, WHICH IS COMPRISED OF BOARD MEMBERS, MEETS TO REVIEW THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. AVERA MCKENNAN COMPARES ITS COMPENSATION PLAN TO OTHER HEALTHCARE ORGANIZATIONS SIMILAR IN SIZE AND COMPLEXITY TO AVERA MCKENNAN ON A NATIONAL BASIS TO ENSURE COMPENSATION IS COMPARABLE. AVERA MCKENNAN UTILIZES MULTIPLE SALARY SURVEYS AND AN INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE A MARKET ANALYSIS FOR EACH EXECUTIVE'S SUGGESTED PAY OR PAY RANGE. INDIVIDUAL SALARIES REFLECT RELATED EDUCATION AND EXPERIENCE, AS WELL AS THE SCOPE OF THE DUTIES TO ASSURE AMOUNTS PAID ARE REASONABLE.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 PER IRS INSTRUCTIONS AND THEREFORE AVAILABLE TO THE GENERAL PUBLIC.
FORM 990, PART VI, SECTION B, LINE 16B:	THERE IS NO WRITTEN POLICY OR PROCEDURE REQUIRING THE ORGANIZATION TO EVALUATE ITS PARTICIPATION IN JOINT VENTURE ARRANGEMENTS. 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 MUST BE APPROVED BY THE BOARD AND THE MEMBER.
FORM 990, PART IX, LINE 11G	MEDICAL FEES: PROGRAM SERVICE EXPENSES 8,012,774. MANAGEMENT AND GENERAL EXPENSES 236,829. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,249,603. FFS OTHER: PROGRAM SERVICE EXPENSES 52,655,704. MANAGEMENT AND GENERAL EXPENSES 90,813,834. FUNDRAISING EXPENSES 77,772. TOTAL EXPENSES 143,547,310. RESEARCH EXPENSES: PROGRAM SERVICE EXPENSES 2,568,050. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,568,050. SHARED SERVICES: PROGRAM SERVICE EXPENSES 105,893. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 105,893.
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 ST. MARY'S AND AVERA MARSHALL. 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:	EQUITY TRANSFERS, NET -8,111,940. OTHER CHANGES IN UNRESTRICTED NET ASSETS 193,050.
FORM 990, PART XII, LINE 2C:	THE AUDIT COMMITTEE OF AVERA HEALTH, THE PARENT ORGANIZATION OF AVERA MCKENNAN, SELECTS THE AUDITOR AND REVIEWS THE AUDITED FINANCIAL STATEMENTS FOR AVERA MCKENNAN. ALSO, THE FINANCE COMMITTEE AT AVERA MCKENNAN TAKES RESPONSIBILITY FOR REVIEWING THE AUDITED FINANCIAL STATEMENTS.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
SIOUX FALLS HOSPITAL MANAGEMENT LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	571175045	562141521	MANAGEMENT COMPANY OF HEART HOSPITAL	NC	$6,250,640	$19,182,376	WEST 69TH STREET LLC
WEST 69TH STREET LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	571175045	460224743	HOLDING COMPANY	SD	$6,250,640	$19,182,376	AVERA MCKENNAN
ALUMEND LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	571175045	460224743	RESEARCH AND DEVELOPMENT	SD	-$2,568,051	$1,627,816	AVERA MCKENNAN
MRIS LLC
1325 S CLIFF AVE PO BOX 5045	SIOUX FALLS	SD	571175045	470874983	HEALTHCARE SERVICES	SD	$0	$0	AVERA MCKENNAN

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	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
AVERA ST ANTHONY'S HOSPITAL
300 N 2ND STREET	ONEILL	NE	68763	470463911	HEALTHCARE SERVICES	NE	501(C)(3)	LINE 3	AVERA HEALTH	0
AVERA HOLY FAMILY
826 NORTH 8TH STREET	ESTHERVILLE	IA	51334	420680370	HEALTHCARE SERVICES	IA	501(C)(3)	LINE 3	AVERA HEALTH	0
AVERA HOLY FAMILY FOUNDATION
826 NORTH 8TH STREET	ESTHERVILLE	IA	51334	421317452	FUNDRAISING	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	0
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 HEALTH
3900 WEST AVERA DRIVE STE 300	SIOUX FALLS	SD	57108	460422673	PROMOTION OF HEALTH	SD	501(C)(3)	LINE 10		0	N/A
AVERA QUEEN OF PEACE
525 NORTH FOSTER	MITCHELL	SD	57301	460224604	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3	AVERA HEALTH	0
SACRED HEART HEALTH SERVICES
501 SUMMIT STREET	YANKTON	SD	57078	460225483	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3	AVERA HEALTH	0
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	0
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	0
AVERA ST MARY'S
801 EAST SIOUX AVENUE	PIERRE	SD	57501	460230199	HEALTHCARE SERVICES	SD	501(C)(3)	LINE 3	AVERA HEALTH	0
AVERA MARSHALL
300 S BRUCE STREET	MARSHALL	MN	56258	410919153	HEALTHCARE SERVICES	MN	501(C)(3)	LINE 3	AVERA HEALTH	0
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 STE 300	SIOUX FALLS	SD	57108	460451539	HEALTH FINANCING AND HEALTH PLAN ADMIN	SD	501(C)(4)		AVERA HEALTH	0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct	Share Of Total IncomeShareOfTotalIncomeAmt
AVERA HOME MEDICAL EQUIPMENT OF FLOYD 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		AVERA QUEEN OF PEACE	EXCLUDED	$339,443	0	0	0.50000
SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC
310 S PENNSYLVANIA ST	ABERDEEN	SD	57401	460461429	SURGICAL ASSOCIATES	SD	N/A
AVERA HME OF SPENCER HOSPITAL LLC
2400 S MINNESOTA AVENUE 102	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		AVERA MCKENNAN	RELATED	$38,364,752	0	0	0.66670	$12,501,279
BROOKINGS HEALTH SYSTEM - AVERA HME LLC
101 22ND AVE SUITE 101	BROOKINGS	SD	57006	453204123	MEDICAL SERVICES - HOME MEDICAL EQUIPMENT	SD	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Share Of Total IncomeShareOfTotalIncomeAmt	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
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	BIOTECHNOLOGY	SD		C	Yes (1)	ALUMEND LLC	-$4,400,929	1.00000
SOUTH DAKOTA STATE MEDICAL HOLDING COMPANY 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	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (1)	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	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
AVERA HEART HOSPITAL OF SOUTH DAKOTA LLC
R	$2,818,938	INTERCOMPANY DETAIL FROM GL
AVERA HEART HOSPITAL OF SOUTH DAKOTA LLC
S	$10,966,748	INTERCOMPANY DETAIL FROM GL
AVERA HEART HOSPITAL OF SOUTH DAKOTA LLC
L	$2,085,040	INTERCOMPANY DETAIL FROM GL
AVERA HEART HOSPITAL OF SOUTH DAKOTA LLC
Q	$874,317	INTERCOMPANY DETAIL FROM GL

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	FORM 990, SCHEDULE R, PART V, LINE 2, COLUMN C	FormAndLineReferenceDesc
Explanation	THE AMOUNTS REPORTED IN COLUMN C ARE REPORTED BASED ON A REVIEW OF GENERAL LEDGER ACTIVITY IN INTERCOMPANY ACCOUNTS, AND REVIEW OF EQUITY ACCOUNTS FOR CONTRIBUTIONS AND DISTRIBUTIONS.	ExplanationTxt