2018-05-15T07:47:32-05:00 2017-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2016-07-01 460422673 AVERA HEALTH AVER 6053227300 3900 WEST AVERA DRIVE No 300 SIOUX FALLS SD 57108 Jim Breckenridge Secretary/Treasurer 6053224700 2018-05-10 1 Kim Hunwardsen P00484560 6122536500 2018-05-10 198.135.125.11 2018-05-10 14:19:31 CD P D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC 29C631FCBD7EE613918B5A80576D837C30D7D376 2016 2021-01-29 14:40:06Z John Porter 3900 WEST AVERA DRIVE No 300 SIOUX FALLS SD 57108 221045858 0 0928 X www.avera.org X 1998 SD Promotion of Health 14 12 1381 35 327831 -179911 17527901 15789136 170934945 187050828 2733287 15603501 245067 450275 191441200 218893740 5992337 5790679 0 0 98056871 110023045 0 0 0 67343079 79902077 171392287 195715801 20048913 23177939 1018218771 1067436720 744633910 755278638 273584861 312158082 X Avera Health is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values. 0 0 171962134 5790679 186830145 Avera Health delivers health care to individuals and communities through a system of nearly 330 affiliated health care facilities, which are referred to collectively as "Avera." Avera, the health ministry of the Benedictine and Presentation Sisters, serves the people of eastern South Dakota and surrounding states with a wide spectrum of health services delivered through hospitals, long-term care facilities, clinics and other health programs.Avera Health VisionWorking with its partners, Avera Health shall provide a quality, cost-effective health ministry, which reflects Gospel values. We shall improve the health care of the people we serve through a regionally integrated network of persons and institutions.Avera ValuesIn caring for life, the Avera community is guided by the Gospel values of compassion, hospitality and stewardship.Avera is sponsored by the Benedictine Sisters of Yankton, S.D., and the Presentation Sisters of Aberdeen, S.D. In accordance with its Catholic mission, Avera adheres to "The Ethical and Religious Directives for Catholic Health Care Services".Avera facilities return any revenues over expenses that they receive to the people in their communities in three ways:We provide care of those who cannot afford to pay. Avera affiliates provide free or discounted health and health-related services to persons who cannot afford to pay all or part of a bill, including persons who are uninsured and low-income patients, using income-related discounts. As the number of uninsured persons grows, so does the need for charity care, or free or discounted health services provided to those who cannot afford to pay.Charity care/financial assistance is free or discounted health and health-related services provided to persons who cannot afford to pay all or part of a bill, including persons who are uninsured and low-income patients, using an income-related schedule. The dollar amount provided for charity care is based on the actual cost of providing that service, not the amount that would have been charged for that service. Charity care does not include bad debt.Medicaid, State Children's Health Insurance Program (SCHIP), local and state government programs that reimburse health care providers for persons not eligible for Medicaid and other government programs provide health coverage for thousands of individuals in our region. However, they generally do not reimburse hospitals and doctors for the full costs of services. In many instances, payment is based on data from previous years that doesn't accurately reflect the rapidly changing nature of health services, such as new processes, new equipment, new technologies and rising costs for supplies. In accordance with "A Guide for Planning and Reporting Community Benefit" (St. Louis: Catholic Health Association of the United States, 2008), unpaid costs of Medicare are not included in this amount. Community benefits are programs or activities that provide treatment or promote health and healing as a response to identified community needs. These programs and services are not provided for marketing purposes. A community benefit must meet at least one of the following criteria: improve access to health care services; enhance health of the community; advance medical or health care knowledge; or relieve or reduce the burden of government or other community efforts. Included in this category are community health improvement services, health professions education, subsidized health services, research activities, financial and in-kind contributions, community-building and leadership activities and community-benefit-operations activities.Avera operates under the premise that social and institutional wellness are best promoted through joint efforts of various religious and community-sponsored institutions. Choosing collaboration and empowerment enables us to be better stewards of our human, financial, technical and environmental resources.Our caregivers are supported by the resources and expertise of the region's largest health system. Management and other support services are provided through the Avera Central Office, and Avera's six regional centers: Avera St. Luke's in Aberdeen, SD; Avera Marshall Regional Medical Center in Marshall, MN.; Avera Queen of Peace in Mitchell, SD; Avera St. Mary's in Pierre, SD; Avera McKennan in Sioux Falls, SD; and Avera Sacred Heart in Yankton, SD. As a leading health system in the region, Avera is committed to meeting the needs of communities it serves through the provision of quality health care services guided by Christian values and by making a positive impact on the community. Avera Health acts as the leader of the Avera health ministry, serving as an overall parent to support its affiliated tax-exempt health care organizations. Through Avera Health, affiliates collaborate to improve the lives and health of individuals and of the communities we serve. This collaboration allows affiliates to access leading edge strategies and expertise while keeping administrative costs as low as possible.Avera Health serves health care facilities that are owned by Avera Health as well as facilities that are owned by local communities. Through Avera Health, affiliates are able to share costs of management, legal and other support services among many facilities rather than each facility incurring those costs separately. Avera Health provides a variety of services for the benefit of affiliates including coordinating the delivery of health care service to the region, overall strategic planning, group purchasing of supplies and services at lowest possible cost and education. Avera Health also coordinates joint investments and risk-management programs for affiliates.Avera eCARE is a visionary care delivery model that provides rural health care professionals around-the-clock access to specialty care physicians, nurses and pharmacists. Using advanced communication technology, eCARE supports rural facilities in the provision of evidence-based, high-quality care and offsets workforce shortages in rural communities. eCARE is a natural extension of Avera's Health mission and its century-long commitment to its rural communities to "maintain access to quality care close to home." Avera eCARE works with some of the most underserved populations in the United States. This includes frontier populations, long term care residents, Native American Reservations, disabled veterans, and inmates. By bringing high quality, on demand access to specialty care, these unique populations are able to receive care within their home community and in a familiar, culturally appropriate setting. They are treated in coordination with the local practitioners that best understand their ongoing care needs. 171962134 1 1 0 1 0 0 0 0 1 1 1 1 0 0 1 1 0 1 0 0 1 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 268 0 1 1381 1 1 1 0 0 0 0 1 1 0 0 0 0 X 14 12 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 0 AL AR CA CT FL GA HI IL KS KY MD MA MI MN MS NV NH NJ NM NY NC ND OR PA RI SC TN UT VA WV WI X X Jim Breckenridge 6053224700 3900 W Avera Dr Ste 300 Sioux Falls SD 57108 Dan Eisenbraun Chair 5.20 0.00 X X 0 0 0 Sister Debra Kolecka Vice Chair 5.00 1.50 X X 0 0 0 Ken Karels Director 5.00 0.00 X 0 0 0 Sister Mary Jaeger Director 5.00 6.00 X 0 0 0 Sister Barbara McTague Director 5.00 2.00 X 0 0 0 Sister Janet Horstman Director 5.00 2.00 X 0 0 0 Sister JoAnn Sturzl Director 5.00 2.00 X 0 0 0 Dr Merritt Gregg Warren Director 5.00 40.00 X 0 223511 26529 Sister Mary Kay Panowicz Director 5.00 0.00 X 0 0 0 Mark Shlanta Director 5.00 0.00 X 0 0 0 Cathy Clark Director 5.00 0.00 X 0 0 0 Dr J Michael Bacharach Director 5.00 0.00 X 0 0 0 Dr Dale Vizcarra Director 5.00 0.00 X 0 0 0 John Porter President & CEO 40.00 2.00 X X 1668459 0 40388 James Breckenridge Sec/Treas & SrVP Finance 40.00 0.00 X 859650 0 28054 Fredrick Slunecka Chief Operating Officer 40.00 0.00 X 1156796 0 38606 David Flicek Chief Administrative Officer 40.00 1.00 X 609904 0 38280 David Erickson Sr VP Medical Affairs 40.00 0.00 X 702440 0 38280 Todd Forkel Pres/CEO-St. Luke's 1.00 40.00 X 652544 0 41576 Richard Korman Senior VP - General Counsel 1.00 40.00 X 577638 0 46130 David Kapaska Pres/CEO-McKennan 1.00 40.00 X 912822 0 42634 James Veline Senior VP - CIO 1.00 40.00 X 555850 0 29710 7696103 223511 370187 145 0 1 0 CDW Government 230 N Milwaukee Ave Vernon Hills IL 60061 Computer Hardware Consulting 16776538 Avera McKennan 1325 S Cliff Avenue Sioux Falls SD 57117 Services, computer hardware & software 9525769 Elekta 400 Perimeter Center Terrace Suite Atlanta GA 30346 Computer Hardware/Software/Consulting/Ca 4057292 Medspeed 655 West Grand Avenue Elmhurst IL 60126 Courier Services 3529604 Medical Information Technology 1 Meditech Circle Westwood MA 02090 Hardware/Software Consulting 3313011 131 476240 1170193 146686 4551896 9444121 511928 15789136 ACS revenue 900099 149995390 149995390 eCare revenue 900099 22493650 22493650 PACE revenue 561000 7076610 6406640 669970 Premier expense credit 900099 6412104 6412104 Inc from affiliates 561000 69004 518291 -449287 1004070 1004070 187050828 2768304 2768304 1433849 1326701 107148 107148 107148 13296966 15123 476892 0 12820074 15123 12835197 12835197 691652 1170193 348525 343127 343127 218893740 186830145 327831 15946628 X 5651134 5651134 139545 139545 4576584 4576584 80940997 73976200 6964797 5667429 5127625 539804 13570625 11274395 2296230 5267410 4811840 455570 65166 65166 1206611 773833 432778 34009161 28365946 5643215 6594336 6590618 3718 5739056 5359916 379140 5129354 5114222 15132 3318771 3019814 298957 1808928 1677811 131117 1190619 1122517 68102 781202 781202 16664099 15840577 823522 214132 117310 96822 Grant Prog Expenditures 1125436 1125436 License & publications 548567 542110 6457 Foundation expenses 539782 539782 UBI tax -13410 -13410 980267 791503 188764 195715801 171962134 23753667 0 X 7219487 2587101 872897 819321 9231068 11520461 4974471 4750610 180711 962367 6099852 7678449 162889181 60192389 96593254 102696792 678919195 755017402 137216010 156100597 43432 33615 16139552 16139552 60728842 9130453 1018218771 1067436720 20996814 20592416 6189222 6078613 10394733 10473243 583975073 645715791 83517570 30823538 39560498 41595037 744633910 755278638 X 269879457 308992474 3189652 2720423 515752 445185 273584861 312158082 1018218771 1067436720 X 23177939 1585723 13809559 X 0 1 X 1 1 1 X 8049256 8015201 12575041 17527901 15789136 61956535 92494783 125942998 150269980 170255307 186832895 725795963 578521 612510 691652 1882683 100544039 133958199 163423542 188395718 203313683 789635181 5755 78763 33177 117695 49428377 67619274 93124170 113505331 122171044 445848196 49428377 67619274 93129925 113584094 122204221 445965891 343669290 980380 761213 626811 456596 2875452 5700452 980380 761213 626811 456596 2875452 5700452 328468 105051 129714 92791 656024 101852887 134824463 164180067 188945105 206189135 795991657 0.43170 0.45740 0.00720 0.00600 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 49040 1 46611 0 1 2957 98608 0 Part II-B, Line 1: Through paid staff and paid consultants Avera Health meets with legislatures. Avera Health provides grants to other organizations for lobbying and pays dues of which a small portion is attributable to lobbying. 0 1 X 4854052 583639 147566 548377 32869 5004011 4361194 413851 391376 277515 34854 4854052 3542771 367555 782973 296350 35755 4361194 3302432 477896 155637 370880 22314 3542771 6046321 328355 656901 3729145 3302432 0.55520 0.23830 0.20650 0 0 13544035 948600 14492635 29744865 7438658 22306207 3988005 2025687 1962318 98107119 50728044 47379075 16556557 16556557 102696792 Non-publicly traded hedge, private equity, debt, and multi-strategy funds 126628933 F Non-publicly traded real estate 16022704 F NPPC, LLC 100000 C Premier Purchasing Partners, L.P. 857551 F Interest in Innovation Institute 12491409 F 156100597 Estimated insurance claims payable 37276254 Bond interest payable 4318783 41595037 X Part IV, Line 2b: Avera Health administers the Avera Health Pooled Investment Fund, a fund that is maintained for the benefit of facilities that are sponsored, operated, or managed by Avera Health. Investments are made in conformity with the objectives and guidelines of the Avera Health Pooled Investment Committee. Within the fund, participating facilities share in a pool of investments that are managed by various fund managers. Investments that are held for participating facilities are recorded as Avera Health Pooled Investments with a corresponding liability account of Custodial Funds - Avera Health Pooled Investments on the balance sheet. Avera Health also holds its own investments within the pooled fund and records their allocated share of income and losses from these investments as investment income in the financial statements. Part V, Line 4: The Organization's endowment consists of approximately 98 individual funds established for a variety of purposes related to health and wellness programs in Avera affiliated organizations. Part X, Line 2: Avera Health and most of its sponsored organizations are considered nonprofit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. These organizations are required to file a Return of Organization Exempt from Income Tax (Form 990) with the Internal Revenue Service (IRS). Avera Health and certain sponsored organizations also file an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report their unrelated business taxable income. Avera Health and its sponsored organizations believe that they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. The federal Form 990T filings and taxable subsidiary returns for consolidated subsidiaries are no longer subject to federal tax examinations by tax authorities for years before 2014. Central America and the Caribbean - 0 0 Investments reported on cost basis 84314422 0 0 0 0 0 0 84314422 0 84314422 1 0 0 0 0 0 Race Against Breast Cancer 526796 340777 186019 3903 578 The Big Grape Reserve 243850 204988 38862 20437 1000 23 1091199 624428 466771 322607 1861845 1170193 691652 24340 1578 322607 348525 343127 1 Aberdeen Catholic School System 1400 N Dakota St Aberdeen SD 57401 460336005 501(c)(3) 93621 Sponsorship Aberdeen Christian School Inc 1500 E Melgaard Rd Aberdeen SD 57401 911806433 501(c)(3) 10000 Sponsorship Aberdeen Development Corporation 416 Production St N Aberdeen SD 57401 466011831 501(c)(6) 7500 Sponsorship Aberdeen Family Y Foundation Inc 5 South State Street Aberdeen SD 57401 460419782 501(c)(3) 5000 Community Benefit Aberdeen Ride Line 205 N 4th St Aberdeen SD 57401 466000010 501(c)(3) 12960 Community Benefit Aberdeen United Way 202 S Main St 200 Aberdeen SD 57401 237086355 501(c)(3) 5000 Community Benefit Avera St Mary's Foundation 801 E Sioux Pierre SD 57501 460230199 501(c)(3) 10000 Sponsorship Boys and Girls Club of Aberdeen 1111 1st Ave SE Aberdeen SD 57401 237062273 501(c)(3) 5000 Community Benefit Boys and Girls Club of the Sioux Empire 824 E 14th St Sioux Falls SD 57104 460399482 501(c)(3) 7500 Community Benefit Boys and Girls Club of Yankton 2008 Mulberry St Yankton SD 57078 731630215 501(c)(3) 40000 Community Benefit Brandon Valley Booster Club 301 S Splitrock Blvd Brandon SD 57005 460393971 501(c)(3) 6500 Sponsorship Brookings Health System 300 22nd Ave Brookings SD 57006 466000069 501(c)(3) 35000 Sponsorship Butterfly House & Aquarium 4320 S Oxbow Ave Sioux Falls SD 57106 522370420 501(c)(3) 7000 Sponsorship Canton School District 800 N Main St Canton SD 57013 466002143 City of Canton 10000 Sponsorship Career & Technical Education Academy 4700 W Career Cir Sioux Falls SD 57107 466002586 501(c)(3) 10000 Sponsorship Catholic Community Foundation for Eastern SD 523 N Duluth Ave Sioux Falls SD 57104 466000424 501(c)(3) 100000 Sponsorship Charis Ministry Partners 1300 E 10th St Sioux Falls SD 57103 383775128 501(c)(3) 6000 Community Benefit Children's Home Society of South Dakota 801 N Sycamore Ave Sioux Falls SD 57110 460224542 501(c)(3) 6000 Community Benefit Coalition to Protect American's Healthcare PO Box 30211 Bethesda MD 20824 522253225 501(c)(4) 30000 Sponsorship Corn Palace 604 N Main St Mitchell SD 57301 460422673 City of Mitchell, SD 5000 Sponsorship Dakota Heartland Development Association PO Box 1087 Mitchell SD 57301 460394983 501(c)(6) 5000 Sponsorship Dakota Wesleyan University 1200 W University Ave Mitchell SD 57301 460224589 501(c)(3) 30000 Sponsorship Dakotabilities Inc 1116 S 4th Ave Sioux Falls SD 57105 460306216 501(c)(3) 12000 Community Benefit Daktronics Inc PO Box 86 Minneapolis MN 55486 460306862 501(c)(3) 15000 Sponsorship Destiny Healthcare International 1417 S Minnesota Ave Sioux Falls SD 57105 510529480 501(c)(3) 15000 Community Benefit Downtown Sioux Falls Inc 230 S Phillips Ave 102 Sioux Falls SD 57104 363627217 501(c)(4) 5000 Sponsorship EmBeYWCA 300 W 11th St Sioux Falls SD 57104 460234998 501(c)(3) 59000 Sponsorship Etc for Her 1112 S Holly Ave Sioux Falls SD 57105 460422673 19000 Sponsorship Face It Together Sioux Falls 231 S Phillips Ave 201 Sioux Falls SD 57101 943472044 501(c)(3) 15000 Community Benefit Family Visitation Center 311 E 14th St Sioux Falls SD 57104 263654937 501(c)(3) 12000 Community Benefit Feeding South Dakota 4701 N Westport Ave Sioux Falls SD 57107 363293534 501(c)(3) 25000 Community Benefit South Dakota Golf Association Junior Golf Foundation 2604 W Russell St Sioux Falls SD 57104 460449824 501(c)(3) 5000 Sponsorship Flandreau High School 600 W Community Dr Flandreau SD 57028 460422673 City of Flandreau 5000 Sponsorship Forward Sioux Falls PO Box 907 Sioux Falls SD 571010907 460396647 150000 Community Benefit Furniture Mission of South Dakota 209 N Nesmith Ave Sioux Falls SD 57103 810584450 501(c)(3) 8000 Community Benefit Goodwill of the Great Plains 3100 W 4th St Sioux City IA 51103 420727509 501(c)(3) 53141 Sponsorship Ground Works Midwest 201 N Weber Ave Sioux Falls SD 57103 475498537 501(c)(3) 5000 Community Benefit Harrisburg School District PO Box 187 Harrisburg SD 57032 466002218 City of Harrisburg 25000 Sponsorship Philanthropy Promotions Inc 2601 W 60th St N Sioux Falls SD 57107 870695596 501(c)(3) 7500 Sponsorship Friends of Levitt Shell Sioux Falls Inc 131 E Falls Park Dr Sioux Falls SD 57104 611699910 501(c)(3) 50000 Sponsorship LifeLight Communications Inc 2601 S Western Ave Sioux Falls SD 57105 460460742 501(c)(3) 25000 Sponsorship LifeScape Foundation 2011 W 26th St Ste 201 Sioux Falls SD 57105 460353254 501(c)(3) 12500 Community Benefit Lutheran Social Services 705 E 41st St 200 Sioux Falls SD 57105 460224731 501(c)(3) 50000 Community Benefit McCrossan Foundation Inc 47135 260th St Sioux Falls SD 57107 460241590 501(c)(3) 11000 Sponsorship Mitchell Area Cooperative PO Box 1087 Mitchell SD 57301 460394983 5500 Sponsorship Mitchell Technical Institute Foundation 1800 E Spruce St Mitchell SD 57301 460452950 501(c)(3) 45000 Sponsorship Mitchell United Way 304 N Lawler St Mitchell SD 57301 461250302 501(c)(3) 5000 Community Benefit Mount Marty College 1105 W 8th St Yankton SD 57078 460283336 501(c)(3) 50000 Sponsorship Northern State University 1200 S Jay St Aberdeen SD 57401 460422673 State of SD 150000 Sponsorship OLLI at University Center 4801 N Career Ave Sioux Falls SD 571071329 466000364 501(c)(3) 7500 Community Benefit Parkston Area Development Corporation PO Box 772 Parkston SD 573660772 460444442 501(c)(6) 50000 Community Benefit Pierre Post 8 Baseball Hyde Baseball Stadium Pierre SD 57501 466008690 501(c)(19) 10000 Sponsorship Pierre School District 211 Poplar St Pierre SD 57501 466001892 City of Pierre 6600 Sponsorship Presentation College 1500 N Main St Aberdeen SD 57401 460280847 501(c)(3) 50000 Community Benefit Pride in the Tiger Foundation 400 Tiger Dr Marshall MN 56258 411948007 501(c)(3) 10000 Sponsorship Redwood Area Communities Foundation 901 Cook St Redwood Falls MN 56283 416005484 501(c)(3) 5000 Sponsorship Ronald McDonald House Charities of South Dakota Inc 808 E 24th St Sioux Falls SD 57105 460371152 501(c)(3) 20000 Community Benefit Central SD RSVP 801 E Dakota Ave Pierre SD 57501 460378424 501(c)(3) 10000 Community Benefit Safe Harbor PO Box 41 Aberdeen SD 574020041 460344310 501(c)(3) 10000 Community Benefit Sculpture Walk 300 S Phillips Ave L104 Sioux Falls SD 57104 208535871 501(c)(3) 11000 Sponsorship Sioux Center Hospital and Health Center Foundation 1101 9th St SE Sioux Center IA 51250 420796764 501(c)(3) 10000 Community Partnership Sioux Council Boy Scouts of America 800 N West Ave Sioux Falls SD 57104 460224599 501(c)(3) 5000 Sponsorship Sioux Empire Baseball Association 1601 W 44th Pl Ste 3 Sioux Falls SD 571056377 411903475 501(c)(3) 16000 Sponsorship Sioux Empire Fastpitch Softball Association PO Box 88206 Sioux Falls SD 57109 237223489 501(c)(3) 7500 Sponsorship Sioux Empire United Way 1000 N West Ave Ste 120 Sioux Falls SD 571041332 460233701 501(c)(3) 80000 Sponsorship Sioux Falls CASA 300 N Dakota Ave 609 Sioux Falls SD 57104 460430647 501(c)(3) 5000 Community Benefit Sioux Falls Catholic Schools 3100 W 41st St Sioux Falls SD 57105 460413591 501(c)(3) 900000 Sponsorship Sioux Falls Jazz & Blues Society PO Box 1285 Sioux Falls SD 571011285 460418356 501(c)(3) 20000 Sponsorship Sioux Falls Youth Hockey Assoc 4235 W Mesa Pass Sioux Falls SD 57106 460427805 501(c)(3) 17500 Sponsorship SME of Sioux Falls PO Box 90310 Sioux Falls SD 571090310 466012934 501(c)(6) 5997 Sponsorship South Dakota Ag & Rural Leadership Box 2170 Animal Science Center 132 Brookings SD 57007 364293293 501(c)(3) 10000 Sponsorship South Dakota Parks and Wildlife Foundation 523 E Capitol Pierre SD 57501 460387968 501(c)(3) 5000 Sponsorship SD HOSA 1400 W 22nd St Sioux Falls SD 57105 460422673 501(c)(3) 25000 Sponsorship South Dakota State University 815 Medary Ave Box 525 Brookings SD 57007 466000364 State of SD 1528000 Sponsorship South Dakota Symphony Orchestra 301 S Main Ave Sioux Falls SD 57104 466017026 501(c)(3) 41000 Sponsorship Southeast Tech Foundation 2320 N Career Ave Sioux Falls SD 57107 364112897 501(c)(3) 20000 Community Benefit Special Olympics of South Dakota 800 E I-90 Lane Sioux Falls SD 57104 460359776 501(c)(3) 52500 Sponsorship The Banquet 900 E 8th St Sioux Falls SD 57103 460387495 501(c)(3) 5000 Community Benefit Capital Area United Way 800 W Dakota Ave Pierre SD 57501 460403398 501(c)(3) 5000 Community Benefit United Way of Greater Yankton 610 W 23rd St 11 Yankton SD 57078 460252854 501(c)(3) 12000 Community Benefit United Way of Southwest Minnesota 109 S 5th St 300 Marshall MN 56258 416023143 501(c)(3) 5000 Community Benefit University of Sioux Falls 1101 W 22nd St Sioux Falls SD 57105 460224600 501(c)(3) 400000 Sponsorship Volunteers of America PO Box 89306 Sioux Falls SD 57109 237353508 501(c)(3) 15000 Sponsorship Washington High School 501 N Sycamore Ave Sioux Falls SD 57110 466002586 City of Sioux Falls 17000 Sponsorship Washington Pavilion 301 S Main Ave Sioux Falls SD 57104 460435791 501(c)(3) 55000 Sponsorship Yankton Area Progressive Growth 803 E 4th St Yankton SD 57078 460348636 501(c)(6) 60000 Sponsorship Yankton County Historical Society 610 Summit St Yankton SD 57078 466012522 501(c)(3) 50000 Sponsorship 76 11 Haiti scholarships 22 26100 Premium assistance to employees 63 113445 Part I, Line 2: The Organization makes grants to other organizations exempt under 501(c)(3) to ensure the funds will be used for charitable purposes. During the year ending June 30, 2017, the Organization made contributions to other non-public charities in furtherance of community development. The contributions are approved by the Board for this purpose. Scholarship funds have different sets of criteria for determining eligibility and winners. Assistance to individuals is determined with assistance from each hospital's social services department or within a committee at the hospital. X 1 1 X X X X 0 0 0 0 0 0 0 0 0 Dr Merritt Gregg Warren Director 0 218497 0 0 0 5014 0 4497 0 22838 0 250846 0 0 John Porter President & CEO 1213711 0 0 0 454748 0 15900 0 24488 0 1708847 0 0 0 James Breckenridge Sec/Treas & SrVP Finance 627758 0 0 0 231892 0 15900 0 12154 0 887704 0 0 0 Fredrick Slunecka Chief Operating Officer 857381 0 0 0 299415 0 15900 0 22706 0 1195402 0 0 0 David Flicek Chief Administrative Officer 484384 0 0 0 125520 0 15900 0 23186 0 648990 0 0 0 David Erickson Sr VP Medical Affairs 553781 0 0 0 148659 0 15900 0 23186 0 741526 0 0 0 Todd Forkel Pres/CEO-St. Luke's 488898 0 0 0 163646 0 19196 0 23186 0 694926 0 0 0 Richard Korman Senior VP - General Counsel 454445 0 0 0 123193 0 21200 0 25736 0 624574 0 0 0 David Kapaska Pres/CEO-McKennan 680086 0 0 0 232736 0 21200 0 21434 0 955456 0 0 0 James Veline Senior VP - CIO 410676 0 0 0 145174 0 21200 0 8837 0 585887 0 0 0 Part I, Line 1a All Senior Executives are eligible for $2,500 per year to pay for social club dues. If an employee chooses to take advantage of this benefit, the amount is included in their taxable income. Those paid: John Porter $2,500 David Kapaska 2,043 James Breckenridge 2,500 Fredrick Slunecka 2,500 A South Dakota Health and Educational Facilities Authority 460315509 83755VUS1 2012-05-01 206383927 2012A funded a project and refunded Series 2008A and Series 2002 0 0 0 B South Dakota Health and Educational Facilities Authority 460315509 83755VNH3 2008-07-01 61495000 2008C refunded 2006 Series 0 0 0 C South Dakota Health and Educational Facilities Authority 460315509 83755VNB6 2008-06-18 189222932 2012B refunded Series 1994, 2000, and bridge loan 0 0 0 D South Dakota Health and Educational Facilities Authority 460315509 83755VVY7 2014-06-26 61821688 2014A Various capital projects 0 0 0 A 142153927 206383927 1032422 38100000 167251505 2014 1 1 1 1 B 5745000 61495000 388831 31169 61075000 2010 1 0 1 1 C 68487932 189222932 1272562 282213 91009361 96658796 2010 1 0 1 1 D 61821688 821688 61000000 2015 0 0 1 1 A 0 1 1 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 0 0 1 1 1 Bank of America/Merrill 25.000000000000 0 1 0 0 1 C 0 0 0 1 1 1 Bank of America/Merrill 24.100000000000 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 Schedule K, Part IV, Line 2C: The arbitrage analysis is performed annually, therefore the analysis was completed as of June 30, 2017 for Bonds A, B, C, and E. Schedule K, Series 2008B The bond issued 6/18/08 consisted of Series 2008A in the amount of $139,205,000 and 2008B in the amount of $50,320,000. Series 2008A bond was paid off with the issuance of the 2012A bond. The 2008B bond is interest only payments until 7/01/2038. A South Dakota Health and Educational Facilities Authority 460315509 83755VNB6 2008-06-18 189222932 2008B refund bonds issued 1/12/1995 and 3/01/2000 and capital expenditures 0 0 0 A 189222932 1272562 282213 149849658 37818499 2010 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 0 0 0 1 A 1 X 14 326664 Avg of high/low X 1 95000 Amount over FMV of land X Art 4 34000 cost X Staging, sound, lights 1 15750 cost X 1929 Ford Model A 1 12000 cost X Drawstring bags 1 7000 cost X Yamaha Clavinova Piano 1 6900 cost X Merchandise 1 5000 cost X Lowry Organ Model 510 DXL 1 5000 cost X Concert tickets and golf items 1 1650 cost X 100 baby blankets 1 1000 cost X Twins tickets and suite 1 900 cost X Wine 1 465 cost X Minnesota Wild signed jersey and stick 1 425 cost X Harley Davidson merchandise 1 140 cost X Jams and jelly 1 34 cost 0 0 1 1 Part I, Line 32b: Avera Health uses third parties to process and sell the stocks received. Part I, Line 33: The only amounts included in revenue for the financial statement reporting are non-cash contributions of stock securities. Non-cash contributions not included for financial statements include items for the benefit of the Avera facilities which include special event donations. Form 990, Part VI, Section A, line 6 The organization has two classes of members: Sponsorship Members and System Members. Sponsorship Members shall consist collectively of (i) those persons serving from time to time as the President and Council of the Presentation Sisters of the Blessed Virgin Mary of Aberdeen, South Dakota and (ii) those persons serving from time to time as the Prioress and Council of the Benedictine Convent of the Sacred Heart (Yankton, S.D.). System Members shall consist of six Sisters- three Presentation Sisters appointed by the Presentation Sponsorship Members and three Benedictine Sisters appointed by the Benedictine Sponsorship Members. Form 990, Part VI, Section A, line 7a The System Members have the power to appoint the Board of Directors of Avera Health and to suspend or remove a Director at any time, with or without cause. They also have the power to appoint Benedictine or Presentation Sisters to the Boards of Directors of any sponsored work or ministry of Avera Health. Form 990, Part VI, Section A, line 7b The following powers shall be reserved to and exercised exclusively by the Sponsorship Members and none of the following actions shall be taken by Avera Health without action of the Sponsorship Members: (a) To approve the adoption, amendment or repeal of the statements of philosophy, mission, Guiding Principles and values of Avera Health; (b) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Avera Health, and to give final approval of any such action with respect thereto; (c) To establish policies regarding the alienation of real property and precious artifacts associated with the healthcare ministry which are under the canonical stewardship of the Presentation Sisters or the Benedictine Sisters; (d) To approve any plan of merger, consolidation or dissolution of Avera Health, or the divestiture of any sponsored work or ministry associated with Avera Health; (e) To change the composition of the Sponsorship Members, including the addition of other individuals, parties or entities to be Sponsorship Members; and (f) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of Avera Health. The following powers shall be reserved to and exercised exclusively by the System Members and none of the following actions shall be taken by Avera Health without action of the System Members: (a) To appoint the Board of Directors of Avera Health and to suspend or remove a Director at any time, with or without cause; (b) To appoint Benedictine or Presentation Sisters to the Boards of Directors of any sponsored work or ministry of Avera Health; (c) To appoint the Chair and Vice Chair of the Board of Directors; (d) To appoint, evaluate, suspend or remove the President and Chief Executive Officer; (e) To review and approve the operating and capital budgets, including expenditures outside of budget, and the strategic plan, of Avera Health; (f) To adopt procedures for assuring that corporate actions are consistent with the philosophy, mission, Guiding Principles and values of Avera Health; (g) To provide recommendations to the Sponsorship Members on matters requiring Sponsorship Members' approval or action; (h) To adopt policies designed to effectuate the powers reserved to the System Members; and (i) To exercise oversight of the Guiding Principles and such authorities which may be assigned or delegated by the Sponsorship Members. Form 990, Part VI, Section A, line 8b Avera Health does not have any committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the CEO and CFO. After initial reviews, the return is provided to the 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 15 Annually the Compensation Committee of Avera Health, which is comprised of six (6) system members appointed by the religious orders, meets with an independent consultant regarding fair market value for compensation of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are not made available to the general public. Form 990, Part IX, line 11g Purchased services: Program service expenses 335,452. Management and general expenses 6,308. Fundraising expenses 0. Total expenses 341,760. Contracted services: Program service expenses 26,315,497. Management and general expenses 5,477,688. Fundraising expenses 0. Total expenses 31,793,185. Repairs and maintenance: Program service expenses 1,335,210. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,335,210. Professional fees: Program service expenses 16,393. Management and general expenses 159,219. Fundraising expenses 0. Total expenses 175,612. Recruitment: Program service expenses 363,394. Management and general expenses 0. Fundraising expenses 0. Total expenses 363,394. Form 990, Part X, Line 20: Avera Health is only disclosing a portion of the tax exempt bonds on Part X, Line 20. The bonds were issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Marshall, Avera St. Mary's, and Avera Sacred Heart. In accordance with IRS Instructions, information related to the entire tax exempt bond reporting is being reported on Avera Health's tax return on Schedule K. Form 990, Part XI, line 9: Net equity transfers 12,514,356. Insurance program admin income not recognized for tax reporting 13,026,668. Change in interest in net assets of foundations and trusts -61,649. Contributions received by Foundation - not reflected in financial statement -10,658,556. Net assets released from restrictions -1,011,260. Form 990, Part VI Question 16b: There is no written policy or procedure. In the event of any such proposed transaction, the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member. Avera Communication LLC 3900 West Avera Drive Suite 300 Sioux Falls SD 571085434 460453770 Telecommunications SD 1138676 411847 Avera Health Avera eCare LLC 3900 West Avera Drive Sioux Falls SD 571085721 Telehealth SD 22493650 0 Avera Health Avera St Anthony's Hospital 300 N 2nd Street ONeill NE 68763 470463911 Healthcare services NE 501(c)(3) Line 3 Avera Health 1 Avera Holy Family 826 North 8th Street Estherville IA 51334 420680370 Healthcare services IA 501(c)(3) Line 3 Avera Health 1 Avera Holy Family Foundation 826 North 8th Street Estherville IA 51334 421317452 Support of Holy Family Hospital and Home Health Agency IA 501(c)(3) Line 10 Avera Holy Family 0 St Benedict Health Center 401 West Glynn Drive Parkston SD 57366 460226738 Healthcare services SD 501(c)(3) Line 3 Avera Health 1 St Benedict Health Center Foundation West Glynn Drive PO Box B Parkston SD 57366 460458725 Support health related services SD 501(c)(3) Line 12a, I St Benedict Health Center 0 Avera McKennan 1325 S Cliff Ave PO Box 5045 Sioux Falls SD 57117 460224743 Healthcare services SD 501(c)(3) Line 3 Avera Health 1 Avera Queen of Peace Hospital 525 North Foster Mitchell SD 57301 460224604 Healthcare services SD 501(c)(3) Line 3 Avera Health 1 Sacred Heart Health Services 501 Summit Street Yankton SD 57078 460225483 Healthcare services SD 501(c)(3) Line 3 Avera Health 1 Avera Gettysburg 606 East Garfield Gettysburg SD 57442 460234354 Healthcare services SD 501(c)(3) Line 3 Avera St Mary's 0 Avera at Home 5116 S Solberg Ave Sioux Falls SD 57108 460399291 Home services SD 501(c)(3) Line 10 Avera Health 1 Lewis and Clark Health Education and Service Agency 1000 W 4th Street Suite 9 Yankton SD 57078 460337013 Healthcare education SD 501(c)(3) Line 10 Sacred Heart Health Services 0 Avera St Luke's 305 South State Street Aberdeen SD 57401 460224598 Healthcare services SD 501(c)(3) Line 3 Avera Health 1 Avera St Mary's 801 East Sioux Avenue Pierre SD 57501 460230199 Healthcare services SD 501(c)(3) Line 3 Avera Health 1 Avera Marshall 300 S Bruce Street Marshall MN 56258 410919153 Healthcare services MN 501(c)(3) Line 3 Avera Health 1 Avera Tyler 240 Willow Street Tyler MN 56178 410853163 Healthcare services MN 501(c)(3) Line 3 Avera Marshall 0 Avera Health Plans Inc 3900 West Avera Drive Suite 101 Sioux Falls SD 57108 460451539 Health financing & health plan admin SD 501(c)(4) Avera Health 1 Avera Home Medical Equipment of Floyd Valley Hospital LLC 714 Lincoln St NE Lemars IA 51031 820582350 Medical services - home medical equipment SD N/A Avera Home Medical Equipment of Sioux Center LLC 38 19th St SW Sioux Center IA 51250 753203100 Medical services - home medical equipment SD N/A Q&M Properties LLC 525 North Foster Mitchell SD 57301 731652049 Medical clinic building SD N/A Surgical Associates Endoscopy Clinic LLC 310 S Penn Aberdeen SD 57401 460461429 Surgical associates SD N/A Avera Home Medical Equipment of Spencer Hospital LLC 2400 S Minnesota Ave Sioux Falls SD 57117 800619999 Medical Services - home medical equipment SD N/A Heart Hospital of South Dakota LLC 4500 W 69th Street Sioux Falls SD 57108 562143771 Healthcare Services SD N/A Brookings Health System - Avera HME LLC 101 22nd Ave Suite 101 Brookings SD 57006 453204123 Healthcare Services SD N/A Accounts Management Inc 5132 S Cliff Ave Suite 101 Sioux Falls SD 57108 460373021 Collection agency SD Avera Health C 2679528 2501027 0.75000 1 Avera Property Insurance Inc 610 W 23rd St PO Box 38 Yankton SD 57078 460463155 Insurance SD Avera Health C 435365 1186748 1.00000 1 Valley Health Services 501 Summit Street Yankton SD 57078 460357149 Rental real estate SD N/A C 0 Alucent Medical Inc 1325 S Cliff Avenue PO Box 5045 Sioux Falls SD 571175045 471818349 Biotech Research SD N/A C 0 South Dakota State Medical Holding Company Inc 2600 W 49th Street Sioux Falls SD 57105 460401087 Insurance SD Avera Health C 79380363 26074630 1.00000 1 DakotaCare Administrative Services Inc 2600 W 49th Street Sioux Falls SD 57105 460424322 Insurance SD Avera Health C 8150084 6308067 1.00000 1 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 Avera Marshall D 249539 Change in note receivable Avera St Mary's D 194769 Change in note receivable Accounts Management Inc L 385560 General ledger Avera at Home L 1361434 General ledger Avera Health Plans Inc L 425000 General ledger Avera Marshall L 5537507 General ledger Avera McKennan L 81507000 General ledger Avera Queen of Peace Hospital L 10790714 General ledger Avera Sacred Heart Health Services L 13606646 General ledger Avera St Luke's L 15996620 General ledger Avera St Mary's L 6952794 General ledger Dakotacare L 100000 General ledger Avera Marshall P 553032 Vendor payment listing Avera McKennan P 8165161 Vendor payment listing Avera Queen of Peace Hospital P 166116 Vendor payment listing Avera Sacred Heart Health Services P 282122 Vendor payment listing Avera St Luke's P 196705 Vendor payment listing Avera St Mary's P 69640 Vendor payment listing Accounts Management Inc P 70846 Vendor payment listing Avera Health Plans Inc P 317737 Vendor payment listing Avera at Home Q 512541 Customer invoice listing Avera Marshall Q 1709958 Customer invoice listing Avera McKennan Q 25996740 Customer invoice listing Avera Queen of Peace Hospital Q 4170768 Customer invoice listing Avera Sacred Heart Health Services Q 6347455 Customer invoice listing Avera St Luke's Q 7418718 Customer invoice listing Avera St Mary's Q 2664298 Customer invoice listing Accounts Management Inc Q 111658 Customer invoice listing Avera Health Plans Inc Q 130384 Customer invoice listing Avera St Luke's C 111751 General ledger Schedule R, Part I, Identification of Disregarded Entities Avera eCare, LLC was formed on June 2, 2017. Schedule R, Part IV, related Organizations Taxable as a Corporation or Trust Avera eCare was formed February 19, 2016 and dissolved June 2, 2017. The Corporation had no activity during its existence.