AVERA QUEEN OF PEACE: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: AVERA QUEEN OF PEACE (EIN 46-0224604)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2017-05-09
IRS object ID: 201731299349302323
Schema version: 2015v3.0
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 H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-09T14:44:43-05:00	ReturnTs
Tax Period End	2016-06-30	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	2015-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	460224604	EIN

Business Name BusinessName

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

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	William E Flett	PersonNm
Person Title	Sec/Treas & VP of Finance	PersonTitleTxt
Phone	6059952251	PhoneNum
Signature	2017-05-04	SignatureDt
Discuss With Paid Preparer	0	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Kim Hunwardsen CPA	PreparerPersonNm
PTIN	P00484560	PTIN
Phone	6122536500	PhoneNum
Preparation	2017-05-04	PreparationDt

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

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

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

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$107,616,409	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.averaqueenofpeace.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1905	FormationYr
Legal Domicile State	SD	LegalDomicileStateCd
Activity Or Mission	Promotion of health	ActivityOrMissionDesc
Voting Members Governing Body	18	VotingMembersGoverningBodyCnt
Voting Members Independent	13	VotingMembersIndependentCnt
Total Employee	989	TotalEmployeeCnt
Total Volunteers	54	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$283,044	PYContributionsGrantsAmt
CY Contributions Grants	$205,641	CYContributionsGrantsAmt
PY Program Service Revenue	$106,176,795	PYProgramServiceRevenueAmt
CY Program Service Revenue	$106,138,833	CYProgramServiceRevenueAmt
PY Investment Income	$1,600,903	PYInvestmentIncomeAmt
CY Investment Income	$917,063	CYInvestmentIncomeAmt
PY Other Revenue	-$299,256	PYOtherRevenueAmt
CY Other Revenue	-$200,565	CYOtherRevenueAmt
PY Total Revenue	$107,761,486	PYTotalRevenueAmt
CY Total Revenue	$107,060,972	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,604,567	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$275,247	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$55,155,185	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$60,184,304	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$169,412	CYTotalFundraisingExpenseAmt
PY Other Expenses	$45,276,679	PYOtherExpensesAmt
CY Other Expenses	$46,026,583	CYOtherExpensesAmt
PY Total Expenses	$102,036,431	PYTotalExpensesAmt
CY Total Expenses	$106,486,134	CYTotalExpensesAmt
PY Revenues Less Expenses	$5,725,055	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$574,838	CYRevenuesLessExpensesAmt
Total Assets BOY	$142,177,140	TotalAssetsBOYAmt
Total Assets EOY	$134,504,013	TotalAssetsEOYAmt
Total Liabilities BOY	$48,060,314	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$45,662,750	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$94,116,826	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$88,841,263	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Avera is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	Yes (1)	SignificantChangeInd
Expense	$89,051,490	ExpenseAmt
Grant	$275,247	GrantAmt
Revenue	$106,188,058	RevenueAmt
Desc	Avera Queen of Peace's mission is to provide healthcare services to Mitchell, SD residents and the surrounding area. They provide acute care and long-term healthcare services, of which there were 7,245 acute patient days, 2,245 swing-bed patient days, 1,115 nursery patient days, 29,215 nursing home resident days, 8,914 assisted living resident days, and 2,181 independent living days. The breakout of these statistics per facility is as follows.Avera Queen of Peace Hospital6,854 Acute patient days1,732 Swing-bed patient days1,115 Newborn patient daysAvera Brady Health and Rehabilitation29,215 Long-term care resident days8,914 Assisted living days2,181 Independent living daysAvera Weskota Memorial Medical Center (CAH)337 Acute patient days347 Swing-bed patient daysAvera De Smet Memorial Hospital (CAH)54 Acute patient days166 Swing-bed patient days Avera Queen of Peace maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy and equivalent service statistics. The amount of charges foregone, based on established rates, were $4,266,732.Avera Queen of Peace also provides community benefit health activities at less than or at no cost to support those in the area serviced. These activities include community education programs; special programs for the elderly, handicapped, and medically underserved; and a variety of broad community support activities. During the year ended June 30, 2016, specific activities include meals delivered to residential homes; meeting facilities; programs for patients and families suffering from cancer, diabetes, breathing disorders, and others; assistance to health educators; and emergency healthcare providers.As a member of the Avera Health network, Avera Queen of Peace upholds the vision of the Presentation and Benedictine Sisters to work through collaboration to provide a quality, effective health ministry and to improve the health care of individuals and our communities through a regionally integrated network of persons and institutions. Avera Queen of Peace engages in activities designed to improve the health of individuals and communities in response to a calling to heal the sick, the elderly, and the oppressed.	Desc
Total Program Service Expenses	$89,051,490	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	Yes (1)	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	138	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	989	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
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	18	GoverningBodyVotingMembersCnt
Independent Voting Member	13	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	0	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	0	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	William E Flett	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6059952251	PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Terry Torgerson
Chairperson	2.50	0.00	Yes (X)	Yes (X)	$0	$0	$0
Diane Sandhoff
Vice Chair	2.50	0.00	Yes (X)	Yes (X)	$0	$0	$0
Loren Noess
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Quinten Burg
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Sister Kathleen Crowley
Board Member	2.50	4.00	Yes (X)		$0	$0	$0
Gopal Vyas
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Sister Bonita Gacnik
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
David Olson
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Jason Bradley
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Lori Essig
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Jerry Thomsen
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Sharry Knock
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Michael Krause DO
Board Member/Physician	5.00	0.00	Yes (X)		$38,538	$0	$0
Jean Koehler
Board Member	2.50	0.00	Yes (X)		$0	$0	$0
Sister Joan Reichelt
Board Member	2.50	3.30	Yes (X)		$0	$0	$0
Patricia Malters MD
Board Member (thru Sept 2015)	40.00	0.00	Yes (X)		$194,487	$0	$20,219
Hillary Rockwell MDBoard
Member/Physician (effect. Jan 2016)	40.00	0.00	Yes (X)		$419,184	$0	$41,692
Martin Christensen MDBoard
Member/Physician (thru Jan 2016)	2.50	0.00	Yes (X)		$500	$0	$0
Jennifer Tegethoff MDBoard
Member/Physician (effect. Feb 2016)	40.00	0.00	Yes (X)		$337,327	$0	$44,582
Thomas Clark
President & CEO	40.00	0.00	Yes (X)	Yes (X)	$0	$436,913	$41,702
William E Flett
Sec/Treas & VP of Finance	40.00	0.00		Yes (X)	$174,406	$0	$38,575
Brian Kampmann MD
Orthopedics, Sports Medicine	40.00	0.00			$905,888	$0	$44,032	Yes (X)
Anwarul Haq MD
Hematology and Oncology	40.00	0.00			$700,921	$0	$21,848	Yes (X)
Chris Krouse DO
Orthopedics, Sports Medicine	40.00	0.00			$1,014,568	$0	$42,254	Yes (X)
Dileep Bhat MD
Urology	40.00	0.00			$525,684	$0	$38,108	Yes (X)
Scott VanKeulen MD
General Surgery	40.00	0.00			$487,181	$0	$43,032	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$4,798,684	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$436,913	TotReportableCompRltdOrgAmt
Total Other Compensation	$376,044	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	63	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
Journey Group Companies
800 South 7th Ave	Sioux Falls	SD	57104	Construction Services	$12,979,011
Avera Health
3900 W Avera Drive Suite 300	Sioux Falls	SD	57108	Shared Services	$10,006,469
Perspective Inc
196 E 6th St Ste 100	Sioux Falls	SD	57104	Architectural	$426,334
Wapiti Medical Group-Dakota LLC
107 Flynn Dr Ste 600	Milbank	SD	57252	Medical Locum Services	$289,326
Horizon Health Care Inc
PO Box 99	Howard	SD	57349	Medical Locum Services	$244,437

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	19	CntrctRcvdGreaterThan100KCnt
Government Grants	$121,207	GovernmentGrantsAmt
All Other Contributions	$84,434	AllOtherContributionsAmt
Noncash Contributions	$711	NoncashContributionsAmt
Total Contributions	$205,641	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient & Resident Services	622110	$103,060,784	$103,060,784
Other Revenue	900099	$2,135,402	$2,135,402
Cafeteria	900099	$497,571	$497,571
Meaningful Use Revenue	900099	$325,304	$325,304
Interest in Avera Health Fnd	900099	$88,116	$88,116

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$31,656	TotalRevenueColumnAmt
Related Or Exempt Func Income	$31,656	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$106,138,833	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$101,770	TotalRevenueColumnAmt
Exclusion	$101,770	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$297,036	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$546,947	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$249,911	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$249,911	TotalRevenueColumnAmt
Exclusion	-$249,911	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$759,814	SecuritiesAmt
Other	$63,843	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$8,364	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$759,814	SecuritiesAmt
Other	$55,479	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$815,293	TotalRevenueColumnAmt
Exclusion	$815,293	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$247	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$126	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$121	TotalRevenueColumnAmt
Exclusion	$121	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	Operating Interest	Desc
Business	900099	BusinessCd
Total Revenue Column	$49,225	TotalRevenueColumnAmt
Related Or Exempt Func Income	$49,225	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$49,225	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$107,060,972	TotalRevenueColumnAmt
Related Or Exempt Func Income	$106,188,058	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$667,273	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	$275,247	TotalAmt
Program Services	$275,247	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,164,794	TotalAmt
Program Services	$948,297	ProgramServicesAmt
Management And General	$216,497	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$131,982	TotalAmt
Program Services	$131,982	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$46,548,413	TotalAmt
Program Services	$41,165,746	ProgramServicesAmt
Management And General	$5,271,279	ManagementAndGeneralAmt
Fundraising	$111,388	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,567,232	TotalAmt
Program Services	$2,273,099	ProgramServicesAmt
Management And General	$288,065	ManagementAndGeneralAmt
Fundraising	$6,068	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$6,951,877	TotalAmt
Program Services	$6,146,451	ProgramServicesAmt
Management And General	$789,211	ManagementAndGeneralAmt
Fundraising	$16,215	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,820,006	TotalAmt
Program Services	$2,490,911	ProgramServicesAmt
Management And General	$322,609	ManagementAndGeneralAmt
Fundraising	$6,486	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$194,004	TotalAmt
Management And General	$194,004	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$6,920	TotalAmt
Management And General	$6,920	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$13,823,442	TotalAmt
Program Services	$6,167,344	ProgramServicesAmt
Management And General	$7,656,098	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$21,474	TotalAmt
Program Services	$11,851	ProgramServicesAmt
Management And General	$9,623	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$7,743,047	TotalAmt
Program Services	$6,109,349	ProgramServicesAmt
Management And General	$1,612,267	ManagementAndGeneralAmt
Fundraising	$21,431	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$242,312	TotalAmt
Program Services	$131,618	ProgramServicesAmt
Management And General	$110,694	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,910,410	TotalAmt
Program Services	$1,362,089	ProgramServicesAmt
Management And General	$548,321	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$331,756	TotalAmt
Program Services	$259,506	ProgramServicesAmt
Management And General	$68,073	ManagementAndGeneralAmt
Fundraising	$4,177	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$113,787	TotalAmt
Program Services	$55,474	ProgramServicesAmt
Management And General	$54,774	ManagementAndGeneralAmt
Fundraising	$3,539	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$756,297	TotalAmt
Program Services	$756,297	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,496,190	TotalAmt
Program Services	$4,496,190	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$916,916	TotalAmt
Program Services	$914,459	ProgramServicesAmt
Management And General	$2,457	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$11,652,596	$11,652,596
Bad Debt Expense	$3,085,244	$3,085,244
Equipment Lease and Ren	$29,316	$27,816	$1,500
Taxes and Licenses	$9,147	$9,147

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$693,725	TotalAmt
Program Services	$580,777	ProgramServicesAmt
Management And General	$112,840	ManagementAndGeneralAmt
Fundraising	$108	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$106,486,134	TotalAmt
Program Services	$89,051,490	ProgramServicesAmt
Management And General	$17,265,232	ManagementAndGeneralAmt
Fundraising	$169,412	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$4,498,284	BOYAmt
EOY	$4,287,747	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$13,125,887	BOYAmt
EOY	$13,693,222	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,425,877	BOYAmt
EOY	$1,492,565	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,496,103	BOYAmt
EOY	$1,036,171	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$122,387,173	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$61,939,867	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$48,671,906	BOYAmt
EOY	$60,447,306	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$966,799	BOYAmt
EOY	$983,099	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$59,440,525	BOYAmt
EOY	$48,671,997	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$1,665,495	BOYAmt
EOY	$1,975,001	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,785,026	BOYAmt
EOY	$1,540,710	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$9,101,238	BOYAmt
EOY	$376,195	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$142,177,140	BOYAmt
EOY	$134,504,013	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$10,497,229	BOYAmt
EOY	$8,329,087	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$71,908	BOYAmt
EOY	$46,979	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$35,433,963	BOYAmt
EOY	$34,962,737	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$6,359	BOYAmt
EOY	$4,557	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,050,855	BOYAmt
EOY	$2,319,390	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$48,060,314	BOYAmt
EOY	$45,662,750	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$90,773,261	BOYAmt
EOY	$86,065,086	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,539,692	BOYAmt
EOY	$1,970,452	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$803,873	BOYAmt
EOY	$805,725	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$94,116,826	BOYAmt
EOY	$88,841,263	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$142,177,140	BOYAmt
EOY	$134,504,013	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$574,838	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$1,985,566	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$3,864,835	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	$8,835	OtherActivitiesAmt
Total Lobbying Expenditures	$8,835	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

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

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	0	AgentTrusteeEtcInd
Incl Escrow Custodial Acct Liab	Yes (1)	InclEscrowCustodialAcctLiabInd
Explanation Provided	Yes (X)	ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,065,019	BeginningYearBalanceAmt
Contributions	$1,990,675	ContributionsAmt
Investment Earnings Or Losses	$117,527	InvestmentEarningsOrLossesAmt
Other Expenditures	$473,098	OtherExpendituresAmt
Administrative Expenses	$19,025	AdministrativeExpensesAmt
End Year Balance	$2,681,098	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,040,814	BeginningYearBalanceAmt
Investment Earnings Or Losses	$24,205	InvestmentEarningsOrLossesAmt
End Year Balance	$1,065,019	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,034,190	BeginningYearBalanceAmt
Investment Earnings Or Losses	$6,624	InvestmentEarningsOrLossesAmt
End Year Balance	$1,040,814	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.26670	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.15390	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.57940	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	$917,404	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$2,908,464	OtherCostOrOtherBasisAmt
Book Value	$3,825,868	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$72,962,675	OtherCostOrOtherBasisAmt
Depreciation	$32,658,668	DepreciationAmt
Book Value	$40,304,007	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$38,991,439	OtherCostOrOtherBasisAmt
Depreciation	$27,926,856	DepreciationAmt
Book Value	$11,064,583	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,607,191	OtherCostOrOtherBasisAmt
Depreciation	$1,354,343	DepreciationAmt
Book Value	$5,252,848	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$60,447,306	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (3 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
Interest in Avera Health Foundation	$2,829,621	F
Interest in net assets of Mabee Trust	$785,495	F
Assets Limited to use - Avera Pooled Investments	$45,056,881	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$48,671,997	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	Derivative liability	Desc
Amt	$2,319,390	Amt

Field	Value	IRS element (for citing)
Total Liability	$2,319,390	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part IV, Line 2b:	The Organization holds funds in trust on behalf of its residents.
Part V, Line 4:	The organization's endowments consist of a portion of their interest in the net assets of Avera Health Foundation and their beneficial interest in the Mabee Trust. Avera Health Foundation includes endowment funds which have been established for a variety of purposes. The endowment fund assets included in the Organization's beneficial interest in the Mabee Trust have been established to purchase equipment and furnishings for the Organization. As required by generally accepted accounting principles, net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments (if any), are classified and reported based on the existence or absence of donor-imposed restrictions. The Organization's permanently restricted endowment funds are donor restricted. The Organization currently does not have any board-designated endowment funds.
Part X, Line 2:	Avera Health and 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 for consolidated subsidiaries are no longer subject to federal tax examinations by tax authorities for years before 2012.

Schedule H IRS990ScheduleH

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	2683	PersonsServedCnt
Total Community Benefit Expns	$1,487,345	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,487,345	NetCommunityBenefitExpnsAmt
Total Expense	0.01440	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	8168	PersonsServedCnt
Total Community Benefit Expns	$8,260,737	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,021,568	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,239,169	NetCommunityBenefitExpnsAmt
Total Expense	0.03130	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	10851	PersonsServedCnt
Total Community Benefit Expns	$9,748,082	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,021,568	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,726,514	NetCommunityBenefitExpnsAmt
Total Expense	0.04570	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	10	ActivitiesOrProgramsCnt
Persons Served	138	PersonsServedCnt
Total Community Benefit Expns	$13,923	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$13,923	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	1	PersonsServedCnt
Total Community Benefit Expns	$70,988	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$70,988	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	3911	PersonsServedCnt
Total Community Benefit Expns	$719,077	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$389,625	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$329,452	NetCommunityBenefitExpnsAmt
Total Expense	0.00320	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	18	ActivitiesOrProgramsCnt
Persons Served	24	PersonsServedCnt
Total Community Benefit Expns	$443,847	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$443,847	NetCommunityBenefitExpnsAmt
Total Expense	0.00430	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	34	ActivitiesOrProgramsCnt
Persons Served	4074	PersonsServedCnt
Total Community Benefit Expns	$1,247,835	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$389,625	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$858,210	NetCommunityBenefitExpnsAmt
Total Expense	0.00830	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	34	ActivitiesOrProgramsCnt
Persons Served	14925	PersonsServedCnt
Total Community Benefit Expns	$10,995,917	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,411,193	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,584,724	NetCommunityBenefitExpnsAmt
Total Expense	0.05400	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	14461	PersonsServedCnt
Total Community Benefit Expns	$88,212	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$61,459	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$26,753	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$5,500	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,500	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	14461	PersonsServedCnt
Total Community Benefit Expns	$93,712	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$61,459	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$32,253	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$3,085,244	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$34,469,373	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$42,799,811	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$8,330,438	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Hospital Facilities HospitalFacilitiesGrp (3 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc	Critical Access HospitalCriticalAccessHospitalInd
Avera Queen of Peace Hospital
1	525 North Foster Street	Mitchell	SD	57301	www.averaqueenofpeace.org	10552	Yes (X)	Yes (X)	Yes (X)	8 Provider Based Clinics
Avera Weskota Memorial Medical Center
2	609 1st Street NE	Wessington Springs	SD	57382	www.avera.org/weskota	48209	Yes (X)		Yes (X)		Yes (X)
Avera De Smet Memorial Hospital
3	306 Prairie Avenue SW	De Smet	SD	57231	www.avera.org/de-smet	50726	Yes (X)		Yes (X)		Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (3 entries)

FacilityFacilityNum	First Licensed CY Or PYFirstLicensedCYOrPYInd	Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd	CHNA ConductedCHNAConductedInd	Community DefinitionCommunityDefinitionInd	Community DemographicsCommunityDemographicsInd	Existing ResourcesExistingResourcesInd	How Data ObtainedHowDataObtainedInd	Community Health NeedsCommunityHealthNeedsInd	Other Health IssuesOtherHealthIssuesInd	Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd	Consulting ProcessConsultingProcessInd	Information GapsInformationGapsInd	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	Other WebsiteOtherWebsiteInd	Other Website URLOtherWebsiteURLTxt	Paper Copy Public InspectionPaperCopyPublicInspectionInd	Implementation Strategy AdoptImplementationStrategyAdoptInd	Implementation Strategy AdptImplementationStrategyAdptYr	Strategy Posted WebsiteStrategyPostedWebsiteInd	Strategy Website URLStrategyWebsiteURLTxt	Strategy AttachedStrategyAttachedInd	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	FAP Notice DisplayedFAPNoticeDisplayedInd	Communtity Notified FAPCommuntityNotifiedFAPInd	Other PublicityOtherPublicityInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	Permit No ActionsPermitNoActionsInd	Collection ActivitiesCollectionActivitiesInd	FAP Notified Upon AdmissionFAPNotifiedUponAdmissionInd	FAP Notified Before DischargeFAPNotifiedBeforeDischargeInd	FAP Notified All PatientsFAPNotifiedAllPatientsInd	Documented Elig DeterminationDocumentedEligDeterminationInd	Other Actions TakenOtherActionsTakenInd	Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd	Other Method UsedOtherMethodUsedInd	Amounts Generally BilledAmountsGenerallyBilledInd	Gross ChargesGrossChargesInd
Avera Queen of Peace Hospital
1	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	15	Yes (1)	0	0	Yes (1)	Yes (X)	http://www.avera.org/queen-of-peace	Yes (X)	See Part V	Yes (X)	Yes (1)	15	Yes (1)	see Part V	0	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)	http://www.avera.org/experience/ah/financial-assistance-charity-care/	Yes (X)	http://www.avera.org/experience/ah/financial-assistance-charity-care/	Yes (X)	http://www.avera.org/experience/ah/financial-assistance-charity-care/	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 Weskota Memorial Medical Center
2	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)		15	Yes (1)	0	0	Yes (1)	Yes (X)	www.avera.org/weskota/	Yes (X)	See Part V	Yes (X)	Yes (1)	15	Yes (1)	See Part V	0	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)	http://www.avera.org/experience/ah/financial-assistance-charity-care/	Yes (X)	http://www.avera.org/experience/ah/financial-assistance-charity-care/	Yes (X)	http://www.avera.org/experience/ah/financial-assistance-charity-care/	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 De Smet Memorial Hospital
3	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)		15	Yes (1)	0	0	Yes (1)	Yes (X)	www.avera.org/de-smet/	Yes (X)	See Part V	Yes (X)	Yes (1)	15	Yes (1)	See Part V	0	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)	http://www.avera.org/experience/ah/financial-assistance-charity-care/	Yes (X)	http://www.avera.org/experience/ah/financial-assistance-charity-care/	Yes (X)	http://www.avera.org/experience/ah/financial-assistance-charity-care/	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 (26 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Avera Queen of Peace Hospital	Part V, Section B, Line 5: The Administrative Fellow, in collaboration with local organizations and individuals, obtained primary data pertaining to the primary service area from 97 individual surveys, 14 key informant individuals, four focus groups, and 10 sector policy and procedure checklists. Key informant and sector checklists were conducted with Davison County Health Department and Regional Health Department management as well as community members and organizations within the community representing a broad range of interests, including medically underserved, low income, and diverse populations. The public health departments provide services to individuals living in poverty and vulnerable populations. Of the persons seen at the regional health departments, 34% are of American Indian ethnicity; 17% alone for Davison County. Invitations to participate in focus groups were sent to community organizations and advertisements were placed in various local newspapers throughout the region.
Avera Weskota Memorial Medical Center	Part V, Section B, Line 5: Avera Weskota Memorial Hospital gathered both primary and secondary data for the assessment. Primary data from three focus groups and written responses from individual surveys was collected and summarized by a Community Development Specialist from Planning & Development District II of Yankton, SD. Individuals representing a wide range of interests participated in the focus groups held at the Wessington Springs Community Club, the Wessington Springs Area Senior Citizens Center, and the Jerauld County Court House. Key community informants including the community health nurse were consulted and participated in committees that helped to prioritize the needs of the community.
Avera De Smet Memorial Hospital	Part V, Section B, Line 5: Avera De Smet Memorial Hospital partnered with the City of De Smet, De Smet Development Corporation, De Smet Chamber of Commerce, De Smet Event and Wellness Center and the School districts for De Smet, Iroquois, and Arlington to collect primary data from individual surveys and individual key informant interviews. Data was then evaluated and prioritized by a steering committee.
Avera Queen of Peace Hospital	Part V, Section B, Line 11: BEHAVIORAL HEALTH In both the FY2013 and FY2016 CHNA report, behavioral health was identified a priority to the community. Although great efforts have been made to address this issue, the region continues to be designated as a Mental Health Care Healthcare Professional Shortage Area (HPSA). Access to services, early intervention, education, and supports are critical to achieve improved long-term outcomes for individuals and communities. The hospital has developed following goals and objectives outlining specific actions and strategies that will help to address this need. Goal #1 Improve mental health and prevent crisis situations within our communities by increasing access to behavioral health services and supports. Objective #1 Increase access to behavioral health services and supportsObjective #2 Reduce suicide attempts and death rate by increasing access to services and supports. Goal #2 Improve recovery rates and reduce public health crisis related to alcohol and substance use disorders. Objective #1 Increase access to substance abuse services and supports. Goal #3 Improve behavioral health and substance use disorders screening, wellness, and awareness through education and self-management programs. Objective #1 Increase screenings for behavioral health and substance use disorders. Objective #2 Increase participation in self-management wellness educationObjective #3 Increase behavioral health and substance use disorder awarenessACCESS TO CAREIn both the FY2016 and FY2013 CHNA, access to primary and mental healthcare services was identified as a priority of the community. Although great efforts have been made, much of the area is still designated a Primary Care Healthcare Professional Shortage Area and most of the area remains designated as a Medically Underserved Area/Population. Increasing access to primary care, specialties, and care coordination teams contributes to improved health outcomes. Access to services, early intervention, education, and supports are critical to achieve improved long-term outcome for individuals and communities.Goal #1 Improve access to primary care and mental healthcare services. Objective #1 Increase primary care services. Objective #2 Increase awareness of services and supportsPREVENTION, WELLNESS, SCREENING, AND EDUCATIONIn both the FY2016 and FY2013 CHNA, continual education related to how physical and mental health issues impact overall health of an individual and learning to manage chronic disease conditions was identified to be a priority of the community. As the focus on community and population health increases, it becomes more critical to invest resources and create partnerships related to prevention, wellness, screenings and education. The hospital's education programs, participation in health fairs, and support group programs are intended to address community education and supports. Personalized chronic disease management education and supports are also essential to improve the overall health of individuals and communities. Partnerships and collaborations with health agencies, providers, and community organizations are essential to increase breadth and depth of prevention, wellness, screening, and education knowledge.Goal #1 Build a culture of health through collaborative prevention, wellness, screening, and education. Objective #1 Increase regional collaboration efforts with public health agencies, community health committees, health organizations, and other agencies focused on prevention and wellness events.Objective #2 Increase regional collaboration with public health agencies, health committees, health organizations, and other agencies focused on screening. Goal #2 Engage and empower individuals to actively manage their chronic disease through education and supports.Objective #1 Increase effective education and support opportunities for individuals diagnosed with diabetes.Objective #2 Increase effective education and support opportunities for individuals diagnosed with high blood pressure.Objective #3 Expand Better Choices Better Health chronic disease management program through increased referrals and partnership development.Items not being addressed: Nutrition - We will defer to the local schools, grocers, Salvation Army, and other food pantries the concerns of the community regarding the following: * Children being hungry during the school day* Fresh food expense* Expanding meals for the poor, soup kitchens* Salvation Army expansion of the food pantryPhysical Activity - We will defer to the City of Mitchell Parks and Recreation, local wellness centers, local and civic organizations the concerns of the community regarding the following: * Cost to participate often to high* Free play and recess have been cut from the school day* Scholarships for children's activities * Lack of information on bike paths* Need for more indoor and outdoor winter activities Transportation - We will defer to Palace Transit, Avera Foundation, and local cab services the concerns of the community regarding the following: * Affordable shuttle service to Sioux Falls* Transportation barriers* Need for subsidized transportation* Need for car poolsEducation - We will defer to the Mitchell Public School officials, Mitchell Chamber of Commerce, and local civic organizations the concerns of the community regarding the following: * Parenting classes * Parents not valuing their children's education* Employee educational opportunities* Need for a liaison with schools to identify mental and physical health issues
Avera Weskota Memorial Medical Center	Part V, Section B, Line 11: The Health Education Team consists of representatives from Avera Weskota Memorial Hospital, Horizon Health Care, Weskota Manor Avera, and the South Dakota Department of Health, Jerauld County Office of Child and Family Services. The team's purpose is to provide health education to the community in the Wessington Springs area. The Health Education Team coordinates community education programs and health screenings at several events throughout the year. The three needs that will be addressed are: 1 Prevention/Wellness Care2 Community Education Regarding Mental Health Issues - Alcohol, Drug Use and Depression 3 Perceived Lack of Healthcare ServicesPrevention/Wellness Care: Goal # 1 - Provide and promote prevention and wellness education and screening opportunities to community members locally.Objective #1 - Provide and promote improvements in long term health as a result of physical activity by increasing access, education and event opportunities locally.Objective #2 - Provide and promote improvements in long term health as a result of good nutrition through prevention and wellness education and awareness opportunities locally.Objective #3 - Provide and promote overall health prevention and wellness education and awareness opportunities locally.Community Education Regarding Mental Health Issues- Alcohol, Drug Use, and DepressionGoal #1 - Provide and promote community education and individual services to increase awareness and understanding of behavioral health and substance use disorders.Objective # 1 - Provide and promote opportunities that increase education and awareness of depression.Objective #2 - Provide and promote screening and treatment options locally.Perceived Lack of Healthcare ServicesGoal #1 - Improve the perceived lack of healthcare services through communication, education, and community events.Objective #1 - Increase utilization of local health care services through awareness, education, and communication. Objective #2 - Increase awareness of services through communication and community events.CHNA Needs Not Addressed:Though Avera Weskota Memorial Hospital is a leader in identifying the needs of the community, some needs fall outside the span of control of the hospital. Unmet needs identified by the 2016 Community Health Needs Assessment will be addressed by recommended community organizations. These unmet needs include: * Assisted Living: Assisted living was identified as a need in the community for the 2013 and 2016 CHNA. In 2013, this issue was referred to Weskota Manor Avera. Developing assisted living is in the nursing home's long range strategic plan, but it is not financially feasible at this time. The health care community, hospital advisory board, and nursing home governing board will be educated regarding this plan. Avera Weskota Memorial Hospital will refer the identified need to Weskota Manor Avera for consideration in their long range strategic planning.In-home services are available to assist tenants in the independent living apartments. Services include: skilled home health and hospice services, hot meal programs, bus transit services and homemaker programs. * Recruitment of Healthcare Workers: Recruitment of healthcare staff was also identified as a concern. Low unemployment rate as well as a shortage of healthcare and home maker program applicants is a problem across the state. The facility will continue to apply creative ideas to recruitment and will not pursue this as a community health needs priority. Avera Weskota Memorial Hospital and the other healthcare facilities will continue to work with this issue. The hospital is using the South Dakota Retention Bonus as an incentive to recruit and retain professional staff, in addition to loan forgiveness and bonuses. This incentive has helped recruit and retain some, but not all, staff. Avera Weskota is participating in a Margaret A. Cargill Foundation Grant with Dakota Wesleyan University to educate and prepare Certified Nursing Assistants (CNA) and nurses in rural communities. In addition, the hospital will participate with University of South Dakota and United States Department of Agriculture (USDA) project, a project whereby student education is delivered via telemedicine to rural students at the facility.
Avera De Smet Memorial Hospital	Part V, Section B, Line 11: The five priorities are more medical doctors locally, affordable housing, high cancer rates, need for mental health, and senior transport and activities. Avera De Smet Memorial Hospital leadership three year implementation plans will focus on the following prioritized needs: * More Medical Doctors locally (Access to Care)* High Cancer Rates (Wellness and Prevention Education and Screening)* Mental Health (Behavioral Health)Access to Care Goal #1 - Provide the residents of Kingsbury County better access to care locally.Objective #1 - Recruit more local medical doctors to our area.Objective # 2 - Recruit more medical doctors to our area for outreach services.Objective #3 - Recruit more providers to be credentialed to provide eCare Telemedicine services in our area.Objective #4 - Improve home health services in our service area.Wellness, Prevention Education, and ScreeningGoal #1 - Provide and promote prevention and wellness education and screening opportunities to community members locally. Objective #1 - Provide and promote cancer prevention and wellness education and screening opportunities locally.Objective #2 - Provide and promote chronic disease management prevention and wellness education locally.Objective #3 - Promote overall health education and awareness by supporting and participating in community events.Behavioral Health Goal # 1 - Address the need for mental health services through satellite clinics or telemedicine.Objective #1 - Provide mental health screenings with primary care providers.Objective #2 - Increase the number of options and supports for patients seeking behavioral health services.Objective #3 - Increase community awareness and education of local services provided to community members.The following unmet needs that will not be addressed include affordable housing, senior transportation, and activities. These needs will be addressed by other organizations withing the community.
Avera Queen of Peace Hospital	Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera Weskota Memorial Medical Center	Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera De Smet Memorial Hospital	Part V, Section B, Line 13h: Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide.
Avera Queen of Peace Hospital	Part V, Section B, Line 16i: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera Weskota Memorial Medical Center	Part V, Section B, Line 16i: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera De Smet Memorial Hospital	Part V, Section B, Line 16i: A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Avera Queen of Peace Hospital	Part V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility.
Avera Weskota Memorial Medical Center	Part V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility.
Avera De Smet Memorial Hospital	Part V, Section B, Line 20e: If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility.
Avera Queen of Peace Hospital	Part V, Section B, Line 22d: The hospital facility calculated the amount generally billed under the look-back method using the lowest inpatient and outpatient combined Medicare and commercial payment rate. This rate will be reviewed and updated on an annual basis each October.
Avera Weskota Memorial Medical Center	Part V, Section B, Line 22d: The hospital facility calculated the amount generally billed under the look-back method using the lowest inpatient and outpatient combined Medicare and commercial payment rate. This rate will be reviewed and updated on an annual basis each October.
Avera De Smet Memorial Hospital	Part V, Section B, Line 22d: The hospital facility calculated the amount generally billed under the look-back method using the lowest inpatient and outpatient combined Medicare and commercial payment rate. This rate will be reviewed and updated on an annual basis each October.
Avera Queen of Peace 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 Weskota Memorial 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 De Smet 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.
Part V, Section B, Line 10a	The most recently adopted implementation strategy for each of the facilities has been posted to the following website:http://www.avera.org/app/files/public/67531/2016-chna-implementationplan-queen-of-peace.pdf
Schedule H, Part V, Line 11, Avera Queen of Peace Hospital:	Objective #2 Increase effective education and support opportunities for individuals diagnosed with high blood pressure.Specific Actions and Strategies: * Provide nutrition education to individuals diagnosed with high blood pressure * Increase attendance and expand monthly blood pressure clinics * Provide relevant health education materials to attendees of blood pressure clinics* Increase referral to Better Choices Better Health chronic disease management programs* Conduct feasibility studies on additional options for heart screenings such as Planet Heart and Calcium Screening* Increase targeted outreach for heart health education and support counties with high incidence rates such Hutchinson, Aurora, Brule and Davison CountiesObjective #3 Expand Better Choices Better Health chronic disease management program through increased referrals and partnership development.Specific Actions and Strategies: * Designate staff to be trained as lay leaders* Participate in Better Choices Better Health Advisory Council * Increase referrals from primary care providers and coordinated care teams* Develop partnerships with Retired and Senior Volunteer Program (RSVP) trained lay leaders to increase number of workshops held per year* Develop working relationships with lay leaders regionally to expand program * Develop tactics to expand program to Native Americans* Provide meeting space as needed for program* Support existing Parkinson's, diabetes, gluten-free, and cancer support groups by providing meeting space, educational topics, and speakers* Create a strategic plan to increase participation and potentially expand support groups * Monitor health outcomes and improvements and report to executive teams, community leaders, and providers. Items not being addressed: Nutrition - We will defer to the local schools, grocers, Salvation Army, and other food pantries the concerns of the community regarding the following: * Children being hungry during the school day* Fresh food expense* Expanding meals for the poor, soup kitchens* Salvation Army expansion of the food pantryPhysical Activity - We will defer to the City of Mitchell Parks and Recreation, local wellness centers, local and civic organizations the concerns of the community regarding the following: * Cost to participate often to high* Free play and recess have been cut from the school day* Scholarships for children's activities * Lack of information on bike paths* Need for more indoor and outdoor winter activitiesTransportation - We will defer to Palace Transit, Avera Foundation, and local cab services the concerns of the community regarding the following: * Affordable shuttle service to Sioux Falls* Transportation barriers* Need for subsidized transportation* Need for car poolsEducation - We will defer to the Mitchell Public School officials, Mitchell Chamber of Commerce, and local civic organizations the concerns of the community regarding the following: * Parenting classes * Parents not valuing their children's education* Employee educational opportunities* Need for a liaison with schools to identify mental and physical health issues
Schedule H, Part V, Line 7b, Avera Queen of Peace Hospital:	www.avera.org/about/community-health-needs-assessments/
Schedule H, Part V, Line 7b, Avera Weskota Memorial Medical Center:	www.avera.org/about/community-health-needs-assessments/
Schedule H, Part V, Line 7b, Avera De Smet Memorial Hospital:	www.avera.org/about/community-health-needs-assessments/

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - Avera Brady Health and Rehab
500 S Ohman St	Mitchell	SD	57301	Nursing Home
2 - Avera Brady Assisted Living
1414 W Cedar Ave	Mitchell	SD	57301	Assisted Living

Supplemental Information Detail SupplementalInformationDetail (13 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:	Our 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:	Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Community health improvement services, line 7e, health professions education, line 7f, and cash and in-kind donations, line 7i were compiled using actual costs recorded in the CBISA software. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report.
Part I, Ln 7 Col(f):	Avera Queen of Peace bad debt expense of $3,085,244 is included on Form 990, Part IX, Line 25, Column (A) but excluded for purposes of calculating this percentage.
Part II, Community Building Activities:	Avera Queen of Peace supports numerous economic development organizations with participation at meetings and donations throughout its service area. Additionally, Avera Queen of Peace works with Dakota Wesleyan University, the Mitchell Technical Institute, and local high schools to address healthcare worker shortages in the communities of its service area. Avera Queen of Peace also partners with the Mitchell Senior Meals program to ensure access to nutritious meals for the elderly.
Part III, Line 4:	The footnote to the Organization's financial statements that describes bad debt expenses is located in Footnote 1 on page 10 of the attached audited financial statements.
Part III, Line 8:	Medicare allowable costs of care are based on the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Avera Queen of Peace follows the CHA guidelines in reporting community benefits and therefore any Medicare shortfall (as calculated including our non-cost report entities) is excluded from our community benefit report. However, Medicare is the Organization's largest payer and patients with Medicare coverage are accepted regardless of whether or not a surplus or deficit is realized from providing the services. This basis therefore means providing Medicare services promotes access to healthcare services which is a key advantage for our community.
Part III, Line 9b:	If the patient qualifies for the organization's financial assistance policy for low-income, uninsured patients and is cooperating with the organization with regard to efforts to settle an outstanding bill within current self-pay collection policy guidelines and timeframes, the organization or its agent shall not send, nor intimate that it will send, the unpaid bill to any outside collection agency. Avera organizations will allow all individuals 120 days from the first post discharge statement to apply for financial assistance before sending the uncollected account to an outside collection agency. Avera will provide the patient with a statement or final notice that contains a listing of the specific collection action(s) it intends to initiate, and a deadline after which they may be initiated no earlier than 30 days before action is initiated. If the patient qualifies for 100% charity care, no further bills will be sent. A letter will be sent instead indicating that the patient's bill has been completely forgiven.
Part VI, Line 2:	Avera Queen of Peace conducted a Community Health Needs Assessment for each facility during 2015 and 2016. The Community Health Needs Assessments for Avera Queen of Peace, Avera Weskota Memorial Medical Center and Avera De Smet Memorial Hospital were adopted by the Avera Queen of Peace Governing Board on May 24, 2016. The CHNA implementation plans for the three facilities was adopted by the Avera Queen of Peace Governing Board on September 27, 2016.
Part VI, Line 3:	A summary of the financial assistance policy is posted in the Hospital facility's emergency rooms, waiting rooms, and admissions office and is included in the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility.
Part VI, Line 4:	Avera Queen of Peace's service area includes Davison County and surrounding counties in South Dakota. In 2015, the population for Davison County was estimated to be 19,858. Approximately 17.7% of the population is age 65 or older. The average per capita income is $25,881 and approximately 13.4% of individuals are below the federal poverty level. The nearest like hospital in the area is approximately 72 miles from Avera Queen of Peace.
Part VI, Line 5:	Avera Queen of Peace is a verified Level II trauma center and operates an emergency department staffed 24 hours per day with board certified physicians. Emergency care is provided on an open door basis regardless of ability to pay. Avera Queen of Peace leases two critical access hospitals which provide a broad range of inpatient, outpatient services and 24 hour emergency rooms in two very rural communities.Avera Queen of Peace owns three rural health clinics which provide primary care services in three rural communities.Similar to the hospitals in the Avera Queen of Peace region, the clinics are operated on an open door basis and care is provided regardless of ability to pay.Medical staff privileges are extended to all licensed and qualified applicants. The Avera Queen of Peace Board of Directors is principally comprised of community members from the primary and secondary services areas. Members come from a variety of backgrounds including banking, education, agriculture, healthcare and private industry.
Part VI, Line 6:	Avera is a sponsored ministry of the Benedictine and Presentation Sisters. The communities in which Avera operates all have unique health and community benefit needs. In keeping with the Catholic Healthcare Association guidelines, each hospital strives to meet its community's identified needs. The corporate staff of Avera Health advocates for all members regarding community benefit related matters of state, regional and national importance.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
Dakota Wesleyan University
1200 W University Ave	Mitchell	SD	57301	460224589	501(c)(3)	$250,000	Donation
Mitchell Skating and Hockey Association
PO Box 5	Mitchell	SD	57301	460425100	501(c)(3)	$10,000	Donation

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2:	FormAndLineReferenceDesc
Explanation	The Organization only makes grants to other organizations which are tax-exempt under Section 501(c)(3).	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 (10 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
Patricia Malters MD
Board Member (thru Sept 2015)	$179,639	$0	$11,000	$0	$3,848	$0	$15,251	$0	$5,345	$0	$215,083	$0	$0	$0
Hillary Rockwell MDBoard
Member/Physician (effect. Jan 2016)	$368,201	$0	$14,610	$0	$36,373	$0	$18,260	$0	$24,382	$0	$461,826	$0	$0	$0
Jennifer Tegethoff MDBoard
Member/Physician (effect. Feb 2016)	$314,658	$0	$21,726	$0	$943	$0	$20,600	$0	$24,606	$0	$382,533	$0	$0	$0
Thomas Clark
President & CEO	$0	$346,830	$0	$0	$0	$90,083	$0	$18,872	$0	$23,625	$0	$479,410	$0	$0
William E Flett
Sec/Treas & VP of Finance	$173,843	$0	$0	$0	$563	$0	$14,593	$0	$24,390	$0	$213,389	$0	$0	$0
Brian Kampmann MD
Orthopedics, Sports Medicine	$758,950	$0	$144,500	$0	$2,438	$0	$20,600	$0	$25,028	$0	$951,516	$0	$0	$0
Anwarul Haq MD
Hematology and Oncology	$560,097	$0	$65,000	$0	$75,824	$0	$20,600	$0	$2,502	$0	$724,023	$0	$0	$0
Chris Krouse DO
Orthopedics, Sports Medicine	$987,105	$0	$24,000	$0	$3,463	$0	$20,600	$0	$23,250	$0	$1,058,418	$0	$0	$0
Dileep Bhat MD
Urology	$449,584	$0	$40,000	$0	$36,100	$0	$20,600	$0	$17,508	$0	$563,792	$0	$0	$0
Scott VanKeulen MD
General Surgery	$428,777	$0	$15,000	$0	$43,404	$0	$20,600	$0	$23,382	$0	$531,163	$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 Queen of Peace relied on the related organization for determining the compensation for the President/CEO using the methods described in Part I, Line 3.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
David Malters MD
Family member of board member	$89,710	Compensation	0
Andrea Malters
Family member of board member	$42,272	Compensation	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part III, line 3	The organization ceased the operation of the Wellness Center.
Form 990, Part VI, Section A, line 2	Sister Kathleen Crowley has a business relationship with Thomas Clark.
Form 990, Part VI, Section A, line 6	The sole member of the organization is Avera Health, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under 501(c)(3) of the Internal Revenue Code of 1986, as amended.
Form 990, Part VI, Section A, line 7a	Avera Health, as the sole member, has the power to appoint and remove, with or without cause, members of the Board of Directors.
Form 990, Part VI, Section A, line 7b	Avera Health has the following rights as the Member. 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of Corporation; 2) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Corporation, and to give final approval of any such action with respect thereto; 3) To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the Member; 4) To approve any plan of merger, consolidation or dissolution of the Corporation, or the divestiture of a sponsored work or ministry associated with the Corporation; 5) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the Corporation; 6) To appoint and remove, with or without cause, the Board of Directors of the Corporation. 7) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the Corporation. 8) To approve operating/capital budgets and strategic plans of the Corporation. 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the Member. 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the Member. 11) To establish and maintain employee benefit programs. 12) To establish and maintain insurance programs. 13) To approve major community fund drives. 14) To approve the appointment of auditors. 15) To adopt policies designed to effectuate the reserved powers of the Member.
Form 990, Part VI, Section A, line 8b	Avera Queen of Peace Hospital does not have committees with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11	The return is reviewed initially by the CFO. The return is made available to the Board of Directors for review 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 CEO is compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of six (6) System Members appointed by the Religious Orders, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes. The compensation of the VP of Finance is determined by Human Resources based on a market analysis of comparable positions. The compensation is approved by the CEO.
Form 990, Part VI, Section C, line 19	The Organization's governing documents and conflict of interest policy are not available to the general public. The Organization's financial statements are attached to the Form 990 per IRS instructions and therefore are available to the general public.
Form 990, Part IX, line 11g	Recruitment: Program service expenses 129,196. Management and general expenses 73,629. Fundraising expenses 0. Total expenses 202,825. Repairs and Maintenance: Program service expenses 1,363,916. Management and general expenses 56,124. Fundraising expenses 0. Total expenses 1,420,040. Purchased Services: Program service expenses 3,581,620. Management and general expenses 596,317. Fundraising expenses 0. Total expenses 4,177,937. ACS Fees: Program service expenses 1,092,612. Management and general expenses 6,930,028. Fundraising expenses 0. Total expenses 8,022,640.
Form 990, Part XI, line 9:	Change in Fair Value of Interest Rate Swap -353,535. Equity Transfers -3,511,300.
Form 990, Part XII, Line 2c:	The Audit Committee of Avera Health, parent organization, selects the auditor and reviews the consolidated audited financial statements of Avera Health, which includes Avera Queen of Peace.
Form 990, Part VI, Section B, Line 16b:	There is no written policy or procedure since in the event of any such proposed transaction the board or a committee with delegated authority reviews all materials, valuations and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the organization and its applicable purposes. Any transaction also would be approved by the board and the member.
Form 990, Part X, Line 20:	The issue price includes the filing Organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Marshall, Avera St. Mary's, and Avera Sacred Heart. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Avera Health's tax return (EIN 46-0422673).

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	Integrated Therapy Services LLC	BusinessNameLine1Txt

US Address USAddress

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

Field	Value	IRS element (for citing)
EIN	320450803	EIN
Primary Activities	Physical, Occupational, and Speech Therapy	PrimaryActivitiesTxt
Legal Domicile State	SD	LegalDomicileStateCd
Total Income	$1,014,197	TotalIncomeAmt
End Of Year Assets	$1,041,044	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

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

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Avera Health
3900 West Avera Drive Suite 300	Sioux Falls	SD	57108	460422673	Promotion of Health	SD	501(c)(3)	Line 9	N/A	0
Avera Gettysburg
606 East Garfield	Gettysburg	SD	57442	460234354	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera St Mary's
Avera St Anthony's Hospital
300 N 2nd Street	ONeill	NE	68763	470463911	Healthcare Education	NE	501(c)(3)	Line 3		0	Avera Health
Avera Holy Family
826 North 8th Street	Estherville	IA	51334	420680370	Healthcare Services	IA	501(c)(3)	Line 3		0	Avera Health
Avera Holy Family Foundation
826 North 8th Street	Estherville	IA	51334	421317452	Fundraising	IA	501(c)(3)	Line 9		0	Avera Holy Family
Avera Marshall
300 S Bruce Street	Marshall	MN	56258	410919153	Healthcare Services	MN	501(c)(3)	Line 3		0	Avera Health
Avera Marshall Foundation
300 S Bruce Street	Marshall	MN	56258	411784801	Fundraising	MN	501(c)(3)	Line 7		0	Avera Marshall
St Benedict Health Center
401 West Glynn Drive	Parkston	SD	57366	460226738	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
St Benedict Health Center Foundation
West Glynn Drive PO Box B	Parkston	SD	57366	460458725	Support Health Related Services	SD	501(c)(3)	Line 11a, I		0	St Benedict Health Center
Avera McKennan
1325 S Cliff Ave PO Box 5045	Sioux Falls	SD	57117	460224743	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
Sacred Heart Health Services
501 Summit Street	Yankton	SD	57078	460225483	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
Avera St Mary's
801 East Sioux Avenue	Pierre	SD	57501	460230199	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
Avera at Home
5116 S Solberg Ave	Sioux Falls	SD	57108	460399291	Home Services	SD	501(c)(3)	Line 9		0	Avera Health
Lewis and Clark Health Education and Service Agency
1000 W 4th Street Suite 9	Yankton	SD	57078	460337013	Healthcare Education	SD	501(c)(3)	Line 9		0	Sacred Heart Health Services
Avera St Luke's
305 South State Street	Aberdeen	SD	57401	460224598	Healthcare Services	SD	501(c)(3)	Line 3		0	Avera Health
Avera Tyler
240 Willow Street	Tyler	MN	56178	410853163	Healthcare Services	MN	501(c)(3)	Line 3		0	Avera Marshall
Avera Health Plans Inc
3900 West Avera Drive Suite 101	Sioux Falls	SD	57108	460451539	Health Financing and Health Plan Admin	SD	501(c)(4)			0	Avera Health

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct	Direct Controlling NADirectControllingNACd
Q & M Properties LLC
525 North Foster	Mitchell	SD	57301	731652049	Medical clinic building	SD	Avera Queen of Peace	Related	-$720	$353,429	0	Yes (1)	0.50000
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
Avera Home Medical Equipment of Spencer Hospital LLC
2400 S Minnesota Ave 102	Sioux Falls	SD	57117	800619999	medical services - home medical equipment	SD								N/A
Surgical Associates Endoscopy Clinic LLC
310 S Pennsylvania St	Aberdeen	SD	57401	460461429	surgical associates	SD								N/A
Heart Hospital of South Dakota LLC
4500 W 69th Street	Sioux Falls	SD	57108	562143771	healthcare services	SD								N/A
Brookings Health System - Avera HME LLC
101 22nd Ave Suite 101	Brookings	SD	57006	453204123	Medical Services - Home Medical Equipment	SD								N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct
Accounts Management Inc
5132 S Cliff Ave Suite 101	Sioux Falls	SD	57108	460373021	collection agency	SD	N/A	C	0
Avera Property Insurance Inc
610 W 23rd St Ste 1 PO Box 38	Yankton	SD	57078	460463155	insurance	SD	N/A	C	0
Dr Donald & Marguerite Mabee Trust
c/o First National Bank of South Da	Mitchell	SD	57301	466056202	investing	SD		T	Yes (1)	Avera Queen of Peace Hospital	-$11,985	$785,495	1.00000
Valley Health Services
501 Summit Street	Yankton	SD	57078	460357149	rental real estate	SD	N/A	C	0
Alucent Medical Inc
1325 S Cliff Avenue PO Box 5045	Sioux Falls	SD	571175045	471818349	biotech research	SD	N/A	C	0
South Dakota State Medical Holding Inc
2600 W 49th Street	Sioux Falls	SD	57105	460401087	insurance	SD	N/A	C	0
DakotaCare Administrative Services Inc
2600 W 49th Street	Sioux Falls	SD	57105	460424322	insurance	SD	N/A	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule R, Part II:	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:	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 @ Home.