2017-05-15T15:12:38-05:00 2016-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2015-07-01 460422673 AVERA HEALTH AVER 6053227300 3900 WEST AVERA DRIVE No 300 SIOUX FALLS SD 57108 Jim Breckenridge Secretary/Treasurer 6053224700 2017-05-12 1 Kim Hunwardsen CPA P00484560 6122536500 2017-05-12 2015 2021-01-29 14:40:06Z John Porter 3900 WEST AVERA DRIVE No 300 SIOUX FALLS SD 57108 192373825 0 0928 X www.avera.org X 1998 SD Promotion of Health 15 13 1056 35 680704 92791 12575041 17527901 150926620 170934945 5456718 2733287 425855 245067 169384234 191441200 5116664 5992337 0 0 83328437 98056871 0 0 0 61655404 67343079 150100505 171392287 19283729 20048913 1372841956 1317683771 1111615665 1044098910 261226291 273584861 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 152063486 5992337 170255307 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/Patient Assistance at cost $23,345,248Charity 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.Unpaid Costs of Government and Other Programs $36,751,822 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. Additional Community Benefits $37,875,905Community 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.Total $97,972,975Avera 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.Some of the specific ways Avera Health has improved the communities we served include during the year ended June 30, 2016 are:* Providing support services to nearly 330 affiliated health care facilities* Providing $5,462,308 (shown on Form 990, Part IX, line 1) in financial support for various projects in local communities* Sponsoring education programs including a gerontological care conference, nursing conference, ethics conference, parish nursing conference and more.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. 152063486 1 1 0 1 0 0 0 0 1 1 1 1 0 1 1 1 0 1 0 0 1 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 0 0 1 314 0 1 1056 1 1 1 1 CJ VI 0 0 0 1 1 0 0 0 0 X 15 13 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 0 CA X Jim Breckenridge 6053224700 3900 W Avera Dr Ste 300 Sioux Falls SD 57108 Ken Karels Chair 5.20 0.00 X X 0 0 0 Sister Mary Kay Panowicz Vice Chair 5.00 3.00 X X 0 0 0 Mark Buche 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 0.00 X 0 0 0 Sister Janet Horstman Director 5.00 0.00 X 0 0 0 Sister JoAnn Sturzl Director 5.00 0.00 X 0 0 0 Dr Merritt Gregg Warren Director 5.00 0.00 X 0 0 0 Dan Eisenbraun Director 5.00 0.00 X 0 0 0 Mark Shlanta Director 5.00 0.00 X 0 0 0 Sister Debra Kolecka Director 5.00 1.50 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 40.00 X 0 193431 19425 John Porter President & CEO 40.00 2.00 X X 1536438 0 36280 James Breckenridge Sec/Treas & SrVP Finance 40.00 0.00 X 777186 0 22921 Fredrick Slunecka Chief Operating Officer 40.00 0.00 X 1106960 0 34150 David Flicek Chief Administrative Offic 40.00 1.00 X 592208 0 35882 David Erickson Sr VP Medical Affair 40.00 0.00 X 716508 0 34510 Todd Forkel Pres/CEO-St. Luke's 1.00 40.00 X 518707 0 40404 Doug Ekeren Pres/CEO-Sacred Heart 1.00 40.00 X 463510 0 41722 David Kapaska Pres/CEO-McKennan 1.00 40.00 X 853345 0 39030 Thomas Clark Pres/CEO-Queen of Peace 1.00 40.00 X 436913 0 41702 7001775 193431 346026 108 0 1 0 CDW Government 230 N Milwaukee Ave Vernon Hills IL 60061 Computer Hardware Consulting 15844239 Avera McKennan 1325 S Cliff Avenue Sioux Falls SD 57117 Services, computer hardware & software 11892544 Elekta 400 Perimeter Center Terrace Suite Atlanta GA 30346 Computer Hardware/Software/Consulting/Ca 8075286 Medical Information Technology 1 Meditech Circle Westwood MA 02090 Hardware/Software Consulting 5479767 Medspeed 655 West Grand Avenue Elmhurst IL 60126 Courier Services 3137964 132 912345 989873 63103 4555851 11006729 124742 17527901 ACS revenue 900099 142221543 142221543 eCare revenue 900099 17605148 17605148 Premier expense credit 900099 6315000 6315000 PACE revenue 561000 3810804 3114441 696363 Inc from affiliates 561000 68448 85173 -16725 914002 914002 170934945 375020 375020 82642 0 82642 82642 1066 81576 2818007 22800 480057 2483 2337950 20317 2358267 2358267 612510 989873 450085 162425 162425 191441200 170255307 680704 2977288 X 5462308 5462308 530029 530029 4235647 4235647 144959 144959 71960317 65766882 6193435 4708359 4268715 439644 12282827 9973930 2308897 4724762 4308306 416456 30386 30386 1083916 696511 387405 108380 108380 31866823 29444393 2422430 7615682 7615682 3773188 2922746 850442 2553291 2549700 3591 2598031 2325745 272286 1697317 1526870 170447 1671547 1387089 284458 301374 301374 11421388 10675329 746059 235517 99250 136267 Grant Prog Expenditures 835506 835506 License & publications 347306 332652 14654 Project expenses 269629 269629 UBI tax 13974 13974 919824 804901 114923 171392287 152063486 19328801 0 4033284 7219487 1317264 872897 8502751 9231068 13323816 4974471 85574 180711 4109762 6099852 140903636 44310382 83023059 96593254 733392516 678919195 135015726 137216010 62734 43432 16139552 389975470 360193842 1372841956 1317683771 18690463 20996814 7102234 6189222 317672205 309859733 649273878 583975073 58604504 83517570 60272381 39560498 1111615665 1044098910 X 259014929 269879457 1695338 3189652 516024 515752 261226291 273584861 1372841956 1317683771 X 20048913 -2802166 -4888177 X 0 1 X 1 1 1 X 8237289 8049256 8015201 12575041 17527901 54404688 75219976 92494783 125942998 150269980 170255307 614183044 578521 612510 1191031 83457265 100544039 133958199 163423542 188395718 669778763 5755 78763 84518 37279233 49428377 67619274 93124170 113505331 360956385 37279233 49428377 67619274 93129925 113584094 361040903 308737860 1214380 980380 761213 626811 456596 4039380 1214380 980380 761213 626811 456596 4039380 550548 328468 105051 129714 92791 1206572 85222193 101852887 134824463 164180067 188945105 675024715 0.45740 0.51260 0.00600 0.00970 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 49040 1 38366 0 1 20974 108380 0 Part II-B, Line 1: Grants to Other Organizations for Lobbying: The Lehmann Group $17,500 Dougherty & Dougherty, LLP 21,240 Tech Schools of South Dakota 5,000 Midwest Solutions, Inc. 5,300 Direct Contact with Legislatures: Avera Day at the SD Legislature $10,464 Paid staff: Deb Fischer Clemens 26,324 Paid staff: Danielle Hamann 1,578 Other Activities: Avera Legislator's Social 2/23/16 $17,339 AHA 7/15/15 916 ATA 9/15/15 204 NIHB 9/15/15 757 AHA 10/15/15 422 Premier 6/16/16 1,336 0 1 X 4361194 413851 391376 277515 34854 4854052 3542771 367555 782973 296350 35755 4361194 3302432 477896 155637 370880 22314 3542771 6046321 328355 656901 3729145 3302432 10228130 328691 -4335972 174528 6046321 0.54390 0.28420 0.17190 0 0 13544035 948600 14492635 29744865 6367741 23377124 3633013 1732920 1900093 83965861 36209721 47756140 9067262 9067262 96593254 Non-publicly traded hedge funds 110543522 F Non-publicly traded real estate 14952824 F NPPC, LLC 100000 C Premier Purchasing Partners, L.P. 1372082 C Premier Stock 10247582 F 137216010 Cash surrender value of life insurance 1722702 Related party receivables 350508912 Deferred financing costs 2993927 Bond project fund 3989947 Interest in South Dakota Community Foundation 978354 360193842 Estimated insurance claims payable 36569245 Bond interest payable 2991253 39560498 X 176342692 -2802166 7388444 4586278 171756414 19684786 19684786 191441200 164347208 -5864915 -5864915 170212123 1180164 1180164 171392287 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 59 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 2013. Certain consolidated entities are subject to federal income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. Deferred tax assets and liabilities are not material as of June 30, 2016 and 2015. The Organization paid an immaterial amount of federal and state income taxes for the years ended June 30, 2016 and 2015. Part XI, Line 2d - Other Adjustments: Insurance program admin income not recognized for tax reporting 8,094,478. Foundation expenses reported in revenue on financial statements -61,948. Non-operating depreciation reported in revenue for financial statements -910,536. Equity transfers reported in revenue on financial statements 266,450. Part XI, Line 4b - Other Adjustments: Contributions reported in fund balance on financial statements 1,652,724. Fundraising events expenses reported in revenue on Form 990 -450,085. Investment income reported in fund balance on financial statement 5,921. Premier Program revenue included in expenses for financial statements 6,315,000. Contributions received by Foundation - not reflected in financial statements 12,161,226. Part XII, Line 2d - Other Adjustments: Fundraising event expenses reported in revenue on Form 990 450,085. Premier Program revenue included in expenses for financial statements -6,315,000. Part XII, Line 4b - Other Adjustments: Foundation expenses reported in revenue on financial statements 61,948. Non-operating depreciation reported in expenses for Form 990 910,536. Foundation expenses reported in fund balance for financial statements 207,680. Central America and the Caribbean - 0 0 Investments reported on cost basis 79869072 0 0 0 0 0 0 79869072 0 79869072 0 0 0 0 0 0 Race Against Breast Cancer 479184 292075 187109 29248 3968 9887 The Big Grape Reserve 237344 190997 46347 36039 11372 23 885855 506801 379054 359571 1602383 989873 612510 65287 15340 369458 450085 162425 1 Aberdeen Catholic School System 1400 N Dakota St Aberdeen SD 57401 460336005 501(c)(3) 92246 Community Benefit Aberdeen Development Corporation 416 Production St N Aberdeen SD 57401 466011831 501(c)(6) 7500 Sponsorship Aberdeen Public Schools Foundation Inc 1224 S 3rd St Aberdeen SD 57401 460423109 501(c)(3) 20000 Sponsorship Aberdeen Ride Line 205 N 4th St Aberdeen SD 57401 466000010 501(c)(3) 12604 Community Benefit ALS Association - MNNDSD Chapter 333 N Washington Ave Ste 105 Minneapolis MN 55401 411756085 501(c)(3) 20000 Sponsorship American Cancer Society 4904 S Technopolis Dr Sioux Falls SD 57106 131788491 501(c)(3) 40650 Sponsorship American Cancer Society Cancer Action Network 555 11th Street NW Washington DC 20004 522340031 501(c)(4) 8500 Sponsorship American Heart Association - Midwest Affiliate PO Box 50035 Prescott AZ 863045035 135613797 501(c)(3) 25000 Sponsorship American Red Cross of Eastern SD 808 West Ave North Sioux Falls SD 57104 530196605 501(c)(3) 10000 Community Benefit Arthritis Foundation PO Box 90445 Sioux Falls SD 57109 581341679 501(c)(3) 10500 Sponsorship Avera Pooled Investments 3900 W Avera Dr Sioux Falls SD 57108 460422673 501(c)(3) 15000 Community Benefit Avera St Mary's Hospital 801 E Dakota Ave Pierre SD 57501 460230199 501(c)(3) 10000 Community Benefit Banquet 900 E 8th St Sioux Falls SD 571031604 460387495 501(c)(3) 5500 Community Benefit Bethesda Home of Aberdeen 1224 S High St Aberdeen SD 574017724 460367117 501(c)(3) 10000 Sponsorship Boys & Girls Club of Brookings Moody County 1126 Southland Ln Brookings SD 57006 731630215 501(c)(3) 40000 Sponsorship Boys & Girls Club of the Sioux Empire 824 E 14th St Sioux Falls SD 57104 460399482 501(c)(3) 9150 Sponsorship Brookings Health System 300 22nd Ave Brookings SD 57006 466000069 501(c)(3) 35000 Community Benefit Canton School District 41-1 800 N Main St Canton SD 57013 466002143 City of Canton 10000 Community Benefit Career & Technical Education Academy 4700 W Career Cir Sioux Falls SD 57107 466002586 501(c)(3) 12000 Sponsorship Catholic Community Foundation for Eastern SD 523 N Duluth Ave Sioux Falls SD 571042714 466000424 501(c)(3) 8333 Sponsorship Catholic Diocese of Sioux Falls 523 N Duluth Ave Sioux Falls SD 57104 466000424 501(c)(3) 35000 Sponsorship City of Fort Pierre PO Box 700 Fort Pierre SD 57532 466000160 City of Fort Pierre 10000 Donation Coalition to Protect America's Healthcare PO Box 30211 Bethesda MD 208240211 522253225 501(c)(4) 30000 Donation Dakota Resources 25795 475th Ave Ste 1 Renner SD 57055 460442430 501(c)(3) 25000 2016 Note Write-off Dakota Wesleyan University 1200 W University Ave Mitchell SD 57301 460224589 501(c)(3) 35489 Sponsorship Daktronics Inc PO Box 86 Minneapolis MN 55486 460306862 501(c)(3) 35000 Sponsorship Delta Dental of South Dakota Foundation 804 N Euclid Ave Ste 101 Pierre SD 57501 911776857 501(c)(3) 20000 Community Benefit 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 Ste 102 Sioux Falls SD 571046708 363627217 501(c)(4) 8000 Sponsorship EmBe 300 W 11th St Sioux Falls SD 571046306 460234998 501(c)(3) 64535 Sponsorship Face It TOGETHER Sioux Falls 5020 S Tennis Ln Ste 4 Sioux Falls SD 57108 943472044 501(c)(3) 10000 Sponsorship Family Visitation Center 311 E 14th St Sioux Falls SD 57104 263654937 501(c)(3) 13000 Community Benefit Feeding South Dakota 4701 N Westport Ave Sioux Falls SD 57107 363293534 501(c)(3) 25500 Sponsorship Fellowship of Christian Athletes 1208 Horizon Dr Marshall MN 56258 440610626 501(c)(3) 31000 Sponsorship Forward Sioux Falls PO Box 907 Sioux Falls SD 571010907 460396647 15000 Community Benefit Furniture Mission of South Dakota 209 N Nesmith Ave Sioux Falls SD 57103 810584450 501(c)(3) 8000 Community Benefit Gettysburg School District 100 E King Ave Gettysburg SD 57442 466002772 City of Gettysburg 15000 Sponsorship Global Voice Inc 1000 N West Ave Sioux Falls SD 57104 460585355 501(c)(3) 8000 Sponsorship Goodwill of the Great Plains 3100 W 4th St Sioux City IA 51103 420727509 501(c)(3) 53141 Sponsorship Governor's Office of Economic Development 711 E Wells Ave Pierre SD 57501 466000364 City of Pierre 16000 Sponsorship Habitat for Humanity - South Dakota PO Box 8116 Brookings SD 57006 460454907 501(c)(3) 17500 Community Benefit Harrisburg Days Foundation PO Box 343 Harrisburg SD 57032 841709233 501(c)(3) 8000 Sponsorship Harrisburg School District PO Box 187 Harrisburg SD 57032 466002218 City of Harrisburg 25000 Community Benefit Helpline Center Inc 1000 N West Ave Ste 310 Sioux Falls SD 571041314 237424387 501(c)(3) 13500 Community Benefit Junior Achievement of South Dakota 1000 N West Ave Ste 110 Sioux Falls SD 57104 460306352 501(c)(3) 17600 Community Benefit Kilian Community College 300 E 6th St Sioux Falls SD 57103 460385443 501(c)(3) 7000 Sponsorship KSFY PO Box 14200 Tallahassee FL 323174200 132982954 12446 Sponsorship LifeLight Communications Inc 2601 S Western Ave Sioux Falls SD 57105 460460742 501(c)(3) 33000 Sponsorship LifeScape Foundation 2011 W 26th St Ste 201 Sioux Falls SD 57105 460353254 501(c)(3) 20000 Sponsorship Mitchell Area Cooperative PO Box 1087 Mitchell SD 57301 460394983 5500 Community Benefit Mitchell Technical Institute Foundation 1800 E Spruce St Mitchell SD 57301 460452950 501(c)(3) 45250 Sponsorship Mitchell Tennis Association 1520 E 5th Ave Mitchell SD 57301 272418913 501(c)(3) 10000 Sponsorship Mount Marty College 1105 W 8th St Yankton SD 57078 460283336 501(c)(3) 51000 Community Benefit NAMI South Dakota PO Box 88808 Sioux Falls SD 571098808 363593027 501(c)(3) 27500 Community Benefit National Multiple Sclerosis Society Upper Midwest Chapter Minneapolis MN 55415 410790658 501(c)(3) 18500 Sponsorship NSU Foundation 620 15th Ave SE Aberdeen SD 57401 237002314 501(c)(3) 154400 Community Benefit OLLI at University Center 4801 N Career Ave Sioux Falls SD 571071329 466000364 501(c)(3) 7500 Sponsorship Philanthropy Promotions Inc 2601 W 60th St N Sioux Falls SD 57107 870695596 501(c)(3) 15000 Sponsorship Pierre School District 211 Poplar St Pierre SD 57501 466001892 City of Pierre 6600 Community Benefit Post 8 Baseball PO Box 431 Pierre SD 57501 466008690 501(c)(19) 10000 Community Benefit 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) 10300 Sponsorship Ronald McDonald House Charities of SD 825 S Lake Ave Sioux Falls SD 57104 460371152 501(c)(3) 30000 Community Benefit Safe Harbor PO Box 41 Aberdeen SD 574020041 460344310 501(c)(3) 30000 Community Benefit SculptureWalk Inc 300 S Phillips Ave Ste L104 Sioux Falls SD 57104 208535871 501(c)(3) 33207 Sponsorship SD Agricultural & Rural Leadership Foundation 1905 N Plaza Blvd Rapid City SD 577029302 364293293 501(c)(3) 10000 Sponsorship SD Youth Foundation Inc 1310 Main Ave S Ste 109 Brookings SD 57006 474832848 501(c)(3) 10000 Community Benefit South Dakota Golf Association 2604 W Russell St Sioux Falls SD 57104 460310847 501(c)(4) 35000 Sponsorship South Dakota State University Dairy/Microbiology Box 2104 A Brookings SD 57007 466000364 State of SD 15000 Sponsorship SDSU Foundation PO Box 525 Brookings SD 57006 460273801 501(c)(3) 1526000 Community Benefit Sertoma Butterfly House & Marine Cove 4320 S Oxbow Ave Sioux Falls SD 57106 522370420 501(c)(3) 7000 Sponsorship Sioux Center Health Foundation 1101 9th St SE Sioux Center IA 51250 420796764 501(c)(3) 10000 Donation Sioux Empire Baseball Association 1601 W 44th Pl Ste 3 Sioux Falls SD 571056377 411903475 501(c)(3) 23809 Sponsorship Sioux Empire Fastpitch Softball Association PO Box 88206 Sioux Falls SD 57109 237223489 501(c)(3) 10000 Sponsorship Sioux Empire United Way 1000 N West Ave Ste 120 Sioux Falls SD 571041332 460233701 501(c)(3) 77200 Community Benefit Sioux Falls Area CASA Program PO Box 1901 Sioux Falls SD 571011901 460430647 501(c)(3) 5500 Community Benefit Sioux Falls Family YMCA 220 S Minnesota Ave Sioux Falls SD 57104 460225021 501(c)(3) 10000 Sponsorship Sioux Falls Health Department 521 N Main Ave Sioux Falls SD 57104 466000425 City of Sioux Falls 15000 Donation Sioux Falls Jazz & Blues Society PO Box 1285 Sioux Falls SD 571011285 460418356 501(c)(3) 21453 Sponsorship Sioux Falls Youth Hockey Association 5000 S Minnesota Ave Ste M Sioux Falls SD 57108 460427805 501(c)(3) 22500 Sponsorship SME Inc PO Box 90310 Sioux Falls SD 571090310 466012934 501(c)(6) 6775 Sponsorship South Dakota High School Coaches Association 801 W Eagle Ridge St Sioux Falls SD 57108 237297479 501(c)(3) 6500 Sponsorship South Dakota Humanities Council 1215 Trail Ridge Rd Ste A Brookings SD 57006 460316222 501(c)(3) 5000 Sponsorship South Dakota Parks and Wildlife Foundation 523 E Capitol Pierre SD 57501 460387968 501(c)(3) 10000 Community Benefit South Dakota Symphony Orchestra 301 S Main Ave Sioux Falls SD 57104 466017026 501(c)(3) 46400 Sponsorship Southeast Tech Foundation 2320 N Career Ave Sioux Falls SD 57107 364112897 501(c)(3) 38000 Sponsorship Special Olympics South Dakota 800 E I-90 Ln Sioux Falls SD 57104 460359776 501(c)(3) 55500 Sponsorship St Joseph's Indian School PO Box 100 Chamberlain SD 57325 460235912 501(c)(3) 20000 Sponsorship United Way of Yankton 610 W 23rd St Ste 11 Yankton SD 57078 460252854 501(c)(3) 12000 Community Benefit University of Sioux Falls 1101 W 22nd St Sioux Falls SD 57105 460224600 501(c)(3) 418035 Community Benefit USD Foundation PO Box 5555 Vermillion SD 57069 466018891 501(c)(3) 30000 Community Benefit USD Sanford School of Medicine Lee Medical Room 217 Vermillion SD 57069 466000364 501(c)(3) 25750 Sponsorship Volunteers of America Dakotas PO Box 89306 Sioux Falls SD 571099306 237353508 501(c)(3) 12500 Sponsorship Washington High School 501 N Sycamore Ave Sioux Falls SD 57110 466002586 City of Sioux Falls 17000 Community Benefit Washington Pavilion 301 S Main Ave Sioux Falls SD 57104 460435791 501(c)(3) 55500 Sponsorship Yankton Area Progressive Growth 803 E 4th St Yankton SD 57078 460348636 501(c)(6) 60000 Sponsorship Yankton Sertoma Little League Baseball PO Box 1049 Yankton SD 57078 460380524 501(c)(3) 20000 Sponsorship 86 11 Haiti scholarships 19 22800 Premium assistance to employees 604 507229 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, 2016, 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 Dale Vizcarra Director 0 191065 0 0 0 2366 0 3905 0 16154 0 213490 0 0 John Porter President & CEO 1187388 0 0 0 349050 0 13450 0 24426 0 1574314 0 0 0 James Breckenridge Sec/Treas & SrVP Finance 604325 0 0 0 172861 0 13450 0 10800 0 801436 0 0 0 Fredrick Slunecka Chief Operating Officer 861910 0 0 0 245050 0 13450 0 22296 0 1142706 0 0 0 David Flicek Chief Administrative Offic 463514 0 0 0 128694 0 13450 0 23480 0 629138 0 0 0 David Erickson Sr VP Medical Affair 562927 0 0 0 153581 0 13450 0 22287 0 752245 0 0 0 Todd Forkel Pres/CEO-St. Luke's 412140 0 0 0 106567 0 18750 0 22586 0 560043 0 0 0 Doug Ekeren Pres/CEO-Sacred Heart 339634 0 0 0 123876 0 18790 0 23691 0 505991 0 0 0 David Kapaska Pres/CEO-McKennan 660694 0 0 0 192651 0 18750 0 21772 0 893867 0 0 0 Thomas Clark Pres/CEO-Queen of Peace 346830 0 0 0 90083 0 18872 0 23625 0 479410 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. 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 Various capital projects 0 0 0 A 137928919 206383927 1032422 38100000 167251505 2014 1 1 1 1 B 3665896 61495000 388831 31169 61075000 2010 1 0 1 1 C 139422932 189222932 1272562 282213 91009361 96658796 2010 1 0 1 1 D 980455 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 0 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, 2016 for Bonds B and C. Schedule K, Part I: The 2008C series was used to refund bond issued 6/22/2006. Linda Breckenridge Spouse of Sec/Treas & SrVP Finance 144959 Employee compensation and benefits 0 X 4 42704 Avg of high/low X Cystocscope & Resectoscope 2 20736 cost X Audio & lighting 1 16600 cost X Sculptures 2 6924 cost X Design work 1 6771 cost X Daktronics display board 1 6000 cost X California trip 1 6000 cost X Gift card 1 4750 cost X Twins tickets 4 4466 cost X Auto detail, golf items, remote control car 3 2300 cost X Pizza oven and wine 2 2200 cost X Sporting event tickets, gas card, car wash 4 2068 cost X Husker tickets and wine rack 5 1099 cost X 4 Viking tickets 4 1000 cost X Hair and makeup products 1 500 cost X Show tickets 4 256 cost X Gift baskets 2 218 cost X Steaks 4 100 cost X Wine 1 50 cost 0 0 1 0 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 11 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 348,005. Management and general expenses 21,473. Fundraising expenses 0. Total expenses 369,478. Contracted services: Program service expenses 27,615,840. Management and general expenses 2,359,273. Fundraising expenses 0. Total expenses 29,975,113. Repairs and maintenance: Program service expenses 1,052,432. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,052,432. Professional fees: Program service expenses 7,610. Management and general expenses 41,684. Fundraising expenses 0. Total expenses 49,294. Recruitment: Program service expenses 420,506. Management and general expenses 0. Fundraising expenses 0. Total expenses 420,506. Form 990, Part XI, line 9: Net equity transfers -826,407. Insurance program admin income not recognized for tax reporting 8,094,478. Change in interest in net assets of foundations and trusts 4,978. Contributions received by Foundation - not reflected in financial statement -12,161,226. 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. 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. Avera Communication LLC 3900 West Avera Drive Suite 300 Sioux Falls SD 571085434 460453770 Telecommunications SD 1275228 522372 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 9 Avera Holy Family 1 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 11a, I St Benedict Health Center 1 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 9 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 9 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 Marshall Foundation 300 S Bruce Street Marshall MN 56258 411784801 Fundraising MN 501(c)(3) Line 7 Avera Marshall 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 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 Estherville LLC PO Box 5045 Sioux Falls SD 57117 201686097 Medical services - home medical equipment SD N/A Avera Home Medical Equipment of Sioux Center LLC 38 19th St SW Sioux Center IA 51250 753203100 Medical services - home medical equipment SD N/A Avera Home Medical Equipment of Marshall LLC 1104 East College Drive Marshall MN 56258 205271924 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 2449566 2024426 0.75000 1 Avera Property Insurance Inc 610 W 23rd St PO Box 38 Yankton SD 57078 460463155 Insurance SD Avera Health C 363945 1117416 1.00000 1 Valley Health Services 501 Summit Street Yankton SD 57078 460357149 Medical equipment 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 108471090 44364686 1.00000 1 DakotaCare Administrative Services Inc 2600 W 49th Street Sioux Falls SD 57105 460424322 Insurance SD Avera Health C 4389590 7838680 1.00000 1 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 Avera at Home D 8389699 Change in note receivable Avera St Mary's D 187277 Change in note receivable Accounts Management L 340128 General ledger Avera at Home L 2042160 General ledger Avera Health Plans Inc L 628954 General ledger Avera Marshall L 5108244 General ledger Avera McKennan L 75193632 General ledger Avera Queen of Peace Hospital L 10243128 General ledger Avera Sacred Heart Health Services L 12549564 General ledger Avera St Luke's L 15238808 General ledger Avera St Mary's L 6355952 General ledger Avera Marshall P 444594 Vendor payment listing Avera McKennan P 11892545 Vendor payment listing Avera Queen of Peace Hospital P 308476 Vendor payment listing Avera Sacred Heart Health Services P 345140 Vendor payment listing Avera St Luke's P 156208 Vendor payment listing Avera St Mary's P 92346 Vendor payment listing Schedule R, Part II, Identification of Related Tax-Exempt Organizations Effective October 1, 2015, Avera Health Plans Inc. obtained tax exempt status under IRC 501(c)(4). Avera Health Plans Inc. was previously taxed as a C-corporation. Effective March 1, 2016, Avera Tyler was acquired by Avera Health. Schedule R, Part III, Identification of Related Organizations Taxable as a Partnership Avera Home Medical Equipment of Estherville, LLC dissolved effective October 1, 2015. Avera Home Medical Equipment of Marshall, LLC dissolved effective January 1, 2016. Operations of both entities were transferred to Avera at Home.